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 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
... Show MoreIncremental Sheet Metal Forming (ISMF) is a modern sheet metal forming technology which offers the possibility of manufacturing 3D complex parts of thin sheet metals using the CNC milling machine. The surface quality is a very important aspect in any manufacturing process. Therefore, this study focuses on the resultant residual stresses by forming parameters, namely; (tool shape, step over, feed rate, and slope angle) using Taguchi method for the products formed by single point incremental forming process (SPIF). For evaluating the surface quality, practical experiments to produce pyramid like shape have been implemented on aluminum sheets (AA1050) for thickness (0.9) mm. Three types of tool shape used in this work, the spherical tool ga
... Show MoreThe current study aims to find a new plan to manage the water quality of the western part of the Hammar Marsh to reduce the salts that cause problems for the marshes and preserve their environmental life by isolating the southwestern part of the Hammar Marsh by closing the outlet under the railway embankment. The outlet is discharging saline water to the east-western part of Al Hammar Marsh. After isolating the southwestern part of the marsh, a new outlet is proposed. The impact of the flow hydrodynamics on improving the water quality was simulated using the SMS model. The hydrodynamics and water quality simulation models for the marsh are : a hydrodynamic model and average depth (SMS RMA2) and a two-dimensional water quality model (SMS
... Show MoreWars represent one of the most serious threats to the world order; It is considered a violation of international laws and norms, and humanitarian principles. From this point comes the study of the importance of the topic entitled (The Future of the Russian-Ukrainian war and the extent of its Reflection on the security of Eastern European countries after the year 2022). This study is based on reviewing future possibilities (scenarios) of war. The Russian-Ukrainian war, which was launched by the Russian government led by Russian President Vladimir Putin in February 2022, is still ongoing at the time of writing this research. This chapter includes three possibilities (scenarios). The first possibility deals with the development of the war t
... Show MoreThe current research aims to know the effect of Needham's constructivist model on the achievement of third-year students in the Life Sciences Department in the teaching methods subject. To achieve the research objectives, the experimental method was followed for the experimental and control groups with dimensional measurement of the achievement variable of the teaching methods subject. The research sample included (62) students in the third year of the Life Sciences Department, distributed into two equal groups in the variables (self-assessment of learning methods - chronological age in years - intelligence level - previous information). To measure the level of students' achievement, an achievement test was constructed consisting of (40) te
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The study aims to clarify the impact of the adoption of the International Financial Reporting Standard (IFRS16) on lease contracts in the General Iraqi Insurance Company on the financial statements, and thus the impact on financial ratios and indicators, Since the financial reporting standard considers lease contracts as an asset called the right to use the asset and is offset by a liability, this changes the way the financial statements are presented, with an addition to both the asset and liability sides. In order to show the extent to which the adoption of the standard reflects on the financial performance
... Show MoreStrives Total Productive Maintenance to increase the overall effectiveness of the equipment through the early involvement in the design and manufacture of equipment productivity. It also operates in an environment of simultaneous engineering work on the synchronization of activities to take advantage of early information by maintenance engineers, design, operation, and that helps to reduce the faults and facilitate future maintenance tasks.
Has adopted a search in the theoretical concept of the total maintenance productivity and concurrent engineering activities carried out during which the conjunction a
... Show MoreImage processing applications are currently spreading rapidly in industrial agriculture. The process of sorting agricultural fruits according to their color comes first among many studies conducted in industrial agriculture. Therefore, it is necessary to conduct a study by developing an agricultural crop separator with a low economic cost, however automatically works to increase the effectiveness and efficiency in sorting agricultural crops. In this study, colored pepper fruits were sorted using a Pixy2 camera on the basis of algorithm image analysis, and by using a TCS3200 color sensor on the basis of analyzing the outer surface of the pepper fruits, thus This separation process is done by specifying the pepper according to the color of it
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