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.
abstract
the research discussed a stage of strategic management. The strategic of the evaluation of the proposed strategy through feedback is to ensure that it is implemented with the least possible variation. The research aims at evaluation a proposed strategy for the Ministry of Planning for the years 2018-2022 in line with the orientations of the state, taking into account the surrounding environmental conditions. It relies on scientific bases and steps to formulate the strategy The extent of the strategy suitability was tested through a set of statistical means and its objectivity was verified through a survey of a number of specialized experts who were selected in accordance with the principle
... Show MoreIt is very necessary for the political theater to be within the space of every theatrical performance, so that the theater carries the diverse and enlightened values and cultures of this world. political theatre. In the first chapter, the researcher dealt with (the methodological framework), which includes the research problem identified by the researcher with the following question (the functional diversity of the directorial vision in the political theater)
Importance, purpose, limits and seal by defining terminology.
In the second chapter, the researcher dealt with the theoretical framework on two topics, the first (transformations of directorial vision in theatrical performance) and the second topic (aesthetic experiences i
Abstract.The goal of this article is to find the CEO of Iraqi companies that use strategic planning and determine if they are capable of diagnosing the traits of strategic planning systems that improve these companies' capacity to successfully address crisis-related needs. The capacity of the company to successfully react to crisis needs and demands is enhanced by the use of strategic planning, according to a review of data from 64 enterprises utilizing statistical analysis. Furthermore, top and division or unit managers must be involved and committed for strategic planning to be successful. It also has to be planned with an external orientation and get more than just lip service from top and unit or division level managers. In other words,
... Show MoreJet grouting is one of the most widely applied soil improvement techniques. It is suitable for most geotechnical problems, including improving bearing capacity, decreasing settlement, forming seals, and stabilizing slopes. One of the difficulties faced by designers is determining the strength and geometry of elements created using this method. Jet grouted soil-cement columns in soil are a complicated issue because they are dependent on a number of parameters such as soil type, grout and water flow rate, rotation and lifting speed of monitor, nozzle jetting force, and water to cement ratio of slurry. This paper discusses the effect of the water-cement ratio on the physical and mechanical characteristics of soilcrete. In t
... Show MoreUniversity Campuses, as any lively physical entity, is subject to continuous variation due to . growth, development and change. This reality covers the existing or futuristic additives or additions, consecutively these changes may have a strong sensation of disorientation as a result of formatic changes in buildings, or in movement paths. And it epitomized the research problem to "the need for knowledge to clarify the impact of intellectual and executive policy in achieving coherence, functional and space organization of the elements of the university urban environment and in the stages of future growth and change," the search targeted "to highlight the study of constraction politics on campus Bmqomad
... Show MoreMaximizing the water productivity for any agricultural system is considered an adaptation to the potential climate change crisis. It is required, especially in arid and semi-arid environments in Iraq. Therefore, this study assessed the potential impact of climate change on the different environments in the Qadissiya and Nineveh provinces. The ensemble of six GCM models employed for the regional climate model of the HCLIM-ALADIN in high-resolution 10*10 km2 and Aqua-Crop was used to examine the response of water productivity and yield of winter wheat. With and without CO2 concentration changing under different water regimes in the near term (2020-2040
Objective: to assessthe impact of psychological and social climacteric changes on quality of life among
middle age women in Baghdad city
Methodology: : A descriptive analytic study was conducted to study the quality of life among middle age
women due topsychological and social climacteric changes from February 2013- July 2013. A purposive
sampleconsisted of three hundred (300) womenaged (40-65) years who were attending health centers in two
sectors in Baghdad / AL- Russafa andAL- karhk . The data were collected through using interview technique ,
and questionnaire format , which comprises two parts, first part consist (socio-demographic characteristic , the
second part quality of life domains (psychological and socia
To develop a petrol engine so that it works under the bi-engine pattern (producer gas-petrol) without any additional engine modifications, a single-point injection method inside the intake manifold is a simple and inexpensive method. Still, it leads to poor mixing performance between the air and producer gas. This deficiency can cause unsatisfactory engine performance and high exhaust emissions. In order to improve the mixing inside the intake manifold, nine separate cases were modelled to evaluate the impact of the position and angle orientation inside the intake manifold on the uniformity and spread of the mixture under AFR=2.07. A petrol engine (1.6 L), the maximum engine speed (8000 rpm), and bi-engine mode (petrol-producer ga
... Show MoreA mathematical method with a new algorithm with the aid of Matlab language is proposed to compute the linear equivalence (or the recursion length) of the pseudo-random key-stream periodic sequences using Fourier transform. The proposed method enables the computation of the linear equivalence to determine the degree of the complexity of any binary or real periodic sequences produced from linear or nonlinear key-stream generators. The procedure can be used with comparatively greater computational ease and efficiency. The results of this algorithm are compared with Berlekamp-Massey (BM) method and good results are obtained where the results of the Fourier transform are more accurate than those of (BM) method for computing the linear equivalenc
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