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.
Humanity is confronted with a growing array of environmental challenges that demand immediate attention and cannot be disregarded. One of the issues the world faces is air pollution, which presents a significant risk to both the environment and human well-being. The capitalist system has a great impact on the exacerbation of air pollution and environmental deterioration. This impact is reflected in Caryl Churchill’s post-apocalyptic play Not Not Not Not Not Enough Oxygen (1971). The play presents a futuristic scenario in which humanity faces grave consequences due to the polluting practices of capitalism and the unsustainable exploitation of natural resources. It depicts a future in which environmental degradation drives people
... Show MoreIn this research , we study the inverse Gompertz distribution (IG) and estimate the survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes
The imposition of (state) policy on the South Kuril Islands.In the Pacific was a subject
of borders dispute between Japan and Soviet Union which appeared clearly afterthe second
Great War and during the cold war. Despite the end of the Cold War and the collapse of the
Soviet Union in 1991, this conflict has continued, thus both countries had to made a historic
and legitimate claims to demand the rights of sovereignty and ownership of four islands
occupied by the Soviet Union after World War II under the international conventions and
treaties, but these claims are proven failures through the continuation of the regional conflict.
Al2O3 and Al2O3–Al composite coatings were deposited on steel specimens using Oxy-acetylene gas thermal spray gun. Alumina was mixed with Aluminum in six groups of concentrations (0, 5, 10,12,15 and 20% ) Al2O3, Specimens were tested for corrosion using Potentiodynamic polarization technique. Further tests were conducted for the effect of temperature on polarization curve and the hardness tests for the coated specimens. At first, Modelling was carried out using MINITAB-19, least square method, as a 2nd degree nonlinear model, bad results were achieved because of the high nonlinearity. Better result w
Virtual reality, VR, offers many benefits to technical education, including the delivery of information through multiple active channels, the addressing of different learning styles, and experiential-based learning. This paper presents work performed by the authors to apply VR to engineering education, in three broad project areas: virtual robotic learning, virtual mechatronics laboratory, and a virtual manufacturing platform. The first area provides guided exploration of domains otherwise inaccessible, such as the robotic cell components, robotic kinematics and work envelope. The second promotes mechatronics learning and guidance for new mechatronics engineers when dealing with robots in a safe and interactive manner. And the thir
... Show MoreThe research included preparation of new iron(II) complexes with mixed ligands including benzilazine(BA) and semicarbazone ligands {benzilsemicarbazone- BSCH or benzilbis(semicarba-zone)- BBSCH2 or salicylaldehydesemicarbazone- SSCH2 or benzoinsemicarbazone- B'SCH2}.by classical and microwave methods. The resulted complexes have been characterized using chemical and physical methods. The study suggested that the above ligands form ionic complexes having formulae [Fe(SCHi)(BA)(Cl)m](Cl)2-m {where SCH, BSCH, BBSCH2, SSCH¬2 or B'SCH2 ligands; m=1 or 2}. Hexacoordinated mononuclear complexes have been investigated by this study and having octahedral geometries. The effect of laser ray type visible region have been studied on solid ligands and
... Show MorePromoting the production of industrially important aromatic chloroamines over transition-metal nitrides catalysts has emerged as a prominent theme in catalysis. This contribution provides an insight into the reduction mechanism of p-chloronitrobenzene (p-CNB) to p-chloroaniline (p-CAN) over the γ-Mo2N(111) surface by means of density functional theory calculations. The adsorption energies of various molecularly adsorbed modes of p-CNB were computed. Our findings display that, p-CNB prefers to be adsorbed over two distinct adsorption sites, namely, Mo-hollow face-centered cubic (fcc) and N-hollow hexagonal close-packed (hcp) sites with adsorption energies of −32.1 and −38.5 kcal/mol, respectively. We establish that the activation of nit
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