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.
Abu Firas al- Hamdani is one of the most prominent abbasid poets Who characterized their poetry with high artistic quality especially in his Romyate which blended the quality of feelings of grief, sorrow, longing and nostalgia that makes sensitive self conflict that stems with time from one hand and with place on the other hand. Because we are dealing with a poet lived west spatial coercive which it has been hurt him within a time conflict swinging between despair and some times patience and hope other times between the present and his painful reality also between the past and the beautiful times.
This researcher is to stand on this Romyat by monitoring effectiveness of the poetic text based on conflict between the presenc
Deep beams are used in wide construction fields such as water tanks, foundations, and girders in multi-story buildings to provide certain areas free of columns. In practice it is quite often occurring to create web opening in deep beams to supply convenient passage of ventilation ducts, cable channels, gas and water pipes. Experimental studies of ten 10 deep beams were carried out, where two of them are control specimens without openings and eight with large web openings in the shear spans. The variables that have been adopted are the ratio of the shear span to the overall depth of the member cross-section, location and dimensions of the opening. Test results showed that there was a decrease in the load carrying capacity of deep bea
... Show MoreA rapid high performance liquid chromatography method for the determination of sphinganine (Sa) and sphingosine (So) in urine samples by employing a silica-based monolithic column is described. The samples were first extracted using ethyl acetate and derivatized using ortho-phthaldialdehyde in the presence of 2-mercaptoethanol. C20 sphinganine was used as internal standard. Under the optimized conditions, separation was achieved using a mixture of methanol:water (93:7, v/v), column temperature at 30°C, flow rate of 1 mL min−1, and an injection volume of 10 μL. Good linearity was obtained for Sa and So over the concentration range 20–500 ng mL−1(correlation coefficients ≥0.9978). The detection limits were 0.45 ng mL−1 for Sa and
... Show MoreHaruki Murakami (1949-present) is a contemporary Japanese writer whose works have been translated into fifty languages and won him plenty of Japanese and international awards. His short stories are well constructed in a weird realistic manner and are mixed with elements of surrealism. His novels and short stories fall under the genre of magical realism. One of the major revolving themes that Murakami wrote about was the haunting feeling of emptiness and disconnectedness in a world which seems to care much for materialism and self-interests.
The paper explores two of Murakami’s short stories in his book After the Quake (2000) and the relevance of their themes and characters to Iraq after the q
... Show MoreThe Sarmord Formation is one of the overlooked formations that require more investigations than that achieved before. There are many problems in its definition, age, stratigraphy and aerial distribution. Previously in most parts of the Sulaymaniyah, it is not mapped and its outcrops combined with Balambo Formation while in the present study it is differentiated, mapped in the field on the Qaywan anticline and its problems discussed in details with a suggestion of solutions. For laboratory studies, 31 samples are taken on the Qywan Mountain (anticline) at 23 km north of the Sulaimani city for nannofossils biozonation. This study identified 19 species of the recorded calcareous nannofossils, the studied section reveals three biozones
... Show MoreThe investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma
... Show MoreThe current study aims to assess the effectiveness of the cognitive-behavioral programs in reducing stuttering and social anxiety among high-school students. The researchers used the experimental design. The sample consists of (20) male students who reported the highest score on the stuttering severity scale and social anxiety scale. The sample was divided into experimental and control groups (each group consists of 10 participants). The researcher used the type and severity of stuttering scale developed by Onslow et al (2003), translated by Mahmoud Ismail and the social anxiety scale was prepared by the authors. The results showed that there are statistically significant differences in pre-post and follow-up tests amongst the experiment
... Show MoreLean Six Sigma methodologies and Ergonomics principles are the main pillars of this work given their importance in the implementation of continuous improvement in assembly workstations design. When looking at the introduction of the Ergonomics that has been affected by the integration of the Lean and Six Sigma for improvements, it is necessary to understand why these methodologies belong to each other and how they can be handled in the industrial field. The aim of the work seeks towards the impact of analyzing the integration of the basics tools of Lean and Six Sigma that enhanced Ergonomics highlighted the importance of using the priority matrix in the selection of the priority criteria. Two models of a system based on
... Show MoreContemporary management is interested in the process of performance assessment because of its significance in the field of planning and controlling the multiactiveties to attain its goals and uncovering digression of virtual performance after comparing it with the plan or equitable performance.
Digression is analyzed to enable management control centers of authority.
Assessment process significance is closely related by setting definite categories to evaluate the economic activity to know the ability to achieves aims.
This study concentrated on the most important categories that used to evaluate company understudy with ather categories suggested to complete assessment process.
This study is in
... Show More