Background: While warfarin and direct oral anticoagulants (DOACs) are used to manage thromboembolic events, they possess several features that impact adherence. Objective: To assess medication adherence and self-efficacy in patients receiving warfarin or DOAC treatment. Methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital in Baghdad from December 2022 to May 2023 on patients receiving either warfarin or DOACs. The Arabic version of the Adherence to Refills and Medications Scale (ARMS) questionnaire and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C) questionnaire were used to assess adherence and self-efficacy. Results: 181 patients were enrolled in the study, of whom 56.9% received warfarin and 43.1% received DOACs. The mean ARMS score was 13.71, and 81.77% of the patients were adherent to anticoagulant therapy. There was a significant difference in adherence between the warfarin and DOAC groups. The mean SES6C score for the participants was 50.01. Patients in the DOAC group had significantly higher self-efficacy compared to those in the warfarin group. The adherence score correlated significantly with patients’ gender, education level, hospitalization and duration of anticoagulant use, while the SES6C score did not correlate with any of the independent variables. There was a significant negative correlation between self-efficacy scores and medication adherence scores. Conclusions: Patients receiving DOACs showed a higher self-efficacy to manage chronic diseases and lower medication adherence as compared to warfarin. Higher self-efficacy was associated with higher adherence to treatment.
A summary of zooplankton research done in Peruvian marine waters is presented. We first provide a brief overview of the evolution of zooplankton studies off Peru before reviewing zooplankton biodiversity, regional distribution, seasonal and interannual fluctuation, trophodynamics, secondary production, and modeling are some of these topics. We evaluate research on various meroplankton, macroplankton, mesoplankton, and microplankton groups and provide a list of species from both published and unpublished sources. Three regional zooplankton groups have been identified: A shelf group on the continental shelf dominated by Acartia tonsa and Centropages brachiatus; A slope group on the continental shelf with siphonophores, bivalves, foramin
... Show MoreA novel demountable shear connector for precast steel-concrete composite bridges is presented. The connector uses high-strength steel bolts, which are fastened to the top flange of the steel beam with the aid of a special locking nut configuration that prevents bolts from slipping within their holes. Moreover, the connector promotes accelerated construction and overcomes the typical construction tolerance issues of precast structures. Most importantly, the connector allows bridge disassembly. Therefore, it can address different bridge deterioration scenarios with minimum disturbance to traffic flow including the following: (1) precast deck panels can be rapidly uplifted and replaced; (2) connectors can be rapidly removed and replaced; and (
... Show MoreThe city of Samawah is one of the most important cities which emerged in the poverty area within the poverty map produced by the Ministry of Planning, despite being an important provincial centre. Although it has great development potentials, it was neglected for more than 50 years,. This dereliction has caused a series of negative accumulations at the urban levels (environmental, social and economic). Therefore, the basic idea of this research is to detect part of these challenges that are preventing growth and development of the city. The methodology of the research is to extrapolate the reality with the analysis of the results, data and environmental impact assessment of the projec
Objective: to assess the risk factors of coronary artery disease patients.
Methodology: A non-probability (purposive) sample of (100) patients. The study population consisted of
a sample of adults from both genders whose ages were 30 years and more, and was newly diagnosed as
having CAD by coronary angiography in the cardiac catheterization unit of An Nasiriyah heart center.
Results: The result of the study showed that the most common modifiable risk factors were low HDL-C
levels (58%), smoking (53%), hypertension (46%), diabetes mellitus (34%), obesity (30%), high
triglycerides (19%), hypercholesterolemia (17%), and high LDLC (14%). All these factors were positively
and significantly associated with the development
Background: The desire for an attractive appearing fixed orthodontic appliance fueled the use of ceramic brackets and clear accessories. Elastics are one of the most versatile materials available to orthodontists so studying their effect on the esthetic appearance is important. This an in vivo study, conducted to evaluate the effect of exposing stretched clear elastomeric ligatures to the oral environment from four different companies (OrthoTechnology, Morelli, Ortho Organizer, and Ormco). Materials and Methods: A total of 240 elastomeric modules were examined, 60 modules from each brand. Each of the 60 patients enrolled in the study, received 4 elastomeric modules on the 4 lower incisors, one from each brand. The specimens were placed on t
... Show MoreHuman beings have an innate and natural aim to achieve their self-interests and to show their ability to overcome challenges in a better way, therefore the move towards self determination is expressed by intrinsic motivation. The desire of absorbing in this task is to enjoy the task in it self and benefitting from it such a motivation is the desire rooted in human nature to judge and choose in which individual is conscious in his self, abilities and adequacy that help him in control the different situations of life passed by him. His choices and actions are voluntary and non-restricted to intervention or external control because control is inner and subjective, while his behavior is self-regulated with the feeling of
... Show MoreAbstract
The Paper highlights on one of the main activities in marketing management. That is the internal marketing in the commercial banks and its relationship with the quality services offered to satisfy customers needs and wishes in order to reach he ultimate objectives of those banks. Two state and five private banks in Basrah city (Iraq) were taken in a field study. The survey covered the opinions of (184) state bank employees and (158) clients . The analysis of the survey shows that there is a strong relationship between the internal marketing ( in the banks covered by the survey) and the quality of banking objective services and the private banks show greater interest and concern to the internal ma
... Show MoreThis research aims to numerous risks to the portfolio of the insurance company that arise from practicing the activity in general, and the risks arising from insurance contracts in particular, and what is the role of the company in the disclosure to help users (such as owners) to understand and concentration of risks in the financial reporting and identifying movable risks size to reinsurers that may affect the solvency of the portfolio and makes them at a given moment required to fulfill the obligations towards policyholders outweigh the financial capacity, which leads to stumble or bankruptcy.
So I sought this research is to identify the extent of the obligation to disclose the accounting for this risk and the extent of their i
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