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.
The present study attempts to examine verbal/nonverbal impoliteness in the classroom interaction and outside it in one of the movies, namely, The Marva Collins. Impoliteness, which is significantly studied within pragmatics, is a negative attitude towards particular behaviors. It always presumes to have emotional concerns for at least one participant who has caused it. This study is an attempt to examine verbal/nonverbal impoliteness in The Marva Collins movie. The study aims to investigate the different types of impoliteness strategies used in the four selected scenes and find out whether the speaker’s status has anything to do with the types of impoliteness. Besides, the functions performed are also examined by following a qual
... Show MoreThe subject of this study is one of the most interactive media networks, which is the Instagram.The study uses a descriptive approach and focuses on how Instagram turns from a media tool to a marketing tool. The study problematic consists of this question: How Instagram turns to a marketing tool, and what are the advantages and the disadvantages for that?This study highlights the definition of Instagram, the creation of it and its improvement, the Instagram in Bahrain, the Instagram uses, the Instagram as a marketing tool, and the advantages and disadvantages of using Instagram for marketing.The study confirms that Instagram is a new media network, and focuses on how it develops on later stages and mentions the increase of the percentage
... Show MoreThe research aims to show the impact that the information of the supporting bodies can have and its dimensions represented by (information credibility, efficiency and effectiveness of information, cooperation with the tax administration, obligating the taxpayer, accuracy and completeness of information and the appropriate time) in tax inventory, as well as clarifying the moral differences in The response of the surveyed sample according to the personal variables represented by (gender, educational attainment, scientific specialization, job title, years of service), and the descriptive analytical approach was adopted and in light of it, the questionnaire was designed as a main tool in collecting data from the sample of (80)
... Show MoreThe current study aims to identify the feeling of job alienation and organizational commitment among free lecturers in secondary schools, as well as to identify the significance of the differences in the feeling of job alienation according to the gender and the significance of the differences in organizational commitment according to the gender. It also aims to identify the correlation between the feeling of job alienation and organizational commitment. To achieve the objectives of the research, the researcher developed two scales: one consisted of (24) items to measure the vacancy in job alienation and the other consisted of (24) items to measure the organizational commitment. The two tools were applied to a sample of (200) male and fem
... Show MoreA significant influence of temperature width found on the vanadium oxide properties, it plays a major role in highlighting the thermal limits of the three phases (metallic, semiconductor, and dielectric). Two values of the temperature width , and , had taken and studied their effect on both the dielectric constant and its two parts; refractive index, and extinction coefficient, and. It found that: as the temperature width is greater, the more the properties of the three phases for . In addition to increasing the thermal range for phases which can be reached to when , while it's at . Our results have achieved great compatibility with the published results globally. In addition to the effect of both ultraviolet, visible, and infrared
... Show MoreGypsum is one of the important construction materials in Iraq in plastering surfaces and gypsum board , the ability of gypsum to give a comfortable an aesthetic ambiance as a construction material increase the need of gypsum , The particle size , total surface area and particle size distribution were factors affecting plaster properties used for construction properties . In this study gypsum paste was used with different mixing ratios of particle size and studied the physical properties of these types of pastes named (standard consistency ,setting time ,density) and compressive strength . The results showed that the water to gypsum ratio increased with increasing the fineness of the gypsum to (0.75%) and the setting time to the maxi
... Show MoreThis research was to determine the effect of rare earth metal (REM) on the as-cast microstructure of Mg-4Al alloy. The rare earth metal used here is Lanthanum to produce Mg-4Al-1.5La alloy. The microstructure was characterized by optical microscopy. The phases of this alloy were identified by X-ray diffraction. The microstructure of Mg-4Al consists of α-Mg and grain boundaries with precipitated phase particles. With the addition of Lanthanum, three distinct phases were identified in the X-ray diffraction patterns of the as cast Mg-4Al-1.5La: Mg, Al11La3, Al4La. The Mg17Al12 phase was not detected. The addition of Lanthanium increases the hardness and dec
... Show MoreThis paper deals with prediction the effect of soil re-moulding (smear) on the ultimate bearing capacity of driven piles. The proposed method based on detecting the decrease in ultimate bearing capacity of the pile shaft (excluding the share of pile tip) after sliding downward. This was done via conducting an experimental study on three installed R.C piles in a sandy clayey silt soil. The piles were installed so that a gap space is left between its tip and the base of borehole. The piles were tested for ultimate bearing capacity according to ASTM D1143 in three stages. Between each two stages the pile was jacked inside the borehole until a sliding of about 200mm is achieved to simulate the soil re-moulding due to actual pile driving. The re
... Show MoreThis research of using Feldspar in the production self compacting concrete (SCC) ( 5,10,15 )% as partial replacement by weight of cement .In this research some of fresh properties of SCC ( slump flow used V-funnel test and filling ability used ( U- box test ) for concrete mixes and also some of the harden properties of SCC ( compressive and flexural tests ). The research results showed that negative effect of Feldspar on the fresh properties of self compacting concrete but the positive effect of Feldspar on the harden properties of self compacting concrete .
Roller compacted concrete (RCC) is a concrete of no slump, no reinforcement, no finishing, and compacted using vibratory roller. When compared with conventional concrete, it contains less water content
when compared to traditional concrete. The RCC technique achieves significant time and cost savings during the construction of concrete. This study demonstrates the preparation of RCC slab of (38 ×38× 10) cm
samples by using roller compactor which is manufactured in local markets. The Hydrated lime additive is used to study the mechanical and physical properties of that RCC slab samples. This investigation is divided
into two main stages: The First stage consists of hammer compaction method with two gradation of aggregate, dense