Dr Patricia Johnson

Dr Patricia Johnson

Lecturer

Newcastle Business School (Tourism)

Career Summary

Biography

Patricia embarked on her academic career  to examine the perception and management of risk and security in tourist experiences, a study which involved traveling to Iran with the third Australian tour group to enter Iran after the Islamic revolution. Her research maintains an inter-disciplinary and inter-cultural focus and draws from the humanities and social sciences to engage concepts such as ideology, discourse, liminality, risk, cultural capital, the gaze and identity and difference to explore the emerging field of cosmopolitanism and questions relating to cultural literacy and global citizenship. In this, her work assumes a historical perspective to understand the discursive constitution of culture - that is, relationships of power and the ways in which knowledge of others is constructed, legitimated, reproduced and reworked. She maintains an expertise in analyzing travel media, in particular, travel writing to explore 'western' viewing positions over the foreign. Other research interests include destination development and cruise ship tourism and, in particular the roles of stakeholders in knowledge transfer processes and the role of volunteerism in the context of urban tourism. Patricia has been involved with a range of research projects and has provided strategic support to the school's Tourism Research Unit. Her teaching career also reflects this inter-disciplinary focus having taught a number of courses since 2001 at the University of Newcastle in the areas of tourism studies, media studies, cultural studies and sociology. Outside of academia she experience in business management in civil construction and has worked as a consultant devising and researching the effectiveness of workplace training in a range of industry applications.

Research Expertise
Dr Patricia C Johnson's primary research expertise lies within qualitative research method, but is also experienced in designing and carrying out quantitative research. As a researcher, her focus is interdisciplinary and lie within the areas of tourism studies and cultural studies. Patricia maintains an active and interdisciplinary research focus is which draws from English literature, cultural studies, sociology, geography, anthropology, gender studies and tourism studies to engage concepts such as the emerging area of cosmopolitanism, liminality, the tourist gaze and cultural capital. Other areas of interest in research include cruise ship tourism, nautical tourism, destination development and image development. She held a key research position examining stakeholder attitudes about the readiness of Newcastle as a home for cruise ship tourism and is actively engaged in furthering research efforts in this field. Other areas of research that she has been involved in include recreation specialisation and tourist image construction of PNG,and  wine tourism. As lecturer and a dedicated teacher, she is actively involved in research projects involving teaching and learning in the Faculty of Business and Law.

Teaching Expertise
Dr Patricia Johnson is Lecturer and Course Coordinator in Sustainable Tourism Management at Callaghan and Central Coast campuses in NSW and is Course Coordinator in the delivery of courses at the University of Newcastle Singapore. Courses include: Visitor Behaviour and Management, Leisure Behaviour and Management, Event Management, Tourism Policy and Planning, and Tourism Principles and Practices. She also supervises Honours and Postgraduate students in Tourism.  Patricia has substantial experience in teaching at an undergraduate level across disciplines and topic areas having held a number of teaching and lecturing positions at the University of Newcastle since 2001 in the fields of Tourism, Leisure and Recreation, Social Science, Cultural Studies (including media and film studies) and English Language and Open Foundation Studies. She is a committed teacher whose approach to teaching tourism is informed by this interdisciplinary teaching experience.






Qualifications

  • PhD, University of Newcastle
  • Bachelor of Business, University of Newcastle
  • Bachelor of Social Science (Honours), University of Newcastle

Keywords

  • Cosmopolitanism
  • Cruise Ship Tourism
  • Cultural Literacy
  • Cultural Studies
  • Culture and Heritage Management
  • Destination Image
  • Liminality
  • Media Studies
  • Risk and Tourism
  • Tourism Behaviour
  • Tourism Management
  • Travel Writing

Fields of Research

Code Description Percentage
150499 Commercial Services not elsewhere classified 30
150601 Impacts of Tourism 70

Professional Experience

UON Appointment

Title Organisation / Department
Lecturer University of Newcastle
Newcastle Business School
Australia

Academic appointment

Dates Title Organisation / Department
1/01/2010 -  Lecturer University of Newcastle
Business and Law
Australia
1/01/2009 - 1/01/2010 Lecturer University of Newcastle
Business and Law
Australia
1/01/2007 - 1/12/2008 Research Academic University of Newcastle
School of Economics, Politics and Tourism
Australia
1/01/2007 - 1/12/2007 Research Academic University of Newcastle
School of Humanities and Social Science
Australia
1/01/2001 - 1/12/2008 Casual Lecturer and Tutor University of Newcastle
School of Humanities and Social Science
Australia
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (3 outputs)

Year Citation Altmetrics Link
2014 Johnson PC, 'Frameworks of Freedom and Fear: Authorizing the Voice in Women's Travel Writing', Travel, Discovery, Transformation, Transaction Publishers, New Brunswick, New Jersey 101-122 (2014) [B1]
2008 Johnson P, Palmer D, 'Hepatocellular carcinoma: Medical management', Interventional Oncology: Principles and Practice 115-120 (2008)

© Cambridge University Press, 2008. The Need for Systemic Therapies in Hepatocellular Carcinoma: Recent years have seen major advances in local control of hepatocellular carcinoma... [more]

© Cambridge University Press, 2008. The Need for Systemic Therapies in Hepatocellular Carcinoma: Recent years have seen major advances in local control of hepatocellular carcinoma (HCC), and the relevant approaches are described in detail elsewhere in this volume. Thus, although surgical resection (and orthotopic liver transplantation) has long been seen as the only approach to offer cure, or at least long-term survival, other locoregional therapies including percutaneous ethanol injection and thermal ablation now appear to be rivaling surgical resection by many criteria of efficacy. However, it is clear that all these approaches (including surgical resection) are less effective as the tumor increases in size, and conventionally, most are confined to lesions smaller than 5 cm in diameter. This probably reflects the fact that as tumors increase in size, the frequency of vascular invasion increases and with it, the likelihood of metastasis. Thus, if local treatments are applied to larger lesions then the rate of recurrence increases dramatically. Similarly, trans-catheter approaches are recognized to cause extensive tumor necrosis, but evidence of survival improvement has been more difficult to demonstrate because disease progression and tumor re-vascularization are still the rule. Thus to complement these local measures, systemic treatment is urgently required to expand the indications for local therapies and to decrease the recurrence rate (i.e., in the adjuvant setting). At the outset, it should be noted that, largely because of the progress in local treatment, systemic agents have moved ¿down the scale¿ so that new chemotherapeutic agents have been tried mainly in patients with advanced or even terminal disease and this necessarily limits the scope for observing effective treatments.

DOI 10.1017/CBO9780511722226.012
2008 Palmer D, Johnson P, 'The clinical management of hepatic neoplasms', Interventional Radiological Treatment of Liver Tumors 1-24 (2008)

© Cambridge University Press 2009. The liver is the organ most frequently involved by cancer. In developing countries hepatocellular carcinoma is a major public health problem res... [more]

© Cambridge University Press 2009. The liver is the organ most frequently involved by cancer. In developing countries hepatocellular carcinoma is a major public health problem responsible for over 500 000 deaths per year. In the West its incidence is rising, in part due to the increasing prevalence of chronic hepatitis C virus infection. The liver is also the commonest site of metastases, and up to 75% of primary tumors drained by the portal venous system involve the liver before death. This chapter will review the epidemiology, etiology, and current management of hepatocellular carcinoma and of secondary liver cancer, with particular reference to colorectal metastases as a paradigm for the multidisciplinary management of cancer. Hepatocellular carcinoma Epidemiology and etiology Hepatocellular carcinoma (HCC) is one of the commonest malignancies worldwide but with wide geographical variation, the highest incidence occurring in sub-Saharan Africa and the Far East. This variation suggests the importance of environmental factors (Table 1.1). Prime among these are chronic infection by hepatitis viruses B and C (HBV and HCV) and exposure to aflatoxin. In a study of 22 000 Chinese males, 15% of whom were HBV carriers, the relative risk for HCC development in HBV-positive men was 98.4. An HBV vaccination program, inoculating neonates, was initiated in Taiwan in the early 1980s and has resulted in a clear reduction in the incidence of childhood HCC. However, an effect on the incidence of HCC in adults may take a further 20 years to become apparent.

DOI 10.1017/CBO9780511575433.003

Journal article (44 outputs)

Year Citation Altmetrics Link
2018 Johnson PC, 'TOURISM AND SOFT POWER: SCRIPTING SERVICESCAPES FOR THE CHINA OUTBOUND MARKET', TOURISM ANALYSIS, 23 573-586 (2018)
DOI 10.3727/108354218X15391984820558
2017 Keeler BD, Simpson JA, Ng O, Padmanabhan H, Brookes MJ, Acheson AG, et al., 'Randomized clinical trial of preoperative oral versus intravenous iron in anaemic patients with colorectal cancer', British Journal of Surgery, 104 214-221 (2017)

© 2017 BJS Society Ltd Published by John Wiley & Sons Ltd Background: Treatment of preoperative anaemia is recommended as part of patient blood management, aiming to minimiz... [more]

© 2017 BJS Society Ltd Published by John Wiley & Sons Ltd Background: Treatment of preoperative anaemia is recommended as part of patient blood management, aiming to minimize perioperative allogeneic red blood cell transfusion. No clear evidence exists outlining which treatment modality should be used in patients with colorectal cancer. The study aimed to compare the efficacy of preoperative intravenous and oral iron in reducing blood transfusion use in anaemic patients undergoing elective colorectal cancer surgery. Methods: Anaemic patients with non-metastatic colorectal adenocarcinoma were recruited at least 2 weeks before surgery and randomized to receive oral (ferrous sulphate) or intravenous (ferric carboxymaltose) iron. Perioperative changes in haemoglobin, ferritin, transferrin saturation and blood transfusion use were recorded until postoperative outpatient review. Results: Some 116 patients were included in the study. There was no difference in blood transfusion use from recruitment to trial completion in terms of either volume of blood administered (P = 0·841) or number of patients transfused (P = 0·470). Despite this, increases in haemoglobin after treatment were higher with intravenous iron (median 1·55 (i.q.r. 0·93¿2·58) versus 0·50 (-0·13 to 1·33) g/dl; P < 0·001), which was associated with fewer anaemic patients at the time of surgery (75 versus 90 per cent; P = 0·048). Haemoglobin levels were thus higher at surgery after treatment with intravenous than with oral iron (mean 11·9 (95 per cent c.i. 11·5 to 12·3) versus 11·0 (10·6 to 11·4) g/dl respectively; P = 0·002), as were ferritin (P < 0·001) and transferrin saturation (P < 0·001) levels. Conclusion: Intravenous iron did not reduce the blood transfusion requirement but was more effective than oral iron at treating preoperative anaemia and iron deficiency in patients undergoing colorectal cancer surgery.

DOI 10.1002/bjs.10328
Citations Scopus - 20
2016 Toyoda H, Lai PBS, O'Beirne J, Chong CC, Berhane S, Reeves H, et al., 'Long-term impact of liver function on curative therapy for hepatocellular carcinoma: Application of the ALBI grade', British Journal of Cancer, 114 744-750 (2016)

© 2016 Cancer Research UK. Background:Application of curative therapy for hepatocellular carcinoma is crucially dependent on underlying liver function. Using the recently describe... [more]

© 2016 Cancer Research UK. Background:Application of curative therapy for hepatocellular carcinoma is crucially dependent on underlying liver function. Using the recently described ALBI grade we examined the long-term impact of liver dysfunction on survival of early-stage hepatocellular carcinoma (HCC) patients.Methods:This cohort study comprised 2559 HCC patients from different geographic regions, all treated with curative intent. We also examined the relation between indocyanine green (ICG) clearance and ALBI score. Survival was measured from the date of treatment to the date of death or last follow-up.Results:The ALBI score correlated well with ICG clearance. Among those undergoing surgical resection, patients with ALBI grade-1 (good liver function) survived approximately twice as long as those with ALBI grade-2 (less good liver function), although more than 90% of these patients were classified as Child-Pugh (C-P) grade A. In the cohort receiving ablative therapies, there was a similar difference in survival between ALBI grade-1 and grade-2. Cox regression analysis confirmed that the ALBI score along with age, gender, aetiology and tumour factors (AFP, tumour size/number and vascular invasion) independently influenced survival in HCC patients receiving curative treatments.Conclusions:The ALBI score represents a simple approach to the assessment of liver function in patients with HCC. After potentially curative therapy, those with ALBI grade-1 survived approximately twice as long as those with ALBI grade-2. These data suggest that ALBI grade-1 patients are appropriately treated with surgical resection whereas ALBI grade-2 patients may, where the option exists, be more suitable for liver transplantation or the less invasive curative ablative therapies.British Journal of Cancer (2016) 114, 744-750; doi:10.1038/bjc.2016.33 www.bjcancer.com.

DOI 10.1038/bjc.2016.33
Citations Scopus - 49
2016 Johnson P, Lai PB, Toyoda H, 'Reply to: Comment on: 'Long-term impact of liver function on curative therapy for hepatocellular carcinoma: Application of the ALBI grade'', British Journal of Cancer, 115 e6 (2016)
DOI 10.1038/bjc.2016.197
2015 Roayaie S, Jibara G, Tabrizian P, Park JW, Yang J, Yan L, et al., 'The role of hepatic resection in the treatment of hepatocellular cancer', Hepatology, 62 440-451 (2015)

© 2015 by the American Association for the Study of Liver Diseases. Current guidelines recommend surgical resection as the primary treatment for a single hepatocellular cancer (HC... [more]

© 2015 by the American Association for the Study of Liver Diseases. Current guidelines recommend surgical resection as the primary treatment for a single hepatocellular cancer (HCC) with Child's A cirrhosis, normal serum bilirubin, and no clinically significant portal hypertension. We determined how frequently guidelines were followed and whether straying from them impacted survival. BRIDGE is a multiregional cohort study including HCC patients diagnosed between January 1, 2005 and June 30, 2011. A total of 8,656 patients from 20 sites were classified into four groups: (A) 718 ideal resection candidates who were resected; (B) 144 ideal resection candidates who were not resected; (C) 1,624 nonideal resection candidates who were resected; and (D) 6,170 nonideal resection candidates who were not resected. Median follow-up was 27 months. Log-rank and Cox's regression analyses were conducted to determine differences between groups and variables associated with survival. Multivariate analysis of all ideal candidates for resection (A+B) revealed a higher risk of mortality with treatments other than resection. For all resected patients (A+C), portal hypertension and bilirubin >1 mg/dL were not associated with mortality. For all patients who were not ideal candidates for resection (C+D), resection was associated with better survival, compared to embolization and "other" treatments, but was inferior to ablation and transplantation. Conclusions: The majority of patients undergoing resection would not be considered ideal candidates based on current guidelines. Not resecting ideal candidates was associated with higher mortality. The study suggests that selection criteria for resection may be modestly expanded without compromising outcomes, and that some nonideal candidates may still potentially benefit from resection over other treatment modalities.

DOI 10.1002/hep.27745
Citations Scopus - 100
2015 Chan SL, Mo F, Johnson P, Li L, Tang N, Loong H, et al., 'Applicability of BALAD score in prognostication of hepatitis B-related hepatocellular carcinoma', Journal of Gastroenterology and Hepatology (Australia), 30 1529-1535 (2015)

© 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd. Background and Aims: The BALAD score is developed to provide an objective determina... [more]

© 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd. Background and Aims: The BALAD score is developed to provide an objective determination of prognosis for hepatocellular carcinoma (HCC) by incorporating five serum markers, namely albumin, bilirubin, alpha-fetoprotein (AFP), agglutinin-reactive alpha-fetoprotein (AFP-L3), and des-¿-carboxy prothrombin. We aim to study the applicability of BALAD score and prognostication of the three tumor markers in hepatitis B virus-related HCC. Methods: Patients with newly diagnosed HCC were prospectively enrolled. All of the baseline characteristics and serum albumin and bilirubin level were documented at baseline. The levels of the three tumor markers (AFP, AFP-L3, and des-¿-carboxy prothrombin) were determined in archival serum samples. Patients were followed up for survivals according to local practice. The prognostic performances of the three markers and BALAD score were studied in association with overall survival (OS). Results: A total of 198 patients with hepatitis B-related HCC were recruited. AFP and AFP-L3 levels were independent prognostic factors. The number of elevated tumor markers was also predictive of worse OS. BALAD score could stratify the cohort into different patient groups with distinct median OS. The median OS of BALAD score of 0, 1, 2, 3, and 4 was not reached, 26.6, 8.3, 2.6, and 1.9 months, respectively (P<0.0001). BALAD score could further stratify outcomes in each Barcelona Clinic Liver Cancer (BCLC) subgroup. In particular, BALAD score of 3-4 had median OS of 2.6 months only in BCLC stage C patients. Conclusion: BALAD score is applicable in the population of hepatitis B virus-related HCC. The combined use of BALAD score and BCLC staging system could help identify more suitable candidates for clinical trial.

DOI 10.1111/jgh.13005
Citations Scopus - 4
2015 Park JW, Chen M, Colombo M, Roberts LR, Schwartz M, Chen PJ, et al., 'Global patterns of hepatocellular carcinoma management from diagnosis to death: The BRIDGE Study', Liver International, 35 2155-2166 (2015)

© 2015 John Wiley &amp; Sons A/S. Background &amp; Aims: Hepatocellular carcinoma (HCC) is the second most common cause of cancer deaths worldwide. The global HCC BRIDGE study w... [more]

© 2015 John Wiley & Sons A/S. Background & Aims: Hepatocellular carcinoma (HCC) is the second most common cause of cancer deaths worldwide. The global HCC BRIDGE study was a multiregional, large-scale, longitudinal cohort study undertaken to improve understanding of real-life management of patients with HCC, from diagnosis to death. Methods: Data were collected retrospectively from January 2005 to September 2012 by chart reviews of eligible patients newly diagnosed with HCC at participating institutions. Results: Forty-two sites in 14 countries contributed final data for 18¿031 patients. Asia accounted for 67% of patients, Europe for 20% and North America for 13%. As expected, the most common risk factor was hepatitis C virus in North America, Europe and Japan, and hepatitis B virus in China, South Korea and Taiwan. The most common Barcelona Clinic Liver Cancer stage at diagnosis was C in North America, Europe, China and South Korea, and A in Taiwan and Japan. Across all stages, first HCC treatment was most frequently transarterial chemoembolization in North America, Europe, China and South Korea, percutaneous ethanol injection or radiofrequency ablation in Japan and resection in Taiwan. Survival from first HCC treatment varied significantly by region, with median overall survival not reached for Taiwan and 60, 33, 31, 24 and 23¿months for Japan, North America, South Korea, Europe and China respectively (P¿<¿0.0001). Conclusions: Initial results from the BRIDGE study confirm previously reported regional trends in patient demographic characteristics and HCC risk factors, document the heterogeneity of treatment approaches across regions/countries and underscore the need for earlier HCC diagnosis worldwide.

DOI 10.1111/liv.12818
Citations Scopus - 151
2014 Johnson PC, 'Cultural literacy, cosmopolitanism and tourism research', Annals of Tourism Research, 44 255-269 (2014) [C1]

Cosmopolitanism has been approached from a multitude of perspectives yet it continues to pose theoretical challenges in application. This paper assumes a post-disciplinary approac... [more]

Cosmopolitanism has been approached from a multitude of perspectives yet it continues to pose theoretical challenges in application. This paper assumes a post-disciplinary approach to critique these writings and analyse the intersections of tourism/cosmopolitanism/worldmaking. Through these means a philosophical platform is built that advances cultural literacy as the defining principle of cosmopolitanism. Cosmopolitanism encompasses the both-and, and has much to do with cosmopolitics, worldview, cultural orientations and compossibilities of tourism populations. Tourism is at the coalface of inter- and intra-cultural exchange and cultural literacy provides an innovative tool to operationalize worldmaking and address the complexities of an increasingly cosmopolitanized world. These ideas constitute an ontological shift in thinking about tourism and its many contexts. © 2013 Elsevier Ltd.

DOI 10.1016/j.annals.2013.10.006
Citations Scopus - 13Web of Science - 7
2014 Malottki K, Biswas M, Deeks JJ, Riley RD, Craddock C, Johnson P, Billingham L, 'Stratified medicine in European Medicines Agency licensing: A systematic review of predictive biomarkers', BMJ Open, 4 (2014)

Objectives: Stratified medicine is often heralded as the future of clinical practice. Key part of stratified medicine is the use of predictive biomarkers, which identify patient s... [more]

Objectives: Stratified medicine is often heralded as the future of clinical practice. Key part of stratified medicine is the use of predictive biomarkers, which identify patient subgroups most likely to benefit (or least likely to experience harm) from an intervention. We investigated how many and what predictive biomarkers are currently included in European Medicines Agency (EMA) licensing. Setting: EMA licensing. Participants: Indications and contraindications of all drugs considered by the EMA and published in 883 European Public Assessment Reports and Pending Decisions. Primary and secondary outcome measures: Data were collected on: the type of the biomarker, whether itselected a subgroup of patients based on efficacy or toxicity, therapeutic area, marketing status, date of licensing decision, date of inclusion of the biomarker in the indication or contraindication and on orphan designation. Results: 49 biomarker-indication-drug (B-I-D) combinations were identified over 16 years, which included 37 biomarkers and 41 different drugs. All identified biomarkers were molecular. Six drugs (relating to 10 B-I-D combinations) had an orphan designation at the time of licensing. The identified B-ID combinations were mainly used in cancer and HIV treatment, and also in hepatitis C and three other indications (cystic fibrosis, hyperlipoproteinaemia type I and methemoglobinaemia). In 45 B-I-D combinations, biomarkers were used as predictive of drug efficacy and in four of drug toxicity. It appeared that there was an increase in the number of B-I-D combinationsintroduced each year; however, the numbers were too small to identify any trends. Conclusions: Given the large body of literature documenting research into potential predictive biomarkers and extensive investment into stratified medicine, we identified relatively few predictive biomarkers included in licensing. These were also limited to a small number of clinical areas. This might suggest a need for improvement in methods of translation from laboratory findings to clinical practice.

DOI 10.1136/bmjopen-2013-004188
Citations Scopus - 12
2012 Nyangoma SO, Collins SI, Altman DG, Johnson P, Billingham LJ, 'Sample size calculations for designing clinical proteomic profiling studies using mass spectrometry', Statistical Applications in Genetics and Molecular Biology, 11 (2012)

In cancer clinical proteomics, MALDI and SELDI profiling are used to search for biomarkers of potentially curable early-stage disease. A given number of samples must be analysed i... [more]

In cancer clinical proteomics, MALDI and SELDI profiling are used to search for biomarkers of potentially curable early-stage disease. A given number of samples must be analysed in order to detect clinically relevant differences between cancers and controls, with adequate statistical power. From clinical proteomic profiling studies, expression data for each peak (protein or peptide) from two or more clinically defined groups of subjects are typically available. Typically, both exposure and confounder information on each subject are also available, and usually the samples are not from randomized subjects. Moreover, the data is usually available in replicate. At the design stage, however, covariates are not typically available and are often ignored in sample size calculations. This leads to the use of insufficient numbers of samples and reduced power when there are imbalances in the numbers of subjects between different phenotypic groups. A method is proposed for accommodating information on covariates, data imbalances and designcharacteristics, such as the technical replication and the observational nature of these studies, in sample size calculations. It assumes knowledge of a joint distribution for the protein expression values and the covariates. When discretized covariates are considered, the effect of the covariates enters the calculations as a function of the proportions of subjects with specific attributes. This makes it relatively straightforward (even when pilot data on subject covariates is unavailable) to specify and to adjust for the effect of the expected heterogeneities. The new method suggests certain experimental designs which lead to the use of a smaller number of samples when planning a study. Analysis of data from the proteomic profiling of colorectal cancer reveals that fewer samples are needed when a study is balanced than when it is unbalanced, and when the IMAC30 chip-type is used. The method is implemented in the clippda package and is available in R at: http://www.bioconductor.org/help/bioc-views/release/ bioc/html/clippda.html. © 2012 De Gruyter. All rights reserved.

DOI 10.1515/1544-6115.1686
Citations Scopus - 2
2012 Johnson PC, Lyons KD, 'The dynamics of port development: Modelling knowledge transfer and stakeholder involvement', Tourism: An International Interdisciplinary Journal, 60 15-28 (2012) [C1]
Citations Scopus - 2
Co-authors Kevin Lyons
2011 Chan SL, Mo FKF, Johnson PJ, Liem GS, Chan TC, Poon MC, et al., 'Prospective validation of the Chinese University Prognostic Index and comparison with other staging systems for hepatocellular carcinoma in an Asian population', Journal of Gastroenterology and Hepatology (Australia), 26 340-347 (2011)

Background and Aim: Hepatitis B viral (HBV) infection is the predominant etiology of hepatocellular carcinoma (HCC) in Asia. Our group previously reported a staging system known a... [more]

Background and Aim: Hepatitis B viral (HBV) infection is the predominant etiology of hepatocellular carcinoma (HCC) in Asia. Our group previously reported a staging system known as the Chinese University Prognostic Index (CUPI) for HCC populations of which HBV infection is the predominant etiology. This study aims to validate CUPI and compare with other published staging systems. Methods: We analyzed a prospective cohort of patients with newly diagnosed HCC from 2003 to 2005. All patients were staged with CUPI, Barcelona Clinic Liver Cancer Classification (BCLC), Cancer of the Liver Italian Program score (CLIP), tumor-node-metastasis (TNM) and Okuda systems at diagnosis. They were followed with survival data and the performance of each staging system (in terms of homogeneity, discriminatory ability and monotonicity of gradient) were analyzed and compared. Results: A total of 595 patients (80.2% with chronic HBV infection) were analyzed. The median follow-up was 41.4months and the median survival was 6.6months. Multivariate analyses identified symptomatic disease, ascites, vascular involvement, Child-Pugh-stage, alpha-fetoprotein and treatment to be the independent prognostic factors. CUPI could identify three groups with statistically significant survival difference (P<0.0001). Both CUPI and CLIP had the most favorable performance in terms of discriminatory ability, homogeneity and monotonicity. CUPI performed the best in predicting 3-month survival while CLIP performed better in predicting the outcome of 6- and 12-month survival rate. BCLC was inferior to CLIP and CUPI in the overall performance. Conclusion: We have validated CUPI in a population composed of predominant HBV-related HCC. CUPI is an appropriate staging system for HBV-related HCC. In patients with advanced HCC, both CUPI and CLIP offer good risk stratification. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

DOI 10.1111/j.1440-1746.2010.06329.x
Citations Scopus - 50
2010 Johnson P, 'Crisis Management in the Tourism Industry. Beating the Odds?', TOURISM ANALYSIS, 15 615-616 (2010)
2010 Johnson PC, 'Writing liminal landscapes: The cosmopolitan gaze', Tourism Geographies, 12 505-524 (2010) [C1]
DOI 10.1080/14616688.2010.516397
Citations Scopus - 8Web of Science - 7
2010 Johnson PC, 'De-constructing the cosmopolitan gaze', Tourism and Hospitality Research, 10 79-92 (2010) [C1]
DOI 10.1057/thr.2009.27
Citations Scopus - 3Web of Science - 1
2009 Johnson P, Billingham L, 'Sorafenib for liver cancer: the horizon broadens', The Lancet Oncology, 10 4-5 (2009)
DOI 10.1016/S1470-2045(08)70317-6
Citations Scopus - 5
2007 Johnson PC, 'The 'Great Satan' vs the 'Mad Mullahs'', Journal of Intercultural Studies, 28 247-249 (2007) [C3]
DOI 10.1080/07256860701236658
2007 Williams S, Palmer D, Johnson P, 'New medical options for liver tumours', Clinical Medicine, Journal of the Royal College of Physicians of London, 7 351-356 (2007)

Significant progress is being made in the prevention of hepatitis B-related hepatocellular carcinoma (HCC) but hepatitis C-related HCC is increasing in the West and therapeutic ad... [more]

Significant progress is being made in the prevention of hepatitis B-related hepatocellular carcinoma (HCC) but hepatitis C-related HCC is increasing in the West and therapeutic advances in established disease have been modest. Although ablative therapies, including surgical resection, seem effective in patients with small tumours these only represent a minority of patients. For the majority with advanced disease there is some evidence for survival benefit for transarterial chemoembolisation but only in very carefully selected patients. Systemic chemotherapy is of unproven benefit and is now largely confined to clinical trials. In contrast, there has been a steady improvement in the outlook of patients with established metastatic liver cancer when the primary site is colorectal. Survival has increased from around six months to almost two years with the introduction of new cytotoxic agents, irinotecan and oxaliplatin. Somatostatin analogues have had a dramatic impact on the symptomatic control of neuroendocrine tumours, metastatic to the liver that result in the carcinoid syndrome.

DOI 10.7861/clinmedicine.7-4-351
Citations Scopus - 1
2004 Mok TSK, Leung TWT, Brown G, Moyses C, Chan ATC, Yeo W, et al., 'A phase I safety and pharmacokinetic study of OGT 719 in patients with liver cancer', Acta Oncologica, 43 245-251 (2004)

OGT 719 (Oxford GlycoSciences, Abingdon, UK) is a novel nucleoside analogue with a galactose molecule attached to a fluorinated pyrimidine. OGT 719 has the capacity selectively to... [more]

OGT 719 (Oxford GlycoSciences, Abingdon, UK) is a novel nucleoside analogue with a galactose molecule attached to a fluorinated pyrimidine. OGT 719 has the capacity selectively to bind to asialoglycoprotein receptors that are found exclusively on hepatocytes and hepatocellular carcinoma (HCC) cells. The aim of this study was to establish the safety and to examine the pharmacokinetics of this novel compound in patients with liver cancer. Fourteen patients received a total of 37 cycles of OGT 719 at four dose levels ([500 mg/m2 first cycle, 1 000 mg/m2 subsequent cycles], 1 000 mg/m2, 3 300 mg/m2 and 7 500 mg/m2). OGT 719 was administered as a 3-h intravenous infusion in a 250 ml saline solution, daily for 5 days every 4 weeks. Pharmacokinetic parameters were studied during the first cycle of dose levels 1 and 2 (500 mg/m2, and 1 000 mg/m2, respectively). The maximum plasma concentration was attained within 5 min of completing the infusion and almost doubled, dose dependently, with a doubling of the infused dose. The plasma level declined rapidly in a monophasic manner with an elimination half-life of 2.1 and 2.5 h for dose level 1 and 2, respectively. The mean area under the curve (AUCo-t, area under the curve to 24 h; AUCo-8, area under the curve to infinity) doubled at the higher dose level. None of the patients had a significant tumor response. Elimination half-life of OGT 719 by 3-h intravenous infusion is short and monophasic. Toxicity was minimal at the highest dose level.

DOI 10.1080/02841860310023525
Citations Scopus - 6
2004 Mok TSK, Yu SCH, Lee C, Sung J, Leung N, Lai P, et al., 'False-negative rate of abdominal sonography for detecting hepatocellular carcinoma in patients with hepatitis B and elevated serum a-fetoprotein levels', American Journal of Roentgenology, 183 453-458 (2004)

OBJECTIVE. Routine screening for hepatocellular carcinoma among chronic carriers of hepatitis B virus using a combination of abdominal sonography and serum a-fetoprotein levels is... [more]

OBJECTIVE. Routine screening for hepatocellular carcinoma among chronic carriers of hepatitis B virus using a combination of abdominal sonography and serum a-fetoprotein levels is widely practiced. Negative results on an abdominal sonogram generally indicate the absence of hepatocellular carcinoma despite the elevation of a-fetoprotein levels, but the false-negative rate of abdominal sonography has not been established prospectively. SUBJECTS AND METHODS. In our screening program, we routinely investigated patients with Lipiodol (iodized oil) CT when they presented with a-fetoprotein levels above 20 ng/mL or a focal lesion as depicted on abdominal sonography. Lipiodol CT comprised a hepatic angiogram with injection of Lipiodol selectively in the hepatic arteries, followed by an unenhanced CT scan 10 days later. Positive findings on Lipiodol CT were confirmed histologically by biopsy or surgical resection. We defined false-negative as histologic diagnosis of hepatocellular carcinoma within 3 months of normal findings on screening abdominal sonography. RESULTS. One hundred three patients with elevated a-fetoprotein levels were investigated with Lipiodol CT within 2 months of abdominal sonography. Of these, three of 70 patients with negative abdominal sonography had histologically confirmed hepatocellular carcinoma. Thus, abdominal sonography has a false-negative rate of 4.3%. Lipiodol CT is associated with a significant false-positive rate of 43.7%. The sensitivity, specificity, and positive predictive value of abdominal sonography for early detection of hepatocellular carcinoma among hepatitis B virus carriers with elevated a-fetoprotein levels was 85.7%, 81.7%, and 54.5%, respectively. CONCLUSION. Negative results on a screening abdominal sonogram among hepatitis B virus carriers with elevated a-fetoprotein levels does not rule out the presence of small hepatocellular carcinoma. Routine use of Lipiodol CT as a supplementary screening tool is not recommended.

Citations Scopus - 13
2003 Johnson PC, 'Book Review: 'Restoring Tourism Destinations in Crisis: A Strategic Marketing Approach', Current Issues in Tourism, 6 547-550 (2003) [C3]
2003 Lo RSK, Woo J, Zhoc KCH, Li CYP, Yeo W, Johnson P, et al., 'Quality of life of palliative care patients in the last two weeks of life', Journal of Pain and Symptom Management, 24 388-397 (2003)

Quality of life (QOL) is the main consideration in caring for advanced cancer patients, yet little is known about the QOL in the terminal phase. We profiled the QOL of 58 advanced... [more]

Quality of life (QOL) is the main consideration in caring for advanced cancer patients, yet little is known about the QOL in the terminal phase. We profiled the QOL of 58 advanced cancer patients during their last 2 weeks of life using the McGill QOL questionnaire - Hong Kong version. The patients provided ratings of QOL an average of 5.6 (median 6) days pre-death. Palliative care services were successful in maintaining the total QOL score during the dying phase. The mean score was 7.0 of 10. Among the various domains, the physical and existential domains scored relatively poorly at 5.9 and 6 of 10, respectively. The worst physical symptom and meaning of life were the individual items with the poorest scores (4.8 and 5.4 of 10, respectively). Compared with admission, there was statistically significant improvement in the worst physical symptom (P = 0.02) and eating item (P = 0.002), but deterioration in physical well-being (P = 0.03), meaning of existence (P = 0.007), and satisfaction with oneself (P = 0.04). In conclusion, QOL evaluation during the terminal phase identifies important aspects requiring improvement during the last two weeks of life. Physical and existential domains of dying cancer patients needed more attention. © U.S. Cancer Pain Relief Committee, 2002.

DOI 10.1016/S0885-3924(02)00504-3
Citations Scopus - 43
2002 Mok TSK, Wong H, Zee B, Yu KH, Leung TWT, Lee TW, et al., 'A phase I-II study of sequential administration of topotecan and oral etoposide (toposiomerase I and II inhibitors) in the treatment of patients with small cell lung carcinoma', Cancer, 95 1511-1519 (2002)

BACKGROUND. Topotecan (9-dimethylaminomethyl-10-hydroxycampthothecin) is a new topoisomerase I inhibitor with promising efficacy in the treatment of patients with small cell lung ... [more]

BACKGROUND. Topotecan (9-dimethylaminomethyl-10-hydroxycampthothecin) is a new topoisomerase I inhibitor with promising efficacy in the treatment of patients with small cell lung carcinoma (SCLC). Combination with a topoisomerase II inhibitor may potentate the therapeutic effect of topotecan, although there has been conflicting preclinical information on the combination. The objectives of this study were to establish the maximum tolerated dose and to determine the efficacy of the sequential combination of intravenous topotecan and oral etoposide in the treatment of patients with SCLC. METHODS. Patients with histologically confirmed, limited or extensive stage SCLC were eligible. The dose escalation scheme of three cohorts (six patients per cohort) started at intravenous topotecan 0.5 mg/m2 per day for 5 days and oral etoposide 50 mg twice daily for 7 days (21-day cycles). Subsequent dose levels involved escalation of topotecan to 0.75 mg/m2 per day and 1.0 mg/m2 per day for 5 days. A Phase II study was conducted at one dose level below the maximum tolerated dose. The authors alternated the drug sequence with each consecutive cycle and compared the hematologic toxicity between the two sequences. RESULTS. Thirty-six patients (21 patients with limited disease and 15 patients with extensive disease) received a total of 173 courses of sequential combination chemotherapy (topotecan ¿ etoposide, 88 courses; etoposide ¿ topotecan, 85 courses). The authors identified dose levels for the Phase II study as follows: topotecan, 0.75 mg/m2 per day for 5 days; and etoposide, 50 mg twice daily for 7 days. The dose-limiting toxicity was neutropenia. At this dose level, the incidence of Grade 3-4 neutropenia and the incidence of Grade 3-4 thrombocytopenia were 25% and 10.9%, respectively. Two patients died from neutropenic sepsis. There was no significant difference in hematologic toxicities between the two sequences. Complete and partial response rates were 5.6% and 55.6%, respectively (limited disease, 9.5% and 66.75%; extensive disease, 0% and 40%, respectively). The median progression free survival was 31.9 weeks (limited disease, 36.1 weeks; extensive disease, 28.9 weeks; 95% confidence interval, 25.6-36.0 weeks), and the median overall survival was 52.4 weeks (limited disease, 54.9 weeks; extensive disease, 30.1 weeks; 95% confidence interval, 39.6-57.7 weeks). CONCLUSIONS. Combination therapy with topoisomerase I and II inhibitors is a safe and effective regimen for patients with SCLC. Future research on this combination should focus on an oral regimen for patients with extensive disease and poor tolerance to cisplatin. The authors recommend an oral dosage of topotecan at 1.2 mg/m2 per day (equivalent to intravenous topotecan at 0.75 mg/m2 per day) for 5 days followed by etoposide 50 mg twice daily for 7 days. © 2002 American Cancer Society.

DOI 10.1002/cncr.10836
Citations Scopus - 21
2001 Mok TSK, Kanekal S, Lin XR, Leung TWT, Chan ATC, Yeo W, et al., 'Pharmacokinetic study of intralesional cisplatin for the treatment of hepatocellular carcinoma', Cancer, 91 2369-2377 (2001)

BACKGROUND. In the current study the authors examined the pharmacokinetics of direct intralesional injection of cisplatin/epinephrine/bovine collagen gel in patients with hepatoce... [more]

BACKGROUND. In the current study the authors examined the pharmacokinetics of direct intralesional injection of cisplatin/epinephrine/bovine collagen gel in patients with hepatocellular carcinoma and cirrhosis. METHODS. Six patients with cirrhosis and unresectable hepatocellular carcinoma received a direct intralesional injection (range, 6.7-26.7 mg) into their tumors under ultrasonographic guidance. The authors determined the total cisplatin (Pt) concentration in the plasma and urine and nonprotein-bound free Pt in plasma ultrafiltrate using flameless atomic absorption spectrometry. Data from individual patients were analyzed to calculate the pharmacokinetic parameters via a non-compartmental method for constant infusion. To demonstrate that the changes in pharmacokinetics are not related to the underlying cirrhosis, a similar methodology was applied to measure the pharmacokinetic parameters of four similar patients who were treated with cisplatin, 75 mg/m2, as a 1-hour intravenous infusion. RESULTS. The time to attain maximum concentration of total Pt after intralesional injection was dose-dependent and ranged from 2-13 hours. The concentration-time curve was biphasic in nature. The initial half-life of total Pt in patients who received an intralesional injection varied with the cisplatin dose. The initial half-life for cisplatin doses < 15 mg was approximately 9 hours and the initial half-life at higher cisplatin doses (> 15 mg) was approximately 25 hours. The area under the curve (AUC) was dose-dependent with values ranging from 38-150 µm/mL · hour. Pharmacokinetic parameters for free Pt (ultrafiltrate) were significantly different. The time to attain maximum concentration (t-max) and terminal half-life were shorter and the average AUC was approximately 100-fold lower than total Pt. After the intravenous infusion of cisplatin, the t-max for total and free Pt was 1.3 hours and 1.1 hours, respectively. The terminal half-life and average AUC for total Pt was 194 hours and 247 µg/mL per hour, respectively, and its corresponding parameters for free Pt after intravenous infusion were much lower, similar to the findings for the intralesional injection. CONCLUSIONS. The prolonged t-max and initial half-life noted with the intralesional injection of cisplatin/epinephrine/collagen gel are consistent with its proclaimed ability to retain cisplatin at the tumor and delay its release in systemic circulation. The kinetics of intralesional cisplatin injection also suggest local sequestration of the drug in the injected site. Parameters of intravenous cisplatin infusion in cirrhotic patients are similar to those of patients from the historic control group. © 2001 American Cancer Society.

DOI 10.1002/1097-0142(20010615)91:12&lt;2369::AID-CNCR1270&gt;3.0.CO;2-3
Citations Scopus - 24
2001 Lo RSK, Woo J, Zhoc KCH, Li CYP, Yeo W, Johnson P, et al., 'Cross-cultural validation of the McGill quality of life questionnaire in Hong Kong Chinese', Palliative Medicine, 15 387-397 (2001)

The main focus of palliative care services is to improve patients&apos; quality of life (QOL). The potential value of assessment of QOL in palliative care is being increasingly re... [more]

The main focus of palliative care services is to improve patients' quality of life (QOL). The potential value of assessment of QOL in palliative care is being increasingly recognized. The McGill Quality of Life questionnaire (MQOL) is designed specifically for palliative care patients, but its cross-cultural validity needs to be determined before it can be applied in populations of different cultures and ethnic groups. The cross-cultural validity of MQOL was investigated using a translated and modified version in Chinese - the MQOL-HK - in 462 palliative care patients in Hong Kong. Results show that the MQOL-HK is acceptable, valid and reliable. There is good acceptability, construct validity, convergent and divergent validity, test-retest and inter-rater reliability. Our study confirms that QOL does have cross-culturally robust constructs. Principal components analysis shows that the domains of physical, psychological, existential and support are all relevant and applicable in Chinese culture. Multiple regression analysis reveals that existential domain is the most important domain in predicting overall QOL. 'Face', eating and sex are additional facets of QOL that also need to be considered. The worst physical symptom on admission is the item of QOL with the lowest score, which need more care and attention by palliative care workers. A cross-culturally validated QOL instrument cannot just help ensure an accurate evaluation of profile, determinants, and changes of QOL, but is also a valuable asset for future comparison and evaluation of palliative care services and interventions across the world.

DOI 10.1191/026921601680419438
Citations Scopus - 62
2001 Johnson PC, 'An Examination of risk within Tourist Experiences to the Islamic Republic of Iran', Annals of Leisure Research, 4 38-57 (2001) [C1]
2000 Mok TSK, Zee B, Chan ATC, Yeo W, Yang WT, Yim A, et al., 'A phase II study of gemcitabine plus oral etoposide in the treatment of patients with advanced nonsmall cell lung carcinoma', Cancer, 89 543-550 (2000)

BACKGROUND. The authors have designed a non-cisplatin-based chemotherapy regimen for the treatment of patients with advanced nonsmall cell lung carcinoma (NSCLC). This regimen cap... [more]

BACKGROUND. The authors have designed a non-cisplatin-based chemotherapy regimen for the treatment of patients with advanced nonsmall cell lung carcinoma (NSCLC). This regimen capitalizes on the mild toxicity of gemcitabine, a novel nucleoside analog. METHODS. A total of 46 chemotherapy-naive patients with histologically confirmed Stage IIIB or IV NSCLC were enrolled. Eligible patients were treated with gemcitabine 1000 mg/m2 on Days 1, 8, and 15, plus oral etoposide 50 mg daily for 14 days, which was increased to 21 days if there was no World Health Organization (WHO) Grade 3 or 4 toxicity in the 1st 2 cycles (each cycle was 28 days long). All patients were included for analysis of response and survival according to an intention-to-treat principle. RESULTS. The overall response rate was 43.5% (95% confidence interval [CI], 30.7-60.2%). There was 1 complete response (2.2%) and 19 partial responses (41.3%). The median survival was 48.0 weeks (95% CI, 38.1-75.9 weeks) and the 1-year survival rate was 45% (95% CI, 29-62%). The median time to progression for all patients was 39.2 weeks (95% CI, 35.7-49.7 weeks). World Health Organization (WHO) Grade 3 and 4 anemia, neutropenia, and thrombocytopenia was reported in 29%, 32%, and 18% of patients, respectively. Two patients had reactivation of hepatitis B viral infection that resulted in WHO Grade 4 hepatic dysfunction. Other nonhematologic toxicities were uncommon. CONCLUSIONS. This non-cisplatin-based regimen of gemcitabine and oral etoposide achieved a high response and survival rate. Toxicity appeared to be less severe than that associated with existing cisplatin-based regimens. A randomized study of this regimen versus a cisplatin-based regimen is indicated. (C) 2000 American Cancer Society.

DOI 10.1002/1097-0142(20000801)89:3&lt;543::AID-CNCR9&gt;3.0.CO;2-V
Citations Scopus - 16
2000 Johnson P, Bruix J, 'Hepatocellular carcinoma and the art of prognostication', Journal of Hepatology, 33 1006-1008 (2000)
DOI 10.1016/S0168-8278(00)80137-3
Citations Scopus - 15
1999 Tang NLS, Pang CP, Yeo W, Choy KW, Lam PK, Suen M, et al., 'Prevalence of mutations in the BRCA1 gene among Chinese patients with breast cancer', Journal of the National Cancer Institute, 91 882-885 (1999)
Citations Scopus - 47
1999 Mok TSK, Leung TWT, Lee SD, Chao Y, Chan ATC, Huang A, et al., 'A multi-centre randomized phase II study of nolatrexed versus doxorubicin in treatment of Chinese patients with advanced hepatocellular carcinoma', Cancer Chemotherapy and Pharmacology, 44 307-311 (1999)

Purpose: A multi-centre randomized phase II study of single agent nolatrexed dihydrochloride versus doxorubicin was undertaken in Chinese patients with advanced hepatocellular car... [more]

Purpose: A multi-centre randomized phase II study of single agent nolatrexed dihydrochloride versus doxorubicin was undertaken in Chinese patients with advanced hepatocellular carcinoma (HCC) to study and compare the clinical efficacy of the two drugs. Methods: Fifty-four patients with clinical or histological diagnosis of HCC were randomized in a 2:1 ratio to receive nolatrexed or doxorubicin. Nolatrexed 725 mg/m2/day was given by continuous infusion via a central venous device for 5 days and doxorubicin 60 mg/m2was given as a rapid intravenous infusion every 3 weeks. Results: No objective responses were observed in either treatment arm. Two patients in the nolatrexed arm and none in the doxorubicin arm had >50% decline in serum a-fetoprotein. The median survival for the patients in the nolatrexed and doxorubicin arms was 139 days and 104 days, respectively. Moderate toxicities including leukopenia, thrombocytopenia, mucositis and skin rash were observed in both treatment arms. Conclusion: Nolatrexed and doxorubicin are minimally active in the treatment of advanced HCC. Given the small sample size, no difference is observed between the two drugs.

DOI 10.1007/s002800050982
Citations Scopus - 40
1997 Sung JY, Yoe W, Suen R, Chan KL, Lee YT, Chung SCS, Johnson P, 'Cyanoacrylate vs sodium tetradecyl sulphate for the injection of bleeding varices in patients with hepatocellular carcinoma: A prospective randomized study', Gastrointestinal Endoscopy, 45 (1997)

Patients with hepatocellular carcinoma (HCC) complicated by variceal bleeding have a very limited life span. Recurrent bleeding after endoscopic injection sclerotherapy is common.... [more]

Patients with hepatocellular carcinoma (HCC) complicated by variceal bleeding have a very limited life span. Recurrent bleeding after endoscopic injection sclerotherapy is common. AIM To compare the efficacy of endoscopic injection of cyanoacrylate (CYA) versus sodium tetradecyl sulphate (STD) in the control of variceal bleeding in patients with HCC. METHOD Patients known to be suffering from inoperable HCC presented with upper gastrointestinal bleeding were endoscoped within 24h of admission. After bleeding from oesophageal varices was confirmed by endoscopy, the patients were randomized to receive injections of either CYA (0.5 ml cyanoacrylate mixed with 0.7 ml lipoidol) or STD (1.5%). Injections were given intravariceally into each visible column for up to 4 injections for CYA and up to 30 ml for STD. RESULT CYA STD P No. of patients 25 25 M:F 22:3 24:1 Median age (range) 51 (24-72) 59 (31-74) Child's grade (A:B:C) 2:13:10 0:13:12 0.34 Active bleeding (%) 13 (52) 8 (32) 0.68 Control of bleeding (%) 24 (96) 24 (96) 1.00 Rebleeding within 48h (%) 4 (16) 4 (16) 1.00 Blood transfusion (range) 3 (0-10) 2 (0-8) 0.11 In-hospital mortality (%) 7 (28) 10 (40) 0.37 30-day mortality (%) 9 (36) 13 (52) 0.25 CONCLUSION Cyanoacrylate injection has not improved the haemostasis and survival of patients with hepatocellular carcinoma complicated by acute variceal bleeding.

DOI 10.1016/S0016-5107(97)80242-8
Citations Scopus - 1
1996 Teo PML, Kwan WH, Leung SF, Leung WT, Chan A, Choi P, et al., 'Early tumour response and treatment toxicity after hyperfractionated radiotherapy in nasopharyngeal carcinoma', British Journal of Radiology, 69 241-248 (1996)

The aim of the present study was to undertake a planned interim analysis of a prospective randomized trial comparing the tumour response and the acute and subacute complications o... [more]

The aim of the present study was to undertake a planned interim analysis of a prospective randomized trial comparing the tumour response and the acute and subacute complications of hyperfractionated radiotherapy and conventional radiotherapy in non-metastatic nasopharyngeal carcinoma (NPC). 100 patients with newly diagnosed non-metastatic NPC were randomized to receive either conventional radiotherapy (Arm I) or hyperfractionated radiotherapy (Arm II). Stratification was done according to the T-Stage (modified Ho's T-Stage classification). The biological effective dose (10 Gy) to the primary and the upper cervical lymphatics were 75.0 and 73.1 for Arm I and 84.4 and 77.2 for Arm II, respectively. Hyperfractionated radiotherapy was associated with significant mucositis which is of higher grade than conventional radiotherapy (p = 0.0001), but the duration of mucositis was similar between the two Arms and all study patients completed radiotherapy on schedule without interruption of radiotherapy. Early survival and tumour recurrence rates were comparable between the Arms. The preliminary results indicate that the hyperfractionated radiotherapy has excellent patient compliance in Chinese patients, with acceptable acute and subacute toxicities and the local and regional complete tumour response rates being comparable with conventional radiotherapy. The significance of the time required after start of radiotherapy to achieve a complete tumour response is discussed.

DOI 10.1259/0007-1285-69-819-241
Citations Scopus - 26
1995 Lau WY, Leung KL, Leung TWT, Ho S, Chan M, Liew CK, et al., 'Obstructive jaundice secondary to hepatocellular carcinoma', Surgical Oncology, 4 303-308 (1995)

This prospective study aimed to identify different groups of patients with the rare pathology of biliary obstruction caused by hepatocellular carcinoma (HCC). Patients were evalua... [more]

This prospective study aimed to identify different groups of patients with the rare pathology of biliary obstruction caused by hepatocellular carcinoma (HCC). Patients were evaluated with blood tests, chest radiography, ultrasound of the liver and endoscopic retrograde cholangiopancreatography/percutaneous transhepatic cholangiography. Patients who were potentially operable were further assessed with selective hepatic angiography and computed tomography (CT). Of the 38 patients with obstructive jaundice secondary to HCC, the levels of obstruction were extrahepatic in 19 patients and intrahepatic in 19 patients. The clinical presentations and blood biochemistry were similar in these two groups of patients. ¿Curative¿ resection was significantly more common in extrahepatic obstruction (8/19) than in intrahepatic obstruction (0/19) (z2 with Yates correction P = 0.001). All non-resectable tumours, except in four patients with terminally ill disease, were palliated with stents. Survival in patients who had ¿curative¿ liver resection was significantly better than in those who had no resection (median survival 25.3 vs. 2.1 months, log-rank test P = 0.004). Patients with extrahepatic biliary obstruction secondary to HCC had a better chance of being treated by liver resection, which resulted in a significantly improved survival rate compared to patients with intrahepatic obstruction. © 1995, Blackwell Science Ltd.. All rights reserved.

DOI 10.1016/S0960-7404(10)80042-8
Citations Scopus - 23
1995 Teo PML, Leung TWT, Chan ATC, Yu P, Lee WY, Leung SF, et al., 'A retrospective study of the use of cisplatinum-5-fluorouracil neoadjuvant chemotherapy in cervical-node-positive nasopharyngeal carcinoma (NPC)', European Journal of Cancer. Part B: Oral Oncology, 31 373-379 (1995)

A retrospective study on 422 nasopharyngeal carcinoma (NPC) patients with cervical nodal metastases treated between 1984 and 1987 was performed. 169 received neoadjuvant chemother... [more]

A retrospective study on 422 nasopharyngeal carcinoma (NPC) patients with cervical nodal metastases treated between 1984 and 1987 was performed. 169 received neoadjuvant chemotherapy (CHEMO) with cisplatinum and 5-fluorouracil for two or three courses prior to definitive radiotherapy and 253 were treated by radical radiotherapy alone (NCHEMO). While the primary tumour (T-stage) prognosticators had been comparable between the two groups, CHEMO had significantly more advanced cervical nodal metastases with bulkier nodes and more low-cervical and supraclavicular nodes (P < 0.05) which could account for its overall worse survival, poorer regional tumour control and a trend towards worse systemic tumour control. The worse regional control in CHEMO for Ho's N1 could be the result of more bulky nodes and more tumours infiltrating the skull base and/or causing cranial nerve(s) palsy. There was no statistical or apparent difference between CHEMO and NCHEMO for the same Ho's overall stages of NPC with comparable nodal and primary tumour characteristics for the clinical endpoints of actuarial survival rate (ASR), disease-free survival rate (DFS), free of local failure survival rate (FLF), and free from distant metastases survival rate (FDM), despite the presence of significantly more fixed nodes and bulky nodes. This suggests a possible beneficial effect of the neoadjuvant chemotherapy. However, multivariate analysis has not shown the administration of the neoadjuvant chemotherapy to be of prognostic significance. Even though the chemotherapy was well tolerated with little toxicity, we recommend against the routine use of neoadjuvant chemotherapy in cervical-node-positive NPC outside the context of a prospective randomised clinical trial. © 1995.

DOI 10.1016/0964-1955(95)00026-7
Citations Scopus - 14
1994 Sallie R, King R, Silva E, Tibbs C, Johnson P, Williams R, 'Community prevalence of hepatitis C viraemia: A polymerase chain reaction study', Journal of Medical Virology, 43 111-114 (1994)

In order to estimate the prevalence of HCV carriage in an inner city health district, we undertook a polymerase chain reaction (PCR) based survey of sera collected from 1,002 pati... [more]

In order to estimate the prevalence of HCV carriage in an inner city health district, we undertook a polymerase chain reaction (PCR) based survey of sera collected from 1,002 patients attending general practitioners for reasons unrelated to liver disease. The series comprised 305 sample selected sera patients sample from sera 995 patients previously screened by C100 antigen-based anti-HCV tests. Overall, 7 patients were positive for HCV RNA. Four cases had anti-C100 antibodies to HCV, 2 were strictly negative but had high-normal/borderline optical densities by ELISA assay, while one was completely anti-HCV negative. All but one had normal liver function tests. Only 3/7 PCR positive cases had any serum marker for hepatitis B (HBV) exposure (2 HBsAg positive, 1 IgM anti-HBc positive). The minimum point prevalence of HCV carriage in this community is 0.7%, approximating the HBsAg carriage in the same population (1%). HCV carriage in this inner city population is considerably higher than would be predicted by blood donor surveys. A positive anti-HCV antibody (anti-C100) test is poorly predictive (~10%) of HCV RNA carriage in a general practice based population in which measurement of ¿surrogate¿ (HBV related) HCV markers would have detected only 3/7 cases of presumed chronic HCV carriage. © 1994 Wiley-Liss, Inc. Copyright © 1994 Wiley-Liss, Inc., A Wiley Company

DOI 10.1002/jmv.1890430202
Citations Scopus - 11
1993 Silva E, Sallie R, Tibbs C, McFarlane I, Johnson P, Williams R, 'Absence of hepatitis C virus in British patients with type 1 autoimmune chronic active hepatitis - a polymerase chain reaction and serological study', Journal of Hepatology, 19 211-215 (1993)

Despite several studies from continental Europe reporting a high prevalence of antibodies to the hepatitis C virus (HCV), there has been little evidence of such infection in patie... [more]

Despite several studies from continental Europe reporting a high prevalence of antibodies to the hepatitis C virus (HCV), there has been little evidence of such infection in patients from the United Kingdom. The use of the polymerase chain reaction combined with two separate second generation anti-HCV assays is reported here in 58 UK patients with well-documented autoimmune chronic active hepatitis. All patients were in corticosteroid induced remission. All sera were collected prospectively for the specific purpose of this study. HCV-RNA was not detected by use of the polymerase chain reaction in any of the patients and antibodies to HCV were only detected in one patient. No evidence was found for the involvement of the hepatitis C virus in UK patients with classical, corticosteroid sensitive autoimmune chronic active hepatitis. © 1993 Elsevier Scientific Publishers Ireland Ltd. All rights reserved.

DOI 10.1016/S0168-8278(05)80573-2
Citations Scopus - 13
1991 Ketterer B, Meyer DJ, Lalor E, Johnson P, Guengerich FP, Distlerath LM, et al., 'A comparison of levels of glutathione transferase, cytochromes P450 and acetyltransferases in human livers', Biochemical Pharmacology, 41 635-638 (1991)
DOI 10.1016/0006-2952(91)90639-M
Citations Scopus - 13
1987 Forbes A, Portmann B, Johnson P, Williams R, 'Hepatic sarcomas in adults: A review of 25 cases', Gut, 28 668-674 (1987)

Twenty five patients with an apparently primary sarcoma of the liver are reviewed. Presenting complaints were non-specific, but hepatomegaly and abnormal liver function tests were... [more]

Twenty five patients with an apparently primary sarcoma of the liver are reviewed. Presenting complaints were non-specific, but hepatomegaly and abnormal liver function tests were usual. Use of the contraceptive pil (four of 11 women) was identified as a possible risk factor; one patient had previously been exposed to vinyl chloride monomer. Detailed investigation showed that the primary tumour was extrahepatic in nine of the 25 patients. Distinguishing features of the 15 patients with confirmed primary hepatic sarcoma included a lower incidence of multiple hepatic lesions and a shorter time from first symptoms to diagnosis, but the most valuable discriminator was histology. Angiosarcomas and undifferentiated tumours were all of hepatic origin, epithelioid haemangioendotheliomas (EHAE) occured as primary and secondary lesions and all other differentiated tumours arose outside the liver. The retroperitoneum was the most common site of an occult primary tumour and its careful examination therefore crucial: computed tomography scanning was found least fallible in this respect in the present series. Where resection (or transplantation), the best treatment, was not possible, results of therapy were disappointing, prognosis being considerably worse for patients with primary hepatic tumours. Patients with EHAE had a better overall prognosis regardless of primary site.

DOI 10.1136/gut.28.6.668
Citations Scopus - 56
1986 Kirkpatrick K, Johnson P, Morgan J, Lamb S, 'Quality control site visits to clinics in the mulitiple risk factor intervention trial', Controlled Clinical Trials, 7 126-136 (1986)
DOI 10.1016/0197-2456(86)90163-7
Citations Scopus - 1
1984 Zaman S, Melia W, Johnson P, White Y, Williams R, 'Effect of cytotoxic chemotherapy on hepatitis B viral markers in patients with hepatocellular carcinoma', Clinical Oncology, 10 247-252 (1984)

The titre of HBsAg in the serum of patients with HBsAg seropositive hepato-cellular carcinoma rose in 12 (80%) of 15 cases during chemotherapy with either adriamycin or etoposide ... [more]

The titre of HBsAg in the serum of patients with HBsAg seropositive hepato-cellular carcinoma rose in 12 (80%) of 15 cases during chemotherapy with either adriamycin or etoposide and in five cases there was at least a four-fold rise in titre. Anti-HBs and anti-HBc status did not change and serum markers of HBV infection did not become apparent in the 32 patients who were seronegative at presentation. The chemotherapy-related rise in HBsAg titre did not appear to be responsible for deterioration in hepatocellular function and it was not associated with any change in HBeAg/anti-HBe status.

1979 Wheeler PG, Melia W, Jones B, Johnson P, Williams R, Dubbins P, Nunnerley H, 'Non-operative arterial embolisation in primary liver tumours', British Medical Journal, 2 242-244 (1979)

Three patients with primary hepatic tumours were treated by selective arterial embolisation with gelatin-foam fragments to induce necrosis. In the two with histologically proved h... [more]

Three patients with primary hepatic tumours were treated by selective arterial embolisation with gelatin-foam fragments to induce necrosis. In the two with histologically proved hepatocellular carcinoma ultrasonography suggested that necrosis had been induced, as did the rapid initial falls in serum a-fetoprotein concentration by 95 and 81% of the original values respectively. Treatment was continued with a course of adriamycin, and both patients remained well and symptom free at 10 and 12 months. In the third patient, who had an expanding and highly vascular benign hepatic adenoma associated with use of a contraceptive pill, embolisation obliterated the tumour mass. Tumour embolisation should be regarded as only the first step in managing hepatocellular carcinoma and as a means of reducing appreciably the viable tumour mass before chemotherapy. It may be used as the primary and definitive treatment in patients with benign liver tumours. © 1979, British Medical Journal Publishing Group. All rights reserved.

DOI 10.1136/bmj.2.6184.242
Citations Scopus - 84
1977 Kane SP, Kohn J, Johnson P, 'Vitamin B
1976 Krasner N, Johnson P, Bomford A, Eddleston AL, Williams R, 'Proceedings: Hepatoma in chronic liver disease.', Gut, 17 390 (1976)
Citations Scopus - 1
Taunay B, L¿hostis M, Johnson PC, 'Geographical limits of outbound Chinese tourism in France', Journal of Policy Research in Tourism, Leisure and Events, 1-16
DOI 10.1080/19407963.2018.1505108
Show 41 more journal articles

Conference (13 outputs)

Year Citation Altmetrics Link
2014 Keogh C, Johnson P, Kriz A, 'Innovative research by design: Using action research to explore the self-contained accommodation sector', CAUTHE 2014: Tourism and Hospitality in the Contemporary World: Trends, Changes and Complexity, Brisbane (2014) [E1]
2014 Keogh C, Kriz A, Johnson PC, 'Is the Party Over for Second Homes in Australia? How Action Research and Management Theory Can Combine to Aid a Fragmented Sector', Program and abstracts from the IGU Commission for the Geography of Tourism, Leisure and Global Change conference, Skeviks gård, Stockholm, 9-11 June 2014, Skeviks gård, Stockholm, Sweden (2014) [E3]
2012 Johnson PC, 'Frameworks of freedom and fear: Authorising the voice in women's travel writing', Travel Ideals: Engaging with Spaces of Mobility. Inaugural Conference Travel Research Network, Melbourne, Vic (2012) [E3]
2012 Johnson PC, Lyons KD, 'Knowledge transfer: An analysis technique for destination planning process', Proceedings of the 1st Annual Conference on Tourism and Hospitality Research (THoR 2012), Singapore (2012) [E1]
Co-authors Kevin Lyons
2012 Johnson PC, 'Cultural literacy: A technique to analyse cosmopolitanism in tourism research', Proceedings of the 1st Annual Conference on Tourism and Hospitality Research (THoR 2012), Singapore (2012) [E1]
2011 Johnson PC, 'Worldmaking in tourism studies: Adding cultural literacy to the petrie dish of the social sciences', Australian Sociological Association (TASA) Conference: Local Lives/Global Networks, Newcastle, NSW (2011) [E3]
2011 Johnson PC, 'It's a wild world: language, liminality, and a conceptual toolbox of scripts, scapes, and tropes', Fourth Critical Tourism Studies Conference 2011 (CTS IV) Full Papers, Cardiff, Wales (2011) [E1]
2011 Johnson PC, Lyons KD, 'Knowledge transfer in a turbulent context: The case of cruise tourism development in Newcastle, Australia', Proceedings of the CAUTHE 2011 National Conference: Tourism: Creating a Brilliant Blend, Adelaide, SA (2011) [E1]
Co-authors Kevin Lyons
2010 Johnson PC, Pearse A, 'Destination development and cruise ship tourism: Case study Newcastle, NSW', Competition and Collaboration Between Regional Tourism Destinations, Macao, China (2010) [E1]
2010 Dufour JF, Johnson P, 'Liver cancer: From molecular pathogenesis to new therapies. Summary of the EASL single topic conference', Journal of Hepatology (2010)
DOI 10.1016/j.jhep.2009.11.010
Citations Scopus - 33
2009 Johnson PC, 'De-constructing the cosmopolitan gaze', Think Tank IX: Presentations and Papers, Singapore (2009) [E3]
DOI 10.1057/thr.2009.27
2009 Lyons KD, Markwell K, Johnson PC, 'Recreation specialisation and destination image: A case study of birding tourists values and their perceptions of Papua New Guinea', Think Tank IX: Presentations and Papers, Singapore (2009) [E3]
Co-authors Kevin Lyons
2008 Thomas MB, O'Beirne JP, Furuse J, Chan ATC, Abou-Alfa G, Johnson P, 'Systemic therapy for hepatocellular carcinoma: Cytotoxic chemotherapy, targeted therapy and immunotherapy', Annals of Surgical Oncology (2008)

Conventional cytotoxic chemotherapy has not provided clinical benefit or prolonged survival for patients with advanced HCC. This review summarizes the results of prospective clini... [more]

Conventional cytotoxic chemotherapy has not provided clinical benefit or prolonged survival for patients with advanced HCC. This review summarizes the results of prospective clinical trials of several categories of systemic therapy, with emphasis on the more promising results from recent trials of biologically targeted therapeutic agents in HCC. © 2007 Society of Surgical Oncology.

DOI 10.1245/s10434-007-9705-0
Citations Scopus - 84
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Thesis / Dissertation (1 outputs)

Year Citation Altmetrics Link
2013 Smith SJ, Monumentalising Language: Visitor Experience & Meaning Making at the Afrikaanse Taalmonument, Southern Cross University, Lismore NSW Australia (2013)
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Grants and Funding

Summary

Number of grants 4
Total funding $282,607

Click on a grant title below to expand the full details for that specific grant.


20191 grants / $44,500

New Colombo Plan Student Mobility Grant$44,500

This grant provides 15 undergraduate students with a scholarship to undertake an internship placement in China (Beijing, Shanghai or Shenzhen) as part of their degree program. Students will undertake their work placement in a broad spectrum of institutional environments such as legal and financial firms, business and community/ voluntary organisations, industry associations etc. The scholarship enables students to engage a real world organisation with their skills, talents and prior learning, while continuing to learn through practical workplace application in China. The program is designed to position students for a career upon graduation.

Funding body: Department of Foriegn Affairs and Trade

Funding body Department of Foriegn Affairs and Trade
Project Team

Dr Patricia Johnson

Scheme New Colombo Plan
Role Lead
Funding Start 2019
Funding Finish 2019
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

20172 grants / $216,607

Strengthening public service performance: Building capacity in effective governance and public policy in the Kenyan Public Service Commission$195,107

This Australia Awards Fellowship consists of an Executive Training Program and a Research component.  Fifteen Australia Awards Fellows from the Kenyan Public Service Commission (KPSC) will undergo professional development in public service governance, effectiveness and productivity as an executive program specifically designed and coordinated to assist them in building capacity in the organisation. This will be the first year of what is planned to be a three-year program – with funding for the second and third years being dependent on the successful outcomes of the program in 2017.

The KPSC has identified priority needs in the areas of values and ethics, public service productivity and developing capacity for policy analysis and formulation. An increasingly urgent problem facing the KPSC is how to is how to manage the  devolution of public services from the Federal to the Local level. The sheer size of KPSC brings significant challenges affecting organisational behaviour and systemic congruence across government levels (from central to 47 counties). If not addressed in the near future, the lack of capacity and capability in these three areas will become a serious threat to the success of devolution in Kenya with long-term ramifications for the country’s social and political stability.

This DFAT funded program provides an opportunity for the KPSC to develop insights into how to achieve their goals based on a whole of government approach. The program aims to provide experiential and instructed learning and ongoing mentorship in Australia. The KPSC is particularly interested in learning about how to extend (and if necessary redesign) their existing capacity to embed more firmly a culture of ethical and progressive improvement. This program, delivered through seminars supported by site visits to key federal, state and local public service entities in Canberra, Sydney and Newcastle involves experiential learning with experts and counterparts in public service roles. The program aims to facilitate new connections at an individual level while strengthening institutional links between Australia and Kenya.

Funding body: Department of Foriegn Affairs and Trade

Funding body Department of Foriegn Affairs and Trade
Project Team

Dr Patricia Johnson and Professor Jim Jose

Scheme Australia Award Fellowships
Role Lead
Funding Start 2017
Funding Finish 2017
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

Endeavour Mobility Program$21,500

This program provided international mobility scholarships provided 10 undergraduate students from the Faculty of Business and Law with an opportunity to participate in a short-term cultural immersion experience in Kenya. The project provides students with an awareness and understanding of cultural diversity; insight into the complexities of diplomacy, governance, and industry in a developing country context.  This project works to foster a deeper understanding of Kenyan culture from an industry perspective as well as insight into the dynamics and challenges of both the legal and business environments. The project fulfils degree requirements for the BBus, BCom and BLaw. Apart from increasing the number of students graduating with international mobility experience, the project evidences an ongoing effort to strengthen relations between the Faculty and Moi University.

Funding body: Department of Foriegn Affairs and Trade

Funding body Department of Foriegn Affairs and Trade
Project Team

Sher Campbell

Scheme Endeavour Mobility Grant
Role Lead
Funding Start 2017
Funding Finish 2017
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

20161 grants / $21,500

Endeavour Mobility Grant$21,500

This program provided international mobility scholarships provided 10 undergraduate students from the Faculty of Business and Law with an opportunity to participate in a short-term cultural immersion experience in Kenya. The project provides students with an awareness and understanding of cultural diversity; insight into the complexities of diplomacy, governance, and industry in a developing country context.  This project works to foster a deeper understanding of Kenyan culture from an industry perspective as well as insight into the dynamics and challenges of both the legal and business environments. The project fulfils degree requirements for the BBus and BCom. Apart from increasing the number of students graduating with international mobility experience, the project evidences an ongoing effort to strengthen relations between the Faculty and Moi University.

Funding body: Department of Foriegn Affairs and Trade

Funding body Department of Foriegn Affairs and Trade
Project Team

Dr Michael Seamer

Scheme Endeavour Mobility Grant
Role Lead
Funding Start 2016
Funding Finish 2017
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N
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Research Supervision

Number of supervisions

Completed2
Current2

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2016 PhD Network Coopetition for Sustainable Tourism Development: A Case Study in Da Nang and Hue, Vietnam PhD (Leisure & Tourism), Faculty of Business and Law, The University of Newcastle Co-Supervisor
2012 PhD What Rules? Local Government Land Use Decision Making for Events in NSW PhD (Leisure & Tourism), Faculty of Business and Law, The University of Newcastle Principal Supervisor

Past Supervision

Year Level of Study Research Title Program Supervisor Type
2014 PhD Investigating Thai Accommodation Managers' Environmental Management Practices: A Behavioural Intentions Approach PhD (Leisure & Tourism), Faculty of Business and Law, The University of Newcastle Co-Supervisor
2013 PhD Monumentalising LanguageVisitor Experience and Meaning Making at the Afrikaanse Taalmonument Tourism, Southern Cross University Co-Supervisor
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News

Scholarship award for Kenya’s Young Entrepreneur Challenge winner

May 22, 2018

A mobile app to enable farmers in rural Kenya to advertise and sell any daily surplus crops has won the 2018 Nairobi Young Entrepreneur Challenge, hosted by the Newcastle Business School.

Innovative partnership aimed at impact in Kenya

February 27, 2018

A collaboration between academics and government representatives, the Australia Awards fellowship is aimed at strengthening public service performance and building governance capacity in Kenya.

Dr Patricia Johnson

Position

Lecturer
Newcastle Business School
Faculty of Business and Law

Focus area

Tourism

Contact Details

Email patricia.johnson@newcastle.edu.au
Phone 02 4921 5546

Office

Room X-738
Building NeW Space
Location City Campus

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