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.
Chapter-1
Problem of the research:
The studies and researches have noticed the aggravation of violence practice in all educational means using different and innovated styles against children in the school and house in order to upbringing by the parents or the school .
It is a training method for the person to participate in the society and prepare him to be an effective member.
The current research confines the children in age (6-12) years old representing the primary stage who face different kind of violence during the familiar or school education.
The current research aims to:
1 – The kinds of violence which happens to the children in the primary
... Show MoreObjective: Evaluation of the poly ether keton keton polymer (PEKK) coating material on the commercial pure titanium disks (CP Ti) with or without laser surface structuring. Design: In vitro experimental study of PEKK polymer coated material on the CP Ti disks with or without laser surface structuring. Materials and methods: coating the surface of the commercial pure titanium (CP Ti) disks with PEKK polymer was performed via using frictional mode CO2 laser, then the samples disks analyzed by using FESEM. Results: the FESEM reveal good adherence and distribution of the PEKK coated material over the CP Ti substrate by using the frictional mode CO2 laser at 2 watt and 6 ms pulse duration. Conclusion: the frictional mode CO2 laser considered an
... Show MoreThe effect of some environmental factors in the loss rate for high weights virgins are full to the screwworm fly of the ancient world and included temperatures 15,20,25,30,35,40 study showed that the rate of loss in weight virgins advanced to full participants at a temperature of 15 C while notgets evolution
Indium Antimonide (InSb) thin films were grown onto well cleaned glass substrates at substrate temperatures (473 K) by flash evaporation. X-ray diffraction studies confirm the polycrystalline of the films and the films show preferential orientation along the (111) plane .The particle size increases with the increase of annealing time .The transmission spectra of prepared samples were found to be in the range (400-5000 cm-1 ) from FTIR study . This indicates that the crystallinity is improved in the films deposited at higher annealing time.
The aim of this work is studying the binary system ??'??? Ni?)with two ratios (y=36,80) by using casting method for preparing the samples.Magnetic and Mechanical properties have been studidt different httrea^nttem^rature.All the alloys were found a ferromagnetic behavior and sensitive to the heat treatment. Best properties were found at the heat treatment 1100 C°.A significant different results were found above 1100C° for lower magnetic and mechanical values. This is possibly due to the change on the degree of magnetic moment orders, in which most of the moments are started to remove from coupled ferromagnetically.?
This study presents the effect of laser energy on burning loss of magnesium from the holes' drilled in aluminum alloy 5052. High energy free running pulsed Nd:Glass laser of 300 µs pulse duration has been used to perform the experiments. The laser energy was varied from 1.0 to 8.0 Joules, The drilling processes have been carried out under atmospheric pressure and vacuum inside a specially designed chamber. Microhardness of the blind drilled holes has been investigated .The results indicated that the magnesium loss could be manipulated by adjusting the focusing conditions of the laser beam. Almost, the obtained holes were free of cracks with low taper and low sputter deposition. .The holes performed under atmospheric conditions have high
... Show MoreA microbial desalination cell (MDC) is a new approach to bioelectrochemical systems. It provides a more sustainable way to electrical power production, saltwater desalination, and wastewater treatment at the same time. This study examined three operation modes of the MDC: chemical cathode, air cathode, and biocathode MDC, to give clear sight of this system's performance. The experimental work results for these three modes were recorded as power densities generation, saltwater desalination rates, and COD removal percentages. For the chemical cathode MDC, the power density was 96.8 mW/m2, the desalination rate was 84.08 ppm/hr, and the COD removal percentage was 95.94%. The air cathode MDC results were different
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