Impact of Congenital Heart Disease at Adulthood

Since the first surgical techniques for patients with congenital heart disease (ConHD) became available some 55 years ago, virtually every area of patient care has evolved substantially. These improvements lead to an increased survival for patients with ConHD, with over 90% of infants reaching adulthood. This increased survival lead to a shift of focus in that congenital heart disease at adult age nowadays is considered a chronic disease. Therefore, current research does not only focus on survival, but also on the quality of life of these patients. The term quality of life is broad and encompasses many dimensions of life, including – but not limited to – living conditions, wealth and employment, physical and mental health, education, leisure time, psychosocial functioning, lifestyle and social adaptation. In order to investigate the impact of living with a congenital heart defect at adulthood, the aims of this thesis were threefold; 1) To investigate the impact on biographical characteristics 2) To investigate the impact on psychological aspects 3) To investigate the impact on medical aspect

Quantitative cardiovascular magnetic resonance in pregnant women: cross-sectional analysis of physiological parameters throughout pregnancy and the impact of the supine position

There are physiological reasons for the effects of positioning on hemodynamic variables and cardiac dimensions related to altered intra-abdominal and intra-thoracic pressures. This problem is especially evident in pregnant women due to the additional aorto-caval compression by the enlarged uterus. The purpose of this study was to investigate the effect of postural changes

Hardy's inequality for functions vanishing on a part of the boundary

We develop a geometric framework for Hardy's inequality on a bounded domain when the functions do vanish only on a closed portion of the boundary.Comment: 26 pages, 2 figures, includes several improvements in Sections 6-8 allowing to relax the assumptions in the main results. Final version published at http://link.springer.com/article/10.1007%2Fs11118-015-9463-

The CHIP-Family study to improve the psychosocial wellbeing of young children with congenital heart disease and their families: design of a randomized controlled trial

Background: Children with congenital heart disease (CHD) are at increased risk for behavioral, emotional, and cognitive problems. They often have reduced exercise capacity and participate less in sports, which is associated with a lower quality of life. Starting school may present more challenges for children with CHD and their families than for families with healthy children. Moreover, parents of children with CHD are at risk for psychosocial problems. Therefore, a family-centered psychosocial intervention for children with CHD when starting school is needed. Until now, the 'Congenital Heart Disease Intervention Program (CHIP) - School' is the only evidence-based intervention in this field. However, CHIP-School targeted parents only and resulted in non-significant, though positive, effects as to child psychosocial wellbeing. Hence, we expanded CHIP by adding a specific child module and including siblings, creating the CHIP-Family intervention. The CHIP-Family study aims to (1) test the effects of CHIP-Family on parental mental health and psychosocial wellbeing of CHD-children and to (2) identify baseline psychosocial and medical predictors for the e

Sharp embeddings of Besov spaces with logarithmic smoothness

We prove sharp embeddings of Besov spaces B with the classical smoothness a and a logarithmic smoothness a into Lorentz-Zygmund spaces. Our results extend those with a = 0, which have been proved by D. E. Edmunds and H. Triebel. On page 88 of their paper (Math. Nachr. 207 (1999), 79-92) they have written: "Nevertheless a direct proof, avoiding the machinery of function spaces, would be. desirable." In our paper we give such a proof even in a more general context. We cover both the sub-limiting and the limiting cases and we determine growth envelopes of Besov spaces with logarithmic smoothness