Search results for: common challenges

Authors: Tuji Jemal Ahmed

Abstract:

Food quality and safety challenges are prevalent in Ethiopia's food processing industry, which can have adverse effects on consumers' health and wellbeing. The country is known for its diverse range of agricultural products, which are essential to its economy. However, poor food quality and safety policies and management systems in the food processing industry have led to several health problems, foodborne illnesses, and economic losses. This paper aims to highlight the causes and effects of food safety and quality issues in the food processing industry of Ethiopia and discuss potential solutions to address these issues. One of the main causes of poor food quality and safety in Ethiopia's food processing industry is the lack of adequate regulations and enforcement mechanisms. The absence of comprehensive food safety and quality policies and guidelines has led to substandard practices in the food manufacturing process. Moreover, the lack of monitoring and enforcement of existing regulations has created a conducive environment for unscrupulous businesses to engage in unsafe practices that endanger the public's health. The effects of poor food quality and safety are significant, ranging from the loss of human lives, increased healthcare costs, and loss of consumer confidence in the food processing industry. Foodborne illnesses, such as diarrhea, typhoid fever, and cholera, are prevalent in Ethiopia, and poor food quality and safety practices contribute significantly to their prevalence. Additionally, food recalls due to contamination or mislabeling often result in significant economic losses for businesses in the food processing industry. To address these challenges, the Ethiopian government has begun to take steps to improve food quality and safety in the food processing industry. One of the most notable initiatives is the Ethiopian Food and Drug Administration (EFDA), which was established in 2010 to regulate and monitor the quality and safety of food and drug products in the country. The EFDA has implemented several measures to enhance food safety, such as conducting routine inspections, monitoring the importation of food products, and enforcing strict labeling requirements. Another potential solution to improve food quality and safety in Ethiopia's food processing industry is the implementation of food safety management systems (FSMS). An FSMS is a set of procedures and policies designed to identify, assess, and control food safety hazards throughout the food manufacturing process. Implementing an FSMS can help businesses in the food processing industry identify and address potential hazards before they cause harm to consumers. Additionally, the implementation of an FSMS can help businesses comply with existing food safety regulations and guidelines. In conclusion, improving food quality and safety policies and management systems in Ethiopia's food processing industry is critical to protecting public health and enhancing the country's economy. Addressing the root causes of poor food quality and safety and implementing effective solutions, such as the establishment of regulatory agencies and the implementation of food safety management systems, can help to improve the overall safety and quality of the country's food supply.

Keywords: food quality, food safety, policy, management system, food processing industry

Procedia PDF Downloads 76

Authors: Stanley Fore, Sharon Chipeperekwa

Abstract:

The start of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems are increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30000 students per academic year. An observation was made that, during registration students’ stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. A mixed method approach will be adopted which comprises of quantitative and qualitative approaches. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research seeks to identify and analyse the challenges and success factors of introducing an online registration system whilst highlighting the extent to which this system has been able to solve the numerous problems associated with the manual era. The study will assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Respondents will be informed of the objectives of the research, and their consent to participate will be sought. Ethical considerations that will be applied to this study include; informed consent and protection from harm, right to privacy and involvement of the research.

Keywords: online registration, information systems, University of Technology, end-users

Procedia PDF Downloads 244

Authors: Mayada Mazher, Ahmed Moustafa, Ahmed Abdellatif

Abstract:

Background: Autophagy is a eukaryotic, highly conserved catabolic process implicated in many pathophysiologies such as wound healing. Autophagy-associated genes serve as a scaffolding platform for signal transduction of macrophage polarization during the inflammatory phase of wound healing and tissue repair process. In the current study, we report a model for the interplay between autophagy-associated genes and macrophages polarization associated genes. Methods: In silico analysis was performed on 249 autophagy-related genes retrieved from the public autophagy database and gene expression data retrieved from Gene Expression Omnibus (GEO); GSE81922 and GSE69607 microarray data macrophages polarization 199 DEGS. An integrated protein-protein interaction network was constructed for autophagy and macrophage gene sets. The gene sets were then used for GO terms pathway enrichment analysis. Common transcription factors for autophagy and macrophages' polarization were identified. Finally, microRNAs enriched in both autophagy and macrophages were predicated. Results: In silico prediction of common transcription factors in DEGs macrophages and autophagy gene sets revealed a new role for the transcription factors, HOMEZ, GABPA, ELK1 and REL, that commonly regulate macrophages associated genes: IL6,IL1M, IL1B, NOS1, SOC3 and autophagy-related genes: Atg12, Rictor, Rb1cc1, Gaparab1, Atg16l1. Conclusions: Autophagy and macrophages' polarization are interdependent cellular processes, and both autophagy-related proteins and macrophages' polarization related proteins coordinate in tissue remodelling via transcription factors and microRNAs regulatory network. The current work highlights a potential new role for transcription factors HOMEZ, GABPA, ELK1 and REL in wound healing.

Keywords: autophagy related proteins, integrated network analysis, macrophages polarization M1 and M2, tissue remodelling

Procedia PDF Downloads 141

Authors: Olayide Ogunsiji, Glenda McDonald

Abstract:

Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice, yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population. This paper provides insight into the perceptions of academics about how they are preparing undergraduate nursing and midwifery students for culturally competent health care. Academics were drawn from a tertiary educational institution in metropolitan Australia. They responded to a generic email indicating their interest in participating in the study. A total of nine academics who have taught undergraduate nursing and midwifery students in a unit that focused on health and illness perspectives for culturally diverse communities; and provided written consent to participate were included. These academics were engaged in a qualitative digitally-recorded semi-structured face-to-face or telephone interviews which lasted for about 45-60 minutes. Interview data were transcribed verbatim. Through constant comparison, three themes emerged: experiences of the teachers, strategies used for preparing students and challenges in preparing students. The participants spoke about their experiences of teaching in the unit and with the students. They faced challenges related to physical and relational space. They utilised a number of didactic approaches in teaching the unit and critiqued the adequacy of the content in preparing students for practice. This study demonstrated that didactic classroom approaches need to be supported with clinical practice and cultural immersion for a meaningful preparation of nursing and midwifery students to care for culturally diverse populations.

Keywords: cultural competence, nursing students, preparation, undergraduate

Procedia PDF Downloads 146

Authors: Anthony I. Otuonye, Juliet N. Odii, Perpetual N. Ibe

Abstract:

The obvious challenges faced by most commercial bank customers while using the services of ATMs (Automated Teller Machines) across developing countries have triggered the need for an improved system with better security features. Current ATM systems are password-based, and research has proved the vulnerabilities of these systems to heinous attacks and manipulations. We have discovered by research that the security of current ATM-assisted banking services in most developing countries of the world is easily broken and maneuvered by fraudsters, majorly because it is quite difficult for these systems to identify an impostor with privileged access as against the authentic bank account owner. Again, PIN (Personal Identification Number) code passwords are easily guessed, just to mention a few of such obvious limitations of traditional ATM operations. In this research work also, we have developed a system of fingerprint biometrics with PIN code Authentication that seeks to improve the security features of traditional ATM installations as well as other Banking Services. The aim is to ensure better security at all ATM installations and raise the confidence of bank customers. It is hoped that our system will overcome most of the challenges of the current password-based ATM operation if properly applied. The researchers made use of the OOADM (Object-Oriented Analysis and Design Methodology), a software development methodology that assures proper system design using modern design diagrams. Implementation and coding were carried out using Visual Studio 2010 together with other software tools. Results obtained show a working system that provides two levels of security at the client’s side using a fingerprint biometric scheme combined with the existing 4-digit PIN code to guarantee the confidence of bank customers across developing countries.

Keywords: fingerprint biometrics, banking operations, verification, ATMs, PIN code

Procedia PDF Downloads 33

Authors: Melake Kuflom

Abstract:

European power networks involve the use of multiple overhead transmission lines to construct a highly duplicated system that delivers reliable and stable electrical energy to the distribution level. The transmission line protection applied in the existing GB transmission network are normally independent unit differential and time stepped distance protection schemes, referred to as main-1 & main-2 respectively, with overcurrent protection as a backup. The increasing penetration of renewable energy sources, commonly referred as “weak sources,” into the power network resulted in the decline of fault level. Traditionally, the fault level of the GB transmission network has been strong; hence the fault current contribution is more than sufficient to ensure the correct operation of the protection schemes. However, numerous conventional coal and nuclear generators have been or about to shut down due to the societal requirement for CO2 emission reduction, and this has resulted in a reduction in the fault level on some transmission lines, and therefore an adaptive transmission line protection is required. Generally, greater utilization of renewable energy sources generated from wind or direct solar energy results in a reduction of CO2 carbon emission and can increase the system security and reliability but reduces the fault level, which has an adverse effect on protection. Consequently, the effectiveness of conventional protection schemes under low fault levels needs to be reviewed, particularly for future GB transmission network operating scenarios. The proposed paper will evaluate the transmission line challenges under high penetration of renewable energy sources andprovides alternative viable protection solutions based on the problem observed. The paper will consider the assessment ofrenewable energy sources (RES) based on a fully rated converter technology. The DIgSILENT Power Factory software tool will be used to model the network.

Keywords: fault level, protection schemes, relay settings, relay coordination, renewable energy sources

Procedia PDF Downloads 193

Authors: Martin Georgiev, Milena Nanova, Damyan Damov

Abstract:

Architects, engineers, and developers need to analyse and implement a wide spectrum of data in different formats, if they want to produce viable residential developments. Usually, this data comes from a number of different sources and is not well structured. The main objective of this research project is to provide parametric tools working with real geodesic data that can generate residential solutions. Various codes, regulations and design constraints are described by variables and prioritized. In this way, we establish a common workflow for architects, geodesists, and other professionals involved in the building and investment process. This collaborative medium ensures that the generated design variants conform to various requirements, contributing to a more streamlined and informed decision-making process. The quantification of distinctive characteristics inherent to typical residential structures allows a systematic evaluation of the generated variants, focusing on factors crucial to designers, such as daylight simulation, circulation analysis, space utilization, view orientation, etc. Integrating real geodesic data offers a holistic view of the built environment, enhancing the accuracy and relevance of the design solutions. The use of generative algorithms and parametric models offers high productivity and flexibility of the design variants. It can be implemented in more conventional CAD and BIM workflow. Experts from different specialties can join their efforts, sharing a common digital workspace. In conclusion, our research demonstrates that a generative parametric approach based on real geodesic data and collaborative decision-making could be introduced in the early phases of the design process. This gives the designers powerful tools to explore diverse design possibilities, significantly improving the qualities of the building investment during its entire lifecycle.

Keywords: architectural design, residential buildings, urban development, geodesic data, generative design, parametric models, workflow optimization

Procedia PDF Downloads 41

Authors: Khodr Fakih

Abstract:

The Ombudsman is a procedural mechanism that provides a different approach of dispute resolution. The ombudsman primarily deals with specific grievances from the public against governmental injustice and misconduct. The ombudsman theory is considered an important instrument to any democratic government. This is true since it improves the transparency of the governmental activities in a world in which executive power are rising. Many countries have adopted the concept of Ombudsman but under different terminologies. This paper will provide the different types of Ombudsman and the common activities/processes of fulfilling their mandates.

Keywords: administration, citizens, government, mediator, ombudsman, presidential mediator

Procedia PDF Downloads 325

Authors: Dovilė Bačėninaitė, Karina Džermeikaitė, Justinas Kirvela, Ramūnas Antanaitis

Abstract:

Bacteria are often present in the mouth of cattle. Some of them can cause abscesses. Starting with severe swelling of the mouth, muscle spasm, or locked jaw, it can lead to inability to open its mouth, move the neck, cause pain while eating. While the calf is unable to eat properly, it becomes more susceptible to infectious diseases, lower weight gain can be observed. Abscesses can be considered as a continuum of oral disease, whereby early stages of the lumpy jaw could proceed from gingivitis to periodontal disease. In the event of tissue damage, bacteria can enter the bloodstream, even cause sepsis. The most common lesions occur when animals eat sharp grass, coarse fodder, sharp, piercing foreign bodies (this is especially common for calves when they are trying to eat inedible objects). A crossbred Holstein calf presented with a history of proliferative outgrowth in the mandibular region. On clinical examination, needle aspiration, mandibular swelling revealed sticky, white curd-like fluid containing. Pus bacteriology revealed gram-negative cocci. They were sensitive to amoxicillin, cephalexin, enrofloxacin, ceftiofur. Blood morphology was in physiological ranges. The calf was treated surgically. The growth was excised, the puss drained and the wound was flushed with potassium permanganate solution (0,01%). A week after clinical surgery examination was performed. The swelling was decreased. Superficial bacterial infections are often associated with poor hygiene, which should be improved before treatment is commenced. Clipping away dirty hair and gently washing affected areas of skin daily with solutions such as povidone-iodine, potassium permanganate is effective. Appropriate antibiotic therapy, based on sensitivity testing, may be used where there is evidence of systemic illness.

Keywords: calf, abscess, lumpy jaw, pus, Streptococcus, Staphylococcus, Actinobacillus, infection

Procedia PDF Downloads 261

Authors: Amir Ali Fatoorchi

Abstract:

Regardless of the advantage of LoT devices, they have limitations like storage, compute, and security problems. In recent years, a lot of Blockchain-based research in IoT published and presented. In this paper, we present the Security issues of LoT. IoT has three levels of security issues: Low-level, Intermediate-level, and High-level. We survey and compare blockchain-based solutions for high-level security issues and show how the underlying technology of bitcoin and Ethereum could solve IoT problems.

Keywords: Blockchain, security, data security, IoT

Procedia PDF Downloads 206

Authors: F. S. Al-Anzi, M. Sarfraz, A. Elmi, A. R. Khan

Abstract:

Researchers are responding to the environmental challenges of Kuwait in localized, innovative, effective and economic ways. One of the vital and significant examples of the natural challenges is lack or water and desertification. In this research, the project team focuses on redesigning a prototype, using Value Engineering Methodology, which would provide similar functionalities to the well-known technology of Waterboxx kits while reducing the capital and operational costs and simplifying the process of manufacturing and usability by regular farmers. The design employs used tires and recycled plastic sheets as raw materials. Hence, this approach is going to help not just fighting desertification but also helping in getting rid of ever growing huge tire dumpsters in Kuwait, as well as helping in avoiding hazards of tire fires yielding in a safer and friendlier environment. Several alternatives for implementing the prototype have been considered. The best alternative in terms of value has been selected after thorough Function Analysis System Technique (FAST) exercise has been developed. A prototype has been fabricated and tested in a controlled simulated lab environment that is being followed by real environment field testing. Water and soil analysis conducted on the site of the experiment to cross compare between the composition of the soil before and after the experiment to insure that the prototype being tested is actually going to be environment safe. Experimentation shows that the design was equally as effective as, and may exceed, the original design with significant savings in cost. An estimated total cost reduction using the VE approach of 43.84% over the original design. This cost reduction does not consider the intangible costs of environmental issue of waste recycling which many further intensify the total savings of using the alternative VE design. This case study shows that Value Engineering Methodology can be an important tool in innovating new designs for reducing costs.

Keywords: desertification, functional analysis, scrap tires, value engineering, waste recycling, water irrigation rationing

Procedia PDF Downloads 195

Authors: Izabela Kapsa

Abstract:

Civic participation is an important aspect of democracy. The contemporary model of democracy is based on citizens' participation in political decision-making (deliberative democracy, participatory democracy). This participation takes many forms of activities like display of slogans and symbols, voting, social consultations, political demonstrations, membership in political parties or organizing civil disobedience. The countries of Central and Eastern Europe after 1989 are characterized by great social, economic and political diversity. Civil society is also part of the process of democratization. Civil society, funded by the rule of law, civil rights, such as freedom of speech and association and private ownership, was to play a central role in the development of liberal democracy. Among the many interpretations of concepts, defining the concept of contemporary democracy, one can assume that the terms civil society and democracy, although different in meaning, nowadays overlap. In the post-communist countries, the process of shaping and maturing societies took place in the context of a struggle with a state governed by undemocratic power. State fraud or repudiation of the institution is a representative state, which in the past was the only way to manifest and defend its identity, but after the breakthrough became one of the main obstacles to the development of civil society. In Central and Eastern Europe, there are many obstacles to the development of civil society, for example, the elimination of economic poverty, the implementation of educational campaigns, consciousness-related obstacles, the formation of social capital and the deficit of social activity. Obviously, civil society does not only entail an electoral turnout but a broader participation in the decision-making process, which is impossible without direct and participative democratic institutions. This article considers such broad forms of civic participation and their characteristics in Central and Eastern Europe. The paper is attempts to analyze the functioning of electronic forms of civic participation in Central and Eastern European states. This is not accompanied by a referendum or a referendum initiative, and other forms of political participation, such as public consultations, participative budgets, or e-Government. However, this paper will broadly present electronic administration tools, the application of which results from both legal regulations and increasingly common practice in state and city management. In the comparative analysis, the experiences of post-communist bloc countries will be summed up to indicate the challenges and possible goals for further development of this form of citizen participation in the political process. The author argues that for to function efficiently and effectively, states need to involve their citizens in the political decision-making process, especially with the use of electronic tools.

Keywords: Central and Eastern Europe, e-participation, e-government, post-communism

Procedia PDF Downloads 183

Authors: Gayatri Mahajan

Abstract:

Modern Construction Technology (CT) includes a broad range of advanced techniques and practices that bound the recent developments in material technology, design methods, quantity surveying, facility management, services, structural analysis and design, and other management education. Adoption of recent digital transformation technology is the need of today to speed up the business and is also the basis of construction improvement. Incorporating and practicing the technologies such as cloud-based communication and collaboration solution, Mobile Apps and 5G,3D printing, BIM and Digital Twins, CAD / CAM, AR/ VR, Big Data, IoT, Wearables, Blockchain, Modular Construction, Offsite Manifesting, Prefabrication, Robotic, Drones and GPS controlled equipment expedite the progress in the Construction industry (CI). Resources used are journaled research articles, web/net surfing, books, thesis, reports/surveys, magazines, etc. The outline of the research organization for this study is framed at four distinct levels in context to conceptualization, resources, innovative and emerging trends in CI, and better methods for completion of the construction projects. The present study conducted during 2020-2022 reveals that implementing these technologies improves the level of standards, planning, security, well-being, sustainability, and economics too. Application uses, benefits, impact, advantages/disadvantages, limitations and challenges, and policies are dealt with to provide information to architects and builders for smooth completion of the project. Results explain that construction technology trends vary from 4 to 15 for CI, and eventually, it reaches 27 for Civil Engineering (CE). The perspective of the most recent innovations, trends, tools, challenges, and solutions is highly embraced in the field of construction. The incorporation of the above said technologies in the pandemic Covid -19 and post-pandemic might lead to a focus on finding out effective ways to adopt new-age technologies for CI.

Keywords: BIM, drones, GPS, mobile apps, 5G, modular construction, robotics, 3D printing

Procedia PDF Downloads 98

Authors: Amir Hossein Ashari, Sedighe Erfan Manesh

Abstract:

One of the problems in developing countries is renovating the historical context and inducing behaviors appropriate to modern life to such a context. This study was conducted using field and library methods in 2012. Similar cases carried out in Iran and developing countries were compared to unveil the strengths and weaknesses of these projects. At present, in the historical context of Shiraz, the distance between two religious shrines of Shahcheragh (Ahmad ibn Musa) and Astaneh (Sayed Alaa al-Din Hossein), which are significant places in religious, cultural, social, and economic terms, is an area full of historic places called Bein Al-Haramein. Unfortunately, some of these places have been worn out and are not appropriate for common uses. The basic strategy of Bein Al-Haramein was to improve social development of Shiraz, to enhance the vitality and dynamism of the historical context of Bein Al-Haramein and to create tourist attractions in order to boost the city's economic and social stability. To this end, the project includes the huge Bein Al-Haramein Commercial Complex which is under construction now. To construct the complex, officials have decided to demolish places of historical value which can lead to irreparable consequences. Iranian urban design has always been based on three elements of bazaars, mosques and government facilities with bazaars being the organic connector of the other elements. Therefore, the best strategy in the above case is to provide for a commercial connection between the two poles. Although this strategy is included in the project, lack of attention to renovation principles in this area and complete destruction of the context will lead to its irreversible damage and will destroy its cultural and historical identity. In urban planning of this project, some important issues have been neglected including: preserving valuable buildings and special old features of the city, rebuilding worn buildings and context to attract trust and confidence of the people, developing new models according to changes, improving the structural position of old context with minimal degradation, attracting partnerships of residents and protecting their rights and finally using potential facilities of the old context. The best strategy for achieving sustainability in Bein Al-Haramein can be the one used in the distance between Santa Maria Novella and Santa Maria Del Fiore churches in historical context where while protecting the historic context and constructions, old buildings were renovated and given different commercial and service uses making them sustainable and dynamic places. Similarly, in Bein Al-Haramein, renovating old constructions and monuments and giving different commercial and other uses to them can help improve the economic and social sustainability of the area.

Keywords: Bein Al-Haramein, sustainability, historical context, historical context

Procedia PDF Downloads 436

Authors: Muqarrab Akbar

Abstract:

Pakistan is considered as a state confronting different internal and external challenges. Extremism is one of the most vital internal challenges faced by Pakistani society. The state’s contradictory policies, political instability, socio-economic injustice, absence of the rule of law are the major reasons behind the proliferation of violence and extremism in society. The fall of the Shah of Iran, the Iranian revolution, the 1979 Afghan war of 1979, the emergence of Al-Qaeda, Talibanisation, war against terrorism, and involvement of Saudia and Iran have further aggravated the culture of violence and extremism in Pakistan. The absence of a narrative of peaceful coexistence and harmony has created a vacuum for youth in Pakistani society. In the contemporary era, civil society and the government of Pakistan has initiated different steps to introduce a narrative to counter violent extremism. These narratives have helped a lot in creating community resilience to promote peace and harmony among Pakistani society in general and to bridge the gap between the Sunni Shia divide in particular. This paper will highlight those factors in detail that threw the society into extremism and violence, particularly with reference to Sunni Shia divide in Pakistan. This paper explores the impact of sectarian violence in Pakistan and highlights the different initiatives and their impacts on Pakistani society at large. A quantitative method has been adopted to explore the results. Empirical study used in the paper was based on the survey conducted by distributing questionnaires among 300 people from both community Sunni and Shia in Pakistan. Some interviews of the religious scholars of both communities are also conducted for this research. The recent developments on the government level and society levels have created community resilience. The results of the survey show that Pakistani society in the contemporary era is more peaceful and tolerant as compared to the past. The research concludes that the counter-narrative approach is positively affecting the peaceful environment in Pakistan.

Keywords: extremism, Pakistan, Shia, Sunni, violence

Procedia PDF Downloads 124

Authors: Marko Kolakovic, Mihaela Mikic, Martina Taborin

Abstract:

Women entrepreneurship is often regarded as the unused economical potential in many countries, including Republic of Croatia. Although women represent a majority in the population, they are still a minority in the field of entrepreneurship and face many challenges in fulfilling their entrepreneurship potential. The reasons are often hided in historical distorted perceptions about value, credibility, competitiveness, responsibility and knowledge which women have, or can have. This is significant for at least two reasons. First, in terms of global economic crisis, the economy needs more quality, more skilled and educated people willing to face entrepreneurial challenges and create new jobs, new opportunities and higher living standards. Second, in the entrepreneurial activity, women finally have a chance to highlight their own abilities, such as knowledge, relentless work, organizational skills, communication and negotiation skills, responsibility, flexibility, etc., in order to insure their economic independence, for a better social position, and to increase confidence and faith in their own abilities. This paper empirically analyses characteristics of women entrepreneurship in Croatia and conducted policies for it improvement. An empirical research was conducted with the goal of discovering real life experiences and attitudes of Croatian women entrepreneurs. Results show that Croatian women entrepreneurs are usually highly educated, have previous work experience and operate in service sector, due to lower need for start-up capital. The biggest obstacle on their entrepreneurial path represents government bureaucracy. Although the number of women entrepreneurs is rising today and the gap between male and women entrepreneurs in Croatia, as well as women entrepreneurship levels lower than the European average, we believe that there is still a long way to reach potential and successful women entrepreneurship development. Research showed that by breaking down the barriers as access to finance, education investments, knowledge, skills and confidence development, women will be able to accomplish more significant and more efficient entrepreneurial outcome.

Keywords: Croatia, policy, SMEs, women entrepreneurial strategy, women entrepreneurship

Procedia PDF Downloads 318

Authors: Obinna Benedict Duru

Abstract:

This study focuses on the elderly and the challenges that confront them. The elderly are that particular segment of our population who by virtue of the aging process have attained the stage in most cases where they are confronted with the challenges of economic dependency and social marginality. These challenges are as a result of the physical and biological decline occasioned by social myths and realities which portray the elderly as a dependent population whose members could not and should not work and who need social assistance that the younger population is obliged to provide. From the moment of birth to the moment of death, our bodies are constantly changing. We are all enmeshed in the process of growing old, a transition from youthfulness to elderliness. In youth-oriented modern societies like ours, we tend to attach positive importance and significance to the biological changes that occur early in life and define later physical changes in negative terms. Children growing up and young adults receive more attention, greater responsibilities and more legal rights to reward them on their way. But few people are congratulated on getting old. We commiserate with people who are getting old and make jokes about their supposedly physical, mental and biological decline. Wrinkles, loss of weight and vitality are all parts of the aging process. In almost all parts of the world, earlier researches have shown that about fifty percent of the elderly who suffer from stroke, arthritis, senility and other age related diseases are the disengaged and neglected elderly. Rapid technological changes render the knowledge and skills of the elderly obsolete; education is geared toward the young and the generational competition for jobs leads to pressures on the elderly to retire. Control of initial resources are shifted to the middle-aged and older workers are pushed into positions of economic dependency. This study therefore, among other things tend to discover how some government policies have affected the elderly particularly in Africa. To discover the prospects and possibilities of the elderly for a better living. To make a comparison of the advances in healthcare giving made in the advanced western societies to the practice in Sub Saharan Africa etc. The hypotheses of this study include: that the elderly in Sub Saharan Africa are more vulnerable than their counterparts in Europe and America. The elderly are more prone to social isolation, and that the elderly are mostly affected by age-related sickness etc. With a survey method as the research design, and sample size of about 500 respondents,probability sampling technique was used. Data which were analyzed using chi-square and tables were collected through primary and secondary sources. The findings made include: that the elderly suffer pains of old age especially when disengaged from work or social activity. That loss of income condemn the elderly to a life of vegetable existence, and that those who do not have other means of re-integration usually see old age with regret and despair. It is therefore, recommended among other things that social welfare scheme and the process of re-integration at old age be introduced for the non pensionable elderly in Africa.

Keywords: elderly, social isolation, dependency, re-integration

Procedia PDF Downloads 325

Authors: Marlene Rosa, Susana Lopes

Abstract:

There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

Procedia PDF Downloads 137

Authors: Aylin Hasbay Büyükkaragöz, Zehra Büyüktuncer, Tuğçe Nur Balcı, Nevin Ergun

Abstract:

Purpose: Nutritional supplement usage is widespread among athletes all over the world. However, the usage among disabled athletes is not well-known. This study aimed to evaluate dietary supplement use in disabled athletes, their motivation for consuming supplements, sources of information, and their side effect. Methods: A total of 75 Turkish National Team's disabled athletes (38 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball), aged 13- 55 years, were participated in the study. Nutritional supplement usage was inquired using a questionnaire by a dietitian at their preparation camps. Results: A total of 22.7% of the athletes (18.4% and 27% of, respectively females and males) used some type of dietary supplements. Protein (35.3%), amino acid (29.4%), carnitine (29.4%), creatine (23.5%) and glucosamine (23.5%) were mostly preferred nutritional supplements by all athletes. The most common supplements use was obtained among weightlifters (71.4%), followed by the athletes of soccer (23.5%), table tennis (15.4%), and basketball (6.7%). No nutritional supplement usage was observed among shooters. Total of 41.2% consumers declared more than one reason for taking nutritional supplements. The main motivation for supplement usage was improving athletic performance (63.5%). Other reasons were weight loss, weight gain, muscle development, health protection and nutritional support. Athletes were more likely to get recommendation about nutritional supplement usage from team coaches (48.9%). Of 35.6% athletes reported that they made their own decision about using supplements. Other information sources were health professional, family member, friend and sale manager of sport retail store. Only 3 of 17 athletes reported side effects which were increased urine output, weight gain, loss of appetite and intestinal gas. Conclusions: Nutritional supplement usage was not common among disabled athletes. However, getting information from incompetent sources is disquieting. Considering their health problems, accurate information from competent sources should be provided to disabled athletes. Moreover, long term effects of nutritional supplements among disabled athletes should be examined in further studies.

Keywords: disabled athletes, ergogenic aid, nutritional supplement, vitamin supplementation

Procedia PDF Downloads 318

Authors: Alice Civera, Mattia Cattaneo, Michele Meoli, Stefano Paleari

Abstract:

Despite the fact that more equal access to higher education has been an objective public policy for several decades, little is known about the effectiveness of alternative means for achieving such goal. Indeed, nowadays, high level of graduate population can be observed both in countries with the high and low level of fees, or high and low level of public expenditure in higher education. This paper surveys the extant literature providing some background on the economic concepts of the higher education market, and reviews key determinants of demand and supply. A theoretical model of aggregate demand and supply of higher education is derived, with the aim to facilitate the understanding of the challenges in today’s higher education systems, as well as the opportunities for development. The model is validated on some exemplary case studies describing the different relationship between the level of public investment and levels of graduate population and helps to derive general implications. In addition, using a two-stage least squares model, we build a macroeconomic model of supply and demand for European higher education. The model allows interpreting policies shifting either the supply or the demand for higher education, and allows taking into consideration contextual conditions with the aim of comparing divergent policies under a common framework. Results show that the same policy objective (i.e., increasing graduate population) can be obtained by shifting either the demand function (i.e., by strengthening student aid) or the supply function (i.e., by directly supporting higher education institutions). Under this theoretical perspective, the level of tuition fees is irrelevant, and empirically we can observe high levels of graduate population in both countries with high (i.e., the UK) or low (i.e., Germany) levels of tuition fees. In practice, this model provides a conceptual framework to help better understanding what are the external conditions that need to be considered, when planning a policy for increasing graduate population. Extrapolating a policy from results in different countries, under this perspective, is a poor solution when contingent factors are not addressed. The second implication of this conceptual framework is that policies addressing the supply or the demand function needs to address different contingencies. In other words, a government aiming at increasing graduate population needs to implement complementary policies, designing them according to the side of the market that is interested. For example, a ‘supply-driven’ intervention, through the direct financial support of higher education institutions, needs to address the issue of institutions’ moral hazard, by creating incentives to supply higher education services in efficient conditions. By contrast, a ‘demand-driven’ policy, providing student aids, need to tackle the students’ moral hazard, by creating an incentive to responsible behavior.

Keywords: graduates, higher education, higher education policies, tuition fees

Procedia PDF Downloads 156

Authors: Babarina Maria, Andropova Margarita

Abstract:

Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

Procedia PDF Downloads 99

Authors: Kalimah Ibrahiim, Israa Elmousa

Abstract:

This study employed the world café method alongside semi-structured interviews within a 'conversation café' setting to engage stakeholders from the public health and primary care sectors. The objective was to collaboratively explore strategies to improve outcomes for young people not in education, employment, or training (NEET). The discussions were aimed at identifying the underlying causes of disparities faced by NEET individuals, exchanging experiences, and formulating community-driven solutions to bolster preventive efforts and shape policy initiatives. A thematic analysis of the qualitative data gathered emphasized the importance of community problem-solving through the exchange of ideas and reflective discussions. Healthcare professionals reflected on their potential roles, pinpointing a significant gap in understanding the specific needs of the NEET population and the unclear distribution of responsibilities among stakeholders. The results underscore the necessity for a unified approach in primary care and the fostering of multi-agency collaborations that focus on addressing social determinants of health. Such strategies are critical not only for the immediate improvement of health outcomes for NEET individuals but also for informing broader policy decisions that can have long-term benefits. Further research is ongoing, delving deeper into the unique challenges faced by this demographic and striving to develop more effective interventions. The study advocates for continued efforts to integrate insights from various sectors to create a more holistic and effective response to the needs of the NEET population, ensuring that future strategies are informed by a comprehensive understanding of their circumstances and challenges.

Keywords: multi-agency working, primary care, public health, social inequalities

Procedia PDF Downloads 20

Authors: Ripudaman S. Minhas, Pardeep K. Benipal, Aisha K. Yousafzai

Abstract:

Background: Children of refugee or asylum-seeking background have multiple, complex needs (e.g. trauma, mental health concerns, separation, relocation, poverty, etc.) that places them at an increased risk for developing learning problems. Families encounter challenges accessing support during resettlement, preventing children from achieving their full developmental potential. There are very few studies in literature that examine the unique parenting challenges refugee families’ face. Providing appropriate support services and educational resources that address these distinctive concerns of refugee parents, will alleviate these challenges allowing for a better developmental outcome for children. Objective: To identify the characteristics of effective parenting interventions that address the unique needs of refugee families. Methods: English-language articles published from 1997 onwards were included if they described or evaluated programmes or interventions for parents of refugee or asylum-seeking background, globally. Data were extracted and analyzed according to Arksey and O’Malley’s descriptive analysis model for scoping reviews. Results: Seven studies met criteria and were included, primarily studying families settled in high-income countries. Refugee parents identified parenting to be a major concern, citing they experienced: alienation/unwelcoming services, language barriers, and lack of familiarity with school and early years services. Services that focused on building the resilience of parents, parent education, or provided services in the family’s native language, and offered families safe spaces to promote parent-child interactions were most successful. Home-visit and family-centered programs showed particular success, minimizing barriers such as transportation and inflexible work schedules, while allowing caregivers to receive feedback from facilitators. The vast majority of studies evaluated programs implementing existing curricula and frameworks. Interventions were designed in a prescriptive manner, without direct participation by family members and not directly addressing accessibility barriers. The studies also did not employ evaluation measures of parenting practices or the caregiving environment, or child development outcomes, primarily focusing on parental perceptions. Conclusion: There is scarce literature describing parenting interventions for refugee families. Successful interventions focused on building parenting resilience and capacity in their native language. To date, there are no studies that employ a participatory approach to program design to tailor content or accessibility, and few that employ parenting, developmental, behavioural, or environmental outcome measures.

Keywords: asylum-seekers, developmental pediatrics, parenting interventions, refugee families

Procedia PDF Downloads 152

Authors: Misganaw Ayele Gelaw

Abstract:

This abstract presents an overview of agricultural investment in Ethiopia, with a focus on the Oromia Region. Ethiopia is a developing country that heavily relies on agriculture as a major contributor to its economic growth and employment. The Oromia Region, located in the central part of the country, is the largest region in Ethiopia and plays a significant role in the agricultural sector. The study aims to explore the current state of agricultural investment in the Oromia Region, focusing on the opportunities, challenges, and potential benefits that arise from such investments. It also highlights the key agricultural investment strategies and policies implemented by the Ethiopian government to attract domestic and foreign investors. To achieve these objectives, a comprehensive literature review and analysis of relevant reports, publications, and government policies will be conducted. The study will also incorporate qualitative and quantitative data collection methods, such as interviews, surveys, and statistical analysis, to provide a well-rounded understanding of agricultural investment dynamics in the Oromia Region. The findings of this study are expected to shed light on the impact of agricultural investments on local farmers, rural development, food security, income generation, and overall economic growth in the Oromia Region. It will also identify the key risk factors and potential mitigations associated with agricultural investment, offering recommendations to policymakers, investors, and stakeholders to improve the effectiveness and sustainability of investment efforts in the region. This abstract highlights the importance of agricultural investment in the Oromia Region and Ethiopia as a whole, as it strives to enhance productivity, increase farmers' income, and contribute to the country's long-term development goals. By understanding the challenges and opportunities associated with agricultural investment, policymakers and investors can develop targeted strategies to ensure inclusive and sustainable growth in the agricultural sector, leading to improved livelihoods and economic prosperity in the Oromia Region.

Keywords: agriculture, investment, agriculture policy, economy

Procedia PDF Downloads 66

Authors: Matej Buzgo, Erico Himawan, Ksenija JašIna, Aiva Simaite

Abstract:

Electrospinning is a versatile and efficient technology for producing nanofibers for biomedical applications. One of the most common polymers used for the preparation of nanofibers for regenerative medicine and drug delivery applications is polycaprolactone (PCL). PCL is a biocompatible and bioabsorbable material that can be used to stimulate the regeneration of various tissues. It is also a common material used for the development of drug delivery systems by blending the polymer with small active molecules. However, for many drug delivery applications, e.g. cancer immunotherapy, PCL biodegradation rate that may exceed 9 months is too long, and faster nanofiber dissolution is needed. In this paper, we investigate the dissolution and small molecule release rates of PCL blends with two hydrophilic polymers: polyethylene oxide (PEO) or polyvinylpyrrolidone (PVP). We show that adding hydrophilic polymer to the PCL reduces the water contact angle, increases the dissolution rate, and strengthens the interactions between the hydrophilic drug and polymer matrix that further sustain its release. Finally using this method, we were also able to increase the nanofiber degradation rate when PCL-PEO and PCL-PVP were used as a shell in the electrospun core-shell nanofibers and spread up the release of active proteins from their core. Electrospinning can be used for the preparation of the core-shell nanofibers, where active ingredients are encapsulated in the core and their release rate is regulated by the shell. However, such fibers are usually prepared by coaxial electrospinning that is an extremely low-throughput technique. An alternative is emulsion electrospinning that could be upscaled using needleless blades. In this work, we investigate the possibility of using emulsion electrospinning for encapsulation and sustained release of the growth factors for the development of the organotypic skin models. The core-shell nanofibers were prepared using the optimized formulation and the release rate of proteins from the fibers was investigated for 2 weeks – typical cell culture conditions.

Keywords: electrospinning, polycaprolactone (PCL), polyethylene oxide (PEO), polyvinylpyrrolidone (PVP)

Procedia PDF Downloads 269

Authors: Sanskriti Singh, Ankit Tomar

Abstract:

Banks are the instrument of growth of a country. Banks mobilize the savings of the public in the form of deposits and channelize it as advances for various activities required for the development of society at large. The advance which becomes unpaid for a certain period is called Non Performing Asset of the bank. The study makes an attempt to bring out the magnitude of NPA and its impact on profit, advances. An attempt is also made to bring out the challenges NPA poses to the banks and suggestions to overcome and to manage NPA effectively.

Keywords: India, NPAs, private banks, public banks

Procedia PDF Downloads 275

Authors: A. Camões, M. Ferreira Dias, M. Amorim

Abstract:

In recent years, the social economy is increasingly seen as a viable means to address social problems. Social enterprises, as well as public projects and initiatives targeted to meet social purposes, offer organizational models that assume heterogeneity, flexibility and adaptability to the ‘real world and real problems’. Despite the growing popularity of social initiatives, decision makers still face a paucity in what concerns the available models and tools to adequately assess its sustainability, and its impacts, notably the nature of its contribution to economic growth. This study was carried out at the local level, by analyzing the social impact initiatives and projects promoted by the Municipality of Albergaria-a-Velha (Câmara Municipal de Albergaria-a-Velha -CMA), a municipality of 25,000 inhabitants in the central region of Portugal. This work focuses on the challenges related to the qualifications and employability of citizens, which stands out as one of the key concerns in the Portuguese economy, particularly expressive in the context of small-scale cities and inland territories. The study offers a characterization of the Municipality, its socio-economic structure and challenges, followed by an exploratory analysis of multiple sourced data, collected from the CMA's documental sources as well as from privileged informants. The purpose is to conduct detailed analysis of the CMA's social projects, aimed at characterizing its potential impact for the model of qualifications and employability of the citizens of the Municipality. The study encompasses a discussion of the socio-economic profile of the municipality, notably its asymmetries, the analysis of the social projects and initiatives, as well as of data derived from inquiry actors involved in the implementation of the social projects and its beneficiaries. Finally, the results obtained with the Better Life Index will be included. This study makes it possible to ascertain if what is implicit in the literature goes to the encounter of what one experiences in reality.

Keywords: measurement, municipalities, social economy, social impact

Procedia PDF Downloads 128

Authors: S. Anastasiou, C. Nathanailides, S. Logothetis, G. Kanlis

Abstract:

The Greek aquaculture industry is second most important economic sector for the growth of the Greek Economy. The purpose of the present work is to present some data for the management challenges that the Aquaculture industry in Greece is currently facing. Currently the Greek aquaculture industry is going through a series of mergers and restructure. The financial status of the different aquaculture companies, the working conditions and management practices may vary according to lending exposure, market mix, company size, and technological parameters of the different fish farm units and rearing systems. Frequently, the aquaculture personnel are exposed to harsh environmental conditions and to occupational risk. Furthermore, there is pressure on the personnel of fish farms to constantly improve their production efficiency and to enhance their work skills to the new methods and practices which are adopted by the aquaculture industry. There is some data to suggest the existence of gender inequality in the workforce of Greek fish farms. Women are paid less, frequently absent higher managerial positions and most of the male workmates consider the job to harsh for women. Nevertheless, high level of job satisfaction was observed in both men and women. This high level of job satisfaction of the aquaculture personnel can be attributed, at least partially, to the nature of the work which has a very distinct working environment but most of the staff has very positive experiences with the interaction with their workmates and the satisfaction of being in a business which always exceeds its production target. Indeed, there is some evidence to suggest that the Greek aquaculture industry is always exceeding its production targets, while it is rapidly adopting and improving new technology, constantly improving of human resources management practices, which include constant training of the staff, very good communication channels between management and the personnel and reducing the risk of occupational hazard to the aquaculture personnel. All these parameters of management may have a determining role for the volume and quality of the production and future of this sector in Greece.

Keywords: aquaculture, fish quality, management, production targets

Procedia PDF Downloads 435

Authors: Abisuga Oluwayemisi Adebola, Kerri Akiwowo, Deon de Beer, Kobus Van Der Walt

Abstract:

The convergence of additive manufacturing (AM) and traditional textile dyeing techniques has initiated innovative possibilities for improving the visual application and customization potential of 3D-printed polymer objects. Textile dyeing techniques have progressed to transform fabrics with vibrant colours and complex patterns over centuries. The layer-by-layer deposition characteristic of AM necessitates adaptations in dye application methods to ensure even colour penetration across complex surfaces. Compatibility between dye formulations and polymer matrices influences colour uptake and stability, demanding careful selection and testing of dyes for optimal results. This study investigates the development interaction between these areas, revealing the challenges and opportunities of applying textile dyeing methods to colour 3D-printed polymer materials. The method explores three innovative approaches to colour the 3D-printed polymer object: (a) Additive Manufacturing of a Prototype, (b) the traditional dyebath method, and (c) the contemporary digital sublimation technique. The results show that the layer lines inherent to AM interact with dyes differently and affect the visual outcome compared to traditional textile fibers. Skillful manipulation of textile dyeing methods and dye type used for this research reduced the appearance of these lines to achieve consistency and desirable colour outcomes. In conclusion, integrating textile dyeing techniques into colouring 3D-printed polymer materials connects historical craftsmanship with innovative manufacturing. Overcoming challenges of colour distribution, compatibility, and layer line management requires a holistic approach that blends the technical consistency of AM with the artistic sensitivity of textile dyeing. Hence, applying textile dyeing methods to 3D-printed polymers opens new dimensions of aesthetic and functional possibilities.

Keywords: polymer, 3D-printing, sublimation, textile, dyeing, additive manufacturing

Procedia PDF Downloads 64

Authors: Manav Sabharwal, Ruda Rai Md, Candace Parker, James Ridley

Abstract:

Wheat is one of the most commonly consumed grains worldwide, which contains gluten. Nowadays, gluten intake is considered to be a trigger for GRDs, including Celiac disease (CD), a common genetic disease affecting 1% of the US population, non-celiac gluten sensitivity (NCGS) and wheat allergy. NCGS is being recognized as an acquired gluten-sensitive enteropathy that is prevalent across age, ethnic and geographic groups. The cause of this entity is not fully understood, and recent studies suggest that it is more common in participants with irritable bowel syndrome (IBS), with iron deficiency anemia, symptoms of fatigue, and has considerable overlap in symptoms with IBS and Crohn’s disease. However, these studies were lacking in availability of complete serologies, imaging tests and/or pan-endoscopy. We performed a prospective study of 745 adult patients who presented to an outpatient clinic for evaluation of chronic upper gastro-intestinal symptoms and subsequently underwent an upper endoscopic (EGD) examination as standard of care. Evaluation comprised of comprehensive celiac antibody panel, inflammatory bowel disease (IBD) serologic markers, duodenal biopsies and Small Bowel Video Capsule Endoscopy (VCE), when available. At least 6 biopsy specimens were obtained from the duodenum and proximal jejunum during EGD, and CD3+ Intraepithelial lymphocytes (IELs) and villous architecture were evaluated by a single experienced pathologist, and VCE was performed by a single experienced gastroenterologist. Of the 745 patients undergoing EGD, 12% (93/745) patients showed elevated CD3+ IELs in the duodenal biopsies. 52% (387/745) completed a comprehensive CD panel and 7.2% (28/387) were positive for at least 1 CD antibody (Tissue transglutaminase (tTG), being the most common antibody in 65% (18/28)). Of these patients, 18% (5/28) showed increased duodenal CD3+ IELs, but 0% showed villous blunting or distortion to meet criteria for CD. Surprisingly, 43% (12/28) were positive for at 1 IBD serology (ASCA, ANCA or expanded IBD panel (LabCorp)). Of these 28 patients, 29% (8/28) underwent a SB VCE, of which 100 % (8/8) showed significant jejuno-ileal mucosal lesions diagnostic for IBD. Findings of abnormal CD antibodies (7.2%, 28/387) and increased CD3+ IELs on duodenal biopsy (12%, 93/745) were observed frequently in patients with UGI symptoms undergoing EGD in an outpatient clinic. None met criteria for CD, and a high proportion (43%, 12/28) showed evidence of overlap with IBD. This suggests a potential causal link of acquired GRDs to underlying inflammation and gut mucosal barrier disruption. Further studies to investigate a role for abnormal antigen presentation of dietary gluten to gut associated lymphoid tissue as a cause are justified. This may explain a high prevalence of GRDs in the population and correlation with IBS, IBD and other gut inflammatory disorders.

Keywords: celiac, gluten sensitive enteropathy, lymphocitic enteritis, IBS, IBD

Procedia PDF Downloads 155