Social and Economic Challenges of Implementing Sustainable Materials on Buildings in Kuwait

Many factors affect attaining the required credits for LEED materials and Many factors affect attaining the required credits for LEED materials and resources (MR) section. There are disadvantages in obtaining credits and LEED certifying an existing building in Kuwait to become a sustainable green building. LEED is still relatively new in Kuwait and the Gulf region, therefore, when certifying an existing governmental building, difficultly is faced with obtaining complete building owners, building upper management and occupant cooperation. This raises challenges when requiring cooperation from building occupants and cleaning staff for the solid waste management credits which require dedication to reduce the amount of waste going to landfills and incinerating facilities. The mindset of the contractor and subcontractor has to change to gain full understanding and cooperation in the waste management of construction materials when constructing new buildings and performing facility alterations on site. The selection of sustainable materials is more challenging as many materials are not available in Kuwait and the surrounding Gulf countries. Transportation from aboard should be decreased as much as possible to reduce cost as well as decreasing negative environmental impacts. Green certified materials are more expensive, therefore decision maker have to be willing to pay the extra cost. This paper discusses the challenges faced by KISR team as a consultancy body to certify an existing building according to LEED rating system from the material and resources aspect. It discusses the acceptance of the building owners, building upper management and the building occupants to this change and their understanding and cooperation. Many materials for MR credits 2 and 3 were found difficult to be obtained in Kuwait and the surrounding gulf region. Some materials were found to be available in the resources (MR) section. There are disadvantages in obtaining credits and LEED certifying an existing building in Kuwait to become a sustainable green building. LEED is still relatively new in Kuwait and the Gulf region, therefore, when certifying an existing governmental building, difficultly is faced with obtaining complete building owners, building upper management and occupant cooperation. This raises challenges when requiring cooperation from building occupants and cleaning staff for the solid waste management credits which require dedication to reduce the amount of waste going to landfills and incinerating facilities. The mindset of the contractor and subcontractor has to change to gain full understanding and cooperation in the waste management of construction materials when constructing new buildings and performing facility alterations on site. The selection of sustainable materials is more challenging as many materials are not available in Kuwait and the surrounding Gulf countries. Transportation from aboard should be decreased as much as possible to reduce cost as well as decreasing negative environmental impacts. Green certified materials are more expensive, therefore decision maker have to be willing to pay the extra cost. This paper discusses the challenges faced by KISR team as a consultancy body to certify an existing building according to LEED rating system from the material and resources aspect. It discusses the acceptance of the building owners, building upper management and the building occupants to this change and their understanding and cooperation. Many materials for MR credits 2 and 3 were found difficult to be obtained in Kuwait and the surrounding gulf region. Some materials were found to be available in th

Risk of breast cancer in women after a salivary gland carcinoma or pleomorphic adenoma in the Netherlands

Salivary and mammary gland tumors show morphological similarities and share various characteristics, including frequent overexpression of hormone receptors and female preponderance. Although this may suggest a common etiology, it remains unclear whether patients with a salivary gland tumor carry an increased risk of breast cancer (BC). Our purpose was to determine the risk of BC in women diagnosed with salivary gland carcinoma (SGC) or pleomorphic adenoma (SGPA). BC incidence (invasive and in situ) was assessed in two nationwide cohorts: one comprising 1567 women diagnosed with SGC and one with 2083 women with SGPA. BC incidence was compared with general population rates using standardized incidence ratio (SIR). BC risk was assessed according to age at SGC/SGPA diagnosis, follow-up time and (for SGC patients) histological subtype. The mean follow-up was 7.0 years after SGC and 9.9 after SGPA diagnosis. During follow-up, 52 patients with SGC and 74 patients with SGPA developed BC. The median time to BC was

Ontoereikende diagnostiek bij een fractuur van het collum mandibulae

Een 13-jarige jongen presenteerde zich bij een mond-, kaak- en aangezichtschirurg na een val van zijn skateboard met pijn aan zijn kin en preauculaire pijn. Er werden op een panoramische röntgenopname geen aanwijzingen gevonden voor een fractuur van het collum mandibulae. Na 2 weken werd hij door zijn orthodontist naar de afdeling Mond-, Kaak- en Aangezichtschirurgie van een medisch centrum verwezen voor een teruggekeerde klasse IIImalocclusie na een kortgeleden afgeronde orthodontische behandeling van dit probleem. Een computertomogram toonde een fractuur van het collum mandibulae. Bij verdenking op een dergelijke fractuur is altijd beeldvorming uit 2 richtingen noodzakelijk