Factors affecting adherence to statins in hypercholesterolemic Kuwaiti patients: A cross-sectional study

Objective: This study examined statin adherence amongst Kuwaiti hypercholesterolemic patients in order to identify factors associated with poor adherence and to determine whether or not an association exists between statin adherence and the risk profile of coronary heart disease (CHD). Subjects and Methods: Two hundred hypercholesterolemic patients (30-69 years of age) were recruited from Kuwaiti primary healthcare clinics and interviewed about demographic characteristics, pre-existing self-reported medical conditions and prescribed medications. The Morisky Medication Adherence Scale was used to assess statin adherence (a self-reported, medication-adherence questionnaire divided into 3 levels, with a score of 8 denoting high adherence, 6 to 50 years) [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.09] for every extra year; p < 0.01). Those without diabetes, i.e. 113 (56.5%), were less likely to report medium adherence than those with diabetes (OR 0.42; 95% CI 0.23-0.75; p < 0.01). Low statin adherence was associated with higher levels of plasma cholesterol (p < 0.001) and low-density lipoprotein (p < 0.01). Conclusion: In this study, there was a high prevalence of low statin adherence, especially among younger patients with fewer concomitant diseases. The results indicated an inverse relationship between statin adherence and CHD risk profile

Computation of Greeks under rough Volterra stochastic volatility models using the Malliavin calculus approach

Using Malliavin calculus techniques we obtain formulas for computing Greeks under different rough Volterra stochastic volatility models. In particular we obtain formulas for rough versions of Stein-Stein, SABR and Bergomi models and numerically demonstrate the convergence

Social and Economic Challenges of Implementing Sustainable Materials on Buildings in Kuwait

Many factors affect attaining the required credits for LEED materials and Many factors affect attaining the required credits for LEED materials and resources (MR) section. There are disadvantages in obtaining credits and LEED certifying an existing building in Kuwait to become a sustainable green building. LEED is still relatively new in Kuwait and the Gulf region, therefore, when certifying an existing governmental building, difficultly is faced with obtaining complete building owners, building upper management and occupant cooperation. This raises challenges when requiring cooperation from building occupants and cleaning staff for the solid waste management credits which require dedication to reduce the amount of waste going to landfills and incinerating facilities. The mindset of the contractor and subcontractor has to change to gain full understanding and cooperation in the waste management of construction materials when constructing new buildings and performing facility alterations on site. The selection of sustainable materials is more challenging as many materials are not available in Kuwait and the surrounding Gulf countries. Transportation from aboard should be decreased as much as possible to reduce cost as well as decreasing negative environmental impacts. Green certified materials are more expensive, therefore decision maker have to be willing to pay the extra cost. This paper discusses the challenges faced by KISR team as a consultancy body to certify an existing building according to LEED rating system from the material and resources aspect. It discusses the acceptance of the building owners, building upper management and the building occupants to this change and their understanding and cooperation. Many materials for MR credits 2 and 3 were found difficult to be obtained in Kuwait and the surrounding gulf region. Some materials were found to be available in the resources (MR) section. There are disadvantages in obtaining credits and LEED certifying an existing building in Kuwait to become a sustainable green building. LEED is still relatively new in Kuwait and the Gulf region, therefore, when certifying an existing governmental building, difficultly is faced with obtaining complete building owners, building upper management and occupant cooperation. This raises challenges when requiring cooperation from building occupants and cleaning staff for the solid waste management credits which require dedication to reduce the amount of waste going to landfills and incinerating facilities. The mindset of the contractor and subcontractor has to change to gain full understanding and cooperation in the waste management of construction materials when constructing new buildings and performing facility alterations on site. The selection of sustainable materials is more challenging as many materials are not available in Kuwait and the surrounding Gulf countries. Transportation from aboard should be decreased as much as possible to reduce cost as well as decreasing negative environmental impacts. Green certified materials are more expensive, therefore decision maker have to be willing to pay the extra cost. This paper discusses the challenges faced by KISR team as a consultancy body to certify an existing building according to LEED rating system from the material and resources aspect. It discusses the acceptance of the building owners, building upper management and the building occupants to this change and their understanding and cooperation. Many materials for MR credits 2 and 3 were found difficult to be obtained in Kuwait and the surrounding gulf region. Some materials were found to be available in th

Wasserstein bounds in CLT of approximative MCE and MLE of the drift parameter for Ornstein-Uhlenbeck processes observed at high frequency

This paper deals with the rate of convergence for the central limit theorem of estimators of the drift coefficient, denoted $\theta$, for a Ornstein-Uhlenbeck process $X \coloneqq \{X_t,t\geq0\}$ observed at high frequency. We provide an Approximate minimum contrast estimator and an approximate maximum likelihood estimator of $\theta$, namely $\widetilde{\theta}_{n}\coloneqq {1}/{\left(\frac{2}{n} \sum_{i=1}^{n}X_{t_{i}}^{2}\right)}$, and $\widehat{\theta}_{n}\coloneqq -{\sum_{i=1}^{n} X_{t_{i-1}}\left(X_{t_{i}}-X_{t_{i-1}}\right)}/{\left(\Delta_{n} \sum_{i=1}^{n} X_{t_{i-1}}^{2}\right)}$, respectively, where $t_{i} = i \Delta_{n}$, $i=0,1,\ldots, n$, $\Delta_{n}\rightarrow 0$. We provide Wasserstein bounds in central limit theorem for $\widetilde{\theta}_{n}$ and $\widehat{\theta}_{n}$.Comment: arXiv admin note: text overlap with arXiv:2102.0481

The Effect Of Curriculum Organization On The Acquisition Of Abstract Declarative Knowledge In Computer Based Instructions.

The United States of America has dropped behind many countries in terms of the Science and Engineering university degrees awarded since the beginning of the nineties. Multiple studies have been conducted to determine the cause of this decline in degrees awarded, and try to reverse the trend in US education. The goal of these studies was to determine the proper instructional methods that facilitate the knowledge acquisition process for the student. It has been determined that not one method works for all types of curriculum, for example methods that have been found to work effectively in curriculum that teaches procedures and physical systems often fail in curriculum that teaches abstract and conceptual content. The purpose of this study is to design an instructional method that facilitates teaching of abstract knowledge, and to demonstrate its effectiveness through empirical research. An experiment including 72 undergraduate students was conducted to determine the best method of acquiring abstract knowledge. All students were presented with the same abstract knowledge but presented in different types of organization. These organization types consisted of hierarchy referred as Bottom Up, Top Down, and Unorganized. Another factor that was also introduced is Graphing, which is a method that is believe to improve the learning process. The experiment was completed in 8 weeks and data was gathered and analyzed. The results strongly suggest that abstract knowledge acquisition is greatly improved when the knowledge is presented in a Bottom Up hierarchical fashion. On the other hand, neither Graphing nor the Top Down or Unorganized conditions affect learning in these novice students. iv This dissertation is dedicated to my parents who established my education career since the beginning of my first day of school. Their prayers and encouragements have an impact toward my life and education

Dietary, Physical Activity and Other Lifestyle Habits and their Associations with Medication Adherence in a Group of Hypercholesterolemic Patients Prescribed Statin Therapy in Kuwait

The growing epidemic of coronary heart disease (CHD) is evident worldwide, accounting for global mortality rates of approximately 7.2 million per year. Coronary heart disease causes are multi-factorial encompassing both intrinsic and extrinsic factors; including age, gender, genetics, diet, physical activity, obesity, psychology, smoking and alcohol intake. Serum low density lipoprotein (LDL), an underlying consequence mainly of poor dietary habits, is strongly associated with increased risk of developing CHD and therefore a major target for CHD risk reduction strategies. Although intrinsic factors such as age, gender and genetics cannot be controlled or corrected, modifiable factors (extrinsic) can be managed and thus CHD risk may be reduced. Prescription of lipid-lowering drugs such as statins (3-hydroxy-3-methyl-glutaryl-CoA reductase or HMG-CoA inhibitors) has significantly increased due to their LDL-cholesterol lowering properties, where subsequently CHD risk may be reduced. There is little doubt in the efficacy of these drugs; the effectiveness however, is the issue in question. Various studies have reported up to 55% non-adherence to statin medications, after 6 months of treatment. It is important to recognize that once statin adherence subsides in these patients, risk reduction is dependent on the alternative concomitant therapies (diet, physical activity, maintenance of weight and smoking cessation), which may or may not have been implemented by the patient. Therefore the goal of this study was investigate the degree of adherence to statin medication, and alternative concomitant behaviours and examine whether an association exists between these various coronary risk reduction factors and overall CHD risk profile.Thesis (PhD Doctorate)Doctor of Philosophy (PhD)School of Public HealthGriffith HealthFull Tex

An In Vitro Comparison of Cyclic Fatigue of Profile® Vortex™ and Endosequence™ Rotary Nickel-Titanium Files

The purpose of this study was to determine the number of rotations to fracture (cyclic fatigue) of the Profile® Vortex™ files (Dentsply Tulsa Dental Specialties, Tulsa, OK) compared to the EndoSequence™ files (Brasseler USA, Savannah, GA) using an in-vitro apparatus simulating a curved canal. Two hundred Profile® Vortex™ files of 25mm length were divided equally into ten groups, one for each of the Profile® Vortex™ files 20/0.04, 20/0.06, 25/0.04, 25/0.06, 30/0.04, 30/0.06, 35/0.04, 35/0.06, 40/0.04, and 40/0.06. Two hundred EndoSequence™ files of 25mm length were divided equally into ten groups of the same tip and taper sizes analogous to the Profile® Vortex™ file groups. Files were rotated at 500 rpm in a fixed groove in the metal block of the apparatus. The angle of deflection for all files was fixed at 33 degrees, determined using the Schneider method. The time from initiation of rotation to fracture was recorded and rotations to fracture were calculated. The data collected was analyzed using a multi-way ANOVA, followed by specific post-hoc contrasts comparing the two brands for each tip and taper combination. The results demonstrated that the Profile® Vortex™ files required significantly greater rotations to fracture than the EndoSequence™ (p \u3c 0.001) in all tip sizes in both 0.04 and 0.06 tapers. Profile® Vortex™ files exhibited a greater resistance to cyclic fatigue than the EndoSequence™ files