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.
A free convective heat transfer from the inside surface of a uniformly heated vertical circular tube has been experimentally investigated under a constant wall heat flux boundary condition for laminar air flow in the ranges of RaL from 6.9108 to 5109. The effect of the different sections (restrictions) lengths placed at the exit of the heated tube on the surface temperature distribution, the local and average heat transfer coefficients were examined. The experimental apparatus consists of aluminum circular tube with 900 mm length and 30 mm inside diameter (L/D=30). The exit sections (restrictions) were included circular tubes having the same inside diameter as the heated tube but with different lengths of
... Show MoreThis present work is concerned with one of the syntactic issues that has been researched by many linguists, grammarians, and specialists in Islamic studies, the estimated answer to a condition. However, this topic is researched this time by examining Imam Al-Qurtbi’s opinions in interpreting related ayas from the holly Quraan in his book (Collector of Quranic Rules) or its transliteration (Al-Jami’ Li Ahkam Al-Quran). Such a step involves commenting on, tracking what Al-Qurtbi said in this regard, discussing it from the points of view of other grammarians, and judging it accordingly, taking into account the apparent surface structures of the examples collected. To achieve this objective, the inductive analytical approach has be
... Show MoreAbstract :
The research aims to Estimate the Strength of Strategic Innovation application in terms of application strength , and on the overall level in number of Iraqi Industrial business organizations . After wards determine whether their is differerences among those organizations in application process for the dimensions , and for the overall process .
The Research revealed number of conclusions including that the process of strategic innovation is applied in a good Level , and demonstrates the desier of the industrial companies Leaders to Launch beyond the familiar products , and to provide new products that
... Show MoreThe subject of social capital is of great importance, as it provides an analytical framework for researchers interested in understanding the impact of the Internet on many dimensions of human and social life. And because social networking sites have infiltrated societies and produced new variables at the level of human and social communication, this study came to examine the relationship between the use of the social networking site Facebook and the accumulation of social capital among a sample of University of Algeria 3 students, by researching the variables of intensity of use and patterns of use as independent variables and their relationship to social capital. The results of the field study revealed a strong relationship between the
... Show MorePurpose: The diagnosis and determine the level of balance between the time available for life and work with the doctors in the hospitals of t the six hospitals in the City of Medicine.
Design / methodology / Approach: It has been relying on ready-scale, to make sure the diagnosis and determine the level of balance between the time available for life and work, where they were distributed on Form 42 doctors in the six hospitals in the City of Medicine, were analyzed by software (Nvivo and SPSS v.22).
Results: The results showed that there is a good level of balance between the time available for life and work with the doctors.
Research limitations: The diffi
... Show MoreThis paper presents an in-depth stylistic analysis of the linguistic artistry andliterary techniques employed by Paulo Coelho in his novel By the River Piedra ISat Down and Wept. A close reading approach guided by stylistics and linguisticsframeworks reveals Coelho's extensive incorporation of imaginative metaphors,vivid imagery, poetic diction, and resonant symbols across the narrative. Analysisspecifically elucidates how Coelho adeptly manipulates various stylistic features toconvey thematic content, shape characterization, and produce aesthetic impacts.Findings provide critical insights into Coelho’s linguistic mastery and contribute toresearch in stylistics and literary linguistics through rigorous examination of anentire contemporary
... Show MoreThe cross section evaluation for (α,n) reaction was calculated according to the available International Atomic Energy Agency (IAEA) and other experimental published data . These cross section are the most recent data , while the well known international libraries like ENDF , JENDL , JEFF , etc. We considered an energy range from threshold to 25 M eV in interval (1 MeV). The average weighted cross sections for all available experimental and theoretical(JENDL) data and for all the considered isotopes was calculated . The cross section of the element is then calculated according to the cross sections of the isotopes of that element taking into account their abundance . A mathematical representative equation for each of the element
... Show MoreThis study explores the role of nanomaterials in the performance of asphalt binders and mixtures. Two commonly available nanomaterials, i.e., nanosilica (NS) and nanoalumina (NA), were used at contents of 0%, 2%, 4%, 6%, and 8% by weight of asphalt binder. A set of experiments was carried out at the binder level to investigate properties such as penetration, softening point, aging-related mass loss, nanomaterial dispersion (storage stability), and workability (rotational viscosity). In addition, the suitability of NS and NS was also assessed through the testing of nanomodified asphalt mixtures, which focused on Marshall properties, the resilient modulus, moisture susceptibility, permanent deformation, and fatigue resistance. The findings in
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