Validation of the Arabic version of medication adherence report scale questionnaire and beliefs about medication -specific questionnaire: A factor analysis study

Medication Adherence Report Scale questionnaire (MARS-5) and the Beliefs about Medication Questionnaire-specific (BMQ-specific) are well known tools to assess adherence to medication and beliefs of chronic patients. However, validated Arabic versions of such questionnaires are lacking. We aim to validate the Arabic versions of BMQ-specific and MARS-5. In this study, a cross-sectional study was performed between November 2019 and March 2020. Participants were reached from secondary and tertiary care clinics in Jordan. Exploratory factor analysis (EFA) and Confirmatory Factor analysis (CFA) were conducted to validate the employed questionnaires on the tested sample. The internal consistency of the questionnaires was assessed by calculating Cronbach's alpha, and Cronbach's alpha if item is deleted. A total of 485 patients who met the inclusion criteria were recruited. The mean age of the participants was 57.14 years (22-82 years); and 39% of the participants were older than 65 years. The most common chronic diseases reported by participants were hypertension and diabetes mellitus, 35.7 and 32.2% respectively. EFA suggested two-factor model for BMQ-specific and one-factor model for MARS-5 which was confirmed by CFA analyses. The resulted Cronbach's alphas of the questionnaires ranged from 0.89-0.93. Both analyses showed that the Arabic versions of both MARS-5 and BMQ-specific are valid and can be used for the suggested study population. Further validation-based research may enhance the transcultural adaptation of such questionnaires

Composition of networks around entrepreneurs: Cross-national comparisons in the Middle East and North Africa

This paper investigates the composition of networks around entrepreneurs in the MENA region and how this composition differs amongst the 14 countries with regards to the size and diversity of the networks used at various stages of venture development. The findings indicate significant difference between entrepreneurs at various stages of venture development for network size and network diversity. The empirical results show that the more the network is diversified, the shorter the duration of the launch of the venture. The investigation also reveals that entrepreneurs with relative large networks are more likely to launch their business in a short time. Copyright © 2013 Inderscience Enterprises Ltd

Technological Innovation in the United Arab Emirates: Process and Challenges

© 2013, © 2013 Taylor and Francis Group, LLC. The purpose of this paper is to enhance our understanding about the current state of R&D in the UAE and its challenges through an exploratory case study of a technological innovation. The innovation process of the Emirati entrepreneur is similar to processes in other parts of the world, but there is no access to government research centers or public research available. The findings suggest that support is needed to increase the efficiency and effectiveness of technological innovation processes in the UAE

Evaluating patient education resources for supporting treatment decisions in latent tuberculosis infection

Objective: People with latent tuberculosis infection (LTBI) are required to make complex treatment decisions, which require an understanding of personal risk and associated benefits. However, many people with LTBI in the United Kingdom are at risk of low health literacy and can also experience language barriers, which can affect decision making. Patient education resources can support understanding but must meet the needs of the target population. The aim of this study was to evaluate the accessibility, readability and content of LTBI patient education resources. Design: Review and descriptive analysis of online LTBI patient education resources. Setting: UK-based online patient education resources. Method: We searched UK public health and charitable organisations for online LTBI patient education resources. Resources were evaluated in terms of accessibility (availability of translated versions); readability (Flesch–Kincaid Reading Ease [FKE], Flesch–Kincaid Grade Level [FKG] and Simplified Measure of Gobbledygook [SMOG]), theoretical content (Extended Common-Sense Model) and principles of shared decision making. Results: Seventeen out of 60 articles identified in the search met the prespecified criteria for inclusion. Translated materials were available for 7 of them. The overall mean ± SD readability scores and corresponding reading ages were FKE 63.51 ± 8.81 (13–15 years), FKG 9.14 ± 8.95 (13–15 years) and SMOG 8.27 ± 1.51 (13–14 years). No resources met Health Education England recommended readability levels for health-related information. Dimensions of cognitive representations of illness and treatment most commonly addressed included treatment control, cause and identity (symptom and label); no resources addressed emotional identity. Conclusion: Current and future LTBI patient education resources would benefit from greater consideration of the needs of non-English language speakers, readability and theoretical content to improve patient illness experience and support informed treatment decision making

Adherence to treatment in children and adolescents with cystic fibrosis:a cross-sectional, multi-method study investigating the influence of beliefs about treatment and parental depressive symptoms

Background: Adherence to treatment is often reported to be low in children with cystic fibrosis. Adherence in cystic fibrosis is an important research area and more research is needed to better understand family barriers to adherence in order for clinicians to provide appropriate intervention. The aim of this study was to evaluate adherence to enzyme supplements, vitamins and chest physiotherapy in children with cystic fibrosis and to determine if any modifiable risk factors are associated with adherence. Methods: A sample of 100 children (≤18 years) with cystic fibrosis (44 male; median [range] 10.1 [0.2-18.6] years) and their parents were recruited to the study from the Northern Ireland Paediatric Cystic Fibrosis Centre. Adherence to enzyme supplements, vitamins and chest physiotherapy was assessed using a multi-method approach including; Medication Adherence Report Scale, pharmacy prescription refill data and general practitioner prescription issue data. Beliefs about treatments were assessed using refined versions of the Beliefs about Medicines Questionnaire-specific. Parental depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results: Using the multi-method approach 72% of children were classified as low-adherers to enzyme supplements, 59% low-adherers to vitamins and 49% low-adherers to chest physiotherapy. Variations in adherence were observed between measurement methods, treatments and respondents. Parental necessity beliefs and child age were significant independent predictors of child adherence to enzyme supplements and chest physiotherapy, but parental depressive symptoms were not found to be predictive of adherence. Conclusions: Child age and parental beliefs about treatments should be taken into account by clinicians when addressing adherence at routine clinic appointments. Low adherence is more likely to occur in older children, whereas, better adherence to cystic fibrosis therapies is more likely in children whose parents strongly believe the treatments are necessary. The necessity of treatments should be reinforced regularly to both parents and children

Adherence to 6-Mercaptopurine in children and adolescents with Acute Lymphoblastic Leukemia

OBJECTIVE: Studies on children with Acute Lymphoblastic Leukemia (ALL) reported non-adherence in 2–54% of cases. The primary objective of this study was to assess rates of adherence to 6-MP using two different methods in children and adolescents with ALL. Secondary aim was to identify factors that influence adherence to 6-MP in children with ALL. METHODS: All eligible children with ALL who are (≤ 19) years old and receive 6-MP therapy for at least 1 month were approached to participate in the study. A total of 52 children with ALL and their primary caregivers were recruited. Adherence measures included an objective method (measuring 6-MP metabolites in packed Red Blood Cells (RBCs)) and a subjective method (using parent and child self-report via the Medication Adherence Report Scale; MARS; Adherence was defined as 90% or greater). RESULTS: Rates of adherence varied across the measurement methods. Packed RBCs sample analysis indicated forty-four patients (84.6%) to be adherent. Using the MARS questionnaires, a total of 49 children (94.2%) were classified as being adherent according to the parental MARS questionnaire scores, while all the 15 children (100%) who answered the MARS (child) questionnaire were classified as adherent. Overall adherence rate was 80.8% within the studied population. CONCLUSION: MARS scale was shown to overestimate adherence compared to measurement of 6-MP metabolites in the blood. A combination of both methods led to increased detection of non-adherence to thiopurine in children with ALL

Bridging the gap between high and low performing pupils through performance learning online analysis and curricula

Metacognition is a neglected area of investment in formal education and in teachers’ professional development. This paper presents an approach and tools, created by a London-based company called Performance Learning Education (PL), for supporting front-line teachers and learners in developing metacognitive competencies. An iterative process adopted by PL in developing and validating its approach is presented, demonstrating its value to real educational practices, it’s research potential in the area of metacognition, and its AI readiness, especially in relation to modelling learners’ non-cognitive competencies

Laboratory models for studying ectopic pregnancy

PURPOSE OF REVIEW: Understanding of the aetiology of tubal ectopic pregnancy (tEP) remains incomplete. We aim to summarize the latest advances in laboratory models of tEP that we believe will, ultimately, contribute to improving the diagnosis and management of the condition. RECENT FINDINGS: Progress in proteome pre-fractionation and multidimensional protein identification technology has proved particularly effective in identifying novel biomarkers of tEP. These, and related global proteomic and genomic approaches, have as yet to be fully exploited in this context but do have substantial potential to inform future hypothesis driven studies. The majority of data generated since 2009 to explain the aetiology of tEP continues to derive from descriptive human ex-vivo studies. In-vitro models of Fallopian tube ciliary and smooth muscle function have improved to a limited degree, on the back of continuing advances in imaging and data acquisition. We believe that the recent development of a primary human Fallopian tube epithelium culture system represents the most significant recent advance in laboratory models for studying ectopic pregnancy. There remain no good animal models of tEP. SUMMARY: The establishment of a viable animal model of tEP remains the key obstacle to a complete understanding the aetiology of the condition

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA