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.
Background: Diabetic is a chronic systemic disorder of glucose metabolism. That could be diagnosed using fasting and/or random plasma glucose and Glycated Haemoglobin (HbA1c). Several biochemical and microbial alterations of saliva could affect dental caries occurrence and severity among diabetic patients. The aim of the present study was to assess the relation of salivary glucose with severity of dental caries and Mutans Streptococci, among uncontrolled and controlled diabetic groups in comparison with non-diabetic control group. Materials and Methods: The total sample composed of adults aged (18-22) years. Divided into 25 uncontrolled diabetic patients (HbA1c > 7), 25 controlled diabetic patients (HbA1c ≤ 7), in addition to 25 no
... Show MoreThe problem of research was the lack of research that dealt with issue of the job design approach that is more suitable for knowledge work, therefore, the research aims to determine the impact of job enrichment, and knowledge capitalon strategic success, starting from the hypothesis that there significant impact of job enrichment and knowledge capital on strategic success, to achieve this goal the researchers from the theoretical literature and related studies conclude to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted job enrichment as independent variable while knowledge capital plays two roles, the first as an independent variable and the second as an intermediate
... Show MoreThe paper aims to identify the impact of discrete realization strategy in the development of reflective thinking among students: (males/females) of Qur'an and Islamic education departments for the course of Islamic jurisprudence according to the variability of sex. The researcher used the experimental approach and adopted an experimental determination with a set part of the two groups (experimental and controlled). He selected the sample deliberately which consists of (147) students spread over four classes (experimental males/ experimental females/ controlled males/ controlled females), and it took last for an academic year of (2010-2011). He, then, prepared a post test to measure the reflective thinking with his five skills (skill of o
... Show MoreThis paper experimentally investigates the heating process of a hot water supply using a neural network implementation of a self-tuning PID controller on a microcontroller system. The Particle Swarm Optimization (PSO) algorithm employed in system tuning proved very effective, as it is simple and fast optimization algorithm. The PSO method for the PID parameters is executed on the Matlab platform in order to put these parameters in the real-time digital PID controller, which was experimented with in a pilot study on a microcontroller platform. Instead of the traditional phase angle power control (PAPC) method, the Cycle by Cycle Power Control (CBCPC) method is implemented because it yields better power factor and eliminates harmonics
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The Central Bank is the backbone of the banking system as a whole, and in order to maintain the banking system, one of the most important functions that the Central Bank performs is the function of supervising and controlling banks, with several tools and methods, and one of the most important of these tools is its creation of the function of a compliance observer, which obligated commercial banks to appoint a person in A bank that performs this function according to certain conditions and granting it some powers that would build a sound and compliant banking system. The function of the compliance observer is to follow up on the bank’s compliance with the instructions and decisions issued by
... Show MoreThis study aims to identify the impact of using the infrastructure of the Information Technology (IT) on the performance of human resources in the public universities. This process is done by doing research in the size, quality, and efficiency of the performance, also speed of achievement and simplification of procedures. Diyala University was chosen for the diagnosis through the opinions and attitudes of its employees. Consequently, suggestions that contribute to improve the performance of the employees and thus its overall performance are obtained. Another objective of this study is identifying the human resources which are currently used in academic institutions and educational services systems because the significant role of th
... Show MoreThe technology in continuous and quick development, that reflects in all parts of our life and interred both scientific and practical fields. Marketing is one of them, a customer’s way to deal with choosing and demanding the product deferent from the traditional way. Some of the buying processes are electronic now, therefore the current research is identifying the digital channels that entered the world of marketing and influenced the activities and types that fall under this name and how it affects in positioning strategy, which is how to install the product or brand in the mind of the customer and was dimensions (brand identity, brand personality, brand communication, brand awareness, brand image), The researcher took t
... Show MoreThis research deals with the financial reporting for non-current assets impairment from the viewpoint of international accounting standards, particularly IAS 36 "Impairment of non-current assets." The research problems focus on the presence of internal and external indicators on impairment of non-current assets in many of companies listed in Iraqi stock exchange. So it is required to apply IAS 36 to reporting for the impairment loss of assets since this impairment impact certain financial indicators. These indicators help users in their decision-making and forecasting future financial situation and the ability of the company to achieve future profits or maintain current profits. The research aims to shedding lig
... Show MoreThe internet is a basic source of information for many specialities and uses. Such information includes sensitive data whose retrieval has been one of the basic functions of the internet. In order to protect the information from falling into the hands of an intruder, a VPN has been established. Through VPN, data privacy and security can be provided. Two main technologies of VPN are to be discussed; IPSec and Open VPN. The complexity of IPSec makes the OpenVPN the best due to the latter’s portability and flexibility to use in many operating systems. In the LAN, VPN can be implemented through Open VPN to establish a double privacy layer(privacy inside privacy). The specific subnet will be used in this paper. The key and certificate will
... Show MoreThe depreciation of the Iraqi dinar against the US dollar, reaching low levels and causing disruptions in the local markets, has had detrimental effects on individuals and companies, particularly those with limited income and the poor. The local currency approached around 1600 dinars per dollar, after the official exchange rate had stabilized at around 1450 dinars per US dollar. This depreciation in the value of the Iraqi dinar can be attributed to financial speculation among currency traders, which directly affected exchange rates and illicit dollar smuggling operations. Bank transfers are also important alongside financial transactions, especially in light of current economic developments in the 21st century. To prevent currency s
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