A Framework for Fire Safety Management in School Facilities

Schools are high-risk type of facilities in fire emergencies. This requires the implementation of safety measures, which comprise administrative and operational efforts to mitigate the occurrence of fire accidents. The review of literature indicated the lack of practical approaches that can be easily adopted for safety management in school facilities. This paper presents the development and implementation of a generic framework for fire safety management in school facilities. A literature review in the domain of fire safety in schools was performed to comprehend various knowledge areas in this context. A generic framework for fire safety management in school facilities was developed. The framework was implemented in a secondary school, located in the Eastern Province of Saudi Arabia, as a case study, to illustrate its applicability. An action plan was developed to improve the level of fire safety in the school facility, under review. The findings indicated that the framework provides a methodological and systematic approach for assessing the level of fire safety in schools, as well as determine the possible actions for improving the overall safety condition in such facilities. The paper provides a useful focus for practitioners and researchers concerned with fire safety in the educational workplace

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Techno-Economic Assessment of Energy Retrofitting Educational Buildings: A Case Study in Saudi Arabia

The buildings and construction sector accounts for the majority of the energy consumption in the Kingdom of Saudi Arabia (KSA). For a sustainable future, energy consumption in the sector should be reduced and existing buildings need to be energy retrofitted. A number of studies present energy retrofitting of residential buildings in KSA; however, there is a lack of studies presenting retrofitting of educational buildings. Thus, the aim of this study is to adopt a BIM-based approach to assess Energy Conservation Measures (ECMs) in a prototypical Government-built educational building in Dammam, KSA. The methodology consists of six prime steps, (1) case study data collection, (2) energy auditing, (3) proposing ECMs, (4) BIM model development, (5) energy assessment, and (6) economic assessment. The energy audit revealed several inefficiencies in the building construction and operation and four ECMs were proposed and simulated. It was found that annual energy consumption can be reduced by 22.7% in the educational building, and the investment for the four ECMs is paid back in 2.7 years only. Therefore, implementing the proposed ECMs is a viable option to energy retrofit such educational buildings in the country, and the presented BIM-based approach can be adopted to efficiently conduct the energy retrofitting process

Post Occupancy Evaluation of the Built Environment: A Case Study of Mosque Facilities

Mosques are religious and cultural facilities that are used as a place of worship, social gatherings, and religious events by Islamic communities. The built environment in these facilities should meet certain technical, functional, and behavioral requirements for worshipers. Mosques could endure critical defects and inadequate performance, with gaps in knowledge, of appraisal tools for their overall performance assessment. Therefore, this research was motivated by the need to identify and purpose an exemplary systematic process upon the conduct of post-occupancy evaluation, owing to the fundamental need for satisfactory conditions that need to be met by mosque facilities. Thus, this paper presents an exemplary post-occupancy evaluation of mosque facilities in Saudi Arabia; as a religious built environment. A triangulation approach of data collection and assessment methods were followed and discussed in this research. A case study mosque was selected, following a review of literature. Interviews and walkthrough inspection identified 34 performance elements. Users’ satisfaction survey data were collected and analyzed. Recommendations were proposed towards improving performance of the case study mosque as a religious built environment that demands satisfactory occupancy conditions. The findings indicated that worshipers were strongly satisfied with the conditions of the built environment in the case study facility; including acoustical comfort, spirituality, and aesthetic performance elements. This paper expands the boundaries of knowledge in terms of identification of mosques’ performance elements

Receptor-defined subtypes of breast cancer in indigenous populations in Africa: a systematic review and meta-analysis.

BACKGROUND: Breast cancer is the most common female cancer in Africa. Receptor-defined subtypes are a major determinant of treatment options and disease outcomes but there is considerable uncertainty regarding the frequency of poor prognosis estrogen receptor (ER) negative subtypes in Africa. We systematically reviewed publications reporting on the frequency of breast cancer receptor-defined subtypes in indigenous populations in Africa. METHODS AND FINDINGS: Medline, Embase, and Global Health were searched for studies published between 1st January 1980 and 15th April 2014. Reported proportions of ER positive (ER+), progesterone receptor positive (PR+), and human epidermal growth factor receptor-2 positive (HER2+) disease were extracted and 95% CI calculated. Random effects meta-analyses were used to pool estimates. Fifty-four studies from North Africa (n=12,284 women with breast cancer) and 26 from sub-Saharan Africa (n=4,737) were eligible. There was marked between-study heterogeneity in the ER+ estimates in both regions (I2>90%), with the majority reporting proportions between 0.40 and 0.80 in North Africa and between 0.20 and 0.70 in sub-Saharan Africa. Similarly, large between-study heterogeneity was observed for PR+ and HER2+ estimates (I2>80%, in all instances). Meta-regression analyses showed that the proportion of ER+ disease was 10% (4%-17%) lower for studies based on archived tumor blocks rather than prospectively collected specimens, and 9% (2%-17%) lower for those with ≥ 40% versus those with <40% grade 3 tumors. For prospectively collected samples, the pooled proportions for ER+ and triple negative tumors were 0.59 (0.56-0.62) and 0.21 (0.17-0.25), respectively, regardless of region. Limitations of the study include the lack of standardized procedures across the various studies; the low methodological quality of many studies in terms of the representativeness of their case series and the quality of the procedures for collection, fixation, and receptor testing; and the possibility that women with breast cancer may have contributed to more than one study. CONCLUSIONS: The published data from the more appropriate prospectively measured specimens are consistent with the majority of breast cancers in Africa being ER+. As no single subtype dominates in the continent availability of receptor testing should be a priority, especially for young women with early stage disease where appropriate receptor-specific treatment modalities offer the greatest potential for reducing years of life lost. Please see later in the article for the Editors' Summary