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.
World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.
World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.
The study is concern on determine the type of Candida spp.in leukemia patients that were infected with oral candidiasis as a result to their immune suppression (weekend immune system) due to their submission to radiation and chemotherapy treatment. The result showed that the most common isolates were C. guillermondii 19 which represent 31.66% of cases, then followed by C. itermedia 11 which represent 18.3%, while the less common isolates were for C. zeylamodes 3 which represent 5%.
This research aims at identifying the communicative habits and content reflections on the communication process, especially the young audience which is one of the main group for whom the announcements are made. Because young people face life with passion and aspiration making them respond to each effect used by the media in the design of the advertising using all the effective techniques, attractive methods for young children like depending on drama, technical tricks, music and logos easily to be remembered and responded to the desires of the young in their entertainment. This research also aims at identifying the impact of the internet as a channel of commercial advertising on the purchasing behavior of young people at the universities
... Show MoreThis study was conducted in the Department of Employment and Loans at the Ministry of Labor and Social Affairs to indicate the importance and impact of both the empowerment and the functional flexibility in evaluating the performance of the employees. To achieve the objectives of the study, the data was collected through a questionnaire form designed for this purpose based on previous studies. Data obtained for a significant evaluation of the relationship between the components of both the empowerment and the functional flexibility with the components of the evaluation and determining the degree of importance of each component of both the empowerment and functional flexibility for the components of the evaluation by the extractio
... Show MoreImpact strength of self-compacted concrete is a field of interest, mostly when the concrete is produced from sustainable materials. This research's main objective is to clarify the ability to use two types of Portland limestone cement (Karasta and Tasluja) in self compacted concrete under impact loading, further to the economic and environmental benefits of the limestone cement. The impact loading was applied by a low-speed test, using the drop ball on concrete. Moreover, the study reveals the resistance of the grids reinforced concrete to impact loading by using polymer grid, and steel grid reinforced concrete slabs. Mixes reinforced by steel mesh had the highest results, indicating that the steel mesh was more robust because it had
... Show MoreIn this work, strains and dynamic crack growth were studied and analyzed in thin flat plate with a surface crack at the center, subjected to cycling low velocity impact loading for two types of aluminum plates (2024, 6061). Experimental and numerical methods were implemented to achieve this research. Numerical analysis using program (ANSYS11-APDL) based on finite element method used to analysis the strains with respect to time at crack tip and then find the velocity of the crack growth under cycling impact loading. In the experimental work, a rig was designed and manufactured to applying the cycling impact loading on the cracked specimens. The grid points was screened in front of the crack tip to measure the elastic-plas
... Show MoreMoney laundering is consider a crime in legal perspective and aphenomenon of negative effects in economic and Social perspective for thevarious countries of the world by the diversity of their economies to make thebadly damaged in the banking service and its reputation in some cases may leadto bankruptcy of banks, and the fact that banks is one of the most importantcircles that revolve the illicit funds, Due to its branched the banking operations,speed and overlap and increase it's complicated with the progress of bankingoperations and the use of electronic services modern here's challenges atvarious levels between the application of the legislation to combat moneylaundering and between actual fact it must find ways and means of legislat
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