Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled in the deprescribing program. The median age was 51.5 years, 56.8% were males, and hypertension was the most common etiology for their chronic kidney disease (CKD); 78% had comorbidities. After deprescription, there was a significant reduction in the number of medications from 6.0 to 4.0 and a reduction in the number of pills from 7.0 to 5.0. Medication adherence accessed using the Arabic version of Morisky, Green, and Levine’s (MGL) adherence scale also had a significant reduction from 2.0 to 1.0. Conclusion: A pharmacist-led deprescribing program is a successful strategy for decreasing the number of medications and daily pills prescribed while simultaneously improving hemodialysis patients' adherence to their regimens without compromising the patient’s safety.
Since the emergence of the science of international relations as an independent academic scientific field, various theories and trends have appeared and have tried to understand and explain the international reality and give a clear picture of what is happening within the international system of interactions and influences and the search for tools for stability and peace in international relations. Among these theories is the feminist theory, which is a new intellectual trend on the level of international relations theories, which tried to give an explanation of what is happening in world politics and in international relations in particular. The main issue that feminist theory is concerned with is the lack of women’s subordination
... Show MoreIn this paper, third order non-polynomial spline function is used to solve 2nd kind Volterra integral equations. Numerical examples are presented to illustrate the applications of this method, and to compare the computed results with other known methods.
In this paper a stage structure prey-predator model with Hollimg type IV functional response is proposed and analyzed. The local stability analysis of the system is carried out. The occurrence of a simple Hopf bifurcation and local bifurcation are investigated. The global dynamics of the system is investigated with the help of the Lyapunov function. Finally, the analytical obtained results are supported with numerical simulation and the effects of parameters system are discussed. It is observed that, the system has either stable point or periodic dynamics.
Adsorption of lead ions from wastewater by native agricultural waste, precisely tea waste. After the activation and carbonization of tea waste, there was a substantial improvement in surface area and other physical characteristics which include density, bulk density, and porosity. FTIR analysis indicates that the functional groups in tea waste adsorbent are aromatic and carboxylic. It can be concluded that the tea waste could be a good sorbent for the removal of Lead ions from wastewater. Different dosages of the adsorbents were used in the batch studies. A random series of experiments indicated a removal degree efficiency of lead reaching (95 %) at 5 ppm optimum concentration, with adsorbents R2 =97.75% for tea. Three mo
... Show MoreProduction sites suffer from idle in marketing of their products because of the lack in the efficient systems that analyze and track the evaluation of customers to products; therefore some products remain untargeted despite their good quality. This research aims to build a modest model intended to take two aspects into considerations. The first aspect is diagnosing dependable users on the site depending on the number of products evaluated and the user's positive impact on rating. The second aspect is diagnosing products with low weights (unknown) to be generated and recommended to users depending on logarithm equation and the number of co-rated users. Collaborative filtering is one of the most knowledge discovery techniques used positive
... Show MoreIn this paper, chip and powder copper are used as reinforcing phase in polyester matrix to form composites. Mechanical properties such as flexural strength and impact test of polymer reinforcement copper (powder and chip) were done, the maximum flexural strength for the polymer reinforcement with copper (powder and chip) are (85.13 Mpa) and (50.08 Mpa) respectively was obtained, while the maximum observation energy of the impact test for the polymer reinforcement with copper (powder and chip) are (0.85 J) and (0.4 J) respectively
Rainwater harvesting could be a possible solution to decrease the consequences of water scarcity and energy deficiency in Iraq and the Kurdistan Region of Iraq (KRI). This study aims to calculate the water and energy (electricity) saved by rainwater harvesting for rooftops and green areas in Sulaimani city, KR, Iraq. Various data were acquired from different formal entities in Sulaimani city. Moreover, Google Earth and ArcMap 10.4 software were used for digitizing and calculating the total rooftop and green areas. The results showed that for the used runoff coefficients (0.8 and 0.95), the harvested rainwater volumes were 2901563 and 12197131 m³ during the study period (2005 – 2006) and (2019-2020). Moreover, by compa
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