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.
This study depicts the removal of Manganese ions (Mn2+) from simulated wastewater by combined electrocoagulation/ electroflotation technologies. The effects of initial Mn concentration, current density (C.D.), electrolysis time, and different mesh numbers of stainless steel screen electrodes were investigated in a batch cell by adopting Taguchi experimental design to explore the optimum conditions for maximum removal efficiency of Mn. The results of multiple regression and signal to noise ratio (S/N) showed that the optimum conditions were Mn initial concentration of 100 ppm, C.D. of 4 mA/cm2, time of 120 min, and mesh no. of 30 (wire/inch). Also, the relative significance of each factor was attained by the analysis of variance (ANO
... Show MoreAs the reservoir conditions are in continuous changing during its life, well production rateand its performance will change and it needs to re-model according to the current situationsand to keep the production rate as high as possible.Well productivity is affected by changing in reservoir pressure, water cut, tubing size andwellhead pressure. For electrical submersible pump (ESP), it will also affected by numberof stages and operating frequency.In general, the production rate increases when reservoir pressure increases and/or water cutdecreases. Also the flow rate increase when tubing size increases and/or wellhead pressuredecreases. For ESP well, production rate increases when number of stages is increasedand/or pump frequency is
... Show MoreAO Dr. Ali Jihad, Journal of Physical Education, 2021
The issue of auditing contracts according to the related services is one of the important topics It has also become necessary to develop traditional procedures and auditing according to international standards to improve the profession of accounting and auditing. From this standpoint, the research aims to indicate the reflection of the contracting audit in accordance with the related services on the auditor's report. in line with the new directions regarding the need to adopt international standards in the Iraqi environment as the research problem focused on the non-comprehensiveness of the audit programs that deal with auditing contracts according to assurance commitments to contribute obtaining Governing evidence, The research
... Show MoreThe purpose of this paper is to identify the statistical indicators of the searched variables and identify the relationship between the cognitive learning outcome and the performance of the two mastering skills by parallel spherical standing and equilibrium on the balance beam. And the identification of the percentage of the cognitive learning outcome contribution to the performance of the two mastering skills by parallel spherical standing and the equilibrium on the balance beam. The two researchers used the descriptive approach in the survey method and the correlational relations, being the most appropriate to the nature of the research problem. The research community for the second stage students in the College of Physical Education and
... Show MoreThe aim of this research is to introduce agricultural insurance, to define financing in the form of salam and the role of agricultural insurance in the prevention of risks to agricultural finance operations in the form of salam by verifying the hypotheses through which to reach the results, including the imposition of risks for agricultural finance in the form of salam, The study of agricultural finance in the form of salm, the deductive approach to the development of the problem of research and hypotheses, and the inductive method to extrapolate the results through analysis and brother The researcher concluded that agricultural insurance works to bridge the risks facing agricultural finance in the form of the ladder in cases of
... Show MoreObjective: This experiment was conducted to study the effects of ionized water on certain egg quality traits and the levels of proteins and enzymes in the blood of the Japanese quail Coturnix japonica . Materials and Methods: One hundred 42-day-old quail were randomly distributed among five treatment groups with four replicates for each group. The following treatments were used: T1 (control): The birds were provided normal water, T2: The birds were provided alkaline water (pH = 8), T3: The birds were provided alkaline water (pH = 9), T4: The birds were provided acidic water (pH = 6) and T5: The birds were provided acidic water (pH = 5). A Complete Randomized Design (CRD) was used to investigate the effects of the studied treatments on diffe
... Show MoreThe studying trying to determine the role of Strategic Intelligence on the Process of Green Manufacturing of Sample of Mineral water factories at Dahuk city. The study submit a theoretical frame of Strategic Intelligence and Green Manufacturing, a supposed sample, had been set to reverye the nature of the relations and effect in the study Varity, the study depend on group of the main and branch concurring with the relations and effect between the Strategic Intelligence and Green Manufacturing to answer the following questions about research to problems:
What are the relationships and effects between stra
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