Long-Term IoT-Based Maternal Monitoring: System Design and Evaluation

Pregnancy is a unique time when many mothers gain awareness of their lifestyle and its impacts on the fetus. High-quality care during pregnancy is needed to identify possible complications early and ensure the mother’s and her unborn baby’s health and well-being. Different studies have thus far proposed maternal health monitoring systems. However, they are designed for a specific health problem or are limited to questionnaires and short-term data collection methods. Moreover, the requirements and challenges have not been evaluated in long-term studies. Maternal health necessitates a comprehensive framework enabling continuous monitoring of pregnant women. In this paper, we present an Internet-of-Things (IoT)-based system to provide ubiquitous maternal health monitoring during pregnancy and postpartum. The system consists of various data collectors to track the mother’s condition, including stress, sleep, and physical activity. We carried out the full system implementation and conducted a real human subject study on pregnant women in Southwestern Finland. We then evaluated the system’s feasibility, energy efficiency, and data reliability. Our results show that the implemented system is feasible in terms of system usage during nine months. We also indicate the smartwatch, used in our study, has acceptable energy efficiency in long-term monitoring and is able to collect reliable photoplethysmography data. Finally, we discuss the integration of the presented system with the current healthcare system.

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Concealed pregnancies and protected postpartum periods

The Anthropological Demography of Health ◽

10.1093/oso/9780198862437.003.0018 ◽

2020 ◽

pp. 472-492

Author(s):

Jan Brunson

Keyword(s):

Maternal Health ◽

Sexual Activity ◽

Postpartum Period ◽

Urban Community ◽

Demographic And Health Survey ◽

Ethnographic Interviews ◽

Critical Junctures ◽

Pregnancy And Postpartum ◽

Nutritional Needs

This chapter analyses the delineation of what counts as a critical period for action and intervention in improving maternal health. Using ethnographic interviews alongside descriptive data from the Nepal Demographic and Health Survey, it analyses two critical junctures for maternal health, the antepartum and postpartum periods, in the context of a particular peri-urban community of Nepal. The postpartum period is socially recognized as sutkeri for Hindu Nepalis, a forty-day period in which a woman who gave birth is considered ritually polluted, but also particularly susceptible to long-term health problems if proper care is not taken for her body in its vulnerable state. This perception of bodily vulnerability and mandated care while sutkeri exists in stark contrast to the absence of such notions and protective practices for the period of pregnancy. Pregnancy, an outwardly visible sign of sexual activity, is a state that one should hide or minimize in order to maintain one’s reputation and honour as a woman. Women worked to conceal their pregnancies, and typically no or little extra care was provided to women to meet their nutritional needs or to enable them to avoid hard physical labour. However, intersecting statuses, such as caste and class, and contexts, such as agricultural households and multi-generational households, crosscut any simple characterizations of the pregnancy and postpartum periods—even within the confines of a subgroup of the Nepali population (Parbatiya) in a single community and place.

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Policies and Programs Critical for Greater Energy Efficiency

Economic Policy ◽

10.18288/1994-5124-2020-2-148-167 ◽

2020 ◽

Vol 15 (2) ◽

pp. 148-167

Keyword(s):

Climate Change ◽

Energy Efficiency ◽

Global Economy ◽

Work Force ◽

Well Being ◽

Good News ◽

Energy Services ◽

Policies And Programs ◽

The Many

In 2018 businesses, households and government enterprises throughout the global economy spent an estimated €7.4 trillion to meet the many demands for various energy services. Current projections suggest that the present scale of annual expenditures may increase by more than 60 percent to €12.0 trillion by 2050 (with all costs expressed in real 2018 values). Although the global economy derives important benefits from the purchase of many energy services, the inefficient use of energy also creates an array of costs and constraints that burden our social and economic well-being. Among these costs or constraints are increased health costs, air pollution, climate change and a less productive economy—especially over the long term. Yet there is good news within the countless energy markets throughout the global economy. Whether improved lighting in homes and schools, transporting people and goods more efficiently, or powering the many industrial processes within any given nation, there are huge opportunities to improve the productive use of energy in ways that reduce total economic costs. And those same energy efficiency upgrades can also reduce greenhouse gas emissions that drive climate change, as well as lessen other impacts on both people and the global environment. However, as this manuscript suggests, it will take an adequately funded set of smart policies and effective programs, including a skilled work force, to drive the optimal scale of energy efficiency investments.

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Description The Activities of Recording and Reporting Maternal Health Monitoring in PWS-KIA Based on Surveillance Attributes

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v2i12014.34-47 ◽

2014 ◽

Vol 2 (1) ◽

pp. 34

Author(s):

Ika Arma Rani ◽

Arief Hargono

Keyword(s):

Maternal Health ◽

Pregnant Women ◽

Health Monitoring ◽

Age Group ◽

Quality Of Data ◽

Maternal Deaths ◽

Low Sensitivity ◽

Alternative Solutions

ABSTRACTMaternal Mortality Rate (MMR) in East Java Province tends to increase every year. In fact, Jember has the highest number of maternal deaths during the period 2009-2011, and placed in 2nd position during 2012. Puskesmas Kaliwates for 3 consecutive years has the highest number of maternal deaths in the Jember. This research aimed to to describe the activities of recording and reporting the maternal health monitoring in PWS KIA system at Puskesmas Kaliwates, Jember regency, in 2012 by using attributes surveillance.The Research design is descriptive. Assessment in attributes of maternal health monitoring on PWS KIA system at Puskesmas Kaliwates in 2012 showed that the system is quite complicated, lack of flexibility, low quality of data, high acceptability, low sensitivity, low NPP, low representativeness, uncertain timelines, and low stability of data.The alternative solutions given are familiarizing midwife to analyze and compose a follow-up planning, improving the quality of the completeness and data’s accuracy, standardizing the entire form on KIA PWS systems to avoid duplication and increase forms simplicity,completing PWS KIA guidelines in Puskesmas, making guidelines on how to fill the form, taking records on register cohort of mother by dividing the sheet into 12 sections by month for pregnant women by gestational age group to facilitate the monitoring of pregnant women and childbirth, developing other surveillance system, forming KIA surveillance team, improving attendance format, and using a computerized system.Keywords: Monitoring maternal health, PWS KIA, Attributes surveillance.

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Assessment of gynaecological and general history parameters inpregnant women in long term refugee camps in Greece: results from a pilot program

Hellenic Journal of Obstetrics and Gynecology ◽

10.33574/hjog.1769 ◽

2019 ◽

Vol 18 (3) ◽

pp. 81-86

Author(s):

Vasilios Pergialiotis ◽

Chryssoula Botsi ◽

Ioanna Papari ◽

Stavroula Gkritziou ◽

Kassiani Mellou ◽

...

Keyword(s):

Pregnant Women ◽

Age Groups ◽

Well Being ◽

Refugee Camps ◽

Pull Out ◽

Health Response ◽

Control And Prevention ◽

European Program ◽

Artificial Abortion

Objective:The purpose of the present article is to present preliminary data related to the gynecological history and current health status of pregnant refugees that reside in long-term refugee camps in Greece. Materials and Methods: The study was funded by the European program “PHILOS – Emergency health response to refugee crisis” of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP), funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs.Refugee pregnant women who resided in long-stay refugee camps of the mainland in Greece in 2017 were recruited. Results: Overall, 456 pregnant women were enrolled in the present study with a mean age of 27.5±6.9 years (median 27, range 17-48 years). 182 women (39.8%) were primigravidae. Mean gravidity was 2.4 (median 2, range 1-11). Among them 105 had a previous delivery, 75 women had 2 previous deliveries, 50 women had 3 previous deliveries and 14 had four previous deliveries. Of those, only six women had access to prenatal screening.Twenty-three women (5%) reported that had at least an artificial abortion performed (median 1, range 1-4) and 87 women (19.0%) had at least one spontaneous abortion (median 1, range 1-6).Two hundred and three women (44.5%) reported the use of a contraceptive method. Among them withdrawal (pull-out method) was the most prevalent accounting for almost half cases (36.9%), by followed by condom, intrauterine devices (IUD) and oral contraceptives. No differences were observed after checking the potential differences among the different age groups (p=.234). Conclusions: Refugee women that reside in long term refugee camps have limited access to national healthcare systems concerning their gynecological and obstetrical assessment. Future studies, should specifically target these problems to help structure specific healthcare plans that will ensure maternal and fetal well-being.

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Lymphedema Management

Oxford Textbook of Palliative Nursing ◽

10.1093/med/9780190862374.003.0018 ◽

2019 ◽

pp. 238-250

Author(s):

Mei R. Fu ◽

Bonnie B. Lasinski ◽

Janet H. Van Cleave ◽

Charles P. Tilley

Keyword(s):

Palliative Care ◽

Quality Care ◽

Well Being ◽

Clinical Settings ◽

Major Health Problem ◽

Incurable Disease ◽

Appropriate Therapy ◽

And Control ◽

Medical Advances

Nurses are the ideal resource for providing and improving quality care for patients suffering from lymphedema because they have access to large, diverse patient populations. Lymphedema or abnormal swelling is seen regularly in palliative and acute care settings. Lymphedema is a major health problem affecting thousands of individuals worldwide, yet it is often overlooked or neglected despite its capacity to cause pain and multiple distressing symptoms as well as to impair patients’ physical, functional, social, sexual, and affective well-being. Even with modern medical advances, lymphedema remains a lifelong, incurable disease requiring ongoing attention, appropriate therapy, and long-term management. Palliative care to alleviate symptoms and control swelling is the ultimate goal for lymphedema treatment and management. This chapter prepares nurses to understand, assess, and manage lymphedema in various clinical settings, including acute, outpatient, community, and palliative care.

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Challenges in Acceptance and Compliance in Digital Health Assessments During Pregnancy: Prospective Cohort Study (Preprint)

10.2196/preprints.17377 ◽

2019 ◽

Author(s):

Katharina Brusniak ◽

Hannah Maria Arndt ◽

Manuel Feisst ◽

Kathrin Haßdenteufel ◽

Lina Maria Matthies ◽

...

Keyword(s):

Pregnant Women ◽

Mobile Apps ◽

Digital Health ◽

Quality Care ◽

Well Being ◽

Socioeconomic Background ◽

User Engagement ◽

Digital Monitoring ◽

Long Time ◽

High Engagement

BACKGROUND Pregnant women are increasingly using mobile apps to access health information during the antenatal period. Therefore, digital health solutions can potentially be used as monitoring instruments during pregnancy. However, a main factor of success is high user engagement. OBJECTIVE The aim of this study was to analyze engagement and factors influencing compliance in a longitudinal study targeting pregnant women using a digital health app with self-tracking. METHODS Digitally collected data concerning demographics, medical history, technical aspects, and mental health from 585 pregnant women were analyzed. Patients filling out ≥80% of items at every study visit were considered to be highly compliant. Factors associated with high compliance were identified using logistic regression. The effect of a change in mental and physical well-being on compliance was assessed using a one-sample <i>t</i> test. RESULTS Only 25% of patients could be considered compliant. Overall, 63% left at least one visit blank. Influential variables for higher engagement included higher education, higher income, private health insurance, nonsmoking, and German origin. There was no relationship between a change in the number of physical complaints or depressive symptoms and study dropout. CONCLUSIONS Maintaining high engagement with digital monitoring devices over a long time remains challenging. As cultural and socioeconomic background factors had the strongest influence, more effort needs to be directed toward understanding the needs of patients from different demographic backgrounds to ensure high-quality care for all patients. More studies need to report on compliance to disclose potential demographic bias.

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Financing and Policy for Long-Term Care

Oxford Research Encyclopedia of Economics and Finance ◽

10.1093/acrefore/9780190625979.013.364 ◽

2018 ◽

Cited By ~ 1

Author(s):

Alexandrina Stoyanova ◽

David Cantarero-Prieto

Keyword(s):

Informal Care ◽

Social Protection ◽

Long Term Care ◽

Quality Care ◽

Functional Limitations ◽

Well Being ◽

Term Care ◽

Traditional Pattern ◽

The Right

Long-term care (LTC) systems entitle frail and disabled people, who experience declines in physical and mental capacities, to quality care and support from an appropriately trained workforce and aim to preserve individual health and promote personal well-being for people of all ages. Myriad social factors pose significant challenges to LTC services and systems worldwide. Leading among these factors is the aging population—that is, the growing proportion of older people, the main recipients of LTC, in the population—and the implications not only for the health and social protection sectors, but almost all other segments of society. The number of elderly citizens has increased significantly in recent years in most countries and regions, and the pace of that growth is expected to accelerate in the forthcoming decades. The rapid demographic evolution has been accompanied by substantial social changes that have modified the traditional pattern of delivery LTC. Although families (and friends) still provide most of the help and care to relatives with functional limitations, changes in the population structure, such as weakened family ties, increased participation of women in the labor market, and withdrawal of early retirement policies, have resulted in a decrease in the provision of informal care. Thus, the growing demands for care, together with a lower potential supply of informal care, is likely to put pressure on the provision of formal care services in terms of both quantity and quality. Other related concerns include the sustainable financing of LTC services, which has declined significantly in recent years, and the pursuit of equity. The current institutional background regarding LTC differs substantially across countries, but they all face similar challenges. Addressing these challenges requires a comprehensive approach that allows for the adoption of the “right” mix of policies between those aiming at informal care and those focusing on the provision and financing of formal LTC services.

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Efficacy of a midwife-coordinated, individualized, and specialized maternity care intervention (ChroPreg) in addition to standard care in pregnant women with chronic disease: protocol for a parallel randomized controlled trial

10.21203/rs.2.143/v2 ◽

2019 ◽

Author(s):

Mie de Wolff ◽

Marianne Johansen ◽

Anne Schoedt Ersboell ◽

Susanne Rosthoej ◽

Anne Brunsgaard ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Pregnant Women ◽

Chronic Diseases ◽

Maternity Care ◽

Standard Care ◽

Controlled Trial ◽

Well Being ◽

Randomized Controlled ◽

Care Intervention ◽

Pregnancy And Postpartum

Abstract Background and objectives: The number of women of childbearing age with chronic diseases is rising. Evidence has shown that obstetric complications and poor psychological well-being are more prevalent among this group, in addition to these women reporting experiences of less than satisfactory care. More research is needed to investigate how to best meet the special needs of this group during pregnancy and postpartum. Previous research has shown that care coordination, continuity of care, woman-centered care and specialized maternity care interventions delivered to women with high-risk pregnancies can improve patient-reported outcomes, pregnancy outcomes, and be cost-effective. However, no previous trials have examined the efficacy and cost-effectiveness of such interventions among pregnant women with chronic diseases. This paper describes the protocol of a randomized controlled trial (RCT) of a midwife-coordinated, individualized and specialized maternity care intervention (ChroPreg) as an add-on to standard care for pregnant women with chronic diseases. Methods/design: This two-arm parallel group RCT study will be conducted from October 2018 – June 2020 at the Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark. Pregnant women with chronic diseases are invited to participate; women will be randomized and allocated 1:1 to the ChroPreg intervention plus standard care or standard care alone. The ChroPreg intervention consists of three main components: 1. Coordinated and individualized care, 2. Additional ante- and postpartum consultations, and 3. Specialized midwives. The primary outcome is length of hospital stay (LOS) during pregnancy and postpartum period and secondary outcomes are: psychological well-being (the five-item World Health Organization Well-being Index, Edinburgh Postnatal Depression Scale, Cambridge Worry Scale), health-related quality of life (the 12-Item Short Form Survey), patient satisfaction (The Pregnancy and Childbirth Questionnaire), number of antenatal contacts, and pregnancy and delivery outcomes. Data is collected via patient-administered questionnaires and medical records. Discussion: This trial is anticipated to contribute to the field of knowledge on which planning of improved antenatal, intra- and postpartum care for women with chronic disease is founded.

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Mental Health and Prenatal Bonding in Pregnant Women During the COVID-19 Pandemic: Evidence for Heightened Risk Compared With a Prepandemic Sample

Clinical Psychological Science ◽

10.1177/21677026211049430 ◽

2021 ◽

pp. 216770262110494

Author(s):

Alyssa R. Morris ◽

Darby E. Saxbe

Keyword(s):

Mental Health ◽

Pregnant Women ◽

Social Contact ◽

Well Being ◽

The United States ◽

Prenatal Bonding ◽

First Time Mothers ◽

Clinically Significant ◽

First Time

We compared 572 pregnant women (319 first-time mothers) surveyed in spring 2020, during the first wave of COVID-19 lockdowns in the United States, with 99 pregnant women (all first-time mothers) surveyed before the pandemic (2014–2020). Compared with the prepandemic sample, women assessed during the pandemic showed elevated depression, anxiety, and stress and weaker prenatal bonding to their infants. These findings remained significant when restricting the pandemic sample to first-time mothers only and held after controlling for race/ethnicity, education, and pregnancy stage. Average levels of depression and anxiety within the pandemic group exceeded clinically significant thresholds, and women who estimated that the pandemic had more negatively affected their social relationships reported higher distress. However, pandemic-related changes to social contact outside the household were inconsistently associated with mental health and with some positive outcomes (fewer depressive symptoms, stronger prenatal bonding). Given that prenatal stress may compromise maternal and child well-being, the pandemic may have long-term implications for population health.

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Changes in Health and Well-Being in COVID-19 Clinically Vulnerable Older English People During the Pandemic

Innovation in Aging ◽

10.1093/geroni/igab046.359 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 95-95

Author(s):

Giorgio Di Gessa ◽

Debora Price

Keyword(s):

Older People ◽

Age Groups ◽

Well Being ◽

Severe Illness ◽

Using Data ◽

June July ◽

Anxiety Depression ◽

Health And Well Being ◽

Specific Health

Abstract People with specific health profiles and diseases (such as diabetes, lung and heart conditions) have been classified as ‘clinically vulnerable’ (CV) to Covid-19, i.e. at higher risk of severe illness and mortality from Covid-19, and were targeted for shielding. However, there is as yet little evidence on how the pandemic and shielding impacted the health and social well-being of CV older people. Using data from Wave 9 (2018/19) and the first Covid-19 sub-study (June/July 2020) of the English Longitudinal Study of Ageing, we investigated changes in health and well-being during the pandemic by clinical vulnerability. We also explored the interactions between CV and age-group (50s, 60s, 70s, 80+), and between CV and shielding. Results suggest that CV older people (~39% of the sample) were more likely to report worse health and social well-being outcomes during the pandemic compared to non-CV participants, even considering pre-pandemic levels of health and well-being. However, changes in health were not uniform across age groups, with those in their 50s and 60s more likely to report greater deterioration in mental health than those in their 70s and over 80. Moreover, older adults who were shielding and were CV reported the most substantial rises in anxiety, depression, receipt of formal care as well as decreases in well-being and physical activity. While policies focussing on shielding CV older people reduce rates of hospitalisation and death from Covid-19, policymakers should address the wider needs of this group if their long-term health and social well-being are not to be compromised.

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