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.
This paper is mainly concerned with the study of the moral aspects that prompts William Shakespeare to attempt a romance in which he has embedded the epitome of his thought, experience, and philosophy concerning certain significant aspects of human life whose absence or negligence may threaten human existence, peace, and stability. From the beginning of history man realizes the importance of prosperity on the many and various levels that touch and address his needs and desires—natural, material, and spiritual. The Tempest, due to the dramatist's awareness of the aforementioned values, reflects the dramatist's duty as to projecting and unfolding these important aspects, rec
... Show MoreThe importance of television has emerged as an effective and influential force in the lives of societies and peoples, And not just a professional media since the fifties of the twentieth century, It was used as a platform to achieve the goals and objectives of the media and politics for governments, agencies and individuals in different countries of the world, Using many methods, methods and techniques that later became important major subjects and curricula and a scientific specialization that was founded for him to study and teach in most international universities, The media, especially television and satellite channels, play an active and significant role in managing crises and conflicts and directing them through the methods of deal
... Show MoreThis paper is mainly concerned with the study of the moral aspects that prompts William Shakespeare to attempt a romance in which he has embedded the epitome of his thought, experience, and philosophy concerning certain significant aspects of human life whose absence or negligence may threaten human existence, peace, and stability. From the beginning of history man realizes the importance of prosperity on the many and various levels that touch and address his needs and desires—natural, material, and spiritual. The Tempest, due to the dramatist's awareness of the aforementioned values, reflects the dramatist's duty as to projecting and unfolding these important aspects, reconciliation and forgiveness, that promote prosperity which is th
... Show MoreDeep submicron technologies continue to develop according to Moore’s law allowing hundreds of processing elements and memory modules to be integrated on a single chip forming multi/many-processor systems-on-chip (MPSoCs). Network on chip (NoC) arose as an interconnection for this large number of processing modules. However, the aggressive scaling of transistors makes NoC more vulnerable to both permanent and transient faults. Permanent faults persistently affect the circuit functionality from the time of their occurrence. The router represents the heart of the NoC. Thus, this research focuses on tolerating permanent faults in the router’s input buffer component, particularly the virtual channel state fields. These fields track packets f
... Show MoreAbstract: Stars whose initial masses are between (0.89 - 8.0) M☉ go through an Asymptotic Giant Branch (AGB) phase at the end of their life. Which have been evolved from the main sequence phase through Asymptotic Giant Branch (AGB). The calculations were done by adopted Synthetic Model showed the following results: 1- Mass loss on the AGB phase consists of two phases for period (P <500) days and for (P>500) days; 2- the mass loss rate exponentially increases with the pulsation periods; 3- The expansion velocity VAGB for our stars are calculated according to the three assumptions; 4- the terminal velocity depends on several factors likes metallicity and luminosity. The calculations indicated that a super wind phase (S.W) developed on the A
... Show MoreTo observe the effect of media of the internal pressure on the equivalent stress distribution in the tube, an experimental study is done by constructing a testing rig to apply the hydraulic pressure and three dies are manufactured with different bulging configurations (square, cosine, and conical). In the other part, ANSYS APDL is generated to analyze the bulging process with hydraulic and rubber (natural and industrial) media. It was found that when the media is a rubber, the stress is decreased about 9.068% in case of cosine die and 5.4439% in case of conical die and 2.8544% in case of square die. So, it can be concluded that the internal pressure in the rubber media is much better than in hydraulic media. Also, the force needed for fo
... Show MoreSurfaces quality is one of the most specified customer requirements for machine parts. The major indication of surfaces quality on machined parts is surface roughness. The research aim is to study the cutting conditions and their effects on the surface roughness. This paper utilizes regression models to predict surface roughness over the machining time for variety of cutting conditions in turning. In the experimental part for turning, different types of materials (Aluminum alloy, Copper alloy, and Gray cast iron) were considered with different cutting speed ( ) and feed rate ( ). A mathematical Model depending on statistical-mathematical method between surface roughness (Rz ) and cutting condition ( , ) were derived, for the three materials
... Show MoreRadiotherapy is medical use of ionizing radiation, and commonly applied to the cancerous tumor because of its ability to control cell growth. The amount of radiation used in photon radiation therapy called dose (measured in grey unit), which depend on the type and stage of cancer being treated. In our work, we studied the dose distribution given to the tumor at different depths (zero-20 cm) treated with different field size (4×4- 23×23 cm). Results show that the deeper treated area has less dose rate at the same beam quality and quantity. Also it has been noted increasing in the field increasing in the depth dose at the same depth even if the radiation energy is constant. Increasing in radiation dose attributed to the scattere
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