Architectural Fire Protection Learning: the ETSAUN Case

Fire protection is a main parameter in the design of buildings, although it is often neglected in the Schools of Architecture because is being considered an “engineering thing”. In Spain, the education system provides a minimum dedication for this matter, but in the case that will be presented in the paper, it has been taken to a higher level. This is because fire protection is provided in three courses as we described in the article. This article will show the teaching itinerary in Architecture Studies Degrees explaining the dynamics of each of the three courses in which students are trained in fire protection, illustrated with real examples of work from the students themselves. We anticipate here that in the first year, students learn the theory, its impact on the Project; in the second year of learning, they relate it to the project at hand; and in the third, this time independently, consolidate learning in a complex project that takes place over two semesters. This teaching experience includes also the description from developing apps for smartphones, to the students practices of fire protection in the Laboratory. Far away from the opportunity of research and specialization that Fire Safety provides for future architects and construction engineers, it must be taken into account that Fire Safety it is not a limitation, Fire Safety becomes more real the architectural project

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

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

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

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

Architectural Fire Protection Learning: the ETSAUN Case

Fire protection is a main parameter in the design of buildings, although it is often neglected in the Schools of Architecture because is being considered an “engineering thing”. In Spain, the education system provides a minimum dedication for this matter, but in the case that will be presented in the paper, it has been taken to a higher level. This is because fire protection is provided in three courses as we described in the article. This article will show the teaching itinerary in Architecture Studies Degrees explaining the dynamics of each of the three courses in which students are trained in fire protection, illustrated with real examples of work from the students themselves. We anticipate here that in the first year, students learn the theory, its impact on the Project; in the second year of learning, they relate it to the project at hand; and in the third, this time independently, consolidate learning in a complex project that takes place over two semesters. This teaching experience includes also the description from developing apps for smartphones, to the students practices of fire protection in the Laboratory. Far away from the opportunity of research and specialization that Fire Safety provides for future architects and construction engineers, it must be taken into account that Fire Safety it is not a limitation, Fire Safety becomes more real the architectural project

Gardens, Japanese: Kenrokuen Garden, Kanazawa, Japan [019]

Photograph of the ropes used to support and protect trees, Kenrokuen Garden, Kanazawa, JapanPine tree (training of branches), Kenrokuen Garden (construsted circa 1670, enlarged 1837), Kanazawa, Japan