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.
The current research aims to focus on strategic vigilance dimensions and contained (environmental vigilance, technological vigilance, competitive vigilance, vigilance marketing) to improve nursing services, which include a) the quality, timeliness, problem-solving and decision-making, relationships with others, leadership skills) and measure the degree link and influence between strategic vigilance in the hospital respondent and improve nursing service that the problem of the research lies in the weakness of strategic plans and health organizations in general and the hospital surveyed (martyr Ghazi al-Hariri), in particular, the lack of awareness of the hospital researched strategy vigilant management to improve nursing services,
... Show MoreThat any industrial company that must think about marketing mechanisms and who are the beneficiaries and the pursuit of gain customer satisfaction with access to competitive advantages. Most industrialized our companies from a variety of problems experienced both in the field of production, marketing, or keep up with new developments or commitment to quality standards, which caused the reluctance of customers to buy local products for various reasons, and especially in light of unplanned economic policy and exposure to market to imported products flooding the market with various goods and services that do not can the domestic industry rival, which has competitive advantages and meet business requirements, but others arrived to stop or as
... Show Moreيجترح الشاعر والت ويتمان انعطافة شعرية لعلاقة الانسان، جسدا وروحا، مع العالم. فهو يستقي الهامه في كتابته لمرثاته (عندما اينع الليلك اخيرا في فناء الدار) من مصادر جمالية واخرى سياسية. ولعل ابرزها تأثره بفكرة الروح الكوني كما جرى طرحها في سياق فلسفة التسامي الامريكية. يظهر ذلك جليا في قصائده التي تتخذ من تماهي روح الانسان مع الطبيعة موضوعة لها. ان فكرة الروح الكوني تلقي ههنا بظلالها على الرتب الانسانية التي
... Show MoreThis study uses load factor and loss factor to determine the power losses of the electrical feeders. An approach is presented to calculate the power losses in the distribution system. The feeder’s technical data and daily operation recorded data are used to calculate and analyze power losses.
This paper presents more realistic method for calculating the power losses based on load and loss factors instead of the traditional methods of calculating the power losses that uses the RMS value of the load current which not consider the load varying with respect to the time. Eight 11kV feeders are taken as a case study for our work to calculate load factor, loss factor and power losses. Four of them (F40, F42, F43 and F
... Show MoreThe aim of this research is to study the extent of the impact of government funding decisions on the financial performance of the directorate of Diyala province. The research problem was based on the financial reality of the directorate, and the data were collected from the financial divisions, planning and follow-up, implementation, and engineers of the resident engineer departments. Demonstrate the impact of government funding decisions on financial performance. Using scientific methods in estimating their financial needs through the annual estimated budget. The use of financial analysis to assess the performance of the Directorate, for the purpose of assessing the financial situation of the Directorate of research. The researc
... Show MoreBackground: Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by joint inflammation, involvement of exocrine salivary and lacrimal glands may occur as extra-articular mani¬festations in this disease. This study aimed to provide evidence of altered in function and composition of salivary gland in patients with rheumatoid arthritis by determine salivary flow rate and some biochemical parameters(total protein, amylase, peroxidase) and to investigate the relationship between disease activity and changes in function and composition of salivary gland. Materials and Methods: Fifty five patients with RA (7 males and 48 females) were enrolled in this study with age range (20-69) years. The patients were separated int
... Show MoreThe present paper attempts to find out the role of developmental loans in promoting strategic crops especially the basis stemming from the problem of non - defining economic feasibility study and the negative or positive revenues of developmental loans, directed to Iraqi Agricultural sector in general and Basic strategic crops in particular which resulted in the difficulty of planning and future prediction to grant loans agriculturally directed in terms of quality and quantity and the arbitrary of distributing these loans .the strategic crops have been selected as sample of population where the sample of Basic strategic crops include wheat and barley .The paper has come to several of conclusions mainly are as follows :- the increase in n
... Show MoreWalt Whitman adds a poetic twist to the relationship of man’s body, soul with the universe. His inspiration in writing his elegy, "When Lilacs Last in the Dooryard Bloom'd," draws on aesthetico-political resources. Major amongst these is his leaning towards the American Transcendentalist idea of the "Over-Soul". The basic topoi in his poems is thus his identification of nature with the soul of man. The idea of the Over-Soul sheds light on the three stages of human loss: suffering, despair, and compensation. Whitman witnessed two political events, the outbreak of the civil war and Abraham Lincoln's death, which were of a particular importance to his life and work: they helped him shape a form and thematic concerns of his own. Buil
... Show MoreTuberculosis (TB) still remains an important medical problem due to high levels of morbidity and mortality worldwide. A series of innate immune mechanisms that create a cytokine network control the pathogenesis of tuberculosis and this response has the capacity to modify the host genomic DNA structure through epigenetic mechanisms such as DNA methylation which could constantly alter the local gene expression pattern that can modulate the metabolism of the tissues and the immune-response. Interferon-gamma (IFN-γ) is an important pro-inflammatory cytokine regulator of the innate immune response to TB. This study aims to determine DNA methylation patterns of INF-γ gene promoter and measure serum IFN- γ level in newly diagnosed TB patient
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