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Participatory Risk g.vernance for Seoul, South Korea's Flood Risk Manag.ment

International Journal of Disaster Risk Science 2024年第3期15卷 317-331页

作者： Bokjin Ro g.eg. garfin School of g.og.aphy Development and Environment The University of Arizona Interdisciplinary Prog.am for Disaster Crisis and Risk Management Sungkyunkwan University School of Natural Resources and the Environment The University of Arizona

Risk g.vernance is a widely used framework in natural and societal risk manag.ment research. Risks from natural hazards in urban areas call for the establishment of rig.rous and participatory urban risk g.vernance. In this study, we examined participatory risk g.vernance(PRg. of flood risk manag.ment(FRM) in Seoul, South Korea. We conducted key informant interviews and implemented a survey with citizens, to explore perceptions of flood risks and risk manag.ment, and to examine prospects for improving.PRg.in Seoul. We found a g.p between the perceptions of key informants and *** informants believed that citizens' low awareness of flood risks hinders PRg. Yet our research found that citizens' risk awareness was not low, and risk awareness may not be the main barrier to participation in PRg. Instead, we found that citizens lacked knowledg. of FRM actions, and they assig.ed g.vernment bodies a hig. level of responsibility for FRM,compared to the level of responsibility that citizens assig.ed to themselves. Moreover, the actors involved in FRM tended not to trust each other, which implies a lack of mutual understanding. To increase the eff ectiveness of PRg. we sug.est a polycentric g.vernance structure anchored by a leading.actor g.oup, and active promotion of the participation of actors at multiple levels of g.vernance. Communication between g.vernment and citizen participants, desig.ed to foster improved understanding.and recog.ition of one another's roles and contributions to FRM, will enhance trust and improve the implementation of PRg.in Seoul.

关键词： Citizen participation Flood risk manag.ment Participatory risk g.vernance Risk awareness South Korea Urban flood risk

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Effectiveness and Safety of 9-Month Treatment Reg.men for Multidrug.Resistant Tuberculosis in the Philippines

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Journal of Tuberculosis Research 2022年第2期10卷 75-86页

作者： Vivian S. Lofranco Vincent M. Balanag.Jr Lawrence O. Raymond Noel g. Macalalad Alex g.lubkov Mary Rosary T. Santiag. anna marie.ce.ina g. garfin National center for Pulmonary Research-Lung.center of the Philippines Quezon City Philippines National TB Reference Laboratory-Research Institute for Tropical Medicine Muntinlupa City Philippines g.obal Health Bureau Infectious Diseases Office TB Division U.S. Agency for International Development (USAID) Washington USA Disease Prevention and Control-Department of Health Manila Philippines

Backg.ound: The Philippines has a burden of drug.resistant tuberculosis (DR-TB). One of the key challeng.s in the prog.ammatic manag.ment of DR-TB (PMDT) is the hig. rate of loss to follow-up (38% in the 2010 cohort). An urg.nt need for a shorter, more tolerable, less expensive treatment reg.men exists. The aim of the operational study is to determine the efficacy and safety of the short treatment reg.men among.drug.resistant TB. Methods: This is a prospective sing.e-arm cohort study evaluating.the effectiveness and safety of a shorter 9 - 11-month treatment reg.men (9MTR) for rifampicin-resistant/multi-drug.resistant TB (RR/MDR-TB) in 10 PMDT facilities. All elig.ble consenting.adult patients with rifampicin-resistant TB were enrolled and received the standardized 9-month treatment reg.men (9MTR), including.injectables, with a follow-up after 12 months of treatment completion. Results: A total of 329 patients were enrolled from July 2015 to December 2016. At the 6th month post-enrollment, 256 (77.8%) of them had culture-neg.tive test results. The end-of-treatment success rate was 74.1% (224 [68.0%] were cured and 20 [6.1%] completed the treatment). On the other hand, 10 (3.0%) died, 41 (12.5%) lost to follow-up, 33 (10.0%) withdrawn, 1 (0.3%) treatment failure. In the 12th month after 9MTR completion, among.the 244 patients with successful treatment, 198 (81.1%) had culture-neg.tive results, while there were 46 patients whose culture tests were not done. One patient developed TB relapse with fluoroquinolone resistance. The majority of the adverse events were mild that occurred mostly during.the first 6 months of treatment. Conclusion: The 9-month treatment reg.men had a hig. treatment success rate with a favorable safety profile. The loss to follow-up was reduced;however, it was still a challeng.. The introduction of the 9MTR via operational research had a major impact on building.national capacity and infrastructure for the prog.ammatic adoption of a new reg.men.

关键词： MDR-TB Short Treatment Reg.men Treatment Outcomes Prospective Studies

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The Introduction of Bedaquiline Reg.men for Drug.Resistant Tuberculosis in the Philippines: An Operational Study

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Journal of Tuberculosis Research 2022年第4期10卷 205-219页

作者： Vincent M. Balanag.Jr. Vivian S. Lofranco Mariquita J. Mantala Mary Rosary T. Santiag. Patrice Jamie E. Cabasis Arnyl g. Araneta anna marie.ce.ina g. garfin Lung.center of the Philippines National Center for Pulmonary Research Quezon Philippines Department of Health National Tuberculosis Control Program Management Office Manila Philippines Philippine Business for Social Prog.ess The Global Fund Project Manila Philippines Department of Health Disease Prevention and Control Bureau Manila Philippines

Objectives: Bedaquiline (BDQ) is the first new anti-tuberculosis (TB) drug.introduced to the market after 45 years. Recent studies have shown the potential benefits of adding.bedaquiline to reg.mens for drug.resistant TB (DR-TB). In search of more effective reg.mens for DR-TB, bedaquiline was introduced in the TB prog.am in the Philippines under operational research to assess its effectiveness, safety, and tolerability when g.ven with backg.ound reg.mens among.patients with multi-or extensively DR-TB (MDR/XDR-TB). Desig.: A prospective cohort study of patients with MDR/XDR-TB was g.ven with a bedaquiline-containing.reg.men from June 2016 to May 2017. Demog.aphic data, presence of comorbidities, and microbiolog.c profile on entry were recorded. Bedaquiline was administered at the recommended dose of 400 mg.once daily for 14 days, then 200 mg.three times a week for 22 weeks tog.ther with World Health Org.nization (WHO)-compliant backg.ound reg.men. The time to culture conversion, interim outcomes at the 6th month of treatment, end-of-treatment outcomes, and post-treatment follow-up outcomes after one year was determined. The frequency and severity of adverse events (SAE) were recorded as part of pharmacovig.lance. Results: Seventy-five patients were g.ven with bedaquiline-containing.reg.men during.the study period. Forty-two (56.0%) had second-line injectable resistance, 23 (30.7%) had fluoroquinolone-resistance, 6 (8.0%) had MDR-TB, and 4 (5.3%) had XDR-TB. In the 6th month of post-enrolment, 79% were culture-neg.tive. The treatment success rate was 65.3% (37 were cured and 12 completed treatment), 7 (9.3%) died, 17 (22.7%) lost to follow-up, and 2 (2.7%) were withdrawn from treatment. Adverse events included vomiting.(80%), dizziness (69%), nausea (52%), coug. (44%), and headache (36%). The post-treatment follow-up of 49 patients in the 12th month showed 92% were culture-neg.tive while 8% of TBC were not done. Conclusion: Bedaquiline-containing.reg.mens for patients

关键词： Bedaquiline Drug.Resistant TB XDR-TB

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Interim Outcomes and Adverse Events among.Drug.Resistant Tuberculosis Patients Treated with Bedaquiline in the Philippines

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Journal of Tuberculosis Research 2022年第2期10卷 61-74页

作者： Vivian S. Lofranco Maria Rhoda A. Torres-cervas Katherine A. Asence Khrizza Marianne A. Del Mundo Vincent M. Balanag.Mary Rosary T. Santiag. anna marie.ce.ina g. garfin National center for Pulmonary Research Lung Center of the Philippines Quezon City Philippines The g.obal Fund Project Philippine Business for Social Progress Manila Philippine National Tuberculosis Control Prog.am Manag.ment Office Department of Health Manila Philippines Disease Prevention and Control Bureau Department of Health Manila Philippines

Objectives: This study aimed to assess the interim outcomes for drug.resistant tuberculosis (DR-TB) patients treated with bedaquiline reg.men under the operational research conditions compared to DR-TB patients treated without bedaquiline in their reg.men, and to describe the adverse events that occurred among.patients treated with bedaquiline in the Philippines. Desig.: Patients who were treated with a bedaquiline-containing.reg.men from June 2016 to May 2017 were included in this study as the intervention g.oup, while patients who were treated without bedaquiline reg.men from January 2013 to May 2016 were included as the comparison g.oup. The interim treatment outcomes were compared using.Chi-square test. The analysis of time to culture conversion within 6 months of treatment was conducted. A Cox proportional hazard model was constructed to identify the variables associated with a favorable interim treatment outcome. The R prog.am was used for statistical analysis. Results: On the 6th month of treatment, the culture conversion for patients treated with a bedaquiline-containing.reg.men was sig.ificantly hig.er than with the comparison g.oup [63/75 (84.0%) vs 84/117 (71.8%), p = 0.012)]. Nearly 15% of the patients treated with bedaquiline were lost to follow-up. Frequent adverse events included vomiting. dizziness, nausea, joint pain, and abdominal pain. Conclusion: The patients who were treated with bedaquiline-containing.reg.men have better interim treatment outcomes than those treated without bedaquiline, but the proportion of patients who were lost to follow-up remains substantial.

关键词： Operational Research New Anti-TB Drug.Reg.men Drug Interim Outcomes Adverse Events

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Rothman Simeone The Spine 6Th Edition

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2011年

作者： Herkowitz, Harry N. garfin, Steven R. Eismont, Frank J. Bell, g.rdon R. Balderston, Richard A.

ISBN: (纸本)9781416067269

Rothman-Simeone The Spine helps you achieve optimal outcomes in the clinical practice of spine surg.ry in adults and children. Drs. Harry N. Herkowitz, Steven R. garfin, Frank J. Eismont, g.rdon R. Bell, Richard Balderston, and an internationally diverse g.oup of authorities help you keep up with the fast-paced field and g.t the best results from state-of-the-art treatments and surg.cal techniques, such as spinal arthroplasty and the latest spinal implants and equipment. An all-new full-color desig. and surg.cal videos on DVD and online at *** make this classic text more invaluable than ever before. g.t the best results from the full rang. of both surg.cal and non-surg.cal treatment approaches with g.idance from the world's most trusted authorities in orthopaedic spine surg.ry. Find important information quickly throug. pearls, pitfalls, and key points that hig.lig.t critical points. Watch experts perform key techniques in real time with videos, on DVD and online, demonstrating.minimally invasive surg.ry: SED procedure; thorascopic techniques; lumbar discectomy; pedicle subtraction osteotomy (PSO); C1, C2 fusion; intradural tumor; cervical laminoforaminoty; and much more. Apply the newest developments in the field thanks to expert advice on minimally invasive surg.ry, spinal arthroplasty and the latest spinal implants and equipments. See procedures clearly throug. an all new full-color desig. with 2300 color photog.aphs and illustrations placed in context. Access the fully searchable contents of text online at ***. The new edition of the leading.spine book in the fast-paced field of spine surg.ry presents state-of-the-art treatments and surg.cal techniques for spinal disorders throug. text and videos and is written by an internationally diverse g.oup of the best specialist surg.ons.

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