Human-Induced Geo-Hazards in the Kingdom of Saudi Arabia: Distribution, Investigation, Causes and Impacts

Different types of geological hazards are induced by human activities in the Kingdom of Saudi Arabia (KSA). These geological hazards include land subsidence and earth fissures, sinkholes, expansive soils, and flash floods. A wide variety of recent geological hazards have been reported in several areas, causing significant human and property losses. Human activities, most notably groundwater extraction, infrastructure development, and agricultural activities, have induced unstable conditions. This chapter provides an overview of the human-induced geological hazard in the KSA, mainly earth fissures and sinkhole, which represent a scarcely explored topic. This work identifies the main types of human-induced geological-hazard formations, distribution, causes, and impacts, illustrated through several case studies in the KSA

A Flood Risk Management Program of Wadi Baysh Dam on the Downstream Area: An Integration of Hydrologic and Hydraulic Models, Jizan Region, KSA

For public safety, especially for people who dwell in the valley that is located downstream of a dam site, as well as the protection of economic and environmental resources, risk management programs are urgently required all over the world. Despite the high safety standards of dams because of improved engineering and excellent construction in recent times, a zero-risk guarantee is not possible, and accidents can happen, triggered by natural hazards, human actions, or just because the dam is aging. In addition to that is the impact of potential climate change, which may not have been taken into account in the original design. A flood risk management program, which is essential for protecting downstream dam areas, is required. Part of this program is to prepare an inundation map to simulate the impact of dam failure on the downstream areas. The Baysh dam has crucial importance both to protect the downstream areas against flooding, to provide drinking water to cities in the surrounding areas, and to use the excess water for irrigation of the agricultural areas located downstream of the dam. Recently, the Kingdom of Saudi Arabia (KSA) was affected by extraordinary rainstorm events causing many problems in many different areas. One of these events happened along the basin of the Baysh dam, which raised the alarm to the decision makers and to the public to take suitable action before dam failure occurs. The current study deals with a flood risk analysis of Wadi Baysh using an integration of hydrologic and hydraulic models. A detailed field investigation of the dam site and the downstream areas down to the Red Sea coast has been undertaken. Three scenarios were applied to check the dam and the reservoir functionality; the first scenario at 100-and 200-year return period rainfall events, the second scenario according to the Probable Maximum Precipitation (PMP), and the third scenario if the dam fails. Our findings indicated that the Baysh dam and reservoir at 100-and 200-year rainfall events are adequate, however, at the PMP the water will spill out from the spillway at ~8900 m3/s causing flooding to the downstream areas; thus, a well-designed channel along the downstream wadi portion up to the Red Sea coast is required. However, at dam failure, the inundation model indicated that a vast area of the section downstream of the dam will be utterly devastated, causing a significant loss of lives and destruction of urban areas and agricultural lands. Eventually, an effective warning system and flood hazard management system are imperative

Association between β-blocker use and mortality in critically ill patients: a nested cohort study

Abstract Background β-blockers have several indications in critically ill patients and are commonly used. The aim of this study is to examine the relationship between the use of β-blockers in critically ill patients and mortality. Methods This was a nested cohort study in which all medical-surgical ICU patients (N = 523) enrolled in a randomized clinical trial of intensive insulin therapy (ISRCTN07413772) were grouped according to β-blocker use during ICU stay. To account for the indication of β-blockers, we constructed a propensity score using selected clinically-relevant and statistically-significant variables related to β-blocker exposure and outcome. The primary endpoints were all-cause ICU and hospital mortality. Secondary endpoints were the development of severe sepsis during ICU stay, ICU and hospital length of stay, and mechanical ventilation duration. Using multivariable models, we adjusted the associations of β-blockers and these outcomes to the propensity score. Results Of the 523 patients enrolled in the study, 89 (17.0%) received β-blockers during their ICU stay. There were no significant associations between β-blocker therapy and ICU mortality (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 0.83–2.9, P = 0.16), hospital mortality (aOR 1.09, 95% CI 0.99–1.20, P = 0.73), the risk of ICU-acquired severe sepsis (aOR 1.67, 95% CI 0.95–2.97, P = 0.08), mechanical ventilation duration (P = 0.17), or ICU length of stay (P = 0.22). However, β-blocker use was associated with increased ICU and hospital mortality among nondiabetic patients (aOR 2.93, 95% CI 1.19–7.23, and 2.43, 95% CI 1.05–5.64, respectively). Conclusions Our study showed that β-blockers during the ICU stay had no significant association with mortality or morbidity. However, β-blocker therapy was associated with increased mortality in non-diabetic patients. Trial registration ISRCTN07413772; (dated 13.07.2005)

Bieten Visiten eine effektive Lehre und Ausbildung? Hindernisse für das Lernen, und was macht eine gute Lehre an einem großen Krankenhaus der Tertiärversorgung aus Sicht von Ärzt*innen in der Ausbildung aus

Background: Ward rounds (WR) have been integral to the process of teaching and learning medicine and also provides a vital opportunity to communicate with the patient, their relatives, and other healthcare professionals. Yet in recent years trainees' perception of the educational value of WRs seems to have declined. Objectives: The aim of this study to assess trainees' perception of the educational value of WRs at King Abdulaziz Medical City(KAMC), Riyadh, a 1500 bed academic hospital in Saudi Arabia.Methods: A self-administered, paper-based survey was distributed to physicians in training at KAMC between October and December 2019. All residents who attended WRs were invited to participate. The questionnaire was adapted from a survey used in a previous study. The demographic section requested details of the respondent's age, gender, specialty, and seniority. The second and third sections asked about the logistics of current ward round practices. It included several questions on the structure as well as the duration and frequency of ward rounds. The fourth and fifth sections asked for participant's perception of the opportunities for, and the obstacles to, learning on ward rounds. The subsequent sections asked several questions onward round structure and the clinical teacher. Responses were requested on a 5-point Likert-type scale (strongly disagree, disagree, neutral, agree, strongly agree). The last section asked the participant for general comments and feedbackResult: The study targeted 250 residents in specialties that routinely performed WRs. Only 166 residents returned the questionnaire (response rate of 66.4%). Male 89 (53.6%), medical 108 (65.1%), surgical 58 (34.9%), resident in first year 81 (48.8%). The overall average time spent on WR was 13 (± 11 SD) hours per week. The WR was perceived as a good opportunity to learn about diagnostic investigation 138 (83%) and patient management 133(80.1%), history taking114 (68.7%) physical examination 103 (62.0%), and time management skills 86 (51.8%). The majority of our trainees felt that the WR was educationally very useful to 86 (52%) and attribute to at least a third of the education they receive during their training. They also reported that about the quarter of the time spent on WRs is devoted to teaching. The good teacher described as enthusiastic to teach 137 (82.5%), provide feedback to trainees 135 (81%), do not rush 139(83.7), communicate to trainee 144 (86.7), and consultant level,101 (60.8). Trainees also identify a few factors that hinder their training such as lack of time 130 (79%), and the number of patients 129 (78.3). Conclusion: This study identifies the strengths and weaknesses of WR in our institution. Finding will help training supervisors in addressing and rectifying these shortcoming and factors hinder training.Hintergrund: Visiten sind ein integrativer Bestandteil des Lehrprozesses und des Lernens in der Medizin und bieten zudem eine sehr wichtige Möglichkeit, um mit Patient*innen, deren Verwandten und anderem Gesundheitspersonal zu kommunizieren. Und trotzdem scheint in den letzten Jahren der Ausbildungswert von Visiten in der Wahrnehmung der Ärzt*innen in der Ausbildung nachzulassen. Ziele: Ziel dieser Studie ist es, die Wahrnehmung der Ärzt*innen in der Ausbildung hinsichtlich des Ausbildungswertes von Visiten in König Abdulaziz Medical City (KAMC), Riad, einem akademischen Lehrkrankenhaus mit 1.500 Betten in Saudi-Arabien, zu untersuchen.Methoden: Unter den Ärzt*innen in der Ausbildung am KAMC wurde zwischen Oktober und Dezember 2019 eine selbsterstellte Umfrage in Papierform verteilt. Alle Assistenzärzt*innen, die an Visiten teilnahmen, wurden zur Beteiligung aufgerufen. Der Fragebogen wurde anhand einer Umfrage erstellt, die bei einer früheren Studie verwendet wurde. Der demografische Teil erfragte Angaben zu Alter, Geschlecht, Fachrichtung und Dienstalter der Befragten. Der zweite und dritte Teil fragte nach der Logistik der gegenwärtigen Visitenpraxis. Sie umfassten verschiedene Fragen zu Struktur sowie Dauer und Häufigkeit von Visiten. Der vierte und fünfte Teil befragte die Teilnehmer*innen nach ihrer Wahrnehmung der Möglichkeiten und Hindernisse von Visiten für das Lernen. Die nachfolgenden Abschnitte stellten verschiedene Fragen zu Visitenstruktur und klinischen Ausbildern. Antworten wurden in Form einer 5-Punkte Likert-Skala erbeten (stimme überhaupt nicht zu, stimme nicht zu, unentschieden, stimme zu, stimme völlig zu). Der letzte Teil bat die Teilnehmer*innen um allgemeine Anmerkungen, Hinweise und FeedbackErgebnis: Die Studie richtete sich an 250 Assistenzärzt*innen in Fachrichtungen, die routinemäßig Visiten durchführen. Nur 166 Assistenzärzt*innen reichten den Fragebogen wieder ein (Rücklaufquote von 66,4%), davon: männliche (89; 53,6%), innere (108; 65,1%), chirurgische (58; 34,9%), Assistenzärzt*innen im ersten Ausbildungsjahr (81; 48,8%). Die Gesamtdurchschnittszeit, die für Visiten aufgewendet wurde, lag bei 13 (± 11 SD) Stunden pro Woche. Die Visiten wurden als gute Möglichkeit angesehen, um etwas über diagnostische Untersuchung (138; 83%) und Patientenmanagement (133; 80,1%), Anamnese (114; 68,7%), körperliche Untersuchung (103; 62,0%) und Zeitmanagementfähigkeiten (86; 51,8%) zu lernen. Die Mehrzahl unserer Ärzt*innen in der Ausbildung hatten den Eindruck, dass die Visiten für ihre Ausbildung sehr nützlich sind (86; 52%) und zu mindestens einem Drittel der Ausbildung, die sie während ihres Studiums erhalten, beitragen. Sie berichteten auch, dass etwa ein Viertel der bei Visiten verbrachten Zeit auf die Lehre verwendet wird. Gute Ausbilder*innen wurden beschrieben als engagierte Lehrer*innen (137; 82,5%), jemand, der den Lernenden Feedback gibt (135; 81%), sie nicht antreibt (139; 83,7%), mit den Lernenden kommuniziert (144; 86,7%) und ihnen beratend zur Seite steht (101; 60,8%). Die Ärzt*innen in der Ausbildung identifizierten auch einige Faktoren, die ihre Ausbildung behindern, wie z. B. Zeitmangel (130; 79%) und die Anzahl der Patient*innen (129; 78,3%). Schlussfolgerung: Diese Studie identifiziert die Stärken und Schwächen von Visiten in unserer Einrichtung. Die Ergebnisse werden den Ausbildungsbetreuer*innen dabei helfen, diese Mängel und Faktoren, die die Ausbildung behindern, anzugehen und zu korrigieren

A Flood Risk Management Program of Wadi Baysh Dam on the Downstream Area: An Integration of Hydrologic and Hydraulic Models, Jizan Region, KSA

For public safety, especially for people who dwell in the valley that is located downstream of a dam site, as well as the protection of economic and environmental resources, risk management programs are urgently required all over the world. Despite the high safety standards of dams because of improved engineering and excellent construction in recent times, a zero-risk guarantee is not possible, and accidents can happen, triggered by natural hazards, human actions, or just because the dam is aging. In addition to that is the impact of potential climate change, which may not have been taken into account in the original design. A flood risk management program, which is essential for protecting downstream dam areas, is required. Part of this program is to prepare an inundation map to simulate the impact of dam failure on the downstream areas. The Baysh dam has crucial importance both to protect the downstream areas against flooding, to provide drinking water to cities in the surrounding areas, and to use the excess water for irrigation of the agricultural areas located downstream of the dam. Recently, the Kingdom of Saudi Arabia (KSA) was affected by extraordinary rainstorm events causing many problems in many different areas. One of these events happened along the basin of the Baysh dam, which raised the alarm to the decision makers and to the public to take suitable action before dam failure occurs. The current study deals with a flood risk analysis of Wadi Baysh using an integration of hydrologic and hydraulic models. A detailed field investigation of the dam site and the downstream areas down to the Red Sea coast has been undertaken. Three scenarios were applied to check the dam and the reservoir functionality; the first scenario at 100- and 200-year return period rainfall events, the second scenario according to the Probable Maximum Precipitation (PMP), and the third scenario if the dam fails. Our findings indicated that the Baysh dam and reservoir at 100- and 200-year rainfall events are adequate, however, at the PMP the water will spill out from the spillway at ~8900 m3/s causing flooding to the downstream areas; thus, a well-designed channel along the downstream wadi portion up to the Red Sea coast is required. However, at dam failure, the inundation model indicated that a vast area of the section downstream of the dam will be utterly devastated, causing a significant loss of lives and destruction of urban areas and agricultural lands. Eventually, an effective warning system and flood hazard management system are imperative

Change of daily process measures over the study period among the whole cohort and in subgroups of ICUs with baseline spontaneous trial (SAT) compliance of >50% and ≤50.

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