Assessing property flood resilience for commercial buildings: some recommendations

Commercial property plays a significant role in the UK economy and presents a major investment asset for both the pensions and insurance industries. UK commercial property forms a significant portion of the economy, with an estimated turnover of £3.2trn and employing about 22.8 million people with an average growth rate of 2.2% since 2008. Commercial property investment rental income derived from business leases on offices, shops, industrial and leisure facilities supports pensions, insurance policies and savings plans. Therefore flooding poses a considerable threat to the security of income from this asset class and means the security of these investments is paramount to the large number of shareholders and stakeholders. In recent years, UK flood risk management policy has recognised that floods cannot be totally prevented and has therefore embraced a proactive and more robust approach of managing flood risk and living with floods, captured under the 'living with water' philosophy. This approach often entails building resilience into the system that is exposed to the risk. For residential properties, the focus has been on development and adaptation to the risks of flooding. This concept is commonly referred to as 'property level' flood resilience or simply, property flood resilience (PFR). Since its inception, this has gained wider recognition in the domain of flood risk management. However, most studies relating to flood-risk effect on properties or PFR have concentrated almost exclusively on residential properties. Given that commercial properties tend to have many different characteristics, for example in form, materials and technologies used, there has up to now been scant research on the application of PFR to them. The aim of this study, therefore, is to explore the application of PFR towards this important component of the building stock and to develop some clear conclusions and recommendations for taking this approach forward. The research adopted a mixed methods approach: - a review of the existing evidence found in the literature, encompassing government reports, policy papers, grey literature and published research. - an online questionnaire survey of commercial property owners and tenants exposed to flood risk. - a detailed case study phase, in York, Sheffield and Worcester area of the UK, in which six examples of flood-affected commercial properties were investigated in detail, comprising interviews with occupiers and owners, site visits and observations and scrutiny of documentation. The case study businesses were: a manufacturing factory, a business centre, a holiday cottage, a sailing club, a rowing club and a touring theatre. The findings revealed The detrimental impact from flooding on commercial properties is evident in a number of ways, making a clear case for businesses to take flood risk seriously and to take action to minimise the impact. Flood risk awareness among the case study businesses was high, but this was possibly due to the fact that most had direct flooding experience. Effort will be needed to promote awareness to businesses not currently at risk, to allow time to prepare risk management strategies. The case studies showed that businesses tended to choose a bespoke package of measures to suite their circumstances, rather than implementing a full suite of all available PFR packages. It was also evident that PFR measures enhanced the reputation of the businesses and increased the value of properties, providing indirect and intangible benefits, as well as reducing the damage from flooding - the principle direct and tangible benefit. Businesses need to fully appreciate the range of benefits into their PFR decision-making. The case studies showed that businesses chiefly relied on their own resources and instincts, or followed the practices of others in developing PFR strategies. This points to the need for business support in this area, especially for SMEs. Recommendations - Flood resilience should be part of an organisation's business risk management strategy and incorporated into its operational management. - The absence of a 'one-size-fits-all model' means businesses need to assess their own flood risks and implement specific PFR measures to address their needs. - future comprehensive research on the costs and benefits of different PFR measures will facilitate and encourage more PFR measures in commercial properties. - There is an urgent need for a 'one-stop' hub organised by government or professional bodies to provide independent, reliable and practical advice and guidance on PFR measures. - PFR measures should be incorporated into building design and construction, where appropriate, to avoid costly retrofitting later

Severity, challenges, and outcome of retroperitoneal hematoma in a Nigeria Tertiary Hospital

Background: Retroperitoneal hematoma (RH) can present as an acute life‑threatening condition, report on RH in low‑income countries are lacking. Objective: We present the severity, pattern, challenges, and outcome of RH in a low‑resource country such as Nigeria. Methods: This was a retrospective observational study of all patients with blunt or penetrating abdominal injury needing surgery, patients with RH among them were analyzed.Results: In the last one decade spanning 2005–2015, our operation database record showed that 247 patients had exploratory laparotomy for blunt and penetrating abdominal trauma. Out of the 115 patients with complete record available, only 43 had RH. The median age of the patients was 30 years, and the most affected age group was 20–29 years. Female to male ratio was 1:13. Only eight patients (18.6%) reached the hospital from the accident site within the first “Golden Hour” of accident, which is the first 1 h postrauma during which treatment intervention believed to have the best outcome. Only two patients (4.7%) got to operating theater within 1 h of reaching hospital. None of our patients had preoperative diagnosis of RH; overall, mortality was two patients (4.7%). Conclusion: Logistical infrastructural inadequacies such as lack of sterile theater bundle and drapes/nonavailability or busy theater space caused delay for patients between presentation in the Accident and Emergency Center and operating theater. None of our patients had a preoperative diagnosis of RH because of lack of access to computerized tomography scan dedicated to trauma in Accident and Emergency Center. The overall mortality of 4.7% in this study, which is on the low side, tends to suggest that mostly mild and stable cases which can make it to the operating table were eventually operated upon. Keywords:  Nigeria, outcome, prehospital care, retroperitoneal hematoma, tertiary institution, trauma

Health workforce and governance: the crisis in Nigeria

Background In Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. We aimed to review recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria. Methods We conducted a scoping literature search of PubMed to identify studies on health workforce and health governance in Nigeria. A critical analysis, with extended commentary, on recent health workforce crises (2010–2016) and the health system in Nigeria was conducted. Results The Nigerian health system is relatively weak, and there is yet a coordinated response across the country. A number of health workforce crises have been reported in recent times due to several months’ salaries owed, poor welfare, lack of appropriate health facilities and emerging factions among health workers. Poor administration and response across different levels of government have played contributory roles to further internal crises among health workers, with different factions engaged in protracted supremacy challenge. These crises have consequently prevented optimal healthcare delivery to the Nigerian population. Conclusions An encompassing stakeholders’ forum in the Nigerian health sector remain essential. The national health system needs a solid administrative policy foundation that allows coordination of priorities and partnerships in the health workforce and among various stakeholders. It is hoped that this paper may prompt relevant reforms in health workforce and governance in Nigeria toward better health service delivery in the country

An Estimate of the Incidence of Prostate Cancer in Africa: A Systematic Review and Meta-Analysis

Prostate cancer (PCa) is rated the second most common cancer and sixth leading cause of cancer deaths among men globally. Reports show that African men suffer disproportionately from PCa compared to men from other parts of the world. It is still quite difficult to accurately describe the burden of PCa in Africa due to poor cancer registration systems.We systematically reviewed the literature on prostate cancer in Africa and provided a continentwide incidence rate of PCa based on available data in the regio

Severity, challenges, and outcome of retroperitoneal hematoma in a Nigeria Tertiary Hospital

Background: Retroperitoneal hematoma (RH) can present as an acute life-threatening condition, report on RH in low-income countries are lacking. Objective: We present the severity, pattern, challenges, and outcome of RH in a low-resource country such as Nigeria. Methods: This was a retrospective observational study of all patients with blunt or penetrating abdominal injury needing surgery, patients with RH among them were analyzed. Results: In the last one decade spanning 2005-2015, our operation database record showed that 247 patients had exploratory laparotomy for blunt and penetrating abdominal trauma. Out of the 115 patients with complete record available, only 43 had RH. The median age of the patients was 30 years, and the most affected age group was 20-29 years. Female to male ratio was 1:13. Only eight patients (18.6%) reached the hospital from the accident site within the first "Golden Hour" of accident, which is the first 1 h postrauma during which treatment intervention believed to have the best outcome. Only two patients (4.7%) got to operating theater within 1 h of reaching hospital. None of our patients had preoperative diagnosis of RH; overall, mortality was two patients (4.7%). Conclusion: Logistical infrastructural inadequacies such as lack of sterile theater bundle and drapes/nonavailability or busy theater space caused delay for patients between presentation in the Accident and Emergency Center and operating theater. None of our patients had a preoperative diagnosis of RH because of lack of access to computerized tomography scan dedicated to trauma in Accident and Emergency Center. The overall mortality of 4.7% in this study, which is on the low side, tends to suggest that mostly mild and stable cases which can make it to the operating table were eventually operated upon

Health workforce and governance: the crisis in Nigeria

Background: In Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. We aimed to review recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria. Methods: We conducted a scoping literature search of PubMed to identify studies on health workforce and health governance in Nigeria. A critical analysis, with extended commentary, on recent health workforce crises (2010-2016) and the health system in Nigeria was conducted. Results: The Nigerian health system is relatively weak, and there is yet a coordinated response across the country. A number of health workforce crises have been reported in recent times due to several months' salaries owed, poor welfare, lack of appropriate health facilities and emerging factions among health workers. Poor administration and response across different levels of government have played contributory roles to further internal crises among health workers, with different factions engaged in protracted supremacy challenge. These crises have consequently prevented optimal healthcare delivery to the Nigerian population. Conclusions: An encompassing stakeholders' forum in the Nigerian health sector remain essential. The national health system needs a solid administrative policy foundation that allows coordination of priorities and partnerships in the health workforce and among various stakeholders. It is hoped that this paper may prompt relevant reforms in health workforce and governance in Nigeria toward better health service delivery in the country.</p

Study characteristics.

<p>Study characteristics.</p

Flow chart of search results.

<p>Flow chart of search results.</p

Search terms for studies of prostate cancer in Africa.

<p>Search terms for studies of prostate cancer in Africa.</p