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.
As asphalt concrete wearing course (ACWC) is the top layer in the pavement structure, the material should be able to sustain stresses caused by direct traffic loading. The objective of this study is to evaluate the influence of aggregate gradation and mineral filler type on Marshall Properties. A detailed laboratory study is carried out by preparing asphalt mixtures specimens using locally available materials including asphalt binder (40-50) penetration grade, two types of aggregate gradation representing SCRB and ROAD NOTE 31 specifications and two types of mineral filler including limestone dust and coal fly ash. Four types of mixtures were prepared and tested. The first type included SCRB specification and
... Show MoreBackground: The main drawback of soft lining materials was that they debonded from the denture base after a certain period of usage. Therefore, the purpose of this research was to determine the impact of oxygen and argon plasma treatment on the shear bonding strength of soft liners to two different kinds of denture base materials: conventional acrylic resin and high impact acrylic resin. Materials and Methods: Heat cure conventional and high impact acrylic blocks (40 for each group) were prepared. A soft liner connected the final test specimen of two blocks of each acrylic material. Shear bond strength (SBS) was assessed using universal testing machine. Additional blocks were also prepared for analyzing Vickers microhardness, contact ang
... Show MoreThe present study aimed to investigate the effects of level pH and the growth phases of Coelastrella saipanensis on Chlorophyll a,b, total, and Carotene. The algae were cultured in BG11 media and grown at different pH levels. We measured chlorophyll a, b, total chlorophyll, growth phases, and carotene concentrations. The results showed that at pH 8.5, the measurements of photosynthetic pigments-chlorophyll a, Chlorophyll b, and the total chlorophyll (0.183, 0.268, and 0.433 mg L-1, respectively). The highest values of chlorophyll a (0.185 mg L-1), and b (0.339 mg L-1), and the total chlorophyll (0.492 mg L-1) were recorded in the stationary phase. In addition, the study found that at pH 8.5 and the beginning of the stationary phase,
... Show MoreThe Contemporary Business Environment is Surrounded by many quick and continues variable and changes which has an effect on the economic units. These variables and changes like the high competition which need many tools to help them to continue and achieve The critical success. So to achieve this they have many competitive strategies like cost leadership strategy, differentiation strategy and focus strategy.
Budget is regarded one of main tools to execute objectives polices and programs of the economic units, beside show how the economic units had execute the available economic resources.
Activity based on budgeting is regarded one of the modern technique in the m
... Show Moreتحتل أدوات السياسة المالية (الإنفاقية والإيرادية) مكانة مهمة بين أدوات السياسات الاقتصادية الأخرى لما تتمتع به من تأثيرات اقتصادية واجتماعية على مجمل النشاط الاقتصادي .
وفي بحثنا هذا سنركز على الآثار الاجتماعية لأدوات السياسة المالية (الإنفاق العام والإيراد العام) لما للتنمية الاجتماعية من أهمية متزايدة في عالمنا اليوم خاصة فيما يتعلق بمقوماتها غير المادية المتمثلة في خدما
... Show MoreThis work provides a historical overview of water storage tanks used for solar energy collection, with a focus on the impact of different geometric configurations on thermal performance and energy storage efficiency. The designs of cylindrical, spherical, rectangular and triangular tanks were reviewed to analyse their effects on thermal gradients, heat retention and energy storage capacity. Within the scope of nominal processes, the study primarily aimed to identify the factors influencing the choice of tank shape in terms of size, capacity and aspect ratio. Another key objective was to assess what enhances heat storage in the tank to improve thermal efficiency. Comparing cylindrical shapes to other shapes, such as spherical, rectan
... Show MoreGod Almighty set out to build mosques, and he commanded to seek their architecture, and the competition for them, and allocate them with types of worship that are not valid in others, and to preserve their sanctity and not to be degraded and taken for mundane purposes and special benefits, because they are considered one of the most prominent features of Islam and the rituals of Islamic society, so this research came to show the rule Sharia in various and contemporary issues that are needed by the imams of the mosques, their rulers, and those responsible for them. Among the issues in which they have examined comparative juristic research and reached the most correct opinion are:
Building mosques over or under buildings and factories i
This research is considered as the beginning of other studies about the iraqi the public and their relationship with the various state institutions. Recently, such studies used to be almost non-existent. The main characteristic that distinguishes the scientific studies, is the fact that it involves a specific problem that needs to be studied and analysed from multiple aspects, otherwise the definition of problem identification wouldn’t have been narrowing the topic into what the researcher wants to address, also not what the title is referring to as topics which the researcher doesn’t want to address. The problem in this research resides in the lack of well planned scientific programs that aims at building a positive mental picture a
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