19.1. Chiang Mai Consultation, 1977: documents

Amidst sudden and unprecedented increases in the severity and frequency of climate-change-induced natural disasters, building critical infrastructure resilience has become a prominent policy issue globally for reducing disaster risks. Sustainable measures and procedures to strengthen preparedness, response, and recovery of infrastructures are urgently needed, but the standard for measuring such resilient elements has yet to be consensually developed. This study was undertaken with an aim to quantitatively measure transportation infrastructure robustness, a proactive dimension of resilience capacities and capabilities to withstand disasters; in this case, floods. A four-stage analytical framework was empirically implemented: 1) specifying the system and disturbance (i.e., road network and flood risks in Chiang Mai, Thailand), 2) illustrating the system response using the damaged area as a function of floodwater levels and protection measures, 3) determining recovery thresholds based on land use and system functionality, and 4) quantifying robustness through the application of edge- and node-betweenness centrality models. Various quantifiable indicators of transportation robustness can be revealed; not only flood-damaged areas commonly considered in flood-risk management and spatial planning, but also the numbers of affected traffic links, nodes, and cars are highly valuable for transportation planning in achieving sustainable flood-resilient transportation systems.

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Defining the Distinctiveness of Urban Heritage Identity: Chiang Mai Old City, Thailand

Social Sciences ◽

10.3390/socsci10030101 ◽

2021 ◽

Vol 10 (3) ◽

pp. 101

Author(s):

Natthakit Phetsuriya ◽

Tim Heath

Keyword(s):

Management Strategies ◽

Place Identity ◽

Heritage Management ◽

World Heritage Site ◽

Local People ◽

Cultural Dynamics ◽

Chiang Mai ◽

Urban Heritage ◽

Heritage Site ◽

Old City

Distinctiveness is a fundamental part of defining place identity. This paper aims to define the identity of place through the distinctiveness of the urban heritage of Chiang Mai Old City, Thailand. Chiang Mai Old City has unprecedented levels of diversity and a cultural dynamics related to its intangible and tangible urban heritage. Moreover, the city is in the important stage of being nominated as a new World Heritage Site of UNESCO, with the city’s distinctiveness being significant in supporting further heritage management strategies. The research presented in this paper mainly focuses on how local people interpret and understand the urban heritage identity of Chiang Mai Old City. This has been achieved through surveys of four hundred participants who live in the Old City and a two-way focus group with five participants in each group. The results provide seven aspects to describe the distinctiveness of Chiang Mai Old City. Moreover, the results can also be used to develop an assessment indicator for defining the distinctiveness of other cities through the engagement of local people.

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Short-Course Versus Long-Course Colistin for Treatment of Carbapenem-Resistant A.baumannii in Cancer Patient

Antibiotics ◽

10.3390/antibiotics10050484 ◽

2021 ◽

Vol 10 (5) ◽

pp. 484

Author(s):

Wasan Katip ◽

Suriyon Uitrakul ◽

Peninnah Oberdorfer

Keyword(s):

Clinical Response ◽

Cancer Patients ◽

Therapy Group ◽

University Hospital ◽

P Value ◽

Chiang Mai ◽

Carbapenem Resistant ◽

Short Course ◽

Significant Difference ◽

Long Course

Carbapenem-resistant Acinetobacter baumannii (CRAB) is one of the most commonly reported nosocomial infections in cancer patients and could be fatal because of suboptimal immune defenses in these patients. We aimed to compare clinical response, microbiological response, nephrotoxicity, and 30-day mortality between cancer patients who received short (<14 days) and long (≥14 days) courses of colistin for treatment of CRAB infection. A retrospective cohort study was conducted in cancer patients with CRAB infection who received short or long courses of colistin between 2015 to 2017 at Chiang Mai University Hospital (CMUH). A total of 128 patients met the inclusion criteria. The results of this study show that patients who received long course of colistin therapy had a higher rate of clinical response; adjusted odds ratio (OR) was 3.16 times in patients receiving long-course colistin therapy (95%CI, 1.37–7.28; p value = 0.007). Microbiological response in patients with long course was 4.65 times (adjusted OR) higher than short course therapy (95%CI, 1.72–12.54; p value = 0.002). Moreover, there was no significant difference in nephrotoxicity (adjusted OR, 0.91, 95%CI, 0.39–2.11; p value = 0.826) between the two durations of therapy. Thirty-day mortality in the long-course therapy group was 0.11 times (adjusted OR) compared to the short-course therapy group (95%CI, 0.03–0.38; p value = 0.001). Propensity score analyses also demonstrated similar results. In conclusion, cancer patients who received a long course of colistin therapy presented greater clinical and microbiological responses and lower 30-day mortality but similar nephrotoxicity as compared with those who a received short course. Therefore, a long course of colistin therapy should be considered for management of CRAB infection in cancer patients.

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Caesarean delivery is associated with increased blood pressure in young adult offspring

Scientific Reports ◽

10.1038/s41598-021-89438-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amaraporn Rerkasem ◽

Sarah E. Maessen ◽

Antika Wongthanee ◽

Sakda Pruenglampoo ◽

Ampica Mangklabruks ◽

...

Keyword(s):

Blood Pressure ◽

Young Adults ◽

Birth Cohort ◽

Fasting Blood Glucose ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Adjusted Relative Risk ◽

Obesity Risk ◽

Chiang Mai ◽

Clinical Assessments

AbstractWe examined the associations between caesarean section (CS) delivery and cardiovascular risk factors in young adults in Thailand. Participants were 632 offspring from a birth cohort in Chiang Mai (Northern Thailand), born in 1989–1990 and assessed in 2010 at a mean age of 20.6 years, including 57 individuals (9.0%) born by CS and 575 born vaginally. Clinical assessments included anthropometry, blood pressure (BP), carotid intima-media thickness, and fasting blood glucose, insulin, and lipid profile. Young adults born by CS had systolic BP (SBP) 6.2 mmHg higher (p < 0.001), diastolic BP 3.2 mmHg higher (p = 0.029), and mean arterial pressure (MAP) 4.1 mmHg higher (p = 0.003) than those born vaginally. After covariate adjustments, SBP and MAP remained 4.1 mmHg (p = 0.006) and 2.9 mmHg (p = 0.021) higher, respectively, in the CS group. The prevalence of abnormal SBP (i.e., pre-hypertension or hypertension) in the CS group was 2.5 times that of those born vaginally (25.0% vs 10.3%; p = 0.003), with an adjusted relative risk of abnormal SBP 1.9 times higher (95% CI 1.15, 2.98; p = 0.011). There were no differences in anthropometry (including obesity risk) or other metabolic parameters. In this birth cohort in Thailand, CS delivery was associated with increased blood pressure in young adulthood.

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