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.
In today’s competitive environment, organizational efficiency and sustained growth are crucial for survival. The performance of an organization is intricately connected to strategic planning, prompting firms to gather and leverage competitive information for a competitive advantage. Senior managers, recognizing this, initiate actions accordingly. This study aims to investigate the relationship between foresight, vision, strategic partnerships, motivation, system thinking, and organizational performance. Data, gathered through a self-administered questionnaire from various textile units, were analysed using structural equation modelling (SEM). The findings indicate that sub-constructs of strategic intelligence positively impact organizatio
... Show MoreIn Production and Operations Management the specialists have tried to develop a strategy to counter the risks arising from the activities of the organization and of waste of various types and therefore the risk management in the contemporary framework represents a phenomenon of new quality, and can not be this phenomenon to take practical dimensions, but the development of culture of the organization towards the risks and deal with all aspects and paint ways to address them within an integrated program, and requires new skills and systems provide accurate information capable of coordination between the various parties within the organization.
The research aims to develop a blu
... Show MoreThe aim of this paper to study the effect of the implicit factors on the entrepreneurial spirit of the students of the Algerian university. Our structural model was proposed based on the model (Shapiro et Sokol, 1982) and the model (Ajzen, 1991). We tested it on a sample of 163 university students at the University of Algiers 3. The model consists of a set of variables (the intention of contracting as a dependent variable, structural and social educational support as independent variables). The results showed that educational and social support factors affect the entrepreneurial spirit of students more than structural support. The Applied Impacts are the enhancing of knowledge capacities of university stu
... Show MoreZygapophyseal joints (or facet joints), are a plane synovial joint which located between the articular facet processes of the vertebral arch which is freely guided movable joints. Ten dried vertebrae were used for the lumbar region and taking (L4) as a sample to reveal stress pathways across the joints by using ANSYS program under different loading conditions which used Finite Elements Analysis model. Results obtained from the ANSYS program are important in understanding the boundary conditions for load analysis and the points of stress concentration which explained from the anatomical point of view and linked to muscle and ligament attachments. This model used as a computational tool to joint biomechanics and to prosthetic im
... Show MoreBackground: Impacted teeth are frequent problem and one of the most affected teeth is the maxillary canine. The early diagnosis of impacted canines by radiographic evaluation is imperative. The aim of this study was to determine the prevalence of impacted maxillary canines in patients attending the Oral diagnosis and Radiology clinic in College of Dentistry, University of Al-Basrah. Materials and Methods: 1280 patients attending the Oral Diagnosis and Radiology clinic in College of Dentistry University of Al-Basrah, between October 2013 and March 2015 were examined for the study. The age of the patients ranged from 15 to 55 years, with a mean age of 22.2 years. Results: The prevalence for maxillary impacted canines in all the cases was fo
... Show MoreObjective(s): To determine the impact of instructional intervention program upon psychological health status for
women who undergo chemotherapy after mastectomy
Methodology: The sample consisted of (100) women, (50) considered as study group, and another (50) the control
group. A pre test was done for both groups (study and control), and then the study samples were exposed to an
instructional intervention and three-dimensional post tests and the length of time between each test 21 days in
the Institute and Hospital of Radiation and Nuclear Medicine. The questionnaire composed of three parts, first,
demographic information; include (age, educational level, type of family, occupation, marital status, and adequacy
of mo
The current work aims to evaluate the association between genetic mutations in thymidylate synthetase (
Quantum key distribution (QKD) provides unconditional security in theory. However, practical QKD systems face challenges in maximizing the secure key rate and extending transmission distances. In this paper, we introduce a comparative study of the BB84 protocol using coincidence detection with two different quantum channels: a free space and underwater quantum channels. A simulated seawater was used as an example for underwater quantum channel. Different single photon detection modules were used on Bob’s side to capture the coincidence counts. Results showed that increasing the mean photon number generally leads to a higher rate of coincidence detection and therefore higher possibility of increasing the secure key rate. The secure key rat
... Show MoreThe increasing complexity of assaults necessitates the use of innovative intrusion detection systems (IDS) to safeguard critical assets and data. There is a higher risk of cyberattacks like data breaches and unauthorised access since cloud services have been used more frequently. The project's goal is to find out how Artificial Intelligence (AI) could enhance the IDS's ability to identify and classify network traffic and identify anomalous activities. Online dangers could be identified with IDS. An intrusion detection system, or IDS, is required to keep networks secure. We must create efficient IDS for the cloud platform as well, since it is constantly growing and permeating more aspects of our daily life. However, using standard intrusion
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