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 research dealt with the effect of the tax examiner's efficiency in detecting tax evasion, as the research problem dealt with tax evasion, especially in Iraq, for many reasons and factors, including those related to tax administration represented in administrative corruption and the complexity of procedures in the tax accounting process and failure to achieve justice in the tax treatment, including the taxpayer himself, as he tries to evade for reasons Related to the level of tax awareness, loss of confidence in the tax administration, and reasons related to the state's inability to manage the services file well and its ability to achieve the set goals, This reflected negatively on the emergence of some of the consequences of
... Show MoreThe Strait of Malacca is one of the waterways of strategic, political, and economic importance. This strait has an increasing importance to its neighboring countries. The Strait of Malacca is very important for China, especially in the field of energy supply security, as the vast ma jority of energy supplies come to China through this strait. China seeks to ensure its security, especially in light of the cooperation of countries that look forward to this strait as well as the United States, and what the United States may cause to China, as many of them are at war with China over the China Sea, not to mention the countries that overlook it. The importance of the research emerges from the basic idea that the strategic importance of the Strait
... Show MoreConstruction projects have a special nature and affect them many factors making them exposed to multiple risks as a result of the length of the implementation period and the multiplicity of stages, starting from the decision stage through implementation until the final delivery, which leads to increased uncertainty and the likelihood of risk.
The process of analysis and risk management is one of the effective and productive methods that are used in managing the construction projects for the purpose of increasing the chances of ending the project successfully in terms of cost, time and quality and at the lowest possible problems.
The research aims first to the effective planning for analysis and risk managemen
... Show MoreThe transition states that Iraq economy lived it after 2003, and the change in tools used by monetary policy based on C.B.I law 56 in 2004, under the especially situation for the economy (structural imbalances and the weakness of banking & financial sector).
The monetary policy adopted the inflation targeting policy to mantain the monetary stability in the economy and considered it an incubator for future growth. It used the exchange rate as a nominal anchor to achieve the goal (because the rentier of economy, finance Shallowness & separation between real sector and finance sector, all this cause the normal channel to transfer the effect of monetary policy (interest rate) ineffective.
... Show MoreThis research aims to examine the effectiveness of a teaching strategy based on the cognitive model of Daniel in the development of achievement and the motivation of learning the school mathematics among the third intermediate grade students in the light of their study of "Systems of Linear Equations”. The research was conducted in the first semester (1439/1440AH), at Saeed Ibn Almosaieb Intermediate School, in Arar, Saudi Arabia. A quasi-experimental design has been used. In addition, a (pre & post) achievement test (20 Questions) and a (pre & post) scale of learning motivation to the school mathematics (25 Items) have been applied on two groups: a control group (31Students), and an experimental group (29 Students). The resear
... Show MoreToxoplasmosis is the most common, widespread disease in the world which is caused by Toxoplasma gondii.The objective of the current study is to determine the effect of the Toxoplasma gondii infection on male sperm, especially on the mitochondria of sperm for men who suffer infertility and the possibility of a hereditary mutation. Sixty seminal fluid and serum samples were taken from sub- fertile patients who attended Teba center for in vitro fertilization / Babylon and similarly samples were also obtained from healthy individuals as a control group, their ages ranged from 20 to 60 years old during the period from 1st may /2016 till 25th January/2017. All samples subjected to the tests included Macroscopic and microscopic examination, molecu
... Show MoreThe aim of this research is to diagnose the impact of competitive dimensions represented by quality, cost, time, flexibility on the efficiency of e-learning, The research adopted the descriptive analytical method by identifying the impact of these dimensions on the efficiency of e-learning, as well as the use of the statistical method for the purpose of eliciting results. The research concluded that there is an impact of the competitive dimensions on the efficiency of e-learning, as it has been proven that the special models for each of the research hypotheses are statistically significant and at a level of significance of 5%, and that each of these dimensions has a positive impact on the dependent variable, and the research recommended
... Show MoreThis manuscript investigated the effect of anchorage CFRP wrapping sheets, bolts, and laminate interlock on increasing the efficiency of flexural strengthening for the post-tension girder using CFRP composites techniques longitudinal laminates at the soffit for partially damaged loss of about 14.3% from its area of prestressed concrete beams, and the impact on restoring the original flexural capacity of PC girder. Mitigating delamination of the soffit of horizontal laminates (CFRP). The texture of the laminate and anchorages influenced the stress of the laminate carbon fiber, the mode of crack propagation and failure, and consequently, the beam's attitude has been investigated in this manuscript. The experimental findi
... Show MoreTo find out the impact of maternal risk factors on the outcome of pregnancy in Baghdad city. A descriptive purposive study was carried out on 100 postpartum women who had delivered for 1 hr. to 24 hrs. ago . the study sample was selected from three hospitals in Baghdad city ( Baghdad teaching hospital ,Fatima Al-Zahra'a maternity and pediatric teaching hospital and Al-Yarmook teaching hospital),during the period from 25 Jan. to 25 Feb. 2006. The data were collected through the use of questionnaire format reviewing pregnants' records and personal interview and were analyzed by using descriptive and inferential statistical approaches. The finding revealed that maternal pregnancy complications had weak effects on pregnancy outcome , while mate
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