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Home > The Influence of Depression on Adherence to Antiretroviral Therapy Among Hiv Infected Patients at Aga Khan University Hospital Nairobi

The Influence of Depression on Adherence to Antiretroviral Therapy Among Hiv Infected Patients at Aga Khan University Hospital Nairobi

Thesis Info

Author

Karanja-Mbugua, Evelyn W.

Department

Internal Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2011

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728072252

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Aim: To determine the influence of depression on adherence to antiretroviral (ARV) therapy among HIV-infected patients. Design: Cross-sectional survey Patients: One hundred and forty HIV-positive patients on treatment with Combination Antiretroviral Therapy selected from the out-patient department of Aga Khan University Hospital took part in the survey. Methodology: Every third patient who was eligible was assessed for adherence to antiretroviral therapy using The Adult AIDS Clinical Trial Group follow up adherence questionnaire followed by screening for depression using the Patient Health Questionnaire 9. Pharmacy data was then retrieved for the same patients and used to assess adherence by the medication possession ratio. The data was then analysed using SPSS and chi square was calculated for relationships between adherence and depression. Odds ratio was also calculated for the risk of depression in the non-adherent group compared to the adherent group. Results: Fifteen patients did not have any pharmacy data available. Sixty five patients had medication possession ratios of >95% indicating good adherence. Sixty patients had medication possession ratios <95% indicating sub-optimal and poor adherence.30% of non-adherent patients were found to have depressive symptoms as compared to 23% in the adherent group. Although this did not reach significant levels, patients who were non-adherent were 1.3 times more likely to be depressed. On multivariate analysis there was no significant association between depression and levels of adherence. There was however a significant association between cash payment for medication and higher viral loads (p= 0.029). Conclusion: This study did not show a significant association between depression and adherence to antiretroviral therapy.
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جس رزق سے آتی ہو پرواز میں کوتاہی

جس رزق سے آتی ہو پرواز میں کوتاہی
خود داری حیات نے جُھکنے دیا نہ سر
حسرت سے اُن کا نقشِ قدم دیکھتے رہے
یہ کائنات جو رنگارنگ مظاہر فطرت سے بھری پڑی ہے ، اس میں ہمیں فلک بوس پہاڑ نظر آرہے ہیں، کہیں کشت ِزعفران بنے کھلیان و کھیت نظر آرہے ہیں، کہیں پیچ و بل کھاتی ہوئی ندیاں اور نہریں نظر آرہی ہیں۔ پہاڑوں سے میٹھے اور ٹھنڈے چشمے نکل کر اس کے حسن کو دوبالا کر رہے ہیں ہر ذی روح کے لیے اس کا رزق مقرر ہے جو اس نے متعین مدت تک حاصل کرنا ہے اور پھر داعی اجل کو لبیک کہہ کر اپنی جان جانِ آفریں کے سپرد کرنی ہے۔ مقررہ کردہ رزق جس کا تعین اس خالق حقیقی کی طرف سے کر دیا گیا ہے اور جس کا ذمہ اس رازقِ کائنات نے لے رکھا ہے وہ تو ہر صورت میں ملنا ہے۔ ’’زمین پر کوئی شے ایسی نہیں ہے جس کے رزق کا ذمہ اللہ تعالیٰ نے خودنہ لے رکھا ہو‘‘ (القرآن)
فضاؤں میں محو پرواز طائرِ خوش الحان بھی اپنارزق حاصل کر رہا ہے ،منبر رسول صلی اللہ علیہ و آلہٖ وسلمپر بیٹھ کر واعظ شیریں بیان بھی اپنارزق حاصل کر رہا ہے، ظلمات ِشب میں سیاہ پتھر پر رینگنے والے کیڑے مکوڑے بھی اپنارزق حاصل کرتے ہیں، آفتاب کی کرنوں سے خائف چمگادڑ بھی اپنے پیٹ کی آگ بجھا کر سوتی ہے۔ شاہین پرواز کی بلندیوں پراپنا رزق حاصل کرتا ہے اور گدھ مردار کے پاس بیٹھ کر اپنارزق حاصل کرتا ہے، کسان ہل چلا کر، پانی لگا کر اور رات سانپ کے سروں کو مسل کر اپنا رزق حاصل کرتا ہے اور راہزن لوٹ مار اور غارتگری سے اپنا رزق حاصل کرتا ہے، قاضی کرسی منصب پر بیٹھ کر اپنا رزق حاصل کرتا ہے...

Analisis Keputusan Pembelian Masyarakat Muslim Pada Mie Instan Lemunilo Di Kota Bagansiapiapi

Keputusan pembelian adalah keputusan final konsumen untuk membeli atau tidaknya suatu barang dan jasa dengan membandingkan banyak pertimbangan. Ketika melakukan keputusan pembelian, seringkali terdapat beberapa pilihan antara dua atau lebih alternatif. Ada pun tujuan dilakukannya penelitian ini untuk menganalisa Pengaruh  Word Of Mouth, Labelisasi Halal, Dan Celebrity Endorser Terhadap Keputusan Pembelian Mie Lemonilo Pada Masyarakat Muslim di Kota Bagansiapiapi . Populasi dalam penelitian ini berjumlah 100 orang Masyarakat Muslim dengan menggunakan metode purposive sampling. Berdasarkan hasil peneltian ini menunjukkan bahwa Word Of Mouth, Labelisasi Halal, Celebrity Endorser berpengaruh terhadap keputusan pembelian baik secara parsial maupun simultan. Hasil Koefisien Determinasi (R2) menunjukkan bahwa besarnya pengaruh dari ketiga variabel bebas secara bersama-sama  terhadap variabel terikatnya sebesar 52,7% dan sisanya sebesar 47,3% merupakan variabel lain yang tidak diteliti kedalam penelitian ini.

Transcendence of Behavioral Finance in Corporate Financial Decisions and its Impact on Corporate Performance: Evidence from Emerging Economies

Prior major studies in the field of corporate finance have centered on financial decisions and corporate performance. While studying the corporate performance and financial decision patterns, classical finance assumes that managers are rational and self-interested in their decision-making. However, behavioral finance contradicts this idea and provides evidence of irrationality in corporate decisions. For this purpose, our study investigated the effect of behavioral biases of corporate finance managers (i.e., self-serving, overconfidence, optimism, anchoring & representativeness, loss aversion and mental accounting) on three facets of corporate financial decisions (i.e. capital structure, dividend policy and working capital management), and how the corporate performance is affected by these financial decisions. This study also focused on the conditional impact of risk perception, financial literacy, and managerial skills on financial decisions of corporate finance managers. For the contextual contribution, the emerging economies like Pakistan, Malaysia, and Turkey have been chosen for the cross-country comparison. This study used primary data to address research questions. Questionnaire items were adapted from different authors, pilot tested and rephrased for numerous validity and reliability measures. The unit of analysis in this cross-sectional study was the financial decision makers of the corporate sector. The results of this study concluded that overconfidence, optimism, anchor/representative and mental accounting bias have a positive impact on risk perception. However, loss aversion bias has a negative impact on risk perception. These relations are significant for all countries except loss aversion bias which is not significant for Malaysia. Self-serving bias has no impact on risk perception and overconfidence. This finding is consistent for all three counties. Risk perception negatively impacts on dividend policy decisions, positively impacts on the capital structure and working capital management decisions. Dividend policy and working capital management positively while capital structure negatively impacts the corporate performance. These results are also consistent with all three counties. Overall results concluded that the behaviorally biased managers impact corporate financial decisions. The results of the moderation of financial literacy and managerial skills indicated that the moderating effect of financial literacy on the relationship of self-serving and anchoring bias with risk perception is not significant for all countries. Financial literacy is moderating the relationship of risk perception with overconfidence and mental accounting for all countries. The moderating effect of financial literacy with optimism on risk perception is supported for Pakistan and Malaysia, however, not supported for Turkey. The moderating impact of financial literacy with loss aversion bias on risk perception is supported only in Pakistan. The moderation of managerial skills on the relationship of risk perception and the corporate financial decision is not found significant for Pakistan, Malaysia, and Turkey. However, it is only significant in the relationship of risk perception and capital structure decisions of Turkey. The risk perception fully mediates the relationship of overconfidence and capital structure while partial mediates with dividend policy and working capital management. The mediation of risk perception between self-serving and financial decisions is not significant for all counties. Moreover, it partially mediates the relationship of optimism and financial decisions while it fully mediates for anchoring for all three countries. Risk perception is not mediating the relationship of loss aversion and financial decisions in Malaysia while partially mediates for Pakistan and Turkey. Overall the mixed results show that in general, risk perception mediates the relationship of behavioral biases and corporate financial decisions. The comparison of family vis-à-vis non-family owned companies reveals that in family-owned companies, the effect of behavioral biases is escalating and vice versa. Owing to the scarce evidence in the literature, this study not only contributes to the existing literature on behavioral aspects but opens some new horizon to understand the behavior of corporate managers of developing countries. This study tries to provide the opportunity for a better understanding of the heteroskedastic policies and decisions of individuals and groups. Based on results and discussion of the study, the policymakers are strongly recommended to look beyond the classical facets by focusing psychological aspects while hiring finance managers with desired experience, personality, management style, and problem-solving skills.