Faith In God as The Source of Goodness And Religious Moderation In Indonesia: A Christian Moral Perspective

Goodness is the basis and goal of all moral actions. Therefore, ethics, be it theological or philosophical, must in some way explain specifically what goodness is and where one can find it. The Christian faith answers this by stating its fundamental belief that God is good. It says that the Christian belief in goodness is based on faith in God, placing each Christian at the heart of the relationship between faith and moral action. After confirming this fundamental Christian belief that God is the centre of all values, in this paper, we will draw out some implications of the relationship between faith as a personal and communal experience of God and the development of an attitude of religious moderation in a pluralistic Indonesian society. Thus, cultivating an attitude of religious moderation does not stop as an external rule but should go further as an ethical imperative for every Christian

Nilai Moral Kristiani dalam Ukiran Figuratif Sa’o Ngaza pada Masyarakat Ngada Nusa Tenggara Timur

This article focuses on extracting one of the local wisdom, namely, figurative carvings on the traditional house (sa’o ngaza) of the Ngada community, East Nusa Tenggara, and reviewing it from the perspective of Christian moral theology. The method used is a qualitative one, employing especially a phenomenological approach and a narrative approach. The data are obtained from direct interviews with key informants who understand the figurative carvings on traditional houses and come from several villages in the Ngada Flores Regency, East Nusa Tenggara. The results show that the figurative carvings contain moral values, such as discipline, hard work, responsible leadership and integrity, loyalty, and sacrifice. These values can be called local wisdom and can be used as a reference for knowledge and understanding for developing moral character to overcome the leadership and social crises that still plague Indonesian society today

Mata Golo, the Ke'o Rado Ritual, and The Death of Jesus Christ on The Cross in the Perspective of the Ngada People in Central Flores Indonesia

Most traditional societies have different conceptions of death and dying. The people of Ngada in Central Flores have a conception of death and dying called ‘mata golo.’ Mata golo is a bad death or a bloody death. This kind of death is caused by, for instance, a natural disaster, being killed by others, being killed in a traffic accident, etc. This article presents a theological inculturation view of the death of Christ on the Cross as a sign of reconciliation and peace in the perspective of mata golo among the Ngada people and in that of the ke’o rado ritual that follows it. This ritual is meant to bring about reconciliation and establish peace between the members of the clan on the one hand and the dead and the ancestors on the other hand. By using the inculturation method, we first listen to the culture. For this, the qualitative research method is used by conducting field research observations, in-depth interviews with key informants, and literature studies of previous studies on mata golo. The result is then compared with the teachings and views of the Catholic Church on the death of Christ. These two themes are then synthesized to build a distinctive theological concept, which could be a contribution to future pastoral services

Presentation, management, and outcomes of older compared to younger adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study

Purpose: Older adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (≥ 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI). Methods: Nested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (≥ 18 years) hospitalized in the ICU during 2019-2021. We compared older versus younger adults in terms of infection characteristics (clinical signs and symptoms, source, and microbiological data), management (imaging, source control, antimicrobial therapy), and outcomes (28-day mortality and hospital discharge). Results: Among 2111 individuals hospitalized in 219 ICUs with HA-BSI, 563 (27%) were ≥ 75 years old. Compared to younger patients, these individuals had higher comorbidity score and lower functional capacity; presented more often with a pulmonary, urinary, or unknown HA-BSI source; and had lower heart rate, blood pressure and temperature at presentation. Pathogens and resistance rates were similar in both groups. Differences in management included mainly lower rates of effective source control achievement among aged individuals. Older adults also had significantly higher day-28 mortality (50% versus 34%, p < 0.001), and lower rates of discharge from hospital (12% versus 20%, p < 0.001) by this time. Conclusions: Older adults with HA-BSI hospitalized in ICU have different baseline characteristics and source of infection compared to younger patients. Management of older adults differs mainly by lower probability to achieve source control. This should be targeted to improve outcomes among older ICU patients

The role of centre and country factors on process and outcome indicators in critically ill patients with hospital-acquired bloodstream infections

Purpose: The primary objective of this study was to evaluate the associations between centre/country-based factors and two important process and outcome indicators in patients with hospital-acquired bloodstream infections (HABSI). Methods: We used data on HABSI from the prospective EUROBACT-2 study to evaluate the associations between centre/country factors on a process or an outcome indicator: adequacy of antimicrobial therapy within the first 24 h or 28-day mortality, respectively. Mixed logistical models with clustering by centre identified factors associated with both indicators. Results: Two thousand two hundred nine patients from two hundred one intensive care units (ICUs) were included in forty-seven countries. Overall, 51% (n = 1128) of patients received an adequate antimicrobial therapy and the 28-day mortality was 38% (n = 839). The availability of therapeutic drug monitoring (TDM) for aminoglycosides everyday [odds ratio (OR) 1.48, 95% confidence interval (CI) 1.03-2.14] or within a few hours (OR 1.79, 95% CI 1.34-2.38), surveillance cultures for multidrug-resistant organism carriage performed weekly (OR 1.45, 95% CI 1.09-1.93), and increasing Human Development Index (HDI) values were associated with adequate antimicrobial therapy. The presence of intermediate care beds (OR 0.63, 95% CI 0.47-0.84), TDM for aminoglycoside available everyday (OR 0.66, 95% CI 0.44-1.00) or within a few hours (OR 0.51, 95% CI 0.37-0.70), 24/7 consultation of clinical pharmacists (OR 0.67, 95% CI 0.47-0.95), percentage of vancomycin-resistant enterococci (VRE) between 10% and 25% in the ICU (OR 1.67, 95% CI 1.00-2.80), and decreasing HDI values were associated with 28-day mortality. Conclusion: Centre/country factors should be targeted for future interventions to improve management strategies and outcome of HABSI in ICU patients

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes