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 changes that have occurred in the business environment and scientific and technological progress, as well as the complexity of administrative problems resulting from its practice of various activities, have led to an increase in the responsibilities entrusted to it, and for the purpose of achieving its strategic objectives, which has made the pillars of corporate governance an inevitable matter required by the nature of modern scientific management of the governorate, the success that companies seek is based on the fertile environment and the dialectical relationship between the individual and the company, and to achieve this success there must be a compatible and harmonious audit environment between the internal and external
... Show MoreThis research shows the issues of Ibn Hisham's illusion in its leadership of the grammarians; As Ibn Hisham attributed - during his presentation of grammatical issues - grammatical opinions to a number of grammarians claiming them in them, and after referring to the main concepts that pertain to those grammarians, we found that Ibn Hisham had delusional in those allegations, in addition to that clarifying the terms illusion and claim in the two circles of language And the terminology, and perhaps the most prominent result in this research is that he worked to investigate these issues by referring to their original sources, with an explanation of the illusions of Ibn Hisham in his attribution to these issues.
This search aim to measure Hardness for Epoxy resin and for unsaturated Polyester resin as base materials for composite Hybrid and the materials used is Hybrid fiber Carbon-Kevlar. The Hand Lay-up method was used to manufacture plates of Epoxy resin (EP) and unsaturated Polyester EP,UPE backed by Hybrid fiber (Carbon-Kevlar) and with small volume fraction 5,10 and 15 for every there are Layer of fibers (1,2 and 3). The hardness test was count for material EP, UPE resin and there composites and that we notice that the Hardness (HB) decreased with increase of temperatures.
A substantial matter to confidential messages' interchange through the internet is transmission of information safely. For example, digital products' consumers and producers are keen for knowing those products are genuine and must be distinguished from worthless products. Encryption's science can be defined as the technique to embed the data in an images file, audio or videos in a style which should be met the safety requirements. Steganography is a portion of data concealment science that aiming to be reached a coveted security scale in the interchange of private not clear commercial and military data. This research offers a novel technique for steganography based on hiding data inside the clusters that resulted from fuzzy clustering. T
... Show MoreThe main idea that led me to write such research paper within the framework of Germanic linguistics is that I have not found any topic dealing with the term correlate in the German language, except in several articles in linguistic journals as well as one topic in a book describing the use of such a linguistic phenomenon in the language system. The research initially deals with the definition of the correlate at the level of the German language system. Correlate is unity describes specific relation of two sentences and identifies denoted constructs. Correlate is called a placeholder at the syntactic level because it does not occupy its original topological fields in the syntactic structure. The correlate (es) or the prepositiona
... Show MoreThe purpose of this study is to compare the influence of three teaching methods, as represented by problem-based learning (PBL), the PBL with lecture method, and the conventional teaching on undergraduate physics students' group work skills among bachelor’s degree physics students. In this study, the pre- and post-test were done and the instruments were administered to the students for data collection. The actual sample size comprises of 122 students, who were selected randomly from the physics department, college of education in iraq. Overall, the statistical results rejected null hypothesis of this study. Thus, using the PBL without or with lecture method enhances the skills of the group work among the bachelor’s degree physics studen
... Show MoreThe Mishrif reservoir (Cenomanian - Turonian) in the Z, H, B and N oilfields in southern Iraq was investigated to clarify how nickel, vanadium, asphaltene, NSO and sulfur content affect the crude oil quality. The GC-Mass and ICP-MS analyses were used to provide fruitful hydrocarbon results. Classification of crude oil based on API gravity broadly indicates the oil's density and general properties. Typically, lighter crude oils are easier to refine, yield higher percentages of valuable products such as gasoline and diesel, and have a higher market value. Heavier crude oils require more processing and may yield more residual products, such as heavy fuel oil and asphalt. The Mishrif crude oil was classified as a medium sour crude oil c
... Show MoreThe study deals with reactivity insertion linear and non linear and/or Ramp reactivity expressed as a polynomial in time in the presence of two Feedback mechanisms, using the neutronic-thermohydraulic coupling in order to predict the neutron behavior as a function of time in terms of reactor power. Also, a comparative study has been achieved in the case of the presence of the feedback mechanisms. Insertion of Ramp reactivities in terms of polynomial in time to study the behavior of power and reactivity as a function of time in the presence of two feedback mechanisms (fuel and coolant) has been carried out and the results are displayed as plots, and showed this results corresponding with international results. The present study shows t
... Show Moreخلاصة (استطاعت اليابان بعد الحرب العالمية الثانية ان تنهض من جديد، وان تحقق تجربة تحديث سياسي جعلها تشهد تبدلات جذرية من الفقر الى الغنى ومن سيطرة الحكم العسكري الى الدولة المنزوعة السلاح ومن التخلف الى التكنولوجيا الاكثر تطورا في العالم, ومن الانغلاق والعزلة وذهنية سكان الجزر الى الانفتاح على ثقافات عصر العولمة ووسائل اعلامها. فكيف يمكن الاستفادة من هذه التجربة الحديثة سياسيا بل وحتى اقت
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