Implementation of Community Based Disaster Risk Management in the Mekong Delta, Vietnam

This master thesis examines the implementation of Community Based Disaster Risk Management (CBDRM) in the Mekong Delta in Vietnam. The report is based on a literature study in the field of CBDRM together with an interview study conducted with organisations operating in the region. The thesis shows that CBDRM has been an effective approach in the Mekong Delta and that used modes and modalities have resulted in more resilient communities with a higher capacity to deal with imminent threats from disasters. However, CBDRM is still a fairly new concept and further research should be conducted in order to study the long-term effects.As a result of global warming the number of disasters will increase in the world. Increased urbanisation and environmental degradation will lead to escalating vulnerability. As a result of this changing landscape of disaster risk a new adaptable approach is needed in order to create sustainable and resilient communities. Community based disaster risk management, CBDRM, is a successful way to achieve this. The Mekong Delta in Vietnam is located in a tropical monsoon region and is therefore highly susceptible to climate change. Floods are causing immense threats to society and the region needs a way of dealing with the increasing and changing challenges of the future. In 2009 a national program was established which aimed at implementing CBDRM in 9000 exposed communities. CBDRM is an approach to disaster risk management where the purpose is to put the community at the centre of the projects. CBDRM consists of three pillars; participation, ownership and sustainability. By involving the people in disaster risk reduction you create communal ownership and thereby sustainability. Today many countries throughout the world is dependent on humanitarian aid. However, in order to create a safer and more sustainable world a shift of focus from response to preparedness is needed. CBDRM creates a possibility to achieve this. By linking CBDRM to sustainable development social, economic and environmental conditions will improve. The outcomes of CBDRM are difficult to measure since it is a long term process and successful implementation tends to result in a lack of visible evidence. Another difficulty is the lack of funding for these long term activities. At Lund University a study was conducted to examine the outcome of CBDRM. The aim was to get a general grasp of the successes and the challenges with the approach. The study was a case study of the Mekong Delta and consisted of a literature and interview study. This study found that CBDRM is achieved through several different activities such as training, education and improved coordination and communication between actors. An example from the Mekong Delta is the successful concept called Train of Trainer, ToT, where certain key people have been taught how to drive and maintain a boat and then used this knowledge to teach others in the community. Teachers are also taught about disaster risk management in order to incorporate the subject into the school curriculum and thereby teach their students about how to deal with risks that are facing them and their families. Another example is how the involvement of women in the different projects have increased their status, not only in terms of disaster risk reduction but also in society as a whole. The study shows that the implementation of CBDRM has led to safer and more resilient communities better capable of dealing with the future challenges of climate change. People now feel a greater ability and responsibility to reduce their own risks. The population is more aware of the risks and have a greater trust towards the authorities. CBDRM is not only a tool to achieve national strength and capability. A disaster rarely affects only one country and a collaboration between actors both nationally and through international cooperation could be beneficial not only from a disaster perspective but also for long-term stability and peace across borders. The national program implemented by the government of Vietnam is placing the country at the forefront in regards to CBDRM and sets a good example for the rest of the world to follow. By Frida Sjöstedt & Viktor Sturegård, 2015-12-

Implementation of Community Based Disaster Risk Management in the Mekong Delta, Vietnam

This master thesis examines the implementation of Community Based Disaster Risk Management (CBDRM) in the Mekong Delta in Vietnam. The report is based on a literature study in the field of CBDRM together with an interview study conducted with organisations operating in the region. The thesis shows that CBDRM has been an effective approach in the Mekong Delta and that used modes and modalities have resulted in more resilient communities with a higher capacity to deal with imminent threats from disasters. However, CBDRM is still a fairly new concept and further research should be conducted in order to study the long-term effects.As a result of global warming the number of disasters will increase in the world. Increased urbanisation and environmental degradation will lead to escalating vulnerability. As a result of this changing landscape of disaster risk a new adaptable approach is needed in order to create sustainable and resilient communities. Community based disaster risk management, CBDRM, is a successful way to achieve this. The Mekong Delta in Vietnam is located in a tropical monsoon region and is therefore highly susceptible to climate change. Floods are causing immense threats to society and the region needs a way of dealing with the increasing and changing challenges of the future. In 2009 a national program was established which aimed at implementing CBDRM in 9000 exposed communities. CBDRM is an approach to disaster risk management where the purpose is to put the community at the centre of the projects. CBDRM consists of three pillars; participation, ownership and sustainability. By involving the people in disaster risk reduction you create communal ownership and thereby sustainability. Today many countries throughout the world is dependent on humanitarian aid. However, in order to create a safer and more sustainable world a shift of focus from response to preparedness is needed. CBDRM creates a possibility to achieve this. By linking CBDRM to sustainable development social, economic and environmental conditions will improve. The outcomes of CBDRM are difficult to measure since it is a long term process and successful implementation tends to result in a lack of visible evidence. Another difficulty is the lack of funding for these long term activities. At Lund University a study was conducted to examine the outcome of CBDRM. The aim was to get a general grasp of the successes and the challenges with the approach. The study was a case study of the Mekong Delta and consisted of a literature and interview study. This study found that CBDRM is achieved through several different activities such as training, education and improved coordination and communication between actors. An example from the Mekong Delta is the successful concept called Train of Trainer, ToT, where certain key people have been taught how to drive and maintain a boat and then used this knowledge to teach others in the community. Teachers are also taught about disaster risk management in order to incorporate the subject into the school curriculum and thereby teach their students about how to deal with risks that are facing them and their families. Another example is how the involvement of women in the different projects have increased their status, not only in terms of disaster risk reduction but also in society as a whole. The study shows that the implementation of CBDRM has led to safer and more resilient communities better capable of dealing with the future challenges of climate change. People now feel a greater ability and responsibility to reduce their own risks. The population is more aware of the risks and have a greater trust towards the authorities. CBDRM is not only a tool to achieve national strength and capability. A disaster rarely affects only one country and a collaboration between actors both nationally and through international cooperation could be beneficial not only from a disaster perspective but also for long-term stability and peace across borders. The national program implemented by the government of Vietnam is placing the country at the forefront in regards to CBDRM and sets a good example for the rest of the world to follow. By Frida Sjöstedt & Viktor Sturegård, 2015-12-

A case of Mycobacterium goodii prosthetic valve endocarditis in a non-immunocompromised patient: use of 16S rDNA analysis for rapid diagnosis

Background: Mycobacterium goodii is a rare cause of significant infection. M. goodii has mainly been associated with lymphadenitis, cellulitis, osteomyelitis, and wound infection. Case presentation: A case of a 76-year-old Caucasian female is presented. The patient developed a prosthetic valve endocarditis caused by M. goodii. She had also suffered from severe neurological symptoms related to a septic emboli that could be demonstrated as an ischemic lesion found on CT of the brain. Transesophageal echocardiography verified a large vegetation attached to the prosthetic valve. Commonly used blood culture bottles showed growth of the bacteria after 3 days. Conclusions: Although M. goodii is rarely involved in these kinds of severe infections, rapidly growing mycobacteria should be recognized during conventional bacterial investigations and identified by molecular tools such as analysis of 16S rDNA. Species identification of nontuberculous mycobacteria is demanding and is preferably done in collaboration with a mycobacterial laboratory. An early diagnosis provides the opportunity for adequate treatment. In the present case, prolonged antimicrobial treatment and surgery with replacement of the prosthetic valve was successful

Little difference between minimum inhibitory concentrations of Mycobacterium tuberculosis wild-type organisms determined with BACTEC MGIT 960 and Middlebrook 7H10

AbstractThe MIC wild-type (WT) distribution for Mycobacterium tuberculosis in BACTEC 960 MGIT is not defined, which may result in poor reproducibility for drug susceptibility testing (DST), as several DST methods with different breakpoints are in use. In a comparison between MGIT and Middlebrook 7H10 medium of seven first- and second-line drugs, including 133 MIC determinations of 15 WT isolates, we found an agreement of 91.7% within ± one MIC dilution step. The results confirm the agreement in MIC testing between 7H10 and MGIT and indicate that breakpoints could be harmonized in order to avoid misclassification

What Is Resistance? Impact of Phenotypic versus Molecular Drug Resistance Testing on Therapy for Multi- and Extensively Drug-Resistant Tuberculosis.

Rapid and accurate drug susceptibility testing (DST) is essential for the treatment of multi- and extensively drug-resistant tuberculosis (M/XDR-TB). We compared the utility of genotypic DST assays with phenotypic DST (pDST) using Bactec 960 MGIT or Löwenstein-Jensen to construct M/XDR-TB treatment regimens for a cohort of 25 consecutive M/XDR-TB patients and 15 possible anti-TB drugs. Genotypic DST results from Cepheid GeneXpert MTB/RIF (Xpert) and line probe assays (LPAs; Hain GenoType MTBDRplus 2.0 and MTBDRsl 2.0) and whole-genome sequencing (WGS) were translated into individual algorithm-derived treatment regimens for each patient. We further analyzed if discrepancies between the various methods were due to flaws in the genotypic or phenotypic test using MIC results. Compared with pDST, the average agreement in the number of drugs prescribed in genotypic regimens ranged from just 49% (95% confidence interval [CI], 39 to 59%) for Xpert and 63% (95% CI, 56 to 70%) for LPAs to 93% (95% CI, 88 to 98%) for WGS. Only the WGS regimens did not contain any drugs to which pDST showed resistance. Importantly, MIC testing revealed that pDST likely underestimated the true rate of resistance for key drugs (rifampin, levofloxacin, moxifloxacin, and kanamycin) because critical concentrations (CCs) were too high. WGS can be used to rule in resistance even in M/XDR strains with complex resistance patterns, but pDST for some drugs is still needed to confirm susceptibility and construct the final regimens. Some CCs for pDST need to be reexamined to avoid systematic false-susceptible results in low-level resistant isolates

Gastric and enteric Helicobacter species in animal models and in the human colon

The Gram-negative genus of Helicobacter consists of many bacterial species that colonize a wide range of animal hosts. The genus can be divided into gastric species that colonize the stomach, and enteric species that preferentially colonize the colon and biliary tree of various animal hosts. Helicobacter pylori cause gastritis, gastro-duodenal ulcer disease and gastric adenocarcinoma and lymphoma in infected individuals. Enteric Helicobacter species cause typhlocolitis, hepatitis and neoplasia of the colon and liver in various rodent models of disease. A novel guinea pig model of H. pylori infection was developed and the infection was found to cause severe inflammatory changes in the stomach and an H. pylori-specific antibody response in infected animals after 3 and 7 weeks of infection. Different strains of H. pylori, with regards to the cagA gene and VacA protein expression, could infect mice. The infection was found to cause an H. pylori specific antibody response in mice infected with strains expressing the VacA protein. Simultaneous co-infection of mice with seven different strains of H. pylori showed evidence of colonization with two different strains. Gastritis was not apparent in mice infected with H. pylori for up to 17 weeks. H. pylori infection was found to lead to substantially more gastritis and serologic antibody response in guinea pigs than in mice. In guinea pigs, the infection was found to cause an elevation of acute-phase protein C3 and cholesterol, which could constitute a possibility to study an H. pylori trigger of extra-alimentary diseases. Helicobacter ganmani was isolated from interleukin-10 deficient mice with typhlocolitis and hepatitis. Analysis of serum antibodies demonstrated an immune response against H. ganmani in animals with disease. This recently described species of Helicobacter was implicated as the possible source of the disease found among the animals but this link needs to be evaluated in a controlled, experimental set-up. The importance of using Helicobacter-free animals for a wide range of experiments, especially when using immune deficient animals, needs to be stressed. Human colon biopsies from 20 patients with inflammatory bowel disease and other ailments were investigated for Helicobacter colonization. DNA resembling H. pylori was detected in two, Helicobacter cholecystus in one and Helicobacter muridarum in one patient. The latter two species have previously not been described in human tissue. No apparent link was found between the detection of Helicobacter species and human inflammatory bowel disease. In summary, this thesis deals with development and optimization of two animal models for H. pylori infection and also explores the role of enteric Helicobacter species in human and animal disease

Kunskapsspridning genom kollektivt och reflektivt lärande En fallstudie av HSB Bostad AB

As the housing construction industry experiences a high pressure, many housing construction companies are increasing their production. HSB Bostad AB, being one of these companies, has high ambitions regarding remaining competitive and successful within the industry. It has shown that many of the errors made by the company, have been done before without being learnt from. As a step in the direction of never repeating mistakes and errors made, HSB Bostad AB has requested that a study is made regarding their need for knowledge sharing routines. This thesis has therefore investigated how knowledge sharing is applied at HSB Bostad AB as well as studied the theories of collective and reflective learning as a potential tool. The case study has been done by an abductive approach, winding a literature study with empirics from observations and interviews. The interviewees were chosen to reflect the employees of the company to a maximum range, with the characteristics of experience, gender, corporate position and divisional belonging. Through the interviews and observations, it was found that HSB Bostad AB is unconsciously working with activities and processes providing opportunities of knowledge sharing. One aspect was the lack of a common vision and understanding for the concept as well as the lack of opportunities for collective reflection. The conclusions made were that a joint, corporal vision and strategy of knowledge sharing could give HSB Bostad AB an advantage in the direction of remaining competitive and successful. Additionally, more specific and explicit recommendations of how to improve their current areas of knowledge sharing are given.Medan byggbranschen upplever en hög efterfrågan på bostäder ökar många byggbolag sina produktionsvolymer. HSB Bostad AB, som är ett av dessa bolag, har höga ambitioner att vara fortsatt konkurrenskraftiga och framgångsrika i branschen. Det har visat sig att många av felen som bolaget upplever återupprepas men utan att lärdomar dragits. Som ett steg i riktningen mot att aldrig upprepa misstag och fel som gjorts har HSB Bostad AB efterfrågat att en studie genomförs gällande deras behov av kunskapsspridningsrutiner. Denna studie har därför undersökt hur kunskapsspridning kan implementeras, både i allmänhet samt med ett fokus på HSB Bostad AB. Vidare har studien undersökt hur kollektiv och reflektivt lärande kan användas i kunskapsspridningssyfte. Denna fallstudie har gjorts med en abduktiv metod där en litteraturstudie varvats med observationer och intervjuer. Intervjurespondenterna valdes för att spegla medarbetarna på bolaget i så stor mån som möjligt med hänsyn till erfarenhet, kön, anställningsgrad samt avdelningstillhörighet. Efter genomförda intervjuer och observationer kunde det urskiljas att HSB Bostad AB arbetar omedvetet med kunskapsspridning genom både aktiviteter och processer. Det som förvånade mest av empirin var bristen på en gemensam vision och förståelse för begreppet kunskapsspridning samt bristen på möjligheter för kollektiv reflektion. Slutsatsen av studien innefattar att en gemensam bolagsmässig vision och strategi för kunskapsspridning kan ge HSB Bostad AB fördel på vägen mot att fortsatt vara konkurrenskraftiga och framgångsrika. Dessutom ges specifika och explicita rekommendationer för hur deras nuvarande områden för kunskapsspridning kan förbättras

Comparative study of Helicobacter pylori infection in guinea pigs and mice - elevation of acute-phase protein C3 in infected guinea pigs

Eighteen Dunkin-Hartley guinea pigs and 50 NMRI mice were inoculated with Helicobacter pylori and the infection followed by culture, histopathology, antibody response, and plasma levels of the acute-phase proteins albumin, C3, and transferrin for up to 7 weeks. The immune response to H. pylori surface proteins was studied by an enzyme immunoassay (EIA) and Western immunoblot and the plasma levels of albumin, C3, and transferrin were analyzed by single radial immunodiffusion. Guinea pigs had a more severe gastritis and a higher EIA immune response than NMRI mice. Serum C3 levels were elevated in infected guinea pigs after 3 and 7 weeks indicating a systemic inflammatory response and a possible link between H. pylori infection and extragastric manifestations such as vasculitis associated with atherosclerosis. Serum cholesterol levels were analyzed in guinea pigs at 7 weeks and indicated a higher level in H. pylori-infected than in control animals, but this difference was not statistically significant