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.
Water provision is sensitive to climate change, and agricultural production and food supply are sensitive to water availability. Water scarcity affects food security and agricultural economic development through changes in agricultural production and changes in the composition of produced goods. Recent droughts also led to a decrease in the volume of water allocated to agriculture, which led to a decrease in total agricultural production and exports, and this has subsequent impacts on food security and economic development. The research aimed to measure the impact of water scarcity on agricultural economic development for the period 1990-2022. The research included three behavioral equations with three endogenous variables: the cult
... Show MoreThe objective of this study was to assess the impact of the COVID-19 pandemic on healthcare providers (HCPs) at personal and professional levels.
This was a cross-sectional descriptive study. It was conducted using an electronic format survey through Qualtrics Survey Software in English. The target participants were HCPs working in any healthcare setting across Iraq. The survey was distributed via two professional Facebook groups between 7 April and 7 May 2020. The survey items were adopted with modifications from three previous studies of Severe Acute Respiratory Syndrome (SARS) and Avia
Abstract
The research aims to determine the impact of the strategy performance evaluation and of the Standards (leadership, people, knowledge, processes, financial) in the achievement of organizational effectiveness in accordance with the dimensions (planning and setting goals, Exploitation of the Environment, achieve the goals, the ability to adapt, information management and communications) and the relationship between them, the problem of the research in the growing interest in the process of performance evaluation for organizations, the erroneous belief that the performance evaluation activity is useful, and the fact that performance evaluation process is one of the main tasks of the work of the Office of the Inspecto
... Show MoreThe problem of the research is that some companies lack the mechanisms and policies that to enhance the loyalty of these valuable resources, which led to difficulties in generating knowledge, producing, storing, investing and investing information to achieve a sustainable competitive advantage. In addition, companies are still working with the traditional wage system (monthly salaries), which makes people not think about adding value to work. The research aims to determine the level of variables for researchers to clarify the impact of the organizational innovation climate on sustainable competitive advantage. The Qualitative approach is used based on research. The research was applied
... Show MoreThere is a need to make serious efforts For Iraqi universities to be in the ranks of advanced universities in the world. This requires attracting teaching talents and providing an incubating environment for them. Therefore, the objective of the research was to explore the influence of (the environment, the development of talents) on sustainable competitive advantages. The research followed the descriptive approach and used the quantitative analysis method. Almaqaal university is the field of study. The study sample size (of 76 people), from almaaqal university teachers, and the sample comprised the available staff specialized in the field of Teaching and research. The questionnaire was utilised as a data collection tool and (spss) program w
... Show MoreA collection of pictures of traditional Kurdish women's national clothing and contemporary clothing was collected. A visit was also made to the city of Sulaymaniyah and the city of Halabja to find out the foundations of traditional clothing for the Kurdish regions and the impact of contemporary fashion on traditional dress. Which represents the culture and regionalism and reflects the picturesque nature of northern Iraq, and in order to complete the study, the parametric measurements of the clothes were analyzed and the graphs of the dress and its accessories were re-drawn to understand and make a comparison between them to study the clear influences and changes and examine the possibility of benefiting from them in sewing contemporary f
... Show MoreSuccessive waves and generations of terrorists attacked the Iraqis in the years following the fall of the regime in Iraq in 2003, after the US invasion of the country under the pretext of weapons of mass destruction. Hence, the Iraqi people enrolled in ongoing war with these armed groups which led to massive casualties due to blasts and missile injuries.
Mechanism of blasts injury can be classified into primary, secondary, tertiary, and quaternary. While bullet injuries can be classified into low and high-energy injuries, the type and severity of the injury will influence the type of management, together with facilities available in