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.
An experimental study is conducted on the utilization of the inlet ethanol injection technique in order to evaluate its impact on the performance of a two-shaft T200D mini-gas turbine engine. The maximum degradation recorded in power output was 32.8% at the climate temperature of 45oC. Nevertheless, at that temperature, adding ethanol with Eth/LPG ratio of 20% by volume brought an enhancement in power output of 19.2% compared to normal LPG run. SFC of the dual-fuel engine ranked a level of 22% higher than that with pure LPG consumption. The overall efficiency suffered a maximum reduction of 14.4% with Eth/LPG fuel ratio of 20%, but when the loading was raised beyond 70% of the engine full load; the efficiency of dual-fuel engi
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يجمع المختصون أن ليس من نقد إلا وكان مُرحِّلا لنظرية لسانية إلى فضائه، فكان أثر اللسانيات السوسيرية، ومن ثم اللسانيات التوليدية التحويلية معروفا، ولم يكن هذا الأثر محدودا باللسانيين أو نقاد الأدب فحسب، بل امتد إلى الشعراء والجماليين أيضا. وفي هذا البحث سنتوقف عند أثر اللسانيات الوظيفية، وهو ما لم يتوقف عنده إلا قلة من المختصين. ولن نقف عند نقد الوظيفيين للشعر، بل سنقف عند نقدهم للرواية، بقراءة
... Show MoreThis study examined the imperative construction: the command, the interrogative, the prohibition, the call, and the wish. In the Diwan of Al-Shamakh bin Dirar; where the poetic verses were monitored in each of the topics of the student's creation, and the rhetorical meanings that he came out with. What is new in this study is that it is the first to study the demanded composition in the poetry of a glorious poet, Al-Shammakh bin Dirar Al-Dhubyani. As his poetry did not receive such a study, it sought to employ what was written by rhetoric scholars, in an attempt to explore the demanded composition in the poetry of Al-Shamakh. The study adopted the descriptive analytical approach, which is based on counting the number of times the poet us
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Idiomatic expressions in Russian journalism make one important borrowed means for making a dialogue with the receiver's intellect in so far as it has the distinct feature of having clarity and exactness of meaning. The meaning is seen as a shortcut for covering a series of concepts and details so as to arrive at the intended meaning. This is done by stimulating the reader by the use of certain clear idioms. The use of such idioms in a journalistic text is not for a linguistic purpose only, but it is a cultural and social phenomenon reflecting the type of current changes in the society and it aims at discoursing with the reader's mind. This paper is a practi
... Show MoreIn most recent studies, long-term retention after orthodontic treatment has been hypothesized that may be necessary to maintain the stability of the dentition and avoid post-treatment changes. The bonded fixed retainer is characterized by its clinical effectiveness, patient acceptance, and lack of patient complaints as compared with a removable retainer. An electronic database (such as PubMed, PubMed Central, Web of Science, Science Direct, Cochrane Library, Scopus, and ResearchGate) has been collected using specific keywords. Of the 152 articles, only randomized clinical trials that investigated different types of fixed retainers or compared fixed with removable retainers were illustrated in tables and included in this review. The
... Show MoreThe construction project is a very complicated work by its nature and requires specialized knowledge to lead it to success. The construction project is complicated socially, technically and economically in its planning, management and implementation aspects due to the fact that it has many variables and multiple stakeholders in addition to being affected by the surrounding environment. Successful projects depend on three fundamental points which are cost-time, performance and specifications. The project stakeholder's objective to achieve best specifications and the cost-time frame stipulated in the contract.
The question is, was the optimum implementation accomplished? The provision for the success of the project
... Show MoreMicrobial fuel cell is a device that uses the microorganism metabolism for the production of electricity under specific operating conditions. Double chamber microbial fuel cell was tested for the use of two cheap electrode materials copper and aluminum for the production of electricity under different operating conditions. The investigated conditions were concentration of microorganism (yeast) (0.5- 2 g/l), solutions temperature (33-45 oC) and concentration of glucose as a substrate (1.5- 6 g/l). The results demonstrated that copper electrode exhibit good performance while the performance of aluminum is poor. The electricity is generated with and without the addition of substrate. Addition of glucose substrate
... Show MoreObjectives: This Paper is an attempt to evaluate the services provided by the private hospitals
and to identify the strength and weakness in
their performance The results can be utilized in stating conclusion and recommendations to improve
and activate the role of private medical sector in society .
Methodology: A questionnaire has be designed for this purpose and distributed to ( 132 ) beneficiaries
mostly from Baghdad private hospitals .
Results: The paper has come out with many important results . Among These are the following :
* these who benefit from services provided by private hospitals believe that the good performance of
such hospital is not due to the medical services alone but also to scientific aspect
ABSTRACT
The research aims to identify the role of scientific planning of inventory by determining the quantity of economic demand and the number of times of purchase and associated annual total costs to achieve a sufficient and appropriate level of inventory . The research was based on the case study methodology. Materials of increasing demand in the Institute of Technical Management and knowledge of the degree of conformity of the procurement plan with the standard indicators adopted in a scientific method ,its include economic order quantity and number of purchasing times .
one of The main results of the research was the existence of a large difference between the quantity of the economic purchase of ea
The purpose of this research is to recognize the relationship between the dimensions of banking service quality and customer's satisfaction , through customer's evaluation of the level of service quality offered to them by Al – Rasheed bank. Also to determine the proportional importance of different dimensions of service quality. In addition to examine the relationship between banking service quality in its dimensions and customer's satisfaction. (150 ) samples were distributed among the bank customers , only (130 ) samples were collected and good for analysis.
The results were analyzed and examined the hypothesis through a group of statistical methods. The most important results is the positive evaluation of the ba
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