God Hospital Research Articles

THEOLOGY OF HOSPITALITY FOR INTRA AND INTER-RELIGIOUS HARMONY: AN INDONESIAN PERSPECTIVE

The theme hospitality has become an emerging theme for recent theological explorations. The theme is prominent in the entire Bible and is relevant to the current global issues such as religious pluralism, immigrants, even ecological challenges. This article seeks to show the centrality of divine hospitality in the Bible and how it is clearly reflected in the Pentecost narrative in Acts 2. Furthermore, this article seeks to demonstrate how theology of hospitality could be relevant to fostering intra and inter-religious harmony, especially in the context of Indonesia. The hospitality of the Spirit as shown in Pentecost shapes the body of Christ as a community of hospitality that would use gifts of the spirit not for self-aggrandizement but to serve other. Hospitality is also a theological statement. When Christians are being hospitable towards the religious other, they embody the hospitality of God, and thus participating in the mission of God.

Uropathogens and their antibiotic susceptibility patterns among diabetic patients at st. john of god hospital, duayaw nkwanta, Ghana: a cross-sectional study.

Uropathogens are microorganisms that cause urinary tract infections (UTIs). Owing to higher blood glucose levels and compromised immune functions, treatment of uropathogens in diabetic patients is a challenge. This study aims to assess the prevalence of uropathogens and their antibiotic susceptibility among diabetic patients at St. John of God Hospital at Duayaw Nkwanta (SJGHDN) in the Ahafo region of Ghana. The cross-sectional study recruited 175 diabetic patients at SJGHDN between August and September 2023. Questionnaires were used to collect patients' background information. Fasting Blood Sugar (FBS) was assessed by using a glucometer. Urine samples were examined for the presence of uropathogens. A sterile inoculating loop with a calibrated volume of 2 µl was used for plating. Each colony equals 500 CFU/mL. Significant uropathogen was determined by multiplying the counted colonies by 500 to obtain CFU/mL. Positive uropathogen was defined as CFU ≥ 105/mL. Significant uropathogen was defined as ≥200 colonies per sample. The disc diffusion method was used to determine antibiotic susceptibility. Out of the 175 patients, 19.4% expressed various uropathogens with Escherichia coli being the predominant. Suboptimal glucose level was the most significant risk factor (p = 0.038). Glucosuria (p = 0.036), hazy urine (p = 0.028), positive leukocyte esterase (p = 0.001), and pus cells in urine sediment (p = 0.020) were significant indicators of uropathogen occurrence. Klebsiella pneumonia and Proteus mirabilis were resistant to ≥4 antibiotics. Amikacin, nitrofurantoin, levofloxacin, ciprofloxacin, and ceftriaxone demonstrated efficacy against the isolates. This study underscores the notable prevalence of uropathogens in diabetic patients and the alarming levels of antibiotic resistance observed. The results highlight the critical need for vigilant monitoring and customized treatment approaches, particularly for diabetic patients exhibiting risk factors such as elevated urine glucose levels, cloudy urine, and presence of leukocyte esterase and pus cells in urine sediment. The significant resistance to frequently used antibiotics like co-trimoxazole and tetracycline points to the necessity of routine susceptibility testing and the use of alternative antibiotics for effective treatment. These findings can assist healthcare providers in more effectively managing and preventing UTIs in diabetic populations.

Rising substance use disorders in Malawi: analysis of hospital-based data (2010 to 2019)

Background Africa has a long history of substance abuse, mostly limited to alcohol, tobacco and cannabis, with the East African region being home to one of the world’s highest rates. There are reports of increasing substance abuse in Malawi but limited research evidence to provide details on the extent and nature of the issue. Despite indications of high prevalence, help seeking behaviour among the population is minimal. Mental health services are underfunded by government, and not a key health priority. Access to affordable psychosocial treatment for substance abuse is limited. This paper reports analysis of service utilisation patterns among those assessed at the St John of God (SJOG) Hospital and referred for psychosocial services for substance abuse treatment since its establishment in 2010. This is the first study in Malawi reporting routinely collected patient data related to substance abuse treatment from outpatient psychosocial services. Methods We descriptively analysed retrospective routinely collected data related to substance use disorders from two SJOG hospital sites that provide psychosocial or psychopharmacological treatment to service users at the mental health clinic from 2010 to 2019. Results Analysis of routinely collected data indicated increasing substance abuse treatment within SJOG psychosocial services between 2010 to 2019, with alcohol, chamba (cannabis) and tobacco related substance use disorders being predominant conditions among service users. Age-related data from 2018–2019 showed 22% of service users were under 18 years, indicating evidence of youth substance abuse. Conclusions These findings indicate growing service utilisation for substance use treatment in outpatient psychosocial services over the last decade in Malawi. Importantly, there is need for better electronic health data recording infrastructure to facilitate monitoring of incidents to inform extent of substance use issues and evidence-based solutions for treatment services in Malawi.

Transforming Hospitality in the Theology of Paul: Lessons for Today's Church

Hospitality is central to ministry, but the stress churches give to welcome can sometimes dilute the call to discipleship. In this article, I explore Paul's approach to hospitality, which includes transformation alongside welcome. Following a general discussion of Christian hospitality, I trace Paul's approach to hospitality in three areas: the hospitality of God, hospitality within the church, and hospitality toward outsiders. In my final section, I unpack some contemporary implications of Paul's approach.

Morphological and Molecular Genetic Retrospective Analysis of KRAS, NRAS, BRAF and MSI (Microsatellite Instability) Pattern in Colorectal Cancer

Gastroenterology Medicine & Research Morphological and Molecular Genetic Retrospective Analysis of KRAS, NRAS, BRAF and MSI (Microsatellite Instability) Pattern in Colorectal Cancer Flavia Vrenna, Anastasia Nocita, Giuseppina Alberto, Rosanna Patarino and Federico Tallarigo* Department of Surgical Pathology, Department of Medicine and Oncology, St John of God Hospital, Crotone, Italy *Corresponding author: Federico Tallarigo, Department of Surgical Pathology, Department of Medicine and Oncology, St John of God Hospital, Crotone, Italy Submission:December 05, 2022;Published: January 26, 2023 DOI: 10.31031/GMR.2023.07.000662 ISSN 2637-7632Volume7 Issue3

Mapagmalasakit/ Matapobre: Two Different Ways of Looking at the Poor in the Parable of the Good Samaritan in the light of the COVID-19 Pandemic

This study rereads the Parable of the Good Samaritan in the context of the coronavirus pandemic. It explores the two ways of looking that the passers-by did when they encountered the man who was robbed and abused by the wayside. I termed these two ways of looking in Filipino as malasakit and matapobre. The priest and the Levite were matapobre (mata: eye/ to look; pobre: poor – literally looking down on the poor) in their reaction in that they saw the man but ignored to aid him. The Good Samaritan showed malasakit (malasin: to look; sakit: pain – looking at pain, being compassionate) because he saw the man and helped him in his misery. In this study, I appropriated the experience of the abused man by the wayside to the experiences of people who suffered the effects of the pandemic. I also enumerated the different displays of the matapobre and the malasakit attitudes of people during this pandemic. The three characters in the Parable all looked down on the poor, yet this looking down should be nuanced. The priest and the Levite looked down with contempt and indifference since they did not do anything for the man they saw. The Samaritan, on the other hand, looked down with his eyes of mercy. I cited Scriptural passages of God and Jesus Christ looking down on humanity, which serves as examples for Christians in their duty to help the poor. Our look of mercy on the poor will obtain for us God’s look of mercy and the privilege of looking at his face forever in heaven.
 
 References
 Papal DocumentsFrancis. Encyclical Letter on Fraternity and Social Friendship, Fratelli Tutti, October 3, 2020, http://www.vatican.va/content/francesco/en/encyclicals/documents/papa-francesco_20201003_enciclica-fratelli-tutti.html Francis. General Audience entitled “Go and do likewise (cf Lk 10:25-37),” (April 27, 2016), http://www.vatican.va/content/francesco/en/audiences/2016/documents/papa-francesco_20160427_udienza-generale.html Francis. Angelus Address, July 14, 2019,http://www.vatican.va/content/francesco/en/angelus/2019/documents/papa-francesco_angelus_20190714.html Benedict XVI. Encyclical Letter on Christian Love, Deus Caritas Est, December 25, 2005, http://www.vatican.va/content/benedict-xvi/en/encyclicals/documents/hf_ben-xvi_enc_20051225_deus-caritas-est.html John Paul II. Apostolic Letter on the Christian Meaning of Human Suffering, Salvifici Doloris, February 11, 1984, http://www.vatican.va/content/john-paul-ii/en/apost_letters/1984/documents/hf_jp-ii_apl_11021984_salvifici-doloris.html
 CatechismsCatechism of the Catholic Church. 2nd ed. Washington, DC: United States Catholic Conference, 2000.Catholic Bishops’ Conference of the Philippines ECCCE. Catechism for Filipino Catholics.Manila: Word and Life Publications, 1997.
 BooksBloomberg, Craig L. Interpreting the Parables. 2nd ed. Leicester: InterVarsity Press, 2012Byrne, Brendan. The Hospitality of God: A Reading of Luke’s Gospel. Collegeville, Minnesota: Liturgical Press, 2015.Leoncini, Dante Luis P. “A Conceptual Analysis of Pakikisama [Getting Along Well with People]” in Filipino Cultural Traits: Claro R. Ceniza Lectures, ed. Rolando M. Gripaldo. United States of America: The Council for Research in Values and Philosophy, 2005.Ratzinger, Joseph (Benedict XVI). Jesus of Nazareth: From the Baptism in the Jordan to the Transfiguration, trans. Adrian J. Walker. New York: Doubleday, 2007.
 Journal ArticlesChamburuka Philemon M. and Ishanesu S. Gusha. “An Exegesis of the Parable of the Good Samaritan (Lk 10:25–35) and Its Relevance to the Challenges Caused by COVID-19.” HTS Teologiese Studies/Theological Studies, 76, no. 1 (2020): 1-7, https://doi.org/10.4102/hts.v76i1.6096 Redona, Marites Rano. “Malasakit: The Filipino Face of God’s Mercy.” The Asian Conference on Cultural Studies 2018, (Kobe, Japan, 1-3 June 2018): 97-106, https://papers.iafor.org/proceedings/conference-proceedings-ACCS2018/ Roukema, Riemer. “The Good Samaritan in Ancient Christianity.” Vigiliae Christianae, 58, no. 1: 56-74, https://doi.org/10.1163/157007204772812331 Sheqi, Nitoli and Chammah J. Kaunda. “Your Neighbour Is Yourself Reflected in the Mirror of Life A Naga Reading of the Good Samaritan Narrative in the Context of COVID-19.” The Ecumenical Review, 72, no. 4, (2020): 609-623, https://doi.org/10.1111/erev.12545
 Website ContentsBalancio, Joyce. “Duterte naniniwalang dumami ang COVID-19 cases dahil sa pagpapabaya ng publiko,” ABS-CBN News, March 9, 2021, https://news.abs-cbn.com/news/03/09/21/duterte-naniniwalang-dumami-ang-covid-19-cases-dahil-sa-pagpapabaya-ng-publiko Bible Hub. “Luke 10 Barnes’ Notes on the Bible,” accessed on May 18, 2021, https://biblehub.com/commentaries/barnes/luke/10.htm Brainy Quote. “Stephen Grellet Quotes,” Accessed May 19, 2021, https://www.brainyquote.com/authors/stephen-grellet-quotes Tan, Michael L. “’Matapobre’ Hospitality,” Inquirer.Net, October 4, 2017, https://opinion.inquirer.net/107624/matapobre-hospitality Vatican News, “Hail Holy Queen,” Accessed May 19, 2021, https://www.vaticannews.va/en/prayers/hail-holy-queen.html

Restrictive interventions on a psychiatric admission ward before and after COVID-19.

Restrictive interventions (seclusion, restraint and special observations) are used on psychiatric wards when there are no other means available to keep a patient or others safe. These measures can be traumatic, and the Mental Health Commission and the Health Service Executive are focused on minimising their use. We set out to determine whether, following a COVID related reduction in bed numbers on a high dependency psychiatric ward in St John of God Hospital in Dublin, there was a change in their incidence. Data on restrictive interventions and challenging behaviours were gathered for 9-month periods before and after March 2020 when COVID related ward changes took place. Figures were also collected on seclusion and restraint for the previous 18 months for a longer-term view. Ward and hospital occupancy levels were also recorded. Between the two time periods, episodes of seclusion fell by 53% and episodes of restraint by 56%. The hours devoted to special observation declined by 30% and incidents of challenging behaviours fell by 26%. Ward occupancy levels fell by only 5%. The longer-term comparison of figures for seclusion and restraint point towards a downward trend from mid-2019 that was accentuated in the post-COVID period. The changes found may relate to reduced crowding on the ward or other COVID related factors such as the emphasis on social distancing and a shared sense of purpose on the ward. The longer-term trend points towards an emerging cultural shift. The challenge now is to sustain and build upon these changes.

Seroepidemiology of Hepatitis B and C Virus Infections: A Five-Year Retrospective Study among Blood Donors in Saboba District in the Northern Region of Ghana.

Methods A five-year hospital-based retrospective study was carried out among 8605 blood donors comprising 8517 males and 88 females using data on blood donors from Saboba Assemblies of God Hospital located in the Saboba District in the Northern Region of Ghana from 2013 to 2017. Blood bank records on HBV and HCV potential blood donors who visited the hospital to donate blood were retrieved. Donor demographic details, i.e., age and gender, were also recovered. Donors who were registered to the hospital but were not residents of the Northern Region were excluded from the study. Donors with incomplete records were also excluded from the study. The data was managed using Microsoft Excel spreadsheet 2016 and analysed using GraphPad Prism statistical software. Results The overall prevalence of asymptomatic viral hepatitis B and C infections in the general adult population was 9.59% (95% CI: 9.00-10.20) and 12.71% (95% CI: 12.00-13.40), respectively, with an HBV/HCV coinfection rate of 2.23% (95% CI: 1.90-2.60). The number of donors generally declined with advancement in years from 2038 (23.68%) since 2013 to as low as 1169 (13.59%) in 2016, except for 2017 where a sharp increase of 1926 (22.38%) was observed. The first and second highest proportions of donors fell within the age categories of 20-29 (51.53% (4434)) and 30-39 (32.90% (2831)) respectively. The seroprevalence rate of HBV, HCV, and HBV/HCV coinfection rates were generally higher among the female group than those observed among the male category. The year-to-year variation in HBV, HCV, and HBV/HCV infections was statistically significant. The highest year-to-year HBV seropositivity rate was 11.48% in the year 2013, while that for HCV and HBV/HCV coinfection was 16.24% and 5.85%, respectively, both documented in the year 2014. HBV and HBV/HCV coinfection rates were highest among donors aged <20 years old, while HCV seroprevalence was highest among donors aged 50-59 years old. Significantly higher odds of HBV/HCV coinfection (OR = 5.2; 95% CI:3.3-8.1) was observed in the 2014 compared to the year 2013. Donors aged <20years were at higher risks of HBV and HBV/HCV coinfection rates compared to the other age groups. Conclusion The seroprevalence of HBV and HCV among donors in the Saboba District of the Northern Region of Ghana is endemic. The HBV/HCV coinfection rate also raises serious concern owing to its high prevalence rate among the younger age. Intensive public health education coupled with mobile screening and mass vaccination of seronegative individuals is advised so as to help curb further spread of the infection and in effect help safeguard the health status of potential donors in the district.

Decomposing the asylum in Samuel Beckett’s Malone Dies: Genetic criticism and the author

This article focuses on Samuel Beckett’s use of the asylum in his novel Malone Dies to explore the role of non-textual elements in genetic criticism (the study of a writer’s creative process through the analysis of their compositional manuscripts), as well as the function of the author in genetic analysis. Taking as its starting point Iain Bailey’s challenge to genetic critics to account for the biographical author which underpins the discipline’s study of written traces in authorial manuscripts, the article contends that genetic criticism must be used in tandem with other approaches such as historicism when studying spaces like Beckett’s asylums. Though Beckett took a scholarly approach when integrating such material into earlier work, making research notes which can be regarded as part of the genetic dossier, the asylum in Malone Dies – based on Dublin’s Saint John of God Hospital – leaves no such trail of textual breadcrumbs. Therefore, we must pay particular attention to the historical function of Saint John of God’s in order to understand how the asylum works in composition and reception. In doing so, an author existing beyond the written traces they leave behind can retake their place in a necessarily incomplete empirical field over five decades after Roland Barthes prematurely declared their death.

Audacious hospitality: nursing in the time of COVID-19

ABSTRACT This theological reflection is based on my experience as a nurse during the COVID-19 pandemic. In this paper I reflect on nursing as a hospitable practice, and examine the unique challenges which impact the provision of hospitable care during this pandemic. Hospitable nursing care is grounded in the hospitality of God as demonstrated through the healing care of Jesus, and in historical examples of Christian care of the sick during past epidemics. The paper examines the tensions experienced by nurses between adhering to protocol and extending hospitality. It concludes that while nursing during a pandemic is fraught with challenges, these can be overcome by a conviction that caring for one’s patient is rooted in the hospitality modeled by Jesus. The commitment to maintain proximity and touch, the gift of presence and life-giving words continue to be priorities for the nurse, especially during a pandemic.

Basic to advanced clinical echocardiography. A self‐assessment tool for the cardiac sonographer

SonographyVolume 7, Issue 4 p. 167-168 RESOURCE REVIEW Basic to advanced clinical echocardiography. A self-assessment tool for the cardiac sonographer Samantha Burgoyne, Corresponding Author Samantha Burgoyne samjagiello@gmail.com orcid.org/0000-0001-5365-2203 Heartcare Bunbury - Suite 21, St John of God Hospital, Bunbury, Western Australia, Australia Correspondence Samantha Burgoyne, Heartcare Bunbury - Suite 21, St John of God Hospital, Cnr of Robertson Rd and Bussell Hwy, Bunbury 6230, WA, Australia. Email: samjagiello@gmail.comSearch for more papers by this authorAustralasian Sonographers Association Cardiac Special Interest Group, Australasian Sonographers Association Cardiac Special Interest GroupSearch for more papers by this author Samantha Burgoyne, Corresponding Author Samantha Burgoyne samjagiello@gmail.com orcid.org/0000-0001-5365-2203 Heartcare Bunbury - Suite 21, St John of God Hospital, Bunbury, Western Australia, Australia Correspondence Samantha Burgoyne, Heartcare Bunbury - Suite 21, St John of God Hospital, Cnr of Robertson Rd and Bussell Hwy, Bunbury 6230, WA, Australia. Email: samjagiello@gmail.comSearch for more papers by this authorAustralasian Sonographers Association Cardiac Special Interest Group, Australasian Sonographers Association Cardiac Special Interest GroupSearch for more papers by this author First published: 03 December 2020 https://doi.org/10.1002/sono.12237Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume7, Issue4December 2020Pages 167-168 RelatedInformation

Management of neutropenic fever in a private hospital oncology unit.

Neutropenic fever is a medical emergency, which poses a significant morbidity and mortality risk to cancer patients receiving chemotherapy. National guidelines recommend that patients presenting with suspected neutropenic fever receive appropriate intravenous antibiotics within 60 min of admission. We aimed to investigate the management of neutropenic fever in a large private oncology centre. A retrospective audit of all patients who presented to St John of God Hospital, Subiaco, in the 2017 calendar year, with a known solid organ malignancy and a recorded diagnosis of neutropenic fever was conducted. Patients were identified through the hospitals Patient Administration System and ICD-10 codes. Information was collected from the hospital medical records using a standardised data collection tool. There were 98 admissions relating to 88 patients with neutropenic fever during the study period. The median age was 64 years (range: 23-85 years) with 57 (65%) females. Antibiotic selections consistent with the Australian guidelines were made in 88 (89%) admissions. The mean time to antibiotic administration was 279 min, with a median of 135 min (range: 15-5160 min). Antibiotics were administered within the recommended time frame in only eight (11%) admissions. Clinicians prescribed antibiotics in accordance with national guidelines; however, there were systemic inefficiencies which resulted in delayed antibiotic initiation. This has resulted in implementation of strategies to minimise delay.

Are viruses associated with disc herniation? A clinical case series

BackgroundThere is some limited evidence for the presence of viruses in herniated disc material including a previous case series that claimed to provide “unequivocal evidence of the presence of herpes virus DNA in intervertebral disc specimens of patients with lumbar disc herniation suggesting the potential role of herpes viruses as a contributing factor to the pathogenesis of degenerative disc disease”. This study has not been replicated. The objective of our study was to determine if viruses were present in herniated disc fragments in participants with a prior history of back pain.MethodsWe recruited fifteen participants with a history of prior low-back pain prior to undergoing disc herniation surgery in the lumbar spine. Harvested disc samples were subject to next generation sequencing for detection of both RNA and DNA viral pathogens. Additionally, samples were analysed by a broadly reactive PCR targeting herpesviral DNA. Ethics approval was granted by the Human Research Ethics Committees of both Murdoch University, and St John of God Hospital, Western Australia.ResultsOf the fifteen research participants, 8 were female. Mean age was 49.4 years (SD 14.5 yrs) with a range of 24–70 years. All participants had prior back pain with mean time since first ever attack being 8.8 years (SD 8.8 yrs). No samples contained significant DNA sequences relating to known human viral agents. Inconsequential retroviral sequences were commonly found and were a mixture of putative animal and human retroviral protein coding segments. All samples were negative for herpesvirus DNA when analysed by pan-herpesvirus PCR.ConclusionsThis study found no viral pathogens in any intervertebral disc fragments of patients who had previous back pain and underwent discectomy for disc herniation and thus it is unlikely that viruses are associated with disc herniation, however given the contradiction between key studies enhanced replication of this experiment is recommended.

196P - The tolerability and efficacy of FOLFIRINOX in gastro-oesophageal carcinoma

Background5-FU based regimens represent the gold standard of therapy for gastroesophageal carcinomas. Options include Cisplatin-5FU doublets, FOLFOX and FOLFIRI, and in the neo-adjuvant setting FLOT is emerging as a popular choice for those with good performance status. We identified two cohorts of patients who received m-FOLFIRINOX as first line treatment of gastroesophageal carcinoma; patients undergoing neo-adjuvant therapy in whom FLOT was thought to be too toxic, and those with extensive metastatic disease where it was thought that they would not be fit enough for second line therapy. In these settings there is a theoretical advantage to FOLFIRINOX as it exploits the synergy between Oxaliplatin and Irinotecan; Oxaliplatin forms platinum-DNA adducts and Irinotecan prevents the repair of these adducts impeding the development of platinum resistance. We prospectively evaluated our single institution use of FOLFIRINOX in both neo-adjuvant and advanced treatment of gastro-oesophageal carcinomas. Methods14 patients with oesophageal, gastro-oesophageal junction or stomach carcinoma gave informed consent to treatment with FOLFIRINOX. Five of these patients had extensive metastatic disease at diagnosis. Response to treatment was recorded via combined CT/PET scanning, endoscopy reports, tumour markers and pathology. ResultsAll nine patients being treated neo-adjuvantly displayed a good metabolic response prior to surgical resection. Of note was one patient who received only two cycles, however achieved reduction in his tumour from T3N2 to T2N0, which was then completely resected. For the five patients with extensive disease, all showed complete metabolic responses on PET, after having an average of 10.6 cycles each of FOLFIRINOX treatment. Only one patient relapsed 6 months after completing treatment, who subsequently responded to FOLFIRINOX retreatment, and died 23 months after diagnosis. ConclusionsFOLFIRINOX appears to be highly effective in the treatment of early stage and metastatic gastro-oesophageal adenocarcinomas, as well as showing an excellent pathological response rate which aids surgical resection. This case series suggest that the regimen should be formally trialled, comparing tolerability and efficacy against FLOT. Legal entity responsible for the studySt John Of God Hospital Subiaco. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

181P - The emerging role of third-line gemcitabine plus nab-paclitaxel in advanced pancreatic adenocarcinoma

BackgroundThere are no standardised, recognised regimens for third line treatment of advanced pancreatic cancer, with most clinicians using best supportive care in this scenario. Gemcitabine plus nab-paclitaxel and FOLFIRINOX are non-cross resistant regimens. This generates the hypothesis that patients who responded well in the first line setting to gemcitabine and nab-paclitaxel could respond again if rechallenged in the third line setting, after second line FOLFIRINOX. MethodsA retrospective analysis was conducted via an electronic database from two of our institutions, of locally advanced or metastatic pancreatic adenocarcinoma patients who were treated with gemcitabine plus nab-paclitaxel both as a first line and third line chemotherapy regimen between January 2013 and July 2019. All patients had an ECOG performance status of 2 or less. Overall survival (OS) was estimated by the Kaplan-Meier method. ResultsWe identified 30 patients in our analysis. 63% of the patients were female, with the median age of all patients at diagnosis being 67 (range, 38 – 82). 60% of the studied patients had locally advanced disease at diagnosis. Median OS from diagnosis was 39.0 months (95% CI, 34.0 – 66.0). Median OS from third-line re-initiation of gemcitabine plus nab-paclitaxel was 29.0 months (95% CI, 9.0 – 36.0). ConclusionsPatient who maintain a good performance status after second line treatment present a management dilemma, as these patients are often reluctant to accept best supportive care when they feel well enough to tolerate another line of chemotherapy. The median OS (29 months) and age (67) is surprising, but probably represents the selection bias of patients who retain sufficient performance status to undergo third line therapy. Patients who have receive first line gemcitabine plus nab-paclitaxel, and second line FOLFIRINOX whilst maintaining good performance status, should be considered for re-treatment with gemcitabine plus nab-paclitaxel, as evidenced by our data from two of our institutions. Phase III studies would be highly beneficial to further investigate this as a potential standard of care for third-line treatment in this group. Legal entity responsible for the studySt John of God Hospital Subiaco. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

182P - Durable response to second-line m-FOLFIRINOX for advanced pancreatic adenocarcinoma in patients with performance status of two or less

BackgroundThe efficacy of FOLFIRINOX in the treatment of pancreatic adenocarcinoma is well known and documented. However, most published data involves young patients with a performance status ≤1 (ACCORD study). Thus, traditionally FOLFIRINOX has been regarded as a first line only treatment for patients with good performance status. Patients requiring second line therapy are not regarded as being fit enough to receive FOLFIRINOX. We have previously published our experience that m-FOLFIRINOX can be utilised safely in these individuals, with appropriate dose reductions. Our position has been supported by a subsequent systematic review (Tong et al.). This updated report of our dual institution experience adds further evidence supporting the use of m-FOLFIRINOX as a second line treatment for pancreatic adenocarcinoma. MethodsA retrospective analysis was conducted on patients with locally advanced or metastatic pancreatic adenocarcinoma from two institutions who received first-line gemcitabine plus nab-paclitaxel, followed by second-line m-FOLFIRINOX between December 2011 and July 2019. All patients had an ECOG performance status of 2 or less. Overall survival (OS) was estimated via the Kaplan-Meier method. ResultsWe identified 85 patients in our analysis, with 64% patients having metastatic disease at diagnosis. The median age of our patients at diagnosis was 65 (range, 26 – 81). The dose intensity of m-FOLFIRINOX was the following: 65% for oxaliplatin, 68% for irinotecan, 18% for bolus 5-fluorouracil (5-FU) and 68% for infusional 5-FU. The median OS of all patients was 46.0 months (95% CI, 35.0 – 68.0). The median OS of locally advanced and metastatic pancreatic cancer from diagnosis was 68.0 months (95% CI, 45.0 – 68.0) and 23.0 months (95% CI, 19.0 – 49.0), respectively. ConclusionsOur expanded case series continues to demonstrate the growing role of m-FOLFIRINOX as a second line therapy for advanced metastatic pancreatic cancer, after the failure of first-line gemcitabine plus nab-paclitaxel. We continue to suggest that formal clinical trials are needed to further investigate this efficacy. Legal entity responsible for the studySt John of God Hospital, Subiaco. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Pharmacoeconomic analysis of antibiotic therapy in surgical site infections .

Surgical site infections (SSIs) are considered to be one of the most common complications in operative treatment due to increased microbiological resistance. Having knowledge of the flora that most frequently cause SSIs in a given population allows for the implementation of effective empirical antibiotic therapies. Such an approach leads to a decrease in both time and costs associated with SSI treatment. The aim of this paper is to assess the most common pathogens causing SSIs in orthopedic and general surgery and to conduct a cost-minimization analysis. A total of 908 isolates from 547 patients with an SSI in general surgery and 463 swabs from 267 patients with an SSI at the department of orthopedics were obtained. All patients were treated at St. John of God Hospital in Katowice from 2011 to 2016. The incidence rate of SSIs was 4.25% in general surgery and 2.66% in orthopedics. The most commonly isolated strains in general surgery were E. coli (24.3%), K. pneumoniae (12.5%), and P. mirabilis (4.76%). Gram-positive cocci dominated the isolates in orthopedics, with S. epidermidis and S. aureus accounting for 19.8% and 13.6%, respectively. The most cost-effective antibiotics for general surgery are currently the cephalosporins cefotaxime or ceftriaxone, either alone or in combination with amikacin, while in orthopedics the most cost-effective were trimethoprim/sulfamethoxazole. Empirical antibiotic therapy should be based on the current epidemiological situation of infections from both a medical and pharmacoeconomic point of view.

Twinning with Tonga: The Experiences of Tongan Stakeholders with a Long-term Partnership with Regional Victoria, Australia

Twinning programs in health have gained increased recognition as a WHO preferred strategy for providing a sustainable strategy for enhancing the delivery of best practice healthcare globally. The Tonga Twinning Program (TTP), represents a longstanding relationship of some twenty-five years between The Ministry of Health in Tonga and St John of God Hospital, Ballarat, Australia and provides a compelling example of what can be achieved. This article presents the findings from a longitudinal exploration of the experiences and perceptions of the TTP through the voices of those key-stakeholders situated in Tonga who have engaged with the program. Informed by the tenets of hermeneutic phenomenology, a modified thematic analysis highlighted two major themes, ‘A shared mission' and ‘The outcomes are more than the tangibles', which supported by a series of sub-themes, identify the core components of the experience of the TTP. This study suggests that the TTP has supported a collective sense of bringing the very best available knowledge and skills to the people of Tonga and has fostered a genuine and open dialogue between partners as a mechanism for change that goes well beyond simply a capacity to replicate skills and instead has establish a genuine reciprocity akin to being a family.

Promoting physical activity in regional and remote cancer survivors (PPARCS) using wearables and health coaching: randomised controlled trial protocol

IntroductionPhysically active cancer survivors have substantially less cancer recurrence and improved survival compared with those who are inactive. However, the majority of survivors (70%–90%) are not meeting the physical activity...

A REALITY IN A DEVELOPING COUNTRY- BENIN: DIAGNOSIS OF CANCER WITH THE ACTIVATION OF AUTOMATED IMMUNOHISTOCHEMISTRY

Background: In the Benin-West state of Africa, cancer is one of the most frequent causes of death. For this reason from September 2015 at Saint John of God Hospital in Tanguieta – Benin – a Histopathology Laboratoy is active with the aim to make diagnosis and address towards adequate therapeutic programs patients affected from cancer and other diseases. The Laboratory has been equipped with a tele pathology system (Cross SS, Dennis T, Start RD. 2002 and Della Mea V. & Beltrami CA. 2000) and from 2018 with an Automatic System for Immunochemistry. Objectives, methods and outcomes: In the last 20 years, in collaboration with the association APOF (Pathologists across the border), diagnostic laboratories have been developed in various African countries: Tanzania - Uganda - Djibouti, etc. Immunohistochemistry has been introduced in these laboratories to formulate a correct and complete diagnosis. In Benin we had a technological breakthrough by introducing an automated immunohistochemistry system. The funds were obtained from the FAI (International Assistance Foundation) of Lugano (Switzerland) and from the UTA – Onlus. The use of validated protocols, the contribution of international experts through telepathology, the training of technical personnel on site, allowed the formulation of correct diagnoses. Conclusion: The development of complete histopathological diagnostic services of automated ICHs, such as that of Benin, is of fundamental importance for the fight against cancer in developing countries. Cancer is fought with research but also with a correct diagnosis. Article DOI: https://dx.doi.org/10.20319/lijhls.2019.43.128137 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.