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 contemporary art culture is considered a resultant of preceding human civilizations from the early days. At the same time, it got closer to the local privacy, because the contemporary Iraqi potter worked hard to create new art, refusing to base his art on the early works, creating art pieces that contains properties to inherited art and their form significance, in order to create a new identity of his own, bringing an empowerment to his deepened civilization, with the goal to create national identity ideas from one hand, and entity and locality from another. Europeans also followed the direction of our civilization, such as (Picasso, Henry Moore, Barbra Hurth, Brankouzi, Hans Arp,..etc). From this point of view comes the importance o
... Show MoreIn order to improve the students’ performance level in some of the skills that are implemented on the mat device of ground movements, including the front and rear rolling, it is necessary to study the most important indicators that have a clear impact on the performance of those rolls. Among the objectives of the research: To identify the percentage of the contribution of flexibility of the hip joint, the angle of the knees and the muscular strength of the arms in the performance of the front and rear rolling skills, an opening of the research sample. The researchers used the descriptive method in the survey method for its suitability to the nature of the work, and the research community was represented by students of the third st
... Show MoreProblem of research as defined, including the following:what is impact organizing of configuration for still life in paintings of students in the Department of Art Education in subject of colors ?Study of well training for organized in painting of still life is necessary for a teacher of art education to contribute effectively to the performance of his letter, so is this research in response to the public goals for a subject of art education. The current research aims to:1. Impact organization of configuration for still life in paintings of students in the Department of Art Education for the first grade in subject of colors2. Role organization of configuration for still life in the painting to serve the educational process in subject of
... Show MoreThe job that confronts players with the effectiveness of shooting with an air rifle is high, so it requires necessary functional adaptations that differ in their degrees from other sports. Regular training in air rifle shooting leads to physiological changes in most of the body's internal systems, and changes and responses can be identified. The functional accompanying physical activity through the presence of body components that reflect these physiological changes in the form of changes in some components, and the importance of research lies in studying the physiological changes accompanying the maximum physical effort and the consequent development of the level of achievement in the effectiveness of shooting with air rifle and body
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This research aims to study the impact of strategic information systems on the development of intellectual capital in the Public Shareholding Electricity Distribution Company in the Hashemite Kingdom of Jordan. To achieve the objectives of the study, a questionnaire was developed for the purpose of data collection, as the number of valid questionnaires for analysis was about (135), and SPSS and AMOS 0.26 software was used to analyze the collected data. The study found out that the respondents' perceptions of the level of importance of strategic information systems and the level of importance of intellectual capital were high, and that the relational capital has ranked as first, followed by structural capital, and h
... Show MoreThe biological effects of pulsed N2-laser on the old world screw-worm fly, Chrysomya bezziana Villeneuve in the pupal stage were investigated. Different laser parameters were involved in this work. The old pupae of 1, 2, 3, 4 and 5 days were exposed to laser radiation during 10, 30 and 60 second with repetition rate 10, 20 and 30 pulse/second. The percent of normal adults emergence (female and male) was investigated. The results showed that the adults emergence was highly decreased as the repetition rate and exposure time increased when the pupae irradiated for 1, 2 and 3 days old as compared with 4 and 5 days. The results also indicated that the pupal period was significantly increased of irradiated pupae for 1, 2, 3 and 4 days old, whi
... Show MoreThe function of internal auditing has become an important function that aims at achieving objectives that are compatible with these developments and changes that have occurred in many countries in the world, which required the emergence of professional associations and institutes in the profession of internal auditing. Improve the guideline of the internal audit units issued by the Federal Audit Bureau to enhance the efficiency of internal audit performance in Iraqi government units. The researchers adopted the statistical method of proving the hypothesis by constructing a questionnaire that included three main axes: supporting the senior management in adopting the current guide, and the second being the importance of improving t
... Show Morebackground: human epidermal growth factor receptor-2 (her2/neu) is related to growth factor receptors with alkaline kinase activity and it is regarded as important prognostic and therapeutic factor that can depended on in breast cancer therapy. HER2/neu expression by immunohistochemistry (IHC) is submitted to a great in terob server inconsistency. Subsequently additional confirmatory tests for assessment of gene alterations and amplification status are needed for patients with early or metastatic breast cancer. In situ hybridization techniques and specifically Chromogenic in situ hybridization (CISH) was arise as a practical, cost-effective, and alternative to fluorescent in situ hybridization in testing for gene alterationAims of the study
... Show MoreThe interplay of species in a polluted environment is one of the most critical aspects of the ecosystem. This paper explores the dynamics of the two-species Lokta–Volterra competition model. According to the type I functional response, one species is affected by environmental pollution. Whilst the other degrades the toxin according to the type II functional response. All equilibrium points of the system are located, with their local and global stability being assessed. A numerical simulation examination is carried out to confirm the theoretical results. These results illustrate that competition and pollution can significantly change the coexistence and extinction of each species.