Search results for: sectional title

Authors: Oluwasefunmi Eunice Irewole, Enrique Armas Arévalos

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Agriculture has played a crucial role in the economy and the development of many countries. Moreover, the basic needs for human survival are; food, shelter, and cloth are link on agricultural production. Most developed countries see that agriculture provides them with food and raw materials for different goods such as (shelter, medicine, fuel and clothing) which has led to an increase in incomes, livelihoods and standard of living. This study aimed at analysing the relationship between International competitiveness of agricultural products, with the area, fertilizer, labour force, economic growth, foreign direct investment, exchange rate and inflation rate in Latin America during the period of 1991-to 2019. In this study, panel data econometric methods were used, as well as cross-section dependence (Pesaran test), unit root (cross-section Augumented Dickey Fuller and Cross-sectional Im, Pesaran, and Shin tests), cointergration (Pedroni and Fisher-Johansen tests), and heterogeneous causality (Pedroni and Fisher-Johansen tests) (Hurlin and Dumitrescu test). The results reveal that the model has cross-sectional dependency and that they are integrated at one I. (1). The "fully modified OLS and dynamic OLS estimators" were used to examine the existence of a long-term relationship, and it was found that a long-term relationship existed between the selected variables. The study revealed a positive significant relationship between International Competitiveness of the agricultural raw material and area, fertilizer, labour force, economic growth, and foreign direct investment, while international competitiveness has a negative relationship with the advantages of the exchange rate and inflation. The economy policy recommendations deducted from this investigation is that Foreign Direct Investment and the labour force have a positive contribution to the increase of International Competitiveness of agricultural products.

Keywords: revealed comparative advantage, agricultural products, area, fertilizer, economic growth, granger causality, panel unit root

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Authors: Katalin Szöllősi, László Szabó

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Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

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Authors: X. Gu, K. L. Blackmore

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The impact factor was introduced to measure the quality of journals. Various impact measures exist from multiple bibliographic databases. In this research, we aim to provide a broader understanding of the relationship between scholarly impact and other characteristics of academic journals. Data used for this research were collected from Ulrich’s Periodicals Directory (Ulrichs), Cabell’s (Cabells), and SCImago Journal & Country Rank (SJR) from 1999 to 2015. A master journal dataset was consolidated via Journal Title and ISSN. We adopted a two-step analysis process to study the quantitative relationships between scholarly impact and other journal characteristics. Firstly, we conducted a correlation analysis over the data attributes, with results indicating that there are no correlations between any of the identified journal characteristics. Secondly, we examined the quantitative relationship between scholarly impact and other characteristics using quartile analysis. The results show interesting patterns, including some expected and others less anticipated. Results show that higher quartile journals publish more in both frequency and quantity, and charge more for subscription cost. Top quartile journals also have the lowest acceptance rates. Non-English journals are more likely to be categorized in lower quartiles, which are more likely to stop publishing than higher quartiles. Future work is suggested, which includes analysis of the relationship between scholars and their publications, based on the quartile ranking of journals in which they publish.

Keywords: academic journal, acceptance rate, impact factor, journal characteristics

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Authors: Ketan Tamirisa, Kathleen P. Tebb

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In the U.S., annually, there are over 1 million pregnancies in teenagers and most (85%) are unintended. The need for proactive prevention measures is imperative to support adolescents with their pregnancy prevention and family planning goals. To date, there is limited research examining the extent to which support from a sexual partner(s) influences contraceptive use. To address this gap, this study assessed the relationship between sexually active adolescents, sex-assigned birth as female, and their perceived support from their sexual partner(s) about their contraceptive use in the last three months. Baseline data from sexually active adolescent females, between 13-19 years who were not currently using a long-acting contraceptive device, were recruited from 32 school-based health centers (SBHCs) in seven states in the U.S. as part of a larger study to evaluate Health-E You/ Salud iTuTM, a web-based contraceptive decision support tool. Fisher’s exact test assessed the cross-sectional association between perceived sexual partner support of contraceptive use in the past three months (felt no support, felt little support, and felt a lot of support), and current use of non-barrier contraception. A total of 91 sexually active adolescent females were eligible and completed the baseline survey. The mean age was 16.7 and nearly half (49.3%) were Hispanic/Latina. Most (85.9%) indicated it was very important to avoid becoming pregnant. A total of 60 participants (65.9%) reported use of non-barrier contraception. Of these, most used birth control pills (n=26), followed by Depo-Provera injection (n=12), patch (n=1), and ring (n=1). Most of the participants (80.2%) indicated that they perceived a lot of support from their partners and 19.8% reported no or little support. Among those reporting a lot of support, 69.9% (51/73) reported current use of non-barrier contraception compared to 50% (9/18) who felt no/little support and reported contraceptive use. This difference approached but did not reach statistical significance (p=0.096). Results from this preliminary data indicate that many adolescents who are coming in for care at SBHCs are at risk of unintended pregnancy. Many participants also reported a lot of support from their sexual partner(s) to use contraception. While the associations only approached significance, this is likely due to the small sample size. This and future research can better understand this association to inform interventions aimed at sexual partners to strengthen education and social support, increase healthcare accessibility, and ultimately reduce rates of unintended pregnancy.

Keywords: adolescents, contraception, pregnancy, SBHCs, sexual partners

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Authors: Mechri hanane, Azzaz Mohammed

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Polycrystalline CuFe thin film was prepared by thermal evaporation process (Physical vapor deposition), using the nanocrystalline CuFe powder obtained by mechanical alloying After 24 h of milling elemental powders. The microscopic study of nanocrystalline powder and the thin film of Cu70Fe30 binary alloy were examined using transmission electron microscopy (TEM) and scanning electron microscope (SEM). The cross-sectional TEM images showed that the obtained CuFe layer was polycrystalline film of about 20 nm thick and composed of grains of different size ranging from 4 nm to 18 nm.

Keywords: nanomaterials, thin films, TEM, SEM

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Authors: Stephanie Fabris Russo, Daiane Costa Guimarães, Jonas Pedro Fabris, Maria Emilia Camargo, Suzana Leitão Russo, José Augusto Andrade Filho

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Among renewable energy sources, solar energy is the one that has stood out. Solar radiation can be used as a thermal energy source and can also be converted into electricity by means of effects on certain materials, such as thermoelectric and photovoltaic panels. These panels are often used to generate energy in homes, buildings, arenas, etc., and have low pollution emissions. Thus, a technological prospecting was performed to find patents related to the use of photovoltaic plates in urban residences. The patent search was based on ESPACENET, associating the keywords photovoltaic and home, where we found 136 patent documents in the period of 1994-2015 in the fields title and abstract. Note that the years 2009, 2010, 2011, 2012, 2013 and 2014 had the highest number of applicants, with respectively, 11, 13, 23, 29, 15 and 21. Regarding the country that deposited about this technology, it is clear that China leads with 67 patent deposits, followed by Japan with 38 patents applications. It is important to note that most depositors, 50% are companies, 44% are individual inventors and only 6% are universities. On the International Patent classification (IPC) codes, we noted that the most present classification in results was H02J3/38, which represents provisions in parallel to feed a single network by two or more generators, converters or transformers. Among all categories, there is the H session, which means Electricity, with 70% of the patents.

Keywords: photovoltaic, urban residences, technology forecasting, prospecting

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Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

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Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2＝5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

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Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

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Authors: Lakmali Anthony, Madeline Gillies

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Background Breast cancer (BC) is usually managed with surgical resection. Many outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO) such as Health-Related Quality of life (HRQoL) provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods Patients who had resection of BC in a regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Results Forty-six patients completed the survey. Clinically significant levels of FCR and emotional distress were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for BC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL for breast cancer. All psychosocial factors measured were associated with HRQoL. Conclusion HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative breast cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: breast cancer, surgery, quality of life, regional population

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Authors: Jean Gray C. Achapero, Mary Margareth P. Ancheta, Patricia Anjelika A. Angeles, Shannon Denzel S. Ao Tai, Carl Brandon C. Barlis, Chrislen Mae B. Benavidez

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Health literacy and awareness of Polycystic ovarian syndrome (PCOS) is a global issue that is under-addressed in the Philippines. Conducting a thorough review of the country's ability to recognize and comprehend the severity of the syndrome should be undertaken, as early treatment is essential to avoid further disorder complications. This research aims to assess the health literacy and awareness of the female residents of Barangay Dagatan, Sabang, and Marauoy Lipa, Batangas on PCOS. It followed a cross-sectional study, and data gathering was done through a pre-assessment using the Single Item Literacy Screener (SILS) and an online population-based survey questionnaire about PCOS awareness. The participants, as based on the objectives and purposive sampling method, were females aged 18-45 years old. Data were analyzed statistically using STATA 13.1 software. The study showed that 339 (76%) out of 444 respondents passed the SILS meaning the residents have proficient health literacy. Among the 339 respondents, 87% (287) had previous knowledge about PCOS. The respondents showed minimal awareness of PCOS symptoms which could be attributed to its broad spectrum of information. Respondents were shown to be most knowledgeable about PCOS physiology, treatment, beliefs, and its remedies. The respondents’ age had no significant association with their health literacy (p=0.31) and PCOS awareness (p=0.60). A significant association was noted, however, in their educational attainment linked with their health literacy (p=<0.0001) and PCOS awareness (p=0.001). It is suggested that reproductive health education even in the lower year levels must be optimized and Local Government Unit (LGU)/Non-Government Organization (NGO)-held seminars should be conducted for knowledge reinforcement. Reliable health information should be more accessible to the public and clinicians must emphasize the importance of the majority of early screening as part of routine physical examination for women of reproductive age to increase health literacy and awareness about PCOS and actively engage in the management of the disease.

Keywords: age, awareness, educational attainment, health literacy, polycystic ovarian syndrome

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Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

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Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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Authors: Daniel Y. Abebe, Jaehyouk Choi

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The objective of this paper is to investigate, through an analytical study, the behavior of both stiffened and un-stiffened removable shear link with perforated web considering different number and size of web openings. Removable shear link with perforated web is a novel shear link beam proposed to be used in eccentrically braced frame (EBF). The proposed link overcomes the difficulties during construction slab due to less cross-sectional areas of the link to control the plastic deformation on the conventional EBF with removable shear link. Finite element analyses were conducted under both cyclic and monotonic loading and from the results obtained design equations are developed.

Keywords: eccentrically braced frame, removable shear link, perforated web, non-linear FE analysis

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Authors: Shahid Mahmood, Ghulam Mueen-Ud-Din, Farah Naz Akbar, Yousaf Quddoos, Syeda Mahvish Zahra, Wajiha Saeed, Tayyaba Sami Ullah

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Obesity is an epidemic across the globe that affects all the segments of the population. Physical inactivity, passionate consumption of junk food, inadequate water intake and an unhealthy lifestyle are evident among university girls that are ruining their health gravely especially fat accumulation. The study was carried out to investigate the potential etiological factors of obesity development in university girls. The cross sectional study was carried out after approval of the Departmental Review Committee for Ethics (DRCE) as the par Declaration of Helsinki at Institute of Food Science and Nutrition (IFSN), University of Sargodha, Sargodha-Pakistan and Department of Food Science and Home Economics, G. C. Women University, Faisalabad-Pakistan. 400 girls were selected randomly from different departments of both universities. Nutritional status of the volunteers was assessed through approved protocols for demographics, anthropometrics, body composition, energetics, vital signs, clinical signs and symptoms, medical/family history, and dietary intake assessment (FFQ), water intake and physical activity level. The obesity was determined on body fat (%). Alarming and unheeded etiological factors for the development of obesity in girls were explored by the study. About 93 % girls had a sedentary level of physical activity, zealous consumption of junk food (5.31±1.23 servings), drank little water (1.09±0.26 L/day) that consequent high heaps of fat (35.06±3.02 %), measly body water (52.38±3.4 %), poor bone mass (05.14±0.31 Kg), and high BMI (26.68±1.14 Kg/m²) in 34% girls. The malnutrition also depicted by poor vital signs i.e. low body temperature (97.11±0.93 °F), slightly higher blood pressure (124.19±4.08 / 85.25±2.97 mmHg), rapid pulse rate (99.2 ± 6.85 beats/min), reduced blood O₂ saturation (96.53±0.96 %), scanty peak expiratory flow rate (297 ± 15.7 L /min). The outcomes of the research articulated that physical inactivity; extreme intakes of junk food, insufficient water consumption are etiological factors for obesity development among girls which are usually overlooked in Pakistan.

Keywords: informed consent, junk food, obesity, physical inactivity

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Authors: Erhan Berk

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The purpose of this study is to examine the efficiency and productivity of the health care sector in Turkey based on four years of health care cross-sectional data. Efficiency measures are calculated by a nonparametric approach known as Data Envelopment Analysis (DEA). Productivity is measured by the Malmquist index. The research shows how DEA-based Malmquist productivity index can be operated to appraise the technology and productivity changes resulted in the Turkish hospitals which are located all across the country.

Keywords: data envelopment analysis, efficiency, health care, Malmquist Index

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Authors: George Eduful, Kingsford J. A. Atanga

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Copper clad steel wire (CCS) is primarily used for grounding applications to reduce the high incidence of copper ground conductor theft in electrical installations. The cross sectional area of the CCS is selected by relating the diameter equivalence to a copper conductor. The main difficulty is how to use a simple analytical relation to determine the right conductivity of CCS for a particular application. The use of Eddy-Current instrument for measuring conductivity is known but in most cases, the instrument is not readily available. The paper presents a simplified approach on how to size and determine CCS conductivity for a given application.

Keywords: copper clad steel wire, conductivity, grounding, skin effect

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Authors: Wenxue Xu

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Fluid resistance damper is an important damping element to attenuate vehicle vibration. It converts vibration energy into thermal energy dissipation through oil throttling. It is a typical fluid-solid-heat coupling problem. A complete three-dimensional flow-structure-thermal coupling dynamics simulation model of a gas-filled fluid-resistance damper was established. The flow-condition-based interpolation (FCBI) method and direct coupling calculation method, the unit's FCBI-C fluid numerical analysis method and iterative coupling calculation method are used to achieve the damper dynamic response of the piston rod under sinusoidal excitation; the air chamber inflation pressure, spring compression characteristics, constant flow passage cross-sectional area and oil parameters, etc. The system parameters, excitation frequency, and amplitude and other excitation parameters are analyzed and compared in detail for the effects of differential pressure characteristics, velocity characteristics, flow characteristics and dynamic response of valve opening, floating piston response and piston rod output force characteristics. Experiments were carried out on some simulation analysis conditions. The results show that the node-based FCBI (flow-condition-based interpolation) fluid numerical analysis method and direct coupling calculation method can better guarantee the conservation of flow field calculation, and the calculation step is larger, but the memory is also larger; if the chamber inflation pressure is too low, the damper will become cavitation. The inflation pressure will cause the speed characteristic hysteresis to increase, and the sealing requirements are too strict. The spring compression characteristics have a great influence on the damping characteristics of the damper, and reasonable damping characteristic needs to properly design the spring compression characteristics; the larger the cross-sectional area of the constant flow channel, the smaller the maximum output force, but the more stable when the valve plate is opening.

Keywords: damper, fluid-structure-thermal coupling, heat generation, heat transfer

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Authors: Mmamapudi Kubjane, Natacha Berkowitz, Rene Goliath, Naomi S. Levitt, Robert J. Wilkinson, Tolu Oni

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Background: South Africa remains a high tuberculosis (TB) burden country globally and the burden of diabetes – a TB risk factor is growing rapidly. As an infectious disease, TB also induces transient hyperglycaemia. Therefore, screening for diabetes in newly diagnosed tuberculosis patients may result in misclassification of transient hyperglycaemia as diabetes. Objective: The objective of this study was to determine and compare the prevalence of hyperglycaemia (diabetes and impaired glucose regulation (IGR)) in TB patients and to assess the cross-sectional association between TB and hyperglycaemia at enrolment and after three months of follow-up. Methods: Consecutive adult TB and non-TB participants presenting at a TB clinic in Cape Town were enrolled in this cross-sectional study and follow-up between July 2013 and August 2015. Diabetes was defined as self-reported diabetes, fasting plasma glucose (FPG) ≥ 7.0 mmol·L⁻¹ or glycated haemoglobin (HbA1c) ≥ 6.5%. IGR was defined as FPG 5.5– < 7.0 mmol·L⁻¹ or HbA1c 5.7– < 6.5%. TB patients initiated treatment. After three months, all participants were followed up and screened for diabetes again. The association between TB and hyperglycaemia was assessed using logistic regression adjusting for potential confounders including sex, age, income, hypertension, waist circumference, previous prisoner, marital status, work status, HIV status. Results: Diabetes screening was performed in 852 participants (414 TB and 438 non-TB) at enrolment and in 639 (304 TB and 335 non-TB) at three-month follow-up. The prevalence of HIV-1 infection was 69.6% (95% confidence interval (CI), 64.9–73.8 %) among TB patients, and 58.2% (95% CI, 53.5–62.8 %) among the non-TB participants. Glycaemic levels were much higher in TB patients than in the non-TB participants but decreased over time. Among TB patients, the prevalence of IGR was 65.2% (95% CI 60.1 - 69.9) at enrollment and 21.5% (95% CI 17.2-26.5) at follow-up; and was 50% (45.1 - 54.94) and 32% (95% CI 27.9 - 38.0) respectively, among non-TB participants. The prevalence of diabetes in TB patients was 12.5% (95% CI 9.69 – 16.12%) at enrolment and 9.2% (95% CI, 6.43–13.03%) at follow-up; and was 10.04% (95% CI, 7.55–13.24%) and 8.06% (95% CI, 5.58–11.51) respectively, among non-TB participants. The association between TB and IGT was significant at enrolment (adjusted odds ratio (OR) 2.26 (95% CI, 1.55-3.31) but disappeared at follow-up 0.84 (0.53 - 1.36). However, the TB-diabetes association remained positive and significant both at enrolment (2.41 (95% CI, 1.3-4.34)) and follow-up (OR 3.31 (95% CI, 1.5 - 7.25)). Conclusion: Transient hyperglycaemia exists during tuberculosis. This has implications on diabetes screening in TB patients and suggests a need for diabetes confirmation tests during or after TB treatment. Nonetheless, the association between TB and diabetes noted at enrolment persists at 3 months highlighting the importance of diabetes control and prevention for TB control. Further research is required to investigate the impact of hyperglycaemia (transient or otherwise) on TB outcomes to ascertain the clinical significance of hyperglycemia at enrolment.

Keywords: diabetes, impaired glucose regulation, transient hyperglycaemia, tuberculosis

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Authors: Mohammed Alhawiti

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This paper investigates the insight of educational practitioners concerning challenges that seriously obstruct the comprehension of ICT-related goals of educational institutes. ICT education is a broad area encircling a variety of discipline; both those traditionally classified as IT such as information systems, engineering etc., as well as recent areas, which cross over a variety of educational fields. The results are from a local survey among national representative samples of institutes across GCC countries. The research entails a brief synopsis of the design of this project, a review of key indicators regarding ICT (Information and Communication Technologies) in various institutions, key obstacles and an investigation of the co-variation between challenges and related factors at the country-level.

Keywords: information, communication technology, GCC countries, education sector

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Authors: Jakyoung Kim, Sungwook Jang

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The purpose of this study is to examine the research trends of life-long education for people with disabilities using a keyword network analysis. For this purpose, 151 papers were selected from 594 papers retrieved using keywords such as 'people with disabilities' and 'life-long education' in the Korean Education and Research Information Service. The Keyword network analysis was constructed by extracting and coding the keyword used in the title of the selected papers. The frequency of the extracted keywords, the centrality of degree, and betweenness was analyzed by the keyword network. The results of the keyword network analysis are as follows. First, the main keywords that appeared frequently in the study of life-long education for people with disabilities were 'people with disabilities', 'life-long education', 'developmental disabilities', 'current situations', 'development'. The research trends of life-long education for people with disabilities are focused on the current status of the life-long education and the program development. Second, the keyword network analysis and visualization showed that the keywords with high frequency of occurrences also generally have high degree centrality and betweenness centrality. In terms of the keyword network diagram, it was confirmed that research trends of life-long education for people with disabilities are centered on six prominent keywords. Based on these results, it was discussed that life-long education for people with disabilities in the future needs to expand the subjects and the supporting areas of the life-long education, and the research needs to be further expanded into more detailed and specific areas. 

Keywords: life-long education, people with disabilities, research trends, keyword network analysis

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Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

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Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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Authors: Christos E. Lampropoulos, Maria Konsta, Tamta Sirbilatze, Ifigenia Apostolou, Vicky Dradaki, Konstantina Panouria, Irini Dri, Christina Kordali, Vaggelis Lambas, Georgios Mavras

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Objectives: Full Mini Nutritional Assessment (MNA) questionnaire is one of the most useful tools in diagnosis of malnutrition in hospitalized patients, which is related to increased morbidity and mortality. The purpose of our study was to assess the nutritional status of elderly, hospitalized patients and examine the hypothesis that MNA may predict mortality and extension of hospitalization. Methods: One hundred fifty patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. The following data were taken into account in analysis: anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission. The latter was compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and extended hospitalization respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 20% per each unit increase of full MNA score (OR=0.8, 95% CI 0.74-0.89, p < 0.0001). Patients who admitted due to cancer were 23 times more likely to die, compared to those with infection (OR=23, 95% CI 3.8-141.6, p=0.001). Similarly, patients who admitted due to stroke were 7 times more likely to die (OR=7, 95% CI 1.4-34.5, p=0.02), while these with all other causes of admission were less likely (OR=0.2, 95% CI 0.06-0.8, p=0.03), compared to patients with infection. According to multivariate linear regression analysis, each increase of unit of full MNA, decreased the admission duration on average 0.3 days (b:-0.3, 95% CI -0.45 - -0.15, p < 0.0001). Patients admitted due to cancer had on average 6.8 days higher extension of hospitalization, compared to those admitted for infection (b:6.8, 95% CI 3.2-10.3, p < 0.0001). Conclusion: Mortality and extension of hospitalization is significantly increased in elderly, malnourished patients. Full MNA score is a useful diagnostic tool of malnutrition.

Keywords: duration of admission, malnutrition, mini nutritional assessment score, prognostic factors for mortality

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Authors: Manisha Bal, B. C. Meikap

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Hydrogen chloride is the most common acid gas emitted by the industries. HCl gas is listed as Title III hazardous air pollutant. It causes severe threat to the human health as well as environment. So, removal of HCl from flue gases is very imperative. In the present study, submerged self-priming venturi scrubber is chosen to remove the HCl gas with water as a scrubbing liquid. Venturi scrubber is the most popular device for the removal of gaseous pollutants. Main mechanism behind the venturi scrubber is the polluted gas stream enters at converging section which accelerated to maximum velocity at throat section. A very interesting thing in case of submerged condition, venturi scrubber is submerged inside the liquid tank and liquid is entered at throat section because of suction created due to large pressure drop generated at the throat section. Maximized throat gas velocity atomizes the entered liquid into number of tiny droplets. Gaseous pollutant HCl is absorbed from gas to liquid droplets inside the venturi scrubber due to interaction between the gas and water. Experiments were conducted at different throat gas velocity, water level and inlet concentration of HCl to enhance the HCl removal efficiency. The effect of throat gas velocity, inlet concentration of HCl, and water level on removal efficiency of venturi scrubber has been evaluated. Present system yielded very high removal efficiency for the scrubbing of HCl gas which is more than 90%. It is also concluded that the removal efficiency of HCl increases with increasing throat gas velocity, inlet HCl concentration, and water level height.

Keywords: air pollution, HCl scrubbing, mass transfer, self-priming venturi scrubber

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Authors: Valentina Colonnello, Paolo Maria Russo

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Decades of cross-species affective neuroscience research by Panksepp and others have identified basic evolutionarily preserved subcortical emotional systems that humans share with mammals and many vertebrates. These primary emotional systems encode unconditional affective responses and contribute to the development of personality traits throughout ontogenesis and interactions with the environment. The Affective Neuroscience Personality Scale (ANPS) measures individual differences in affective personality traits associated with the basic emotional systems of CARE, PLAY, SEEKING, SADNESS, FEAR, and ANGER, along with Spirituality, which is a more cognitively and socially refined expression of affectivity. Though the ANPS’s power to predict human psychological distress has been documented, to the best of our knowledge, its predictive power for psychological wellbeing has not been explored. This study therefore investigates the relationship between affective neuroscience traits and psychological wellbeing facets. Because the emotional systems are thought to influence cognitively-mediated mental processes about the self and the world, understanding the relationship between affective traits and psychological wellbeing is particularly relevant to understanding the affective dimensions of health. In a cross-sectional study, healthy participants (n = 402) completed the ANPS and the Psychological Wellbeing scale. Multiple regressions revealed that each facet of wellbeing was explained by two to four affective traits, and each trait was significantly related to at least one aspect of wellbeing. Specifically, SEEKING predicted all the wellbeing facets, except for positive relations; CARE predicted personal growth, positive relations, purpose in life, and self-acceptance; PLAY and, inversely, ANGER predicted positive relations; SADNESS inversely predicted autonomy, while FEAR inversely predicted purpose in life. SADNESS and FEAR inversely predicted environmental mastery and self-acceptance. Finally, Spirituality predicted personal growth, positive relations, and self-acceptance. These findings are the first to show the relationship between affective neuroscience personality traits and psychological wellbeing. They also call attention to the distinctive role of FEAR and PANIC traits in psychological wellbeing facets, thereby complementing or even overcoming the traditional personality approach to neuroticism as a global trait.

Keywords: affective neuroscience, individual differences, personality, wellbeing

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Authors: Marina Aferiba Tandoh, Elsie Odei

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Peptic Ulcer Disease (PUD) is amongst the commonest gastrointestinal problems that require emergency treatment in order to preserve life. The prevalence of PUD is increasing within the Ghanaian population, deepening the need to identify factors that are associated with its occurrence. This cross-sectional study assessed the nutritional status, socioeconomic and lifestyle factors associated with PUD among patients attending the Out-Patient Department of the Tema General Hospital of Ghana. A food frequency questionnaire and a three-day, 24-hour recall were used to assess the dietary intakes of study participants. A standardized questionnaire was used to obtain information on the participants’ socio-demographic characteristics, lifestyle as well as medical history. The data was analyzed using SPSS version 22. The mean age of study participants was 32.8±15.41years. Females were significantly higher (61.4%) than males (38.6%) (p < 0.001). All participants had received some form of education, with tertiary education being the highest (52.6%). The majority of them managed their condition with medications only (86%), while 10.5% managed it with a combination of medications and diet. The rest were either by dietary counseling only (1.8%), or surgery only (1.8%). or herbal medicines (29.3%), which were made from home (7.2%) or bought from a medical store (10.8%). Most of the participants experienced a recurrence of the disease (42.1%). For those who had ever experienced recurrences of the disease, it happened when they ate acidic foods (1.8%), ate bigger portions (1.8%), starved themselves (1.8%), or were stressed (1.8%). Others also had triggers when they took certain medications (1.8%) or ate too much pepper (1.8%). About 49% of the participants were either overweight or obese with a recurrence of PUD (p>0.05). Obese patients had the highest rate of PUD recurrences (41%). Drinking alcohol was significantly associated with the recurrence of PUD (χ2= 5.243, p=0.026). Other lifestyles, such as weed smoking, fasting, and use of herbal medicine and NSAIDs did not have any significant association with the disease recurrence. There was no significant correlation between the various dietary patterns and anthropometric parameters except dietary pattern one (salty snacks, regular soft drinks, milk, sweetened yogurt, ice cream, and cooked vegetables), which had a positive correlation with weight (p=0.002) and BMI (p=0.038). PUD patients should target weight reduction actions and reduce alcohol intake as measures to control the recurrence of the disease. Nutrition Education among this population must be promoted to minimize the recurrence of PUD.

Keywords: Dietary patterns, lifestyle factors, nutritional status, peptic ulcer disease

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Authors: Ella Sever, Irena Glažar, Ema Saltović

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Conventional cigarette smoking is associated with an increased risk of oral diseases and oral symptoms such as dry mouth, bad breath, burning sensation, and changes in taste sensation. The harmful effects of conventional cigarette smoking on oral health have been extensively studied previously. However, there is a severe lack of studies investigating the effects of Tobacco Heating System (THS) on oral structures. As a preventive measure, a new alternative Tobacco THS has been developed, and according to the manufacturer, it has fewer potentially harmful and harmful constituents and consequently, lowers the risk of developing tobacco-related diseases. The aim is to analyze the effects of conventional cigarettes and THS on salivary flow rate (SFR), and self-reported oral symptoms.The stratified cross-sectional study included 90 subjects divided into three groups: THS smokers, conventional cigarette smokers, and nonsmokers. The subjects completed questionnaires on smoking habits, and symptoms (dry mouth, bad breath, burning sensation, and changes in taste sensation). SFR test were performed on each subject. The lifetime exposure to smoking was calculated using the Brinkman index (BI). Participants were 20-55 years old (median 31), and 66.67 % were female. The study included three groups of equal size (n = 20), and no statistically significant differences were found between the groups in terms of age (p = 0.632), sex (p = 1.0), and lifetime exposure to smoking (the BI) (p=0,129). Participants from the smoking group had an average of 10 (2-30) years of smoking experience in the conventional cigarettes group and 6 (1-20) years of smoking experience in the THS group. Daily consumption of cigarettes/heets per day was the same for both smokers’ groups (12(2-20) cigarettes/heets per day). The self-reported symptoms were present in 40 % of participants in the smokers group. There were significant differences in the presence of halitosis (p = 0.025) and taste sensation (p=0.013). There were no statistical differences in the presence of dry mouth (p =0.416) and burning sensation (0.7). The SFR differed between groups (p < 0.001) and was significantly lower in the THS and conventional cigarette smokers’ groups than the nonsmokers’ group. There were no significant differences between THS smokers and conventional cigarette smokers. The results of the study show that THS products have a similar effect to conventional cigarettes on oral cavity structures, especially in terms of SFR, self-reported halitosis, and changes in taste.

Keywords: oral health, tobacco products, halitosis, cigarette smoking

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Authors: Sulistyaningtyas

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The topic about death and dying is interesting to discuss since it is strongly related to every individual life. As represented in its title, Adonais: An Elegy on the Death of John Keats is a mournful poem written in 1821 by Percy Bysshe Shelley to mourn the loss of young poet John Keats. To compare, In Memoriam A.H.H. is an elegy written in 1850 about the death of Lord Tennyson’s dearest friend, Arthur Henry Hallam. Although both elegies were written to grieve the authors’ loved ones, their grief affects differently to the psychological being of the narrators. Thus, this research aims to examine the essence of death in affecting the narrators psychologically. By using psychoanalytic criticism, this research reveals the different essence of death in the two elegies as the result of the analysis. Moreover, these two elegies also portray the concept of the afterlife, immortality, and the figure of God. In Adonais, the grief of the narrator to Keats leads him to question the very purpose of life. The loss of his favorite poet which makes him feel sorrowful and mad along his 55 stanzas brings him to a higher psychological level to understand himself. He even sees himself as a Christ-like figure, which shows the idea that God is imaginable. Different from Adonais, the narrator of In Memoriam finds something more spiritual by doing his passionate mourning to Hallam. Through some contemplation in his 133 cantos, in the end, he is convinced that the dear one now dwells with a great Spirit who controls the world. He believes that all of the creation in the universe has to follow one law which is set by God. Hence, it can be concluded that death might bring different consequence to the psyche of every living creature.

Keywords: elegy, comparative study, psychoanalytic criticism, the essence of death

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Authors: Etienne Provencal, David L. St-Pierre

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A facility exploiting only electronic gambling machines (EGMs) opened in 2007 in Quebec City, Canada under the name of Salons de Jeux du Québec (SdjQ). This facility is one of the first worldwide to rely on that business model. This paper models the performance of such EGMs. The interest from a managerial point of view is to identify the variables that can be controlled or influenced so that a comprehensive model can help improve the overall performance of the business. The EGM individual performance model contains eight different variables under study (Game Title, Progressive jackpot, Bonus Round, Minimum Coin-in, Maximum Coin-in, Denomination, Slant Top and Position). Using data from Quebec City’s SdjQ, a linear regression analysis explains 90.80% of the EGM performance. Moreover, results show a behavior slightly different than that of a casino. The addition of GameTitle as a factor to predict the EGM performance is one of the main contributions of this paper. The choice of the game (GameTitle) is very important. Games having better position do not have significantly better performance than games located elsewhere on the gaming floor. Progressive jackpots have a positive and significant effect on the individual performance of EGMs. The impact of BonusRound on the dependent variable is significant but negative. The effect of Denomination is significant but weakly negative. As expected, the Language of an EGMS does not impact its individual performance. This paper highlights some possible improvements by indicating which features are performing well. Recommendations are given to increase the performance of the EGMs performance.

Keywords: EGM, linear regression, model prediction, slot operations

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Authors: Samul Sahile Kebede

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Back ground: -Immune hemolytic anemia commonly affects human immune deficiency, infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to the drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV, which accompanies the greatest percent from acquired hemolytic anemia. Objective: -The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at the university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. Methods: - An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination, and antihuman globulin test were performed to the diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. Result; - The overall prevalence of immune hemolytic anemia was 2.8 % (10 of 358 participants). Of these, 5 were males, and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40 % mild and 60 % moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). Conclusion and recommendation; Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.

Keywords: anemia, hemolytic, immune, auto immune, HIV/AIDS

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Authors: Mohammad Hossein Badamchi

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As Leo Strauss demonstrates in his works, Political Philosophy in the western tradition is an epistemic-naturalistic tradition insofar Hanna Arendt mentioning the deep conflict between philosophy and politics, opposed to be named “political philosopher” prefer the title “political thinker” for herself. In fact, the Western political philosophy’s tendency to derive politics from natural law and epistemic argumentations makes a paradox between the actual “the political” and the theoretical “natural politics” in the western tradition. In this paper, we want to show that Hanna Arendt, in her exploration to find a new realm of the non-naturalistic way of thinking about the political is walking on a completely different tradition of political philosophy which was first established by Al-Farabi, the founder of Islamic political philosophy around thousand years after Greek Philosophy. Despite Aristotelian Polis which is a Natural community based on true natural rationality to reach the natural purposes of mankind, Al-Farabi’s Madine (his reconstructed concept of Aristotelian Polis) is completely constructed against natural cities, which are formulated by necessity logic of natural arguments and natural deception of humanity. In fact, Farabi considers the natural understanding of politics as Ignorant ideologies used by governments to suppress people. Madine in Farabi’s work is not a natural institution but is a collaborative constitution founded by citizens. So despite Aristotelian thinking, here we don’t have just A Polis that is the one true polis, but we have various multiple Madines among one, is virtuous not by definition but by real action of citizens and civil relations. Al-Farabi’s political philosophy is not a Naturalistic-epistemic Political Philosophy but is a Phronetic Political Philosophy which Hanna Arendt wants to establish outside of western contemplative anti-active political philosophy tradition.

Keywords: al-farabi, hanna arendt, natural politics, the political, political philosophy

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Authors: Jayanta Bora, Sukhvinder Kaur, Ashok Agarwal, Sangeeta Kaul

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Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility and literacy for effective human immunodeficiency virus (HIV) prevention. This paper examines the association between vulnerability and behavioural outcomes among FSWs in Thane district, Maharashtra under USAID PHFI-PIPPSE project. Methods: Data were used from the Behavioural Tracking Survey, a cross-sectional behavioural study conducted in 2015 with 503 FSWs randomly selected from 12 TI-NGOs which were functioning and providing services to FSWs in Thane district prior to April 2014 in Thane district of Maharashtra. We have created the “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt), and aspects of sex work (mobility and duration in sex work) as a dependent variable. The key independent measures used were program exposure to intervention, service uptake, self-confidence, and self-identity. Bi-variate and multivariate logistic regressions were used to examine the study objectives. Results: A higher proportion of FSWs who were in the age-group 18–25 years from brothel/street /home/ lodge-based were categorized as highly vulnerable to HIV risk as compared to bar-based sex worker (74.1% versus 59.8%, P,0.002); regression analysis highlighted lower odds of vulnerability among FSWs who were aware of services and visited NGO clinic for medical check-up and counselling for STI [AOR= 0.092, 95% CI 0.018-0.460; P,0.004], However, lower odds of vulnerability on confident in supporting fellow sex worker in crisis [AOR= 0.601, 95% CI 0.476-0.758; P, 0.000] and were able to turn away clients when they refused to use a condom during sex [AOR= 0.524, 95% CI 0.342-0.802; P, 0.003]. Conclusion: The results highlight that FSWs associated with TIs and getting services are less vulnerable and highly empowered. As a result of behavioural change communication and other services provided by TIs, FSWs were able to successfully negotiate about condom use with their clients and manage solidarity in the crisis situation for fellow FSWs. Therefore, it is evident from study paper that TI prevention programs may transform the lives of masses considerably and may open a window of opportunity to infuse the information and awareness about HIV risk.

Keywords: female sex worker, HIV prevention, HIV service uptake, vulnerability

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