Degree Of Certainty Research Articles

What are the effects of drugs for nausea and vomiting prevention following general anesthesia? Summary and comments regarding a Cochrane Collaboration network meta-analysis

The aim of this special article is to summarize and discuss, from an anesthesia perspective, the network meta-analysis on drugs used for the prevention of postoperative nausea and vomiting after general anesthesia, in agreement with the Cochrane Colombia collaboration and within the framework of the Cochrane Corners strategy. Through the combination of indirect comparisons and based on the evidence, the use of aprepitant, ramosetron, granisetron, dexamethasone and ondansetron is recommended with a high degree of certainty for the reduction of postoperative nausea and vomiting.

Proficiency of Clear Aligner Therapy: A Systematic Review and Meta-Analysis.

The aim of this study was to evaluate the efficacy and efficiency of orthodontic treatment using clear aligner therapy (CAT). This efficiency was measured using the Peer Assessment Rating (PAR) index, the American Board of Orthodontics (ABO) index, or the similarity between the final ClinCheck and the final scanned models. A search was done electronically between 1998 and 2021 using the Cochrane Library, PubMed, and Google Scholar databases. Three reviewers individually rated the articles. The ROBINS tool and the Cochrane risk of bias tool were used to evaluate the quality of observational research and randomized controlled trials, respectively. The degree of certainty for each selected outcome was evaluated using the grading of recommendations assessment, development, and evaluation (GRADE) approach.Six studies with a total of 166 participants were considered after the full texts of 61 potential reports were reviewed. This research included in the review covered the period from 1998 to 2021 in retrospect.According to the current systematic review and meta-analysis, transparent aligners had a successful outcome. In mild to moderate cases, aligner treatment appears to have a significant advantage in terms of efficiency (treatment time); nonetheless, insufficient evidence of efficacy was observed based on multiple cross-sectional investigations. When compared to traditional brackets, clear aligners provided a more stable course of treatment.

Adaptation and application of the fuzzy synthetic evaluation (FSE) method for characterizing the trophic state of tropical semiarid reservoirs.

Eutrophication is a recurrent problem in water bodies, especially in tropical semiarid reservoirs. The trophic state index (TSI) is an important tool for the environmental management of aquatic systems. However, determining the TSI involves uncertainties that can affect decision-making. This study aimed to adapt and apply the fuzzy synthetic evaluation (FSE) to characterize the TSI considering the uncertainties of the reference eutrophication classification system. The Castanhão reservoir, the largest in the State of Ceará, Brazil, was taken as a case study. The results showed that (i) the uncertainty of the trophic classification system can be characterized by the triangular and trapezoidal membership functions; (ii) the result matrix associates the global trophic level with a degree of certainty, providing greater confidence to the decision maker; (iii) the eutrophication index (EI) is not an adequate tool for hierarchizing the trophic degree; and (iv) the membership level of the global trophic state generated by the FSE method is a suitable alternative to the EI. It is concluded that the proposed FSE model can be a useful tool for improving water resources management, especially in drylands.

Ordovician Tsunamis: Summary of Hypotheses and Implications for Geoheritage Resources

Ordovician tsunamis have been hypothesized for more than 25 years, but the related knowledge is yet to be systematized. The published sources bearing the pieces of this knowledge were collected in the course of the specialized bibliographical survey, and these pieces of evidence were summarized and interpreted with special attention to the spatiotemporal distribution of Ordovician tsunamis. It is found that the latter were reported from many places of the world (24 localities are established), which represent the Gondwana periphery, some isolated continental blocks, and terranes. Tsunamis were hypothesized for all epochs of the considered period, but the evidence is especially numerous for the Middle Ordovician. The degree of certainty of the interpretations of these tsunamis is chiefly moderate. It appears that only a tiny portion of Ordovician tsunamis is known, but the amount of available information is expected, taking into account the possibility of finding very ancient tsunamis. The outcomes of this study contribute to a better awareness of the world’s geoheritage resources. The established localities representing Ordovician tsunamis can be considered potential geosites, two of which are promising start points for further, field-based research.

Analytical solutions for brine invasion across caprock and leakage through an abandoned well in CO2 storage sites

Success in subsurface CO2 storage requires a trapping mechanism that inhibits the flow of storage layer fluid. Due to the wide prevalence of abandoned wells across geological formations, unwanted leakage events of brine and CO2 may occur if old wells near storage sites are not evaluated accurately. The abandoned wells, with time, may become conducive to flow if a sufficient pressure gradient is realized. Classical analytical models theorized abandoned well problems based on Theis’s solution and proposed strategies to find radial coordinates of the abandoned wells. However, in those formulations, brine invasion from storage to the surrounding formation is either disregarded or assumed as a vertical-only flow. In this study, we report a novel mathematical model that accounts for both brine invasion and abandoned well flow. The leakage rate across the abandoned well segment is evaluated from three contributing pressure terms: injection- and the associated brine invasion-induced pressure build-up, leakage-induced pressure drawdown in the storage layer, and leakage-induced pressure build-up in the overlying aquifer. We evaluate the average radial pressure from a two-dimensional coupled flow problem by applying Laplace and Hankel transforms. The obtained solutions in the Hankel-Laplace space were inverted back to the radial-time domain by employing the integration-summation-extrapolation and Stehfest method, respectively. We verified the developed solution against the classical solution analytically and graphically. We observe that Theis’s solution always overestimates the radial pressure as the pressure is diffusing in the lateral direction only. We identified that the abandoned well leakage rate decreases with the increase of permeability ratio, and the degree of reduction is higher in late times. We measured the degree of overestimation in leakage rates compared to classical solutions. A maximum leakage rate is observed for open flow conditions. The abandoned well leakage rate reaches its maximum early when the permeability ratios are higher. The proposed work can be employed as a base solution in old-well leakage modeling to determine the radial coordinate of the abandoned wells with a higher degree of certainty.

The Concept of Aqidah Akhlak Education Curriculum in Forming Istiqamah Character of Elementary School Students

There is a need for an aqidah akhlak education curriculum that can shape the character of istiqamah students at the elementary school level as a basic foundation for good character building. Thus, this research seeks to explore: (1) How is the concept of aqidah akhlak education curriculum in shaping the istiqamah character of elementary school students at the stage of learning planning, learning implementation, and learning evaluation? (2) How is implementing the aqidah akhlak education curriculum in shaping the istiqamah character of elementary school students at the stage of learning planning, learning implementation, and learning evaluation? This research uses a qualitative approach. This type of multi-site study research is chosen to provide a search for the proposed research problem. Data collection techniques were carried out by 1) in-depth interviews, 2) participant observation, and 3) documentation. The data were analyzed with an interactive model consisting of data condensation, data display, conclusion, and verification. Data validity checking is based on four criteria: degree of trust (credibility), degree of transferability, degree of dependability, and degree of certainty (confirmability). The results of this study were found (1) the concept of the aqidah akhlak education curriculum in shaping the istiqamah character of elementary school students at the learning planning, learning implementation, and learning evaluation stages in two Islamic elementary schools in Situbondo and (2) implementation of the aqidah akhlak education curriculum in shaping the istiqamah character of elementary school students at the stage of learning planning, learning implementation, and learning evaluation in two Islamic elementary schools in Situbondo.

Effects of food matrix on the prebiotic efficacy of inulin-type fructans: a randomised trial

Abstract Recently there is much debate in the scientific community over the impact of the food matrix on prebiotic efficacy of inulin-type fructans. Previous studies suggest that prebiotic selectivity of inulin-type fructans towards bifidobacteria is unaffected by the food matrix. Due to differences in study design, definitive conclusions cannot be drawn from these findings with any degree of certainty. In this randomised trial, we aimed to determine the effects that different food matrices had on the prebiotic efficacy of inulin-type fructans following a standardised 10-day, 4-arm, parallel, randomised protocol with inulin either in pure form or incorporated into shortbread biscuits, milk chocolate or a rice drink. Similar increases in Bifidobacterium counts were documented across all four interventions using both fluorescence in situ hybridisation (pure inulin: +0.63; shortbread: +0.59; milk chocolate: +0.65 and rice drink: +0.71 (log10 cells/g wet faeces) and 16S rRNA sequencing quantitative microbiome profiling data (pure inulin: +1.21 × 109; shortbread: +1.47 × 109; milk chocolate: +8.59 × 108 and rice drink: +1.04 × 109 (cells/g wet faeces) (all ). From these results, we can confirm that irrespective of the food matrix, the selectivity of inulin-type fructans towards Bifidobacterium is unaffected, yet the compositional make-up of the food matrix may have implications regarding wider changes in the microbiota.

Advanced Data Analytics and Organic Color Centers for Diagnostic Applications

Biofluids, most notably serum, contain many molecules that together may help to define the physiological state of a person. A grand challenge is to use serum to identify a clinical state with a high degree of certainty. Rather than attempting to accomplish biomarker development on a one-to-one recognition basis, it may be more effective to determine a whole clinical state via perception-based platforms due to recent achievements in sensor technologies and computational algorithms. In this talk, we present the development of carbon nanotube-based nanosensor arrays wherein the optical responses of the nanotubes were used to train machine learning models. We introduce the optical and chemical diversity of nanosensor array using molecular masking effects of DNA-wrapping and covalent functionalization of fluorescent quantum defects on nanotube surface. Machine learning can be employed to process the complex spectral responses of nanosensors and recognize spectroscopic fingerprints of certain clinical states from serum. We will discuss how these methods can complement and improve conventional diagnostic assays.

A volunteer allocation optimization model in response to major natural disasters based on improved Dempster–Shafer theory

Nowadays, factors such as global climate change, environmental damage, and the impact of human activities have led to an increase in natural disasters, and the frequency of natural disaster problems is increasing, which poses a great threat to the safety of people’s lives and property. The increased frequency of natural disasters has increased the need to focus on the ability to prevent and respond to disasters. The increased frequency of natural disasters has increased the need to focus on the capacity for disaster prevention and mitigation. All parties need to take appropriate measures to reduce losses and provide assistance after a disaster occurs. Among them, volunteers are a newly emerged important force for rescue, but volunteers have characteristics that normal rescue organizations do not have, such as voluntary and fragmented nature, therefore, volunteer allocation becomes an important issue today. This study tries to construct a volunteer assignment method, which takes into account several factors in the assignment, such as volunteers’ own willingness to the disaster site, the competency of volunteers’ various abilities, the demand of the disaster site for the task and the time satisfaction of the disaster victims, etc. L-T2FNs are introduced in the assignment process to enhance the degree of certainty; Prospect theory’s value function to consider the disaster victims’ psychology; This study proposes an algorithm to reduce evidence fusion conflicts. This algorithm uses a differential evolutionary algorithm based on the Dempster–Shafer theory to train the lowest conflict index (determined by K and evidence distance) for BPA fusion. Subsequently, the assignment is demonstrated by using the 7.8 magnitude earthquake in Turkey in 2023 as an arithmetic example to provide a solution to the problem of how to allocate volunteers to the appropriate disaster sites.

"It's Their Consent You Have to Wait For": Intimate Partner Violence and BDSM Among Gender and Sexual Minority Youth.

Gender and sexual minoritized (GSM) youth are more likely than their cisgender heterosexual peers to experience intimate partner violence (IPV) and practice bondage and discipline, domination and submission, sadism, and masochism (BDSM). Although IPV and BDSM are vastly different phenomena, superficial similarities (e.g., violent behaviors) can lead to misidentification in both practice and research. This study explores how GSM youth (a) experience and understand the differences between IPV and BDSM and (b) report consensual violent and controlling behaviors when answering items on IPV measures. Nine demographically diverse GSM youth (mean age 21.2) were drawn from a GSM youth-serving organization in the Northeast United States. Participants were interviewed about their experiences with IPV, BDSM, and consent. Participants also were asked to describe the process of completing two standardized measures of IPV. Interviews were coded using conventional and directed content analysis. Eight of nine participants reported IPV victimization, and seven reported BDSM interest or experiences. Four themes emerged: (a) GSM youth experience a spectrum of IPV victimization, often related to their gender and sexual identity; (b) interest in BDSM does not imply an acceptance of IPV; (c) GSM youth have a nuanced understanding of consent and strategies to communicate consent with their partners; and (d) Consent is the organizing framework by which GSM youth distinguish IPV from BDSM. Participants reported various degrees of certainty that they would include BDSM behaviors when answering questions about violent behaviors. Findings underscore the importance of conceptually and operationally differentiating IPV and BDSM. Programs that serve GSM youth should address IPV victimization, offer sex-positive education regarding healthy relationships and BDSM, and assist GSM youth in differentiating abusive behaviors from consensual BDSM. Standardized measures that do not conflate BDSM with IPV are crucial for studying IPV among GSM youth.

Operationalisation of legislation and the will of legislators in the judgments of international courts of war crimes and post-war recovery

ABSTRACT If the substantive truth, the actual situation in a war and post-war recovery based on the consequences of the war, is seemingly easy to determine in law, the judgments of international courts deciding on cases which occurred during the war do not attest to this. Substantive law is important, but procedural law is perhaps more significant with regard to rulings on war and post-war recovery. Only the highest degree of certainty is sufficient for a final and enforceable judgment. One of the key conditions for reaching a final and enforceable judgment is the consideration of the substantive and procedural conditions of proof, which is not possible without legal, relevant and legitimate evidence. This article argues that it should not be forgotten that in cases of legal proceedings against a certain military commander, the country whose armed forces they commanded is also always involved. If a member of a certain armed forces is legally convicted or acquitted, the country on whose behalf they acted as a military person in a military unit of that country is also legally convicted or acquitted. So, in international judicial proceedings, the implementation of procedural legislation and the will of legislators in war and post-war recovery has a different meaning from ‘ordinary’ criminality. War, as an extreme form of human violence which results in the biggest and most tragic events experienced by a country and its population, requires special forms of proving the consequences of war actions. The International Humanitarian Fact-Finding Commission should perhaps play a much greater role in this than it currently does.

Word order evolves at similar rates in main and subordinate clauses

Abstract In syntactic change, it remains an open issue whether word orders are more conservative or innovative in subordinate clauses compared with main clauses. Using 47 dependency-annotated corpora and Bayesian phylogenetic inference, we explore the evolution of S/V, V/O, and S/O orders across main and subordinate clauses in Indo-European. Our results reveal similar rates of change across clause types, with no evidence for any inherent conservatism of subordinate or main clauses. Our models also support evolutionary biases towards SV, VO, and SO orders, consistent with theories of dependency length minimization that favor verb-medial orders and with theories of a subject preference that favor SO orders. Finally, our results show that while the word order in the proto-language cannot be estimated with any reasonable degree of certainty, the early history of the family was dominated by a moderate preference for SVO orders, with substantial uncertainty between VO and OV orders in both main and subordinate clauses.

Attribution Gleanings

Abstract Those engaged in scholarly work might benefit from getting out of their silos of research from time to time and become familiar with parallel research in other areas of study. Very little of historical study involves 100 % certainty; it mostly involves degrees of possibility and probability. Finding out how scholars in other fields deal with similar problems can help us adjust the possibility/probability calibrations in our own field. For example, one can apply standards to determine degrees of certainty to works attributed to Nil Sorskii. One can then apply those standards to the works of other mid-second millennium authors. Meanwhile, the three criteria of historical study can beneficially be applied to questions of authorship, such as the controversies surrounding the attributions to William Shakespeare and to Andrei Kurbskii. No matter how frustrated one might get with one’s opponents, one needs to remember that ad hominem denigration does not advance the cause of scholarship.

Madrasah Aliyah Management Plus Skills in Creating Student Job Readiness (Multi Site Study at MAN 1 Magetan, MAN Blitar City and MA Alma’arif Udanawu Blitar)

This study aims to describe in depth related to: 1) Socialization of the Madrasah Aliyah Program plus Skills in creating Student work readiness, 2) Implementation of the Madrasah Aliyah Program plus Skills in creating Student work readiness, 3) Success of the Madrasah Aliyah program plus Skills in creating Student work readiness 4) Program Evaluation Plus Skills in creating Student Work Readiness. The research methodology uses qualitative methods. Data collection techniques are participant observation, in-depth interviews and documentation. The data analysis technique used is l) data condensation, 2) data presentation, 3) conclusion/verification. Checking the validity of the data is based on several criteria including: degree of trust (creadibility), transferability (transferability), dependability (dependability), and certainty (confirmability). The results of this research show that; 1) A program will be understood and implemented by all parties, when the media, materials and socialization objects to be conveyed are appropriate and relevant. And all parties in these institutions or agencies must always innovate in providing socialization. Innovation programs are needed because the dynamics of socialization media are very dynamic and directly proportional to the environment in which society is located. 2) To increase students’ work readiness, Madrasahs provide students with the freedom to carry out internships and street vendors in the business world and industrial world and in addition to increasing the ability of teachers to either bring in mentors from outside the madrasah or send skilled teachers to attend training and workshops in relevant agencies. Equally important is the synchronization and alignment of the skills curriculum with the world of business and industry. 3) The success of the plus skills program in Madrasas aims to equip students who do not continue their studies to be independent/or entrepreneurship, Madrasas must have a strong networking team to build networks in an effort to improve the quality of Madrasas as well as diversification of Industrial cooperation with the televaned Business World and Industrial World with skills programs implemented in Madrasahs. 4) In terms of evaluation of the program that is launched, there are 2 basic things that can be implemented by Madrasahs both internally and externally. Internally, it can be seen from the mastery of student skills through competency tests that work well with BLK and DU/DI who have collaborated, while for externally it can be seen how many students are accepted to work in DU/DI who have collaborated or other agencies or who work independently in accordance with skills that students choose when studying.

Vaccine safety surveillance in Kenya using GAIA standards: A feasibility assessment of existing national and subnational research and program systems

BackgroundActive surveillance systems for monitoring vaccine safety among pregnant women address some of the limitations of a current passive surveillance approach utilized in low- and middle-income countries (LMIC). However, few active surveillance systems in LMIC exist.Our study assessed the feasibility of utilizing three existing data collection systems in Kenya for active surveillance of maternal immunization and to assess the applicability of Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) case definitions that were initially developed for clinical trials within these systems. MethodsWe assessed applicability of GAIA case definition for maternal Tetanus Toxoid exposure, stillbirth, low birth weight, small for gestational age, Neonatal Invasive Blood Stream Infection (NIBSI), prematurity and neonatal death in two routine web-based health information systems (Kenya EMR and DHIS-2), and a web-based population-based pregnancy research platform (ANCOV11Antenatal, Intrapartum and Postnatal care COVID-19 Surveillance Study (ANCOV).) in Kenya. ResultsAll three HIS were capable of reporting selected outcomes to varying degrees of GAIA certainty. The ANCOV platform was the most robust in collecting and collating clinical data for effective maternal pharmacovigilance. The utilization of facility- and district-aggregated data limits the usefulness of DHIS-2 in pharmacovigilance as currently operationalized. While the Kenya EMR contained individual level data and meets the key considerations for effective pharmacovigilance, it was used primarily for HIV care and treatment records in a small proportion of health facilities and would require additional resources to expand to all antenatal care facilities and to link maternal and infant records. DiscussionPopulation-based research studies may offer a responsive short-term option for implementing maternal vaccine pharmacovigilance in LMICs. However, the foundation exists for long-term capacity building within the national health electronic data systems to provide this critical service as well as ensure participation of the country in international studies on maternal vaccine safety.

MSME Marketing Strategy in South Tangerang City During the Covid-19 Pandemic

This study aims to determine the development and marketing strategy of MSMEs in South Tangerang City during the Covid-19 Pandemic. This study uses a qualitative method. Data collection techniques consist of observation, interviews, and document analysis. Collecting data using observation techniques, interviews and documentation. Data validity is obtained through the degree of trust, transferability, dependability, and certainty. Data analysis techniques include data reduction, data exposure, and data conclusion and verification. The results of the study show that the number of MSMEs in South Tangerang City in 2022 will be 90,128. The marketing strategy carried out by MSMEs in South Tangerang City during the Covid-19 Pandemic was grouped into four aspects, namely product, price, promotion, and distribution/place. From the product aspect, in addition to offering new products, innovations are also made to existing products to make them more attractive to consumers. From the price aspect, many MSME managers make adjustments to prices. From the promotion aspect, in addition to giving discounts, promotions are carried out through word of mouth, MSME community networking, and online. From the aspect of distribution/place, the system for distributing and selling products is more limited, where MSME managers use more facilities through the online system.

Clinical decision-making by fourth-year pharmacy students: Towards an understanding of their uncertainty

IntroductionClinical decision-making is a critical process underpinning much of a pharmacist's daily activities. While it is known that pharmacists hesitate to make decisions, it remains unclear whether pharmacy students experience similar hesitancy. The objective of this study was to better understand the phenomenon of decision-making in pharmacy students. MethodsThis study was designed from a social constructivist paradigm using qualitative case study methodology. The purpose was to investigate issues related to hesitancy in clinical decision-making by fourth-year pharmacy students. Data were collected through observation of students engaging in simulations, post-simulation interviews, and written reflections. Data analysis included multiple stages of coding, followed by pattern identification and discovery of interrelationships. ResultsThe primary themes relating to issues in pharmacy student clinical decision-making were relational factors, teaching and learning, degree of certainty, and personal characteristics. Relational factors include elements of relationships with patients and physicians as well as a sense of autonomy. The theme of teaching and learning included the sub-themes of formal education and learning in the real world. Degree of certainty included patient complexity, weighing risks and benefits, comfort in ambiguity, and a lack of information. Finally, personal characteristics associated with decision-making include personal experiences, leadership skills, and confidence. ConclusionsPharmacy education needs to focus on ensuring preceptors can help model comfort in ambiguity, that assessments include the reality of practice, and ensuring ample practice of decision-making in a simulated environment.

Describing the transition from late pregnancy into early labour – A prospective cohort study

ObjectiveThe time between self-assessed first symptoms and clinical confirmation of labour onset is marked by uncertainty, particularly for primiparas. Accordingly, primiparas often seek professional care to confirm their perceptions of labour onset. This paper describes the transition into early labour among primiparas considering their level of certainty in labour onset and their perception of labour onset symptoms prior to birth. MethodsA prospective exploratory cohort study was conducted in Germany between July 2020 - March 2021 among a convenience sample of 69 primiparas. Respondents recorded in a non-validated questionnaire their perceptions of nine symptoms and degree of certainty about labour onset every day from 37 weeks gestation. Descriptive analysis included certainty in labour onset and dedicated symptoms in relation to days before birth. ResultsThe participants (n=69) reported a little certainty of labour onset up to 32 days before birth and most of them became certain up to four days before birth. Associated symptoms were regular and irregular pain, symptoms of vaginal loss and emotional symptoms. Gastrointestinal symptoms and nausea were not indicated by a majority. Uncertainty of labour onset, however, was indicated up until the day of birth. ConclusionAlthough interpretation is based on a small sample size, primiparas are able to self-diagnose labour onset and report connected symptoms up to four days before birth. We suggest calling this time between self-diagnosis of labour onset and confirmed labour onset based on clinical parameters the transition into early labour.

A Nanosyntactic Analysis of Arabic Complementizers

This study investigates the syntactic composition of complementizers in Arabic from a nanosyntactic perspective (Starke, 2009). The study unravels the dichotomy in the behavior of root complementizers in Arabic; it highlights how the selection of complementizers is impacted by presupposed information and the degree of certainty. In spoken varieties of Arabic, such as Jordanian Arabic and Lebanese Arabic, root complementizers are blocked from root positions, but such positions are accessible for Modern Standard Arabic. Refining Ross' (1970) hidden verbs theorem and Fassi Fehri’s (2012) featural distinction, the study shows that if a complementizer is selected by different triggers of veridicality, such as ʔanna in MSA, ʔɨnn in Jordanian Arabic and ʔɘnno in Lebanese Arabic, the complementizer cannot appear without its trigger, whereas if a complementizer is selected by one trigger, such as ʔɪnna in MSA, the complementizer can be used in root positions without a trigger. Comparing the findings of the study with Baunz' (2018) universal hierarchy, we show that the hierarchy in its current status fails to account for Arabic data. The conclusion gives a stronger contribution for the semantic composition of complementizers.

Effects of knowledge, experience and coordinationon cost certainty for structural engineering designs of high-rise building projectsin Nairobi, Kenya

Clients are increasingly demanding a high degree of cost certainty from their project design teams to ensure that their building projects are completed within the budgeted resources. However, this objective has been negated by various challenges that unfortunately cause budget overruns. This study investigated the effects of experience and project management skills on Change Orders for Structural Engineering High-Rise Buildings in Nairobi County, Kenya. Data was collected from 150 consulting Civil Engineers drawn from the Engineers Board of Kenya register using a web-based structured questionnaire. Analysis of variance and Chi-square tests showed that coordination and experience directly correlated to cost certainty at 5% confidence level. Design coordination significantly helped to narrow gaps for cost certainty as well enhancing better understanding of the project scope. The level of professional experience was found to be critical for problem solving, effective use of design software, quality control of design and documentation and integration. Therefore, professional experience and coordination played a critical role in the reduction of cost overruns during the construction of high-rise buildings in Nairobi.