Personalised eHealth intervention to increase physical activity and reduce sedentary behaviour in rehabilitation after cardiac operations: Study protocol for the PACO randomised controlled trial (NCT03470246)

Introduction: Personalized intervention to increase physical Activity and reduce sedentary behaviour in rehabilitation after Cardiac Operations (PACO) is a smartphone-based and accelerometer-based eHealth intervention to increase physical activity (PA) and reduce sedentary behaviour (SB) among patients recovering from cardiac surgery.Design: Prospective randomised controlled trial.Methods and analysis: The present protocol describes a randomised controlled clinical trial to be conducted in the Heart Centres of Kuopio and Turku university hospitals. The trial comprises 540 patients scheduled for elective coronary artery bypass grafting, aortic valve replacement or mitral valve repair. The patients will be randomised into two groups. The control group will receive standard postsurgical rehabilitation guidance. The eHealth intervention group will be given the same guidance together with personalised PA guidance during 90 days after discharge. These patients will receive personalised daily goals to increase PA and reduce SB via the ExSedapplication. Triaxial accelerometers will be exploited to record patients’ daily accumulated PA and SB, and transmit them to the application. Using the accelerometer data, the application will provide online guidance to the patients and feedback of accomplishing their activity goals. The data will also be transmitted to the cloud, where a physiotherapist can monitor individual activity profiles and customise the subsequent PA and SB goals online. The postoperative improvement in patients’ step count, PA, exercise capacity, quality of sleep, laboratory markers, transthoracic echocardiography (TTE) parameters and quality of life, and reduction in SB and incidence of major cardiac events are investigated as outcomes.Conclusions: The PACO intervention aims to build a personalised eHealth tool for the online tutoring of cardiac surgery patients.</p

Challenges of Religious Literacy in Education : Islam and the Governance of Religious Diversity in Multi-faith Schools

This chapter seeks take part in an emerging research where religion is approached as a whole school endeavor. Previous research and policy recommendations typically focused on teaching about religion in school, but the accommodation of religious diversity in the wider school culture merits more attention. Based on observations in our multiple case studies, we discuss the multi-level governance of religious diversity in Finnish multi-faith schools with a particular focus on the challenges of religious literacy for educators. The three examples we present focus on the inclusion of Muslims in Finnish schools and in particular on the challenges for educator (1) in interpreting the distinction between religion and culture, (2) in recognizing and handling intra-religious diversity, and (3) in being aware of Protestant conceptions of religion and culture. A theme cutting across these examples is how they reflect the tendencies either to see different situations merely through the lens of religion (religionisation), or not to recognize the importance of religion at all (religion-blindness). We argue that religious literacy should be recognized and developed as a vital part of the intercultural competencies of educators.Peer reviewe

A cluster of Candida krusei infections in a haematological unit

<p>Abstract</p> <p>Background</p> <p><it>Candida krusei </it>infections are associated with high mortality. In order to explore ways to prevent these infections, we investigated potential routes for nosocomial spread and possible clonality of <it>C. krusei </it>in a haematological unit which had experienced an unusually high incidence of cases.</p> <p>Methods</p> <p>We searched for <it>C. krusei </it>contamination of the hospital environment and determined the level of colonization in patients and health care workers. We also analyzed the possible association between exposure to prophylactic antifungals or chemotherapeutic agents and occurrence of <it>C. krusei</it>. The <it>C. krusei </it>isolates found were genotyped by pulsed-field electrophoresis method in order to determine possible relatedness of the cases.</p> <p>Results</p> <p>Twelve patients with invasive <it>C. krusei </it>infection and ten patients with potentially significant infection or mucosal colonization were documented within nine months. We were unable to identify any exogenic source of infection or colonization. Genetic analysis of the isolates showed little evidence of clonal transmission of <it>C. krusei </it>strains between the patients. Instead, each patient was colonized or infected by several different closely related genotypes. No association between medications and occurrence of <it>C. krusei </it>was found.</p> <p>Conclusion</p> <p>Little evidence of nosocomial spread of a single <it>C. krusei </it>clone was found. The outbreak may have been controlled by cessation of prophylactic antifungals and by intensifying infection control measures, e.g. hand hygiene and cohorting of the patients, although no clear association with these factors was demonstrated.</p

Performing women: The gendered dimensions of the UK new research economy

This paper explores the development and maintenance of familiar gendered employment patterns and practices in UK universities, which are exemplars of new modes of knowledge production, commodification and marketisation. After discussing in detail the evidence of gender discrimination in UK higher education and the changes in the academic labour process consequent to the incorporation, at least at the policy level, of universities into the ‘knowledge economy’, institution-specific data is used to highlight the gendered aspects of the research economy from the three intermeshing perspectives of research culture, research capital and the research production process. This nexus is constructed in such a way as to systematically militate against women’s full and equal involvement in research. Lack of transparency, increased competition and lower levels of collegiate activity coupled with networking based on homosociability are contributing to a research production process where women are marginalized

Study protocol for prevention of falls: A randomized controlled trial of effects of vitamin D and exercise on falls prevention

Peer reviewe