Home-based telemonitoring versus hospital admission in high risk pregnancies: a qualitative study on women's experiences.

BACKGROUND: Hospital admission during pregnancy complications is considered to be an event of significant impact. Besides conventional in-clinic maternal and fetal monitoring, recent technologies enable home-based telemonitoring with self-measurements in high risk pregnancy. This study is part of a feasibility pilot to explore the usability and acceptability of telemonitoring and aims to gain insight in the experiences and preferences of high risk pregnant women concerning the novel strategy of telemonitoring, opposed to women who were hospitalized in pregnancy. METHODS: Using secured Facebook Groups, we conducted four online focus groups: two focus groups with women who were admitted during pregnancy (n = 11) and two with women who received home telemonitoring in the pilot phase (n = 11). The qualitative data were analyzed thematically. RESULTS: Four major themes emerged from both participant groups: [1] care experience, [2] emotions regarding pregnancy, [3] privacy and [4] impact on daily life. Different views were reported on all four themes, resulting in a direct comparison of experiences during hospitalization and telemonitoring. Most admitted patients reported a growing sense of boredom and anxiety during their clinical admission. Lack of privacy on ward was a great concern, as it affected their contact with hospital staff and family. This issue was not reported amongst telemonitored women. These participants still felt like a patient at times but responded that the comfort of their own home and bed was pleasant. Only a minority of telemonitored participants reported being anxious at times at home, while not having a physician or nurse nearby. Being at home resulted in less travel time for partners or family for hospital visits, which had its positive effects on family life. CONCLUSIONS: Telemonitoring of a high-risk pregnancy provides an innovative manner to monitor fetal and maternal condition from home. Compared to the experiences of hospital admission in high risk pregnancy, it allows women to be in a comforting and private environment during an anxious time in their lives. As future studies should further investigate the safety and cost effectiveness of this novel strategy, women's views on the preference of telemonitoring need to be taken into consideration.

Oxygen exchange with water in heme-oxo intermediates during H2O2-driven oxygen incorporation in aromatic hydrocarbons catalyzed by microperoxidase-8.

The present paper describes the oxygen incorporation into naphthalene and anthracene by H2O2-driven microperoxidase-8, forming alpha-naphthol and anthraquinone, respectively. Microperoxidase-8 is a minienzyme containing a histidinyl-coordinated Fe3+-protoporphyrin IX cofactor covalently attached to an eight-amino-acid peptide. Additional experiments were performed to investigate whether the reaction mechanism involved is like that of peroxidase and/or cytochrome P-450. A reaction pathway like that of cytochrome P-450 implies oxygen transfer to the substrate from the as yet uncharacterized iron-oxo species formed in the reaction of the heine cofactor with H2O2. In contrast, a peroxidase-type reaction chemistry involves reaction pathways proceeding by initial one-electron oxidation of, or H-abstraction from, the substrate, followed by incorporation of oxygen from sources other than the iron-oxo species, i.e. from other than H2O2. The results of the present study exclude Fenton-type chemistry and prove that the minicatalyst is able to catalyze the oxygen incorporation by both peroxidase and cytochrome P-450 types of reaction pathways, while exchange occurs between the high-valency iron-oxo species and H2O. The mechanistic implications of this exchange for cytochrome P-450 are discussed.