Activating the transportation potential of greenways in Saudi Arabia: a case study of Jeddah City

Since the early 1970s, auto-centric planning in Saudi Arabia (SA) has led to car-dependent lifestyles, resulting in health and environmental problems. In the past decade, ambitious policies (e.g., The Saudi Vision 2030), urban design manuals, awareness campaigns, city plans and projects have sought to address this problem by transitioning to sustainable urban mobility. Active transportation (AT) via networks of greenways is a dimension of such a transition and is currently being planned and advocated in Saudi cities. However, current walking and bicycling rates for transportation in SA are extremely low. Simultaneously, there is limited research on greenways in SA, and none has explored the influences on their usage as AT corridors (ATCs). An enhanced understanding of such factors is vital because academic journals found minimal effect on AT over the last thirty years from many greenway investments in various regions worldwide. Therefore, this PhD research aimed to explore the activation barriers and strategies of greenways’ function as facilitators for AT in SA, using Jeddah city as a case study. The review and synthesis of existing literature built an understanding of the state of knowledge concerning the planning and usage of AT and greenways in SA. It also explained the events that evolved greenways’ forms and functions internationally while chronologically relating to urban and open space planning in Saudi cities. Lastly, it examined where and when greenways would be considered routes for daily commutes using a systematic review of published peer-reviewed journal articles from 1991 until 2021. Due to the multidimensionality of such influences, the case study of Jeddah used mixed research methods (web-based questionnaire, environmental audits, field observations, and interviews with experts and leaders of local walking and bicycling groups). Interpretations and inferences of such an empirical study combined the results of these methods thematically and linked them to existing literature. Through (I) assessments of the physical environment at the city, neighbourhood, and site levels, (II) examining the preferences, behaviours, and opinions of users and non-users of greenways in Jeddah city, and (III) understanding the underlying causes to existing conditions, this thesis underscored key impediments that must be overcome. These include automobile-centric lifestyles, planning systems, outdoor temperature, social norms, long commuting distances, lack of AT infrastructure, bicycling skills and knowledge, proximity to greenways, and park facilities and amenities. Results also explained that religious and gender norms on women’s participation in bicycling can affect social support for policies advocating bicycle usage in Saudi cities and the effectiveness of any proposed greenway network in the future. Informed by the interviewed experts, existing literature, and global best practices, the proposed strategies to address the identified barriers stressed the importance of actions across social, environmental, technological, economic and legal domains. These strategies (e.g., improving stakeholders’ participation, integrating with public transit, increasing visibility and awareness, and implementing policies that enable AT) can accelerate the transition towards sustainable transportation in SA

Activating the transportation potential of greenways in Saudi Arabia: a case study of Jeddah City

Since the early 1970s, auto-centric planning in Saudi Arabia (SA) has led to car-dependent lifestyles, resulting in health and environmental problems. In the past decade, ambitious policies (e.g., The Saudi Vision 2030), urban design manuals, awareness campaigns, city plans and projects have sought to address this problem by transitioning to sustainable urban mobility. Active transportation (AT) via networks of greenways is a dimension of such a transition and is currently being planned and advocated in Saudi cities. However, current walking and bicycling rates for transportation in SA are extremely low. Simultaneously, there is limited research on greenways in SA, and none has explored the influences on their usage as AT corridors (ATCs). An enhanced understanding of such factors is vital because academic journals found minimal effect on AT over the last thirty years from many greenway investments in various regions worldwide. Therefore, this PhD research aimed to explore the activation barriers and strategies of greenways’ function as facilitators for AT in SA, using Jeddah city as a case study. The review and synthesis of existing literature built an understanding of the state of knowledge concerning the planning and usage of AT and greenways in SA. It also explained the events that evolved greenways’ forms and functions internationally while chronologically relating to urban and open space planning in Saudi cities. Lastly, it examined where and when greenways would be considered routes for daily commutes using a systematic review of published peer-reviewed journal articles from 1991 until 2021. Due to the multidimensionality of such influences, the case study of Jeddah used mixed research methods (web-based questionnaire, environmental audits, field observations, and interviews with experts and leaders of local walking and bicycling groups). Interpretations and inferences of such an empirical study combined the results of these methods thematically and linked them to existing literature. Through (I) assessments of the physical environment at the city, neighbourhood, and site levels, (II) examining the preferences, behaviours, and opinions of users and non-users of greenways in Jeddah city, and (III) understanding the underlying causes to existing conditions, this thesis underscored key impediments that must be overcome. These include automobile-centric lifestyles, planning systems, outdoor temperature, social norms, long commuting distances, lack of AT infrastructure, bicycling skills and knowledge, proximity to greenways, and park facilities and amenities. Results also explained that religious and gender norms on women’s participation in bicycling can affect social support for policies advocating bicycle usage in Saudi cities and the effectiveness of any proposed greenway network in the future. Informed by the interviewed experts, existing literature, and global best practices, the proposed strategies to address the identified barriers stressed the importance of actions across social, environmental, technological, economic and legal domains. These strategies (e.g., improving stakeholders’ participation, integrating with public transit, increasing visibility and awareness, and implementing policies that enable AT) can accelerate the transition towards sustainable transportation in SA

Greenways of Saudi Arabia: Activating their transportation potential

Since the early 1970s, auto-centric planning in Saudi Arabia (SA) has created car-dependent lifestyles, resulting in health and environmental problems. In the past decade, ambitious policies (e.g., The Saudi Vision 2030), regulations, awareness campaigns, city plans, and projects have sought to address this problem by transitioning to sustainable urban mobility. One form of this is active transportation (AT) via networks of greenways, which is currently being promoted in Saudi cities. However, the contemporary use of greenways for AT - for example, commuting by bike or walking - is extremely low in SA. Additionally, there is limited research on greenways in Middle Eastern countries. Thus, this paper aims to examine the factors hindering the use and development of greenways as AT corridors in SA, thereby informing efforts to unlock their AT potential. After outlining how the forms and functions of greenways in SA evolved compared to their international counterparts, we present Jeddah city as a case study, a city with low rates of AT. Drawing on recent empirical mixed-methods research, an overview and synthesis of factors explaining the low utilisation rate of Jeddah’s greenways as AT corridors is presented. Barriers to AT are categorised as site-specific (e.g., greenway design, safety, maintenance), contextual (e.g., neighbourhood walkability/accessibility, weather), behavioural and perceptual (e.g., conflicts between greenway users and perceptions). In addition to user-based evidence, we identify broader development-related challenges of building a greenway network for AT in Jeddah city, including spatial connectivity, lack of integration with the concerned authorities, limited budgets, and securing and regulating land. Results show that multidimensional impediments to active commuting via greenways in SA are similar to those globally, for example, greenway’s proximity to home addresses (Krizek and Johnson 2007; Wolch et al. 2010). However, other factors are specific to the Saudi context. These include, but are not limited to, the perception of privacy, unsuitability of formal Saudi attire for riding bicycles, and fear of public judgement. We conclude with a comprehensive model that summarises all the factors influencing greenway use for active transport in SA, which can inform future research and practice in this domain

What influences the use of greenways as active transportation corridors?

Cities worldwide are investing in active transportation (AT) infrastructure, particularly in the form of greenways (GWs), to advance several sustainable transport and quality of living agendas. However, many of those investments have not increased the rate of AT and the use of those GWs for utilitarian purposes. To understand why this is the case, a systematic literature review was con-ducted to identify the factors that influence the use of GWs as AT corridors. Results show that commuters’ perceptions, behaviours, and needs of GWs differ from other user types of GWs. An understanding of these factors should inform the planning, design, and management of GWs to maximise their AT potential

The effectiveness of peat-AC composite adsorbent in removing color and Fe from landfill leachate

Adsorption is a commonly used method for the removal of such various pollutants from aqueous solutions. Nowadays, due to cost-effectiveness, the adsorbent should be economical and cheaply available in abundance and it should require minimal for discharge into water bodies. This study was undertaken to investigate the efficiency of activated carbon (AC) to partially replace with peat as an inexpensive adsorbate composite medium for removing color and iron (Fe) from landfill leachate. The process of identifying the optimum composition of the composite adsorbent was carried out using batch technique. It shaken for 2 hours with 200 rpm at pH 7. The optimum ratio of peat and AC had been chosen as 2.0:2.0 for color while 2.5:1.5 for Fe. The value of the removal percentage for color and Fe were 74.4% and 79.6% in respectively. This indicates that peat can be used as a cost-effective medium to partially substitute of commercially AC in the composite for color and iron removal at a considerably lower cost

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system. Results A total of 3288 patients were included in the analysis, of whom 301 (9 center dot 2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0 center dot 001). There were no significant differences in rates of readmission between these groups (6 center dot 6 versus 8 center dot 0 per cent; P = 0 center dot 499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0 center dot 90, 95 per cent c.i. 0 center dot 55 to 1 center dot 46; P = 0 center dot 659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34 center dot 7 versus 39 center dot 5 per cent; major 3 center dot 3 versus 3 center dot 4 per cent; P = 0 center dot 110). Conclusion Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.Results: A total of 3288 patients were included in the analysis, of whom 301 (9.2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0.001). There were no significant differences in rates of readmission between these groups (6.6 versus 8.0 per cent; P = 0.499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0.90, 95 per cent c.i. 0.55 to 1.46; P = 0.659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34.7 versus 39.5 per cent; major 3.3 versus 3.4 per cent; P = 0.110).Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients