Search results for: software project management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16921

Search results for: software project management

3481 Multi-Objective Four-Dimensional Traveling Salesman Problem in an IoT-Based Transport System

Authors: Arindam Roy, Madhushree Das, Apurba Manna, Samir Maity

Abstract:

In this research paper, an algorithmic approach is developed to solve a novel multi-objective four-dimensional traveling salesman problem (MO4DTSP) where different paths with various numbers of conveyances are available to travel between two cities. NSGA-II and Decomposition algorithms are modified to solve MO4DTSP in an IoT-based transport system. This IoT-based transport system can be widely observed, analyzed, and controlled by an extensive distribution of traffic networks consisting of various types of sensors and actuators. Due to urbanization, most of the cities are connected using an intelligent traffic management system. Practically, for a traveler, multiple routes and vehicles are available to travel between any two cities. Thus, the classical TSP is reformulated as multi-route and multi-vehicle i.e., 4DTSP. The proposed MO4DTSP is designed with traveling cost, time, and customer satisfaction as objectives. In reality, customer satisfaction is an important parameter that depends on travel costs and time reflects in the present model.

Keywords: multi-objective four-dimensional traveling salesman problem (MO4DTSP), decomposition, NSGA-II, IoT-based transport system, customer satisfaction

Procedia PDF Downloads 97
3480 The Influence of Gender and Harmful Alcohol Consumption on Academic Performance in Spanish University Students

Authors: M. S. Rodríguez, F. Cadaveira, M. F. Páramo

Abstract:

First year university students comprise one of the groups most likely to indulge in hazardous alcohol consumption. The transition from secondary school to university presents a range of academic, social and developmental challenges requiring new responses that will meet the demands of this highly competitive environment. The main purpose of this research was to analyze the influence of gender and hazardous alcohol consumption on academic performance of 300 university students in Spain in a three-year follow-up study. Alcohol consumption was measured using the Alcohol Use Identification Test (AUDIT), and the average university grades were provided by the Academic Management Services of the University. Analysis of variance showed that the level of alcohol consumption significantly affected academic performance. Students undertaking hazardous alcohol consumption obtained the lowest grades during the first three years at university. These effects were particularly marked in the sample of women with a hazardous pattern of alcohol consumption, although the interaction between gender and this type of consumption was not significant. The study highlights the impact of hazardous alcohol consumption on the academic trajectory of university students. The findings confirm that alcohol consumption predicts poor academic performance in first year students and that the low level of performance is maintained throughout the university career.

Keywords: academic performance, alcohol consumption, gender, university students

Procedia PDF Downloads 290
3479 Multi-Criteria Assessment of Biogas Feedstock

Authors: Rawan Hakawati, Beatrice Smyth, David Rooney, Geoffrey McCullough

Abstract:

Targets have been set in the EU to increase the share of renewable energy consumption to 20% by 2020, but developments have not occurred evenly across the member states. Northern Ireland is almost 90% dependent on imported fossil fuels. With such high energy dependency, Northern Ireland is particularly susceptible to the security of supply issues. Linked to fossil fuels are greenhouse gas emissions, and the EU plans to reduce emissions by 20% by 2020. The use of indigenously produced biomass could reduce both greenhouse gas emissions and external energy dependence. With a wide range of both crop and waste feedstock potentially available in Northern Ireland, anaerobic digestion has been put forward as a possible solution for renewable energy production, waste management, and greenhouse gas reduction. Not all feedstock, however, is the same, and an understanding of feedstock suitability is important for both plant operators and policy makers. The aim of this paper is to investigate biomass suitability for anaerobic digestion in Northern Ireland. It is also important that decisions are based on solid scientific evidence. For this reason, the methodology used is multi-criteria decision matrix analysis which takes multiple criteria into account simultaneously and ranks alternatives accordingly. The model uses the weighted sum method (which follows the Entropy Method to measure uncertainty using probability theory) to decide on weights. The Topsis method is utilized to carry out the mathematical analysis to provide the final scores. Feedstock that is currently available in Northern Ireland was classified into two categories: wastes (manure, sewage sludge and food waste) and energy crops, specifically grass silage. To select the most suitable feedstock, methane yield, feedstock availability, feedstock production cost, biogas production, calorific value, produced kilowatt-hours, dry matter content, and carbon to nitrogen ratio were assessed. The highest weight (0.249) corresponded to production cost reflecting a variation of £41 gate fee to 22£/tonne cost. The weights calculated found that grass silage was the most suitable feedstock. A sensitivity analysis was then conducted to investigate the impact of weights. The analysis used the Pugh Matrix Method which relies upon The Analytical Hierarchy Process and pairwise comparisons to determine a weighting for each criterion. The results showed that the highest weight (0.193) corresponded to biogas production indicating that grass silage and manure are the most suitable feedstock. Introducing co-digestion of two or more substrates can boost the biogas yield due to a synergistic effect induced by the feedstock to favor positive biological interactions. A further benefit of co-digesting manure is that the anaerobic digestion process also acts as a waste management strategy. From the research, it was concluded that energy from agricultural biomass is highly advantageous in Northern Ireland because it would increase the country's production of renewable energy, manage waste production, and would limit the production of greenhouse gases (current contribution from agriculture sector is 26%). Decision-making methods based on scientific evidence aid policy makers in classifying multiple criteria in a logical mathematical manner in order to reach a resolution.

Keywords: anaerobic digestion, biomass as feedstock, decision matrix, renewable energy

Procedia PDF Downloads 436
3478 A Fuzzy Multiobjective Model for Bed Allocation Optimized by Artificial Bee Colony Algorithm

Authors: Jalal Abdulkareem Sultan, Abdulhakeem Luqman Hasan

Abstract:

With the development of health care systems competition, hospitals face more and more pressures. Meanwhile, resource allocation has a vital effect on achieving competitive advantages in hospitals. Selecting the appropriate number of beds is one of the most important sections in hospital management. However, in real situation, bed allocation selection is a multiple objective problem about different items with vagueness and randomness of the data. It is very complex. Hence, research about bed allocation problem is relatively scarce under considering multiple departments, nursing hours, and stochastic information about arrival and service of patients. In this paper, we develop a fuzzy multiobjective bed allocation model for overcoming uncertainty and multiple departments. Fuzzy objectives and weights are simultaneously applied to help the managers to select the suitable beds about different departments. The proposed model is solved by using Artificial Bee Colony (ABC), which is a very effective algorithm. The paper describes an application of the model, dealing with a public hospital in Iraq. The results related that fuzzy multi-objective model was presented suitable framework for bed allocation and optimum use.

Keywords: bed allocation problem, fuzzy logic, artificial bee colony, multi-objective optimization

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3477 Water Ingress into Underground Mine Voids in the Central Rand Goldfields Area, South Africa-Fluid Induced Seismicity

Authors: Artur Cichowicz

Abstract:

The last active mine in the Central Rand Goldfields area (50 km x 15 km) ceased operations in 2008. This resulted in the closure of the pumping stations, which previously maintained the underground water level in the mining voids. As a direct consequence of the water being allowed to flood the mine voids, seismic activity has increased directly beneath the populated area of Johannesburg. Monitoring of seismicity in the area has been on-going for over five years using the network of 17 strong ground motion sensors. The objective of the project is to improve strategies for mine closure. The evolution of the seismicity pattern was investigated in detail. Special attention was given to seismic source parameters such as magnitude, scalar seismic moment and static stress drop. Most events are located within historical mine boundaries. The seismicity pattern shows a strong relationship between the presence of the mining void and high levels of seismicity; no seismicity migration patterns were observed outside the areas of old mining. Seven years after the pumping stopped, the evolution of the seismicity has indicated that the area is not yet in equilibrium. The level of seismicity in the area appears to not be decreasing over time since the number of strong events, with Mw magnitudes above 2, is still as high as it was when monitoring began over five years ago. The average rate of seismic deformation is 1.6x1013 Nm/year. Constant seismic deformation was not observed over the last 5 years. The deviation from the average is in the order of 6x10^13 Nm/year, which is a significant deviation. The variation of cumulative seismic moment indicates that a constant deformation rate model is not suitable. Over the most recent five year period, the total cumulative seismic moment released in the Central Rand Basin was 9.0x10^14 Nm. This is equivalent to one earthquake of magnitude 3.9. This is significantly less than what was experienced during the mining operation. Characterization of seismicity triggered by a rising water level in the area can be achieved through the estimation of source parameters. Static stress drop heavily influences ground motion amplitude, which plays an important role in risk assessments of potential seismic hazards in inhabited areas. The observed static stress drop in this study varied from 0.05 MPa to 10 MPa. It was found that large static stress drops could be associated with both small and large events. The temporal evolution of the inter-event time provides an understanding of the physical mechanisms of earthquake interaction. Changes in the characteristics of the inter-event time are produced when a stress change is applied to a group of faults in the region. Results from this study indicate that the fluid-induced source has a shorter inter-event time in comparison to a random distribution. This behaviour corresponds to a clustering of events, in which short recurrence times tend to be close to each other, forming clusters of events.

Keywords: inter-event time, fluid induced seismicity, mine closure, spectral parameters of seismic source

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3476 Factors Influencing the Profitability of the Conventional and Islamic Banks in Four Asian Countries

Authors: Vijay Kumar, Ron Bird

Abstract:

The study investigates the effect of bank-specific, industry-specific and macroeconomic variables on the profitability of conventional and Islamic banks. Our sample comprises 1,781 bank-year observations of 205 banks from four countries in the Asian region for the period 2004-2014. Our results suggest that credit quality, cost management and bank size are the keys factors that contribute positively to bank profitability in Asia. The banks with high non-performing loans and high cost-to-income ratio are more likely to be exposed to losses. The impacts of the bank-specific variables are stronger than are the industry-specific and macroeconomic variables. We find that Malaysian banks are the least profitable compared to the banks in Bangladesh, Indonesia and Pakistan. There is strong evidence to suggest that conventional banks are more profitable than Islamic banks. Our results suggest that the impact of capital adequacy ratio and bank size and loan to deposit ratio vary across Islamic and conventional banks and across different subsamples.

Keywords: capital adequacy ratio, Islamic banks, non-performing loan ratio, ownership

Procedia PDF Downloads 145
3475 Design and Field Programmable Gate Array Implementation of Radio Frequency Identification for Boosting up Tag Data Processing

Authors: G. Rajeshwari, V. D. M. Jabez Daniel

Abstract:

Radio Frequency Identification systems are used for automated identification in various applications such as automobiles, health care and security. It is also called as the automated data collection technology. RFID readers are placed in any area to scan large number of tags to cover a wide distance. The placement of the RFID elements may result in several types of collisions. A major challenge in RFID system is collision avoidance. In the previous works the collision was avoided by using algorithms such as ALOHA and tree algorithm. This work proposes collision reduction and increased throughput through reading enhancement method with tree algorithm. The reading enhancement is done by improving interrogation procedure and increasing the data handling capacity of RFID reader with parallel processing. The work is simulated using Xilinx ISE 14.5 verilog language. By implementing this in the RFID system, we can able to achieve high throughput and avoid collision in the reader at a same instant of time. The overall system efficiency will be increased by implementing this.

Keywords: antenna, anti-collision protocols, data management system, reader, reading enhancement, tag

Procedia PDF Downloads 287
3474 Automated Prediction of HIV-associated Cervical Cancer Patients Using Data Mining Techniques for Survival Analysis

Authors: O. J. Akinsola, Yinan Zheng, Rose Anorlu, F. T. Ogunsola, Lifang Hou, Robert Leo-Murphy

Abstract:

Cervical Cancer (CC) is the 2nd most common cancer among women living in low and middle-income countries, with no associated symptoms during formative periods. With the advancement and innovative medical research, there are numerous preventive measures being utilized, but the incidence of cervical cancer cannot be truncated with the application of only screening tests. The mortality associated with this invasive cervical cancer can be nipped in the bud through the important role of early-stage detection. This study research selected an array of different top features selection techniques which was aimed at developing a model that could validly diagnose the risk factors of cervical cancer. A retrospective clinic-based cohort study was conducted on 178 HIV-associated cervical cancer patients in Lagos University teaching Hospital, Nigeria (U54 data repository) in April 2022. The outcome measure was the automated prediction of the HIV-associated cervical cancer cases, while the predictor variables include: demographic information, reproductive history, birth control, sexual history, cervical cancer screening history for invasive cervical cancer. The proposed technique was assessed with R and Python programming software to produce the model by utilizing the classification algorithms for the detection and diagnosis of cervical cancer disease. Four machine learning classification algorithms used are: the machine learning model was split into training and testing dataset into ratio 80:20. The numerical features were also standardized while hyperparameter tuning was carried out on the machine learning to train and test the data. Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), and K-Nearest Neighbor (KNN). Some fitting features were selected for the detection and diagnosis of cervical cancer diseases from selected characteristics in the dataset using the contribution of various selection methods for the classification cervical cancer into healthy or diseased status. The mean age of patients was 49.7±12.1 years, mean age at pregnancy was 23.3±5.5 years, mean age at first sexual experience was 19.4±3.2 years, while the mean BMI was 27.1±5.6 kg/m2. A larger percentage of the patients are Married (62.9%), while most of them have at least two sexual partners (72.5%). Age of patients (OR=1.065, p<0.001**), marital status (OR=0.375, p=0.011**), number of pregnancy live-births (OR=1.317, p=0.007**), and use of birth control pills (OR=0.291, p=0.015**) were found to be significantly associated with HIV-associated cervical cancer. On top ten 10 features (variables) considered in the analysis, RF claims the overall model performance, which include: accuracy of (72.0%), the precision of (84.6%), a recall of (84.6%) and F1-score of (74.0%) while LR has: an accuracy of (74.0%), precision of (70.0%), recall of (70.0%) and F1-score of (70.0%). The RF model identified 10 features predictive of developing cervical cancer. The age of patients was considered as the most important risk factor, followed by the number of pregnancy livebirths, marital status, and use of birth control pills, The study shows that data mining techniques could be used to identify women living with HIV at high risk of developing cervical cancer in Nigeria and other sub-Saharan African countries.

Keywords: associated cervical cancer, data mining, random forest, logistic regression

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3473 Predictive Modelling Approach to Identify Spare Parts Inventory Obsolescence

Authors: Madhu Babu Cherukuri, Tamoghna Ghosh

Abstract:

Factory supply chain management spends billions of dollars every year to procure and manage equipment spare parts. Due to technology -and processes changes some of these spares become obsolete/dead inventory. Factories have huge dead inventory worth millions of dollars accumulating over time. This is due to lack of a scientific methodology to identify them and send the inventory back to the suppliers on a timely basis. The standard approach followed across industries to deal with this is: if a part is not used for a set pre-defined period of time it is declared dead. This leads to accumulation of dead parts over time and these parts cannot be sold back to the suppliers as it is too late as per contract agreement. Our main idea is the time period for identifying a part as dead cannot be a fixed pre-defined duration across all parts. Rather, it should depend on various properties of the part like historical consumption pattern, type of part, how many machines it is being used in, whether it- is a preventive maintenance part etc. We have designed a predictive algorithm which predicts part obsolescence well in advance with reasonable accuracy and which can help save millions.

Keywords: obsolete inventory, machine learning, big data, supply chain analytics, dead inventory

Procedia PDF Downloads 306
3472 Blood Lipid Management: Combined Treatment with Hydrotherapy and Ozone Bubbles Bursting in Water

Authors: M. M. Wickramasinghe

Abstract:

Cholesterol and triglycerides are lipids, mainly essential to maintain the cellular structure of the human body. Cholesterol is also important for hormone production, vitamin D production, proper digestion functions, and strengthening the immune system. Excess fats in the blood circulation, known as hyperlipidemia, become harmful leading to arterial clogging and causing atherosclerosis. Aim of this research is to develop a treatment protocol to efficiently break down and maintain circulatory lipids by improving blood circulation without strenuous physical exercises while immersed in a tub of water. To achieve the target of strong exercise effect, this method involves generating powerful ozone bubbles to spin, collide, and burst in the water. Powerful emission of air into water is capable of transferring locked energy of the water molecules and releasing energy. This method involves water and air-based impact generated by pumping ozone at the speed of 46 lts/sec with a concentration of 0.03-0.05 ppt according to safety standards of The Federal Institute for Drugs and Medical Devices, BfArM, Germany. The direct impact of ozone bubbles on the muscular system and skin becomes the main target and is capable of increasing the heart rate while immersed in water. A total time duration of 20 minutes is adequate to exert a strong exercise effect, improve blood circulation, and stimulate the nervous and endocrine systems. Unstable ozone breakdown into oxygen release onto the surface of the water giving additional benefits and supplying high-quality air rich in oxygen required to maintain efficient metabolic functions. The breathing technique was introduced to improve the efficiency of lung functions and benefit the air exchange mechanism. The temperature of the water is maintained at 39c to 40c to support arterial dilation and enzyme functions and efficiently improve blood circulation to the vital organs. The buoyancy of water and natural hydrostatic pressure release the tension of the body weight and relax the mind and body. Sufficient hydration (3lts of water per day) is an essential requirement to transport nutrients and remove waste byproducts to process through the liver, kidney, and skin. Proper nutritional intake is an added advantage to optimize the efficiency of this method which aids in a fast recovery process. Within 20-30 days of daily treatment, triglycerides, low-density lipoproteins (LDL), and total cholesterol reduction were observed in patients with abnormal levels of lipid profile. Borderline patients were cleared within 10–15 days of treatment. This is a highly efficient system that provides many benefits and is able to achieve a successful reduction of triglycerides, LDL, and total cholesterol within a short period of time. Supported by proper hydration and nutritional balance, this system of natural treatment maintains healthy levels of lipids in the blood and avoids the risk of cerebral stroke, high blood pressure, and heart attacks.

Keywords: atherosclerosis, cholesterol, hydrotherapy, hyperlipidemia, lipid management, ozone therapy, triglycerides

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3471 The Right to State Lands: A Case Study of a Squatter Community in Egypt

Authors: Salwa Salman

Abstract:

On February 2016, Egypt’s President Abdel Fattah Al-Sisi ordered the former Prime Minister, Ibrahim Mehleb, to establish a committee responsible for retrieving looted state lands or providing squatters with land titles according to their individual cases. The specificity of desert lands emerges from its unique position in both Islamic law and Egypt’s Civil Code. In Egypt, desert lands can be transferred to private ownership through peaceful occupation and cultivation. This study explores the (re-) conceptualization of land rights, state territoriality, and sovereignty as a part of an emerging narrative on informal land tenure. Through the lens of an informal settlement, the study employs methodological insights from studies in the anthropology of development and their interpretation of Foucauldian discourse analysis to examine official representations on squatting over state lands and put them in conversation with individual narratives on land ownership and dispossession. It also employs Bruno Latour’s actor-network theory to explore the development of social networks through primary land contracts and informal local resource management.

Keywords: State lands, squatter community, Islamic law, Egypt’s Civil Code

Procedia PDF Downloads 152
3470 Determination of Harmful Important Mite (ACARI) and Nematoda Species, Their Distribution and Their Control Possibility on Garlic and Onion Growing Areas in Turkey

Authors: Cihan Cilbircioğlu

Abstract:

Allium sativum L.(garlic) and Allium. cepa L. (onion) are the most common species of the Allium spp. and are produced at the very high rate all over the world. The yield loss caused by pests is the most important problem in the production of these crops. In the absence of control measures, yield loss would be around 35% on average. The yield loss sometimes depending on the pest species and population density can reach about 100%. Mites and nematodes are the most important pests of them. These pests that cause damage to A. sativum and A. cepa shows a wide range of taxonomic categories. The number of common pest mite and nematode species that cause damage to either A. sativum and A. cepa are over 20 species. In this study, detailed information on morphology, life cycle, management, and symptoms of the economically most important harmful important mite (acari) and nematode species of onion and garlic has been provided through careful survey of corresponding researches in Turkey and given information about new practices and approaches on their controls.

Keywords: onion, garlic, pest, acari, nematoda control methods, Turkey

Procedia PDF Downloads 475
3469 Secure Texting Used in a Post-Acute Pediatric Skilled Nursing Inpatient Setting: A Multidisciplinary Care Team Driven Communication System with Alarm and Alert Notification Management

Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

Abstract:

Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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3468 Effects of Structure on Density-Induced Flow in Coastal and Estuarine Navigation Channel

Authors: Shuo Huang, Huomiao Guo, Wenrui Huang

Abstract:

In navigation channels located in coasts and estuaries as the waterways connecting coastal water to ports or harbors, density-induced flow often exist due to the density-gradient or gravity gradient as the results of mixing between fresh water from coastal rivers and saline water in the coasts. The density-induced flow often carries sediment transport into navigation channels and causes sediment depositions in the channels. As a result, expensive dredging may need to maintain the water depth required for navigation. In our study, we conduct a series of experiments to investigate the characteristics of density-induced flow in the estuarine navigation channels under different density gradients. Empirical equations between density flow and salinity gradient were derived. Effects of coastal structures for regulating navigation channel on density-induced flow have also been investigated. Results will be very helpful for improving the understanding of the characteristics of density-induced flow in estuarine navigation channels. The results will also provide technical support for cost-effective waterway regulation and management to maintain coastal and estuarine navigation channels.

Keywords: density flow, estuarine, navigation channel, structure

Procedia PDF Downloads 239
3467 Measurement and Evaluation of Outdoor Lighting Environment at Night in Residential Community in China: A Case Study of Hangzhou

Authors: Jiantao Weng, Yujie Zhao

Abstract:

With the improvement of living quality and demand for nighttime activities in China, the current situation of outdoor lighting environment at night needs to be assessed. Lighting environment at night plays an important role to guarantee night safety. Two typical residential communities in Hangzhou were selected. A comprehensive test method of outdoor lighting environment at night was established. The road, fitness area, landscape, playground and entrance were included. Field measurements and questionnaires were conducted in these two residential communities. The characteristics of residents’ habits and the subjective evaluation on different aspects of outdoor lighting environment at night were collected via questionnaire. A safety evaluation system on the outdoor lighting environment at night in the residential community was established. The results show that there is a big difference in illumination in different areas. The lighting uniformities of roads cannot meet the requirement of lighting standard in China. Residents pay more attention to the lighting environment of the fitness area and road than others. This study can provide guidance for the design and management of outdoor lighting environment at night.

Keywords: residential community, lighting environment, night, field measurement

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3466 Dizziness in the Emergency: A 1 Year Prospective Study

Authors: Nouini Adrâa

Abstract:

Background: The management of dizziness and vertigo can be challenging in the emergency department (ED). It is important to rapidly diagnose vertebrobasilar stroke (VBS), as therapeutic options such as thrombolysis and anticoagulation require prompt decisions. Objective: This study aims to assess the rate of misdiagnosis in patients with dizziness caused by VBS in the ED. Methods and Results: The cohort was comprised of 82 patients with a mean age of 55 years; 51% were women and 49% were men. Among dizzy patients, 15% had VBS. We used Cohen’s kappa test to quantify the agreement between two raters – namely, emergency physicians and neurologists – regarding the causes of dizziness in the ED. The agreement between emergency physicians and neurologists is low for the final diagnosis of central vertigo disorders and moderate for the final diagnosis of VBS. The sensitivity of ED clinal examination for benign conditions such as BPPV was low at 56%. The positive predictive value of the ED clinical examination for VBS was also low at 50%. Conclusion: There is a substantial rate of misdiagnosis in patients with dizziness caused by VBS in the ED. To reduce the number of missing diagnoses of VBS in the future, there is a need to train emergency physicians in neuro vestibular examinations, including the HINTS examination for acute vestibular syndrome (AVS) and the Dix-Hallpike (DH) maneuver for episodic vestibular syndrome. Using video head impulse tests could help reduce the rate of misdiagnosis of VBS in the ED.

Keywords: dizziness, vertigo, vestibular disease, emergency

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3465 Investigation of Yard Seam Workings for the Proposed Newcastle Light Rail Project

Authors: David L. Knott, Robert Kingsland, Alistair Hitchon

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The proposed Newcastle Light Rail is a key part of the revitalisation of Newcastle, NSW and will provide a frequent and reliable travel option throughout the city centre, running from Newcastle Interchange at Wickham to Pacific Park in Newcastle East, a total of 2.7 kilometers in length. Approximately one-third of the route, along Hunter and Scott Streets, is subject to potential shallow underground mine workings. The extent of mining and seams mined is unclear. Convicts mined the Yard Seam and overlying Dudley (Dirty) Seam in Newcastle sometime between 1800 and 1830. The Australian Agricultural Company mined the Yard Seam from about 1831 to the 1860s in the alignment area. The Yard Seam was about 3 feet (0.9m) thick, and therefore, known as the Yard Seam. Mine maps do not exist for the workings in the area of interest and it was unclear if both or just one seam was mined. Information from 1830s geological mapping and other data showing shaft locations were used along Scott Street and information from the 1908 Royal Commission was used along Hunter Street to develop an investigation program. In addition, mining was encountered for several sites to the south of the alignment at depths of about 7 m to 25 m. Based on the anticipated depths of mining, it was considered prudent to assess the potential for sinkhole development on the proposed alignment and realigned underground utilities and to obtain approval for the work from Subsidence Advisory NSW (SA NSW). The assessment consisted of a desktop study, followed by a subsurface investigation. Four boreholes were drilled along Scott Street and three boreholes were drilled along Hunter Street using HQ coring techniques in the rock. The placement of boreholes was complicated by the presence of utilities in the roadway and traffic constraints. All the boreholes encountered the Yard Seam, with conditions varying from unmined coal to an open void, indicating the presence of mining. The geotechnical information obtained from the boreholes was expanded by using various downhole techniques including; borehole camera, borehole sonar, and downhole geophysical logging. The camera provided views of the rock and helped to explain zones of no recovery. In addition, timber props within the void were observed. Borehole sonar was performed in the void and provided an indication of room size as well as the presence of timber props within the room. Downhole geophysical logging was performed in the boreholes to measure density, natural gamma, and borehole deviation. The data helped confirm that all the mining was in the Yard Seam and that the overlying Dudley Seam had been eroded in the past over much of the alignment. In summary, the assessment allowed the potential for sinkhole subsidence to be assessed and a mitigation approach developed to allow conditional approval by SA NSW. It also confirmed the presence of mining in the Yard Seam, the depth to the seam and mining conditions, and indicated that subsidence did not appear to have occurred in the past.

Keywords: downhole investigation techniques, drilling, mine subsidence, yard seam

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3464 Evaluation of the Construction of Terraces on a Family Farm in the Municipality of Jaboticabal (SP), Brazil

Authors: Anderson dos Santos Ananias, Matheus Yuji Shigueoka, Roberto Saverio Souza Costa

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Soil and water conservation can be conceptualized as a combination of management and use methods, which have the function of protecting them against deterioration induced by anthropogenic or natural factors. Thus, the objective of this research was to evaluate the rural extension work in soil conservation carried out at Sítio do Alto in Jaboticabal-SP, through the analysis of planimetric data (latitude and longitude coordinates) and altimetric differences of the empirically constructed terraces by the rural producer and with technical guidance from CATI (Coordination of Integral Technical Assistance). A data collection procedure was carried out in the field, with GPS L1/L2, before the construction of five (5) terraces technically level and after their construction. The results showed that the greatest differences were found on terrace one (1), with a maximum latitude difference of 57 meters, the longitude of 23 m, and altitude of 2 m. These results corroborate the observations in the field, in which the presence of a great erosion caused by the incorrect construction of terrace 1 was verified rainwater to the side of the rural property, where the largest erosion furrows with the beginning of gully formation were found.

Keywords: GPS, mechanical pratice, surface runoff, erosion

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3463 Use of Pheromones, Active Surveillance and Treated Cattle to Prevent the Establishment of the Tropical Bont Tick in Puerto Rico and the Americas

Authors: Robert Miller, Fred Soltero, Sandra Allan, Denise Bonilla

Abstract:

The Tropical Bont Tick (TBT), Amblyomma variegatum, was introduced to the Caribbean in the mid-1700s. Since it has spread throughout the Caribbean dispersed by cattle egrets (Bubulcus ibis). Tropical Bont Ticks vector many pathogens to livestock and humans. However, only the livestock diseases heartwater, Ehrlichia (Cowdria) ruminantium, and dermatophilosis, Dermatophilus congolensis, are associated with TBT in the Caribbean. African tick bite fever (Rickettsia africae) is widespread in Caribbean TBT but human cases are rare. The Caribbean Amblyomma Programme (CAP) was an effort led by the Food and Agricultural Organization to eradicate TBTs from participating islands. This 10-year effort successfully eradicated TBT from many islands. However, most are reinfested since its termination. Pheromone technology has been developed to aid in TBT control. Although not part of the CAP treatment scheme, this research established that pheromones in combination with pesticide greatly improves treatment efficiencies. Additionally, pheromone combined with CO₂ traps greatly improves active surveillance success. St. Croix has a history of TBT outbreaks. Passive surveillance detected outbreaks in 2016 and in May of 2021. Surveillance efforts are underway to determine the extent of TBT on St Croix. Puerto Rico is the next island in the archipelago and is at a greater risk of re-infestation due to active outbreaks in St Croix. Tropical Bont Ticks were last detected in Puerto Rico in the 1980s. The infestation started on the small Puerto Rican island of Vieques, the closest landmass to St Croix, and spread to the main island through cattle movements. This infestation was eradicated with the help of the Tropical Cattle Tick (TCT), Rhipicephalus (Boophilus) microplus, eradication program. At the time, large percentages of Puerto Rican cattle were treated for ticks along with the necessary material and manpower mobilized for the effort. Therefore, a shift of focus from the TCT to TBT prevented its establishment in Puerto Rico. Currently, no large-scale treatment of TCTs occurs in Puerto Rico. Therefore, the risk of TBT establishment is now greater than it was in the 1980s. From Puerto Rico, the risk of TBT movement to the American continent increases significantly. The establishment of TBTs in the Americas would cause $1.2 billion USD in losses to the livestock industry per year. The USDA Agricultural Research Service recently worked with the USDA Animal Health Inspection Service and the Puerto Rican Department of Agriculture to modernize the management of the TCT. This modernized program uses safer pesticides and has successfully been used to eradicate pesticide-susceptible and -resistant ticks throughout the island. The objective of this work is to prevent the infestation of Puerto Rico by TBTs by combining the current TCT management efforts with TBT surveillance in Vieques. The combined effort is designed to eradicate TCT from Vieques while using the treated cattle as trap animals for TBT using pheromone impregnated tail tags attached to treated animals. Additionally, active surveillance using CO₂-baited traps combined with pheromone will be used to actively survey the environment for free-living TBT. Knowledge gained will inform TBT control efforts in St. Croix.

Keywords: Amblyomma variegatum, caribbean, eradication, Rhipicephalus (boophilus) microplus, pheromone

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3462 A Spatial Point Pattern Analysis to Recognize Fail Bit Patterns in Semiconductor Manufacturing

Authors: Youngji Yoo, Seung Hwan Park, Daewoong An, Sung-Shick Kim, Jun-Geol Baek

Abstract:

The yield management system is very important to produce high-quality semiconductor chips in the semiconductor manufacturing process. In order to improve quality of semiconductors, various tests are conducted in the post fabrication (FAB) process. During the test process, large amount of data are collected and the data includes a lot of information about defect. In general, the defect on the wafer is the main causes of yield loss. Therefore, analyzing the defect data is necessary to improve performance of yield prediction. The wafer bin map (WBM) is one of the data collected in the test process and includes defect information such as the fail bit patterns. The fail bit has characteristics of spatial point patterns. Therefore, this paper proposes the feature extraction method using the spatial point pattern analysis. Actual data obtained from the semiconductor process is used for experiments and the experimental result shows that the proposed method is more accurately recognize the fail bit patterns.

Keywords: semiconductor, wafer bin map, feature extraction, spatial point patterns, contour map

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3461 Hydrologic Balance and Surface Water Resources of the Cheliff-Zahrez Basin

Authors: Mehaiguene Madjid, Touhari Fadhila, Meddi Mohamed

Abstract:

The Cheliff basin offers a good hydrological example for the possibility of studying the problem which elucidated in the future, because of the unclearity in several aspects and hydraulic installation. Thus, our study of the Cheliff basin is divided into two principal parts: The spatial evaluation of the precipitation: also, the understanding of the modes of the reconstitution of the resource in water supposes a good knowledge of the structuring of the precipitation fields in the studied space. In the goal of a good knowledge of revitalizes them in water and their management integrated one judged necessary to establish a precipitation card of the Cheliff basin for a good understanding of the evolution of the resource in water in the basin and that goes will serve as basis for all study of hydraulic planning in the Cheliff basin. Then, the establishment of the precipitation card of the Cheliff basin answered a direct need of setting to the disposition of the researchers for the region and a document of reference that will be completed therefore and actualized. The hydrological study, based on the statistical hydrometric data processing will lead us to specify the hydrological terms of the assessment hydrological and to clarify the fundamental aspects of the annual flow, seasonal, extreme and thus of their variability and resources surface water.

Keywords: hydrological assessment, surface water resources, Cheliff, Algeria

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3460 Forecast Based on an Empirical Probability Function with an Adjusted Error Using Propagation of Error

Authors: Oscar Javier Herrera, Manuel Angel Camacho

Abstract:

This paper addresses a cutting edge method of business demand forecasting, based on an empirical probability function when the historical behavior of the data is random. Additionally, it presents error determination based on the numerical method technique ‘propagation of errors’. The methodology was conducted characterization and process diagnostics demand planning as part of the production management, then new ways to predict its value through techniques of probability and to calculate their mistake investigated, it was tools used numerical methods. All this based on the behavior of the data. This analysis was determined considering the specific business circumstances of a company in the sector of communications, located in the city of Bogota, Colombia. In conclusion, using this application it was possible to obtain the adequate stock of the products required by the company to provide its services, helping the company reduce its service time, increase the client satisfaction rate, reduce stock which has not been in rotation for a long time, code its inventory, and plan reorder points for the replenishment of stock.

Keywords: demand forecasting, empirical distribution, propagation of error, Bogota

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3459 Assessment of Women Involvement in Fishing Activities: A Case Study of Epe and Ibeju Lekki LGA, Lagos

Authors: Temitope Adewale, Oladapo Raji

Abstract:

The study was designed to investigate the assessment of women's involvement in fishing. In order to give the study a direction, five research questions, as well as two hypotheses, were postulated, and a total of fifty (50) respondents each were selected from two local government areas for the study. This brings a total of one hundred (100) respondents selected from these local government areas in Lagos state. The outcome of the finding indicates that the percentage of the respondents’ age, 49% was between 31 and 35 years, 56% has a working experience of 6-10 years, 61% were married, 69% had secondary education as their educational level. However, findings show that socio-economic characteristics (x2 =15.504, df=6, p < 0.05) and income (r=0.83, p < 0.05) have a significant relationship on the fishing. It was established that the Women in Fish production/processing were faced with a lot of constraints such as high cost of inputs, inadequate electricity supply, lack of adequate capital, non-availability of the improved oven, non-availability of extension agents, inadequate fish landing, lack of transportation facilities, lack of training on financial management and loan acquisition which affected the level of output of women in Fish processing adversely.

Keywords: women, fishing, agriculture, Lagos

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3458 Comparison Of Data Mining Models To Predict Future Bridge Conditions

Authors: Pablo Martinez, Emad Mohamed, Osama Mohsen, Yasser Mohamed

Abstract:

Highway and bridge agencies, such as the Ministry of Transportation in Ontario, use the Bridge Condition Index (BCI) which is defined as the weighted condition of all bridge elements to determine the rehabilitation priorities for its bridges. Therefore, accurate forecasting of BCI is essential for bridge rehabilitation budgeting planning. The large amount of data available in regard to bridge conditions for several years dictate utilizing traditional mathematical models as infeasible analysis methods. This research study focuses on investigating different classification models that are developed to predict the bridge condition index in the province of Ontario, Canada based on the publicly available data for 2800 bridges over a period of more than 10 years. The data preparation is a key factor to develop acceptable classification models even with the simplest one, the k-NN model. All the models were tested, compared and statistically validated via cross validation and t-test. A simple k-NN model showed reasonable results (within 0.5% relative error) when predicting the bridge condition in an incoming year.

Keywords: asset management, bridge condition index, data mining, forecasting, infrastructure, knowledge discovery in databases, maintenance, predictive models

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3457 The Effect of Non-Surgical Periodontal Therapy on Metabolic Control in Children

Authors: Areej Al-Khabbaz, Swapna Goerge, Majedah Abdul-Rasoul

Abstract:

Introduction: The most prevalent periodontal disease among children is gingivitis, and it usually becomes more severe in adolescence. A number of intervention studies suggested that resolution of periodontal inflammation can improve metabolic control in patients diagnosed with diabetes mellitus. Aim: to assess the effect of non-surgical periodontal therapy on glycemic control of children diagnosed with diabetes mellitus. Method: Twenty-eight children diagnosed with diabetes mellitus were recruited with established diagnosis diabetes for at least 1 year. Informed consent and child assent form were obtained from children and parents prior to enrolment. The dental examination for the participants was performed on the same week directly following their annual medical assessment. All patients had their glycosylated hemoglobin (HbA1c%) test one week prior to their annual medical and dental visit and 3 months following non-surgical periodontal therapy. All patients received a comprehensive periodontal examination The periodontal assessment included clinical attachment loss, bleeding on probing, plaque score, plaque index and gingival index. All patients were referred for non-surgical periodontal therapy, which included oral hygiene instruction and motivation followed by supra-gingival and subg-ingival scaling using ultrasonic and hand instruments. Statistical Analysis: Data were entered and analyzed using the Statistical Package for Social Science software (SPSS, Chicago, USA), version 18. Statistical analysis of clinical findings was performed to detect differences between the two groups in term of periodontal findings and HbA1c%. Binary logistic regression analysis was performed in order to examine which factors were significant in multivariate analysis after adjusting for confounding between effects. The regression model used the dependent variable ‘Improved glycemic control’, and the independent variables entered in the model were plaque index, gingival index, bleeding %, plaque Statistical significance was set at p < 0.05. Result: A total of 28 children. The mean age of the participants was 13.3±1.92 years. The study participants were divided into two groups; Compliant group (received dental scaling) and non-complaints group (received oral hygiene instructions only). No statistical difference was found between compliant and non-compliant group in age, gender distribution, oral hygiene practice and the level of diabetes control. There was a significant difference between compliant and non-compliant group in term of improvement of HBa1c before and after periodontal therapy. Mean gingival index was the only significant variable associated with improved glycemic control level. In conclusion, this study has demonstrated that non-surgical mechanical periodontal therapy can improve HbA1c% control. The result of this study confirmed that children with diabetes mellitus who are compliant to dental care and have routine professional scaling may have better metabolic control compared to diabetic children who are erratic with dental care.

Keywords: children, diabetes, metabolic control, periodontal therapy

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3456 Cost Sensitive Feature Selection in Decision-Theoretic Rough Set Models for Customer Churn Prediction: The Case of Telecommunication Sector Customers

Authors: Emel Kızılkaya Aydogan, Mihrimah Ozmen, Yılmaz Delice

Abstract:

In recent days, there is a change and the ongoing development of the telecommunications sector in the global market. In this sector, churn analysis techniques are commonly used for analysing why some customers terminate their service subscriptions prematurely. In addition, customer churn is utmost significant in this sector since it causes to important business loss. Many companies make various researches in order to prevent losses while increasing customer loyalty. Although a large quantity of accumulated data is available in this sector, their usefulness is limited by data quality and relevance. In this paper, a cost-sensitive feature selection framework is developed aiming to obtain the feature reducts to predict customer churn. The framework is a cost based optional pre-processing stage to remove redundant features for churn management. In addition, this cost-based feature selection algorithm is applied in a telecommunication company in Turkey and the results obtained with this algorithm.

Keywords: churn prediction, data mining, decision-theoretic rough set, feature selection

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3455 Effects of a Cluster Grouping of Gifted and Twice Exceptional Students on Academic Motivation, Socio-emotional Adjustment, and Life Satisfaction

Authors: Line Massé, Claire Baudry, Claudia Verret, Marie-France Nadeau, Anne Brault-Labbé

Abstract:

Little research has been conducted on educational services adapted for twice exceptional students. Within an action research, a cluster grouping was set up in an elementary school in Quebec, bringing together gifted or doubly exceptional (2E) students (n = 11) and students not identified as gifted (n = 8) within a multilevel class (3ᵣ𝒹 and 4ₜₕ years). 2E students had either attention deficit hyperactivity disorder (n = 8, including 3 with specific learning disability) or autism spectrum disorder (n = 2). Differentiated instructions strategies were implemented, including the possibility of progressing at their own pace of learning, independent study or research projects, flexible accommodation, tutoring with older students and the development of socio-emotional learning. A specialized educator also supported the teacher in the class for behavioural and socio-affective aspects. Objectives: The study aimed to assess the impacts of the grouping on all students, their academic motivation, and their socio-emotional adaptation. Method: A mixed method was used, combining a qualitative approach with a quantitative approach. Semi-directed interviews were conducted with students (N = 18, 4 girls and 14 boys aged 8 to 9) and one of their parents (N = 18) at the end of the school year. Parents and students completed two questionnaires at the beginning and end of the school year: the Behavior Assessment System for Children-3, children or parents versions (BASC-3, Reynolds and Kampus, 2015) and the Academic Motivation in Education (Vallerand et al., 1993). Parents also completed the Multidimensional Student Life Satisfaction Scale (Huebner, 1994, adapted by Fenouillet et al., 2014) comprising three domains (school, friendships, and motivation). Mixed thematic analyzes were carried out on the data from the interviews using the N'Vivo software. Related-samples Wilcoxon rank-sums tests were conducted for the data from the questionnaires. Results: Different themes emerge from the students' comments, including a positive impact on school motivation or attitude toward school, improved school results, reduction of their behavioural difficulties and improvement of their social relations. These remarks were more frequent among 2E students. Most 2E students also noted an improvement in their academic performance. Most parents reported improvements in attitudes toward school and reductions in disruptive behaviours in the classroom. Some parents also observed changes in behaviours at home or in the socio-emotional well-being of their children, here again, particularly parents of 2E children. Analysis of questionnaires revealed significant differences at the end of the school year, more specifically pertaining to extrinsic motivation identified, problems of conduct, attention, emotional self-control, executive functioning, negative emotions, functional deficiencies, and satisfaction regarding friendships. These results indicate that this approach could benefit not only gifted and doubly exceptional students but also students not identified as gifted.

Keywords: Cluster grouping, elementary school, giftedness, mixed methods, twice exceptional students

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3454 Effect of Residential Block Scale Envelope in Buildings Energy Consumption: A Vernacular Case Study in an Iranian Urban Context

Authors: M. Panahian

Abstract:

A global challenge which is of paramount significance today is the issue of devising innovative solutions to tackle the environmental issues, as well as more intelligent and foresightful consumption of and management of natural resources. Changes in global climate resulting from the burning of fossil fuel and the rise in the level of energy consumption are a few examples of environmental issues detrimental to any form of life on earth, which are aggravated year by year. Overall, energy-efficient designs and construction strategies can be studied at three scales: building, block, and city. Nevertheless, as the available literature suggests, the greatest emphasis has been on building and city scales, and little has been done as to the energy-efficient designs at block scale. Therefore, the aim of the current research is to investigate the influences of residential block scale envelope on the energy consumption in buildings. To this end, a case study of residential block scale has been selected in the city of Isfahan, in Iran, situated in a hot and dry climate with cold winters. Eventually, the most effective variables in energy consumption, concerning the block scale envelope, will be concluded.

Keywords: sustainability, passive energy saving solutions, residential block scale, energy efficiency

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3453 Lobbyists’ Competencies as a Basis for Shaping the Positive Image of Modern Lobbying

Authors: Joanna Dzieńdziora

Abstract:

Lobbying is an instrument of influence in various decision-making processes. It is also the underestimated issue as a research problem. The lack of research on the modern lobbyist competencies is the most crucial element. The paper presents attempts of finding answers to the following questions: Who should run the lobbying activity? What competencies should a lobbyist possess in order to implement lobbying activities effectively? Searching for answers for the mentioned above questions requires positioning the opportunity to change the image of lobbying in the area of competencies of entities that provide lobbying activities. The aim of the paper is presenting the lobbyist competencies profile in the framework of his professional role. The essence of lobbying activity and its significance in the modern economy as well as areas, the scope of lobbying activities, diagnosis of a modern lobbyist’s competences, lobbyist’s competencies profile that is focused on the professionalization of the lobbying activity, will have been presented in this paper. Indicated research tasks let emerge lobbyist’s competencies in the way that allows identifying and elaborating the lobbyist competencies profile. The profile lets improve lobbying activities. Its elaboration is based on the author’s research results analysis. Taking into consideration the shortages within the theory and research on the lobbying activity, the implementation of this research enables to fill the cognitive gap existing in the theory of management sciences.

Keywords: competencies, competencies profile, lobbying, lobbyist

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3452 Knowledge, Attitude and Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic at the Aga Khan University Hospital, Nairobi, Kenya (AKUHN) Sub-Saharan Africa-Qualitative Study

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

Abstract:

Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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