Promoting physical activity and a healthy active lifestyle in community-dwelling older adults: a design thinking approach for the development of a mobile health application.

Background: Physical activity (PA) has wide-ranging, and well documented benefits for older adults, encompassing physical, cognitive, and mental well-being. The World Health Organization advocates for a minimum of 150-300 min of moderate intensity PA per week, supplemented by muscle-strengthening exercises. However, the rates of PA among older adults remain a concern.

MS@Work in Flanders: The Development of a MS Toolkit for a Stable Employment.

Persons with MS have the highest unemployment rates compared to other chronic diseases. We want to develop a MS Toolkit with several aids for persons with MS to help them gain a sustainable employment with sufficient and permanent attention and guidance for the daily obstacles in the workplace. Therefore, the opportunities and bottlenecks were mapped through a survey with persons with MS and employers, a diary and expert interviews.

First-Trimester Normotension Is a Weak Indicator of Normal Maternal Cardiovascular Function.

Background: As by definition, mean arterial pressure equals the product of cardiac output (CO) and total vascular resistance (TPR), we hypothesized that, irrespective of thresholds to define hypertension, a CO-TPR imbalance might exist in first-trimester normotensive pregnancies with altered risks for adverse gestational outcomes.

Methods: A standard protocol was used for automated blood pressure measurement combined with impedance cardiography assessment of CO and TPR (NICCOMO). First-trimester normotensive pregnant women were categorized into 3 groups relative to the reference 75th percentile (P75) of CO and TPR: (1) normal CO and TPR, (2) high CO, and (3) high TPR.

Maternal Cardiovascular Dysfunction is Associated with Hypoxic Cerebral and Umbilical Doppler Changes.

We investigate the relationship between maternal cardiovascular (CV) function and fetal Doppler changes in healthy pregnancies and those with pre-eclampsia (PE), small for gestational age (SGA) or fetal growth restriction (FGR). This was a three-centre prospective study, where CV assessment was performed using inert gas rebreathing, continuous Doppler or impedance cardiography. Maternal cardiac output (CO) and peripheral vascular resistance (PVR) were analysed in relation to the uterine artery, umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices (PI, expressed as -scores by gestational week) using polynomial regression analyses, and in relation to the presence of absent/reversed end diastolic (ARED) flow in the UA.

Obesity in pregnancy causes a volume overload in third trimester.

Background: Obesity is a major risk factor for cardiovascular diseases. In this study, we aimed to investigate the maternal circulatory differences during pregnancy between obese and normal weight women.

Materials And Methods: The functioning of the maternal circulation (arteries, veins, heart and body fluid) was assessed by ECG-Doppler ultrasound, impedance cardiography (ICG) and bio-impedance during pregnancy in obese women (BMI ≥30 kg/m ) and normal weight, nonobese women (BMI 20-25 kg/m ).

Development of a biophysical screening model for gestational hypertensive diseases.

Background: To investigate the possibility of using maternal biophysical parameters only in screening for the different types of gestational hypertensive diseases.

Methods: A total of 969 pregnant women were randomly screened in first and second trimester, of which 8 developed Early-onset Preeclampsia, 29 Late-onset Preeclampsia, 35 Gestational Hypertension and 897 women had a normal outcome. An observational maternal hemodynamics assessment was done via standardized electrocardiogram-Doppler ultrasonography, Impedance Cardiography and bio-impedance, acquiring functional information on heart, arteries, veins and body fluid.

Low Volume Circulation in Normotensive Women Pregnant with Neonates Small for Gestational Age.

Background: Pregnancies complicated with small for gestational age (SGA) neonates are reported with maternal circulatory maladaptations.

Objectives: We aimed to understand the pathophysiology of the maternal circulation in normotensive SGA pregnancies and to point out the trimestral differences from those with appropriate-to-large (non-SGA [NGA]) neonates.

Methods: An observational study was conducted in 3 trimestral cohorts of normotensive pregnancies, categorized after birth according to neonatal birth weight percentile (BW%) as SGA (BW% ≤10, n = 158) or NGA (BW% > 10, n = 1,038).

Gestational hypertensive disorders show unique patterns of circulatory deterioration with ongoing pregnancy.

A combined assessment of heart, arteries, veins, and body fluid content throughout pregnancy has not yet been reported. We hypothesized that a gradual aggravation of circulatory dysfunction exists from the latent to the clinical phase of gestational hypertensive disease (GHD), and that pathways are unique for preeclampsia with early onset < 34 wk (EPE) and late onset ≥ 34 wk (LPE), and gestational hypertension (GH). Women with singleton pregnancy and no known diseases were invited for a prospective, observational study and had standardized sphygmomanometric blood pressure measurement, bioimpedance body water spectrum analysis, impedance cardiography for cardiac and arterial assessment, and combined Doppler-ECG of hepatic and renal interlobar veins and uterine arteries.

Body fluid volume homeostasis is abnormal in pregnancies complicated with hypertension and/or poor fetal growth.

Objectives: To evaluate body water volumes and cardiac output in each trimester of pregnancies complicated with hypertension and/or poor fetal growth, relative to uncomplicated pregnancy.

Methods: In this semi-longitudinal cohort study, a standardised non-invasive maternal hemodynamics assessment in first, second or third trimester was performed in 1068 women with uncomplicated pregnancy (UP), 75 with early onset (EPE) and 117 with late onset preeclampsia (LPE), 139 with gestational hypertension (GH), 129 with small for gestational age (SGA) neonates and 43 with essential hypertension (EH). Women with hypertension or SGA were included prior to onset of symptoms or at diagnosis of disease; 46% of women (758/1631) were assessed in ≥ 2 trimesters.

Prenatal Remote Monitoring of Women With Gestational Hypertensive Diseases: Cost Analysis.

Background: Remote monitoring in obstetrics is relatively new; some studies have shown its effectiveness for both mother and child. However, few studies have evaluated the economic impact compared to conventional care, and no cost analysis of a remote monitoring prenatal follow-up program for women diagnosed with gestational hypertensive diseases (GHD) has been published.

Objective: The aim of this study was to assess the costs of remote monitoring versus conventional care relative to reported benefits.

The impact of a remote monitoring program on the prenatal follow-up of women with gestational hypertensive disorders.

Objectives: In 2015, we showed the value of a remote monitoring (RM) follow-up program for women diagnosed with gestational hypertensive disorders (GHDs) compared with women who received conventional care (CC). We want to confirm or refute the conclusions drawn in 2015, by including data from 2016.

Study Design: A two year retrospective study in which all women diagnosed with GHD, who underwent prenatal follow-up at the outpatients prenatal clinic of Ziekenhuis Oost-Limburg (Genk, Belgium) during 2015 and 2016, were included.

Maternal hemodynamics: a method to classify hypertensive disorders of pregnancy.

Background: The classification of hypertensive disorders of pregnancy is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in hypertensive disorders of pregnancy considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome.

Objective: This study aimed to examine cardiovascular parameters in a cohort of patients affected by hypertensive disorders of pregnancy according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of hypertensive disorders of pregnancy.

Remote Monitoring of Hypertension Diseases in Pregnancy: A Pilot Study.

Background: Although remote monitoring (RM) has proven its added value in various health care domains, little is known about the remote follow-up of pregnant women diagnosed with a gestational hypertensive disorders (GHD).

Objective: The aim of this study was to evaluate the added value of a remote follow-up program for pregnant women diagnosed with GHD.

Methods: A 1-year retrospective study was performed in the outpatient clinic of a 2nd level prenatal center where pregnant women with GHD received RM or conventional care (CC).

Why non-invasive maternal hemodynamics assessment is clinically relevant in early pregnancy: a literature review.

Background: The maternal cardiovascular system adapts quickly when embryo implantation is recognized by the body. Those adaptations play an important role, as a normal cardiovascular adaptation is a requirement for a normal course of pregnancy. Disturbed adaptations predispose to potential hypertensive disorders further in pregnancy [1-3].

Maternal body fluid composition in uncomplicated pregnancies and preeclampsia: a bioelectrical impedance analysis.

Objectives: Body fluid composition changes during the course of pregnancy and there is evidence to suggest that these changes are different in uncomplicated pregnancies compared to hypertensive pregnancies. The aim of this study was to evaluate the changes in maternal body fluid composition during the course of an uncomplicated pregnancy and to assess differences in uncomplicated pregnancies versus hypertensive pregnancies by using a bio-impedance analysis technique.

Study Design: Body fluid composition of each patient was assessed using a multiple frequency bioelectrical impedance analyser.

Effects of Transcranial Direct Current Stimulation on the Recognition of Bodily Emotions from Point-Light Displays.

Perceiving human motion, recognizing actions, and interpreting emotional body language are tasks we perform daily and which are supported by a network of brain areas including the human posterior superior temporal sulcus (pSTS). Here, we applied transcranial direct current stimulation (tDCS) with anodal (excitatory) or cathodal (inhibitory) electrodes mounted over right pSTS (target) and orbito-frontal cortex (reference) while healthy participants performed a bodily emotion recognition task using biological motion point-light displays (PLDs). Performance (accuracy and reaction times) was also assessed on a control task which was matched to the emotion recognition task in terms of cognitive and motor demands.

Type-specific orthostatic hemodynamic response of hypertensive diseases in pregnancy.

Posture changes may differ between types of hypertensive disease. The aim is to evaluate the orthostatic response of impedance cardiography (ICG) measurements in uncomplicated and hypertensive pregnancies. Measurements were performed in supine and standing position in 202 women: 41 uncomplicated pregnancies (UP), 59 gestational hypertension (GH), 35 early-onset (EPE, < 34 weeks) and 67 late-onset (LPE, ≥ 34 weeks) preeclampsia were assessed.

Hepatic hemodynamics and fetal growth: a relationship of interest for further research.

Background: It is well known that hepatic hemodynamics is an important physiologic mechanism in the regulation of cardiac output (CO). It has been reported that maternal cardiac output relates to neonatal weight at birth.

Aims: In this study, we assessed the correlation between maternal hepatic vein Doppler flow parameters, cardiac output and neonatal birth weight.