1
|
Costa B, Vale N. Advances in Psychotropic Treatment for Pregnant Women: Efficacy, Adverse Outcomes, and Therapeutic Monitoring. J Clin Med 2024; 13:4398. [PMID: 39124665 PMCID: PMC11312735 DOI: 10.3390/jcm13154398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Advancements in psychotropic therapy for pregnant women are pivotal for addressing maternal mental health during the perinatal period. Screening for mood and anxiety symptoms during pregnancy is recommended to enable early intervention. Psychotropic medications, including antidepressants, benzodiazepines, antipsychotics, and mood stabilizers, are commonly used, but challenges remain regarding their safety and efficacy during pregnancy. Pregnancy induces significant changes in pharmacokinetics, necessitating personalized dosing strategies and careful monitoring. Real-time monitoring technologies, such as smartphone-integrated platforms and home-based monitoring, enhance accessibility and accuracy. Prospective studies and collaboration among healthcare providers are essential for evidence-based guidelines and optimal treatment strategies. Reducing stigma around mental health during pregnancy is crucial to ensure women seek help and discuss treatment options, promoting understanding and acceptance within the community.
Collapse
Affiliation(s)
- Bárbara Costa
- PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Centre for Parasite Biology and Immunology, Department of Infectious Diseases, National Health Institute Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal
| | - Nuno Vale
- PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| |
Collapse
|
2
|
Groeneveld S, Bin Noon G, den Ouden MEM, van Os-Medendorp H, van Gemert-Pijnen JEWC, Verdaasdonk RM, Morita PP. The Cooperation Between Nurses and a New Digital Colleague "AI-Driven Lifestyle Monitoring" in Long-Term Care for Older Adults: Viewpoint. JMIR Nurs 2024; 7:e56474. [PMID: 38781012 PMCID: PMC11157177 DOI: 10.2196/56474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 05/25/2024] Open
Abstract
Technology has a major impact on the way nurses work. Data-driven technologies, such as artificial intelligence (AI), have particularly strong potential to support nurses in their work. However, their use also introduces ambiguities. An example of such a technology is AI-driven lifestyle monitoring in long-term care for older adults, based on data collected from ambient sensors in an older adult's home. Designing and implementing this technology in such an intimate setting requires collaboration with nurses experienced in long-term and older adult care. This viewpoint paper emphasizes the need to incorporate nurses and the nursing perspective into every stage of designing, using, and implementing AI-driven lifestyle monitoring in long-term care settings. It is argued that the technology will not replace nurses, but rather act as a new digital colleague, complementing the humane qualities of nurses and seamlessly integrating into nursing workflows. Several advantages of such a collaboration between nurses and technology are highlighted, as are potential risks such as decreased patient empowerment, depersonalization, lack of transparency, and loss of human contact. Finally, practical suggestions are offered to move forward with integrating the digital colleague.
Collapse
Affiliation(s)
- Sjors Groeneveld
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
- Research Group Smart Health, Saxion University of Applied Sciences, Enschede, Netherlands
- TechMed Center, Health Technology Implementation, University of Twente, Enschede, Netherlands
| | - Gaya Bin Noon
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Marjolein E M den Ouden
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
- Research Group Care and Technology, Regional Community College of Twente, Hengelo, Netherlands
| | - Harmieke van Os-Medendorp
- Domain Health, Sports, and Welfare, Inholland University of Applied Sciences, Amsterdam, Netherlands
- Spaarne Gasthuis Academy, Hoofddorp, Netherlands
| | - J E W C van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Section of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Rudolf M Verdaasdonk
- TechMed Center, Health Technology Implementation, University of Twente, Enschede, Netherlands
| | - Plinio Pelegrini Morita
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Research Institute for Aging, University of Waterloo, Waterloo, ON, Canada
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
3
|
Menegatti E, Proto A, Paternò G, Gadda G, Gianesini S, Raisi A, Pagani A, Piva T, Zerbini V, Mazzoni G, Grazzi G, Taibi A, Zamboni P, Mandini S. The Effect of Submaximal Exercise on Jugular Venous Pulse Assessed by a Wearable Cervical Plethysmography System. Diagnostics (Basel) 2022; 12:diagnostics12102407. [PMID: 36292096 PMCID: PMC9600745 DOI: 10.3390/diagnostics12102407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/18/2022] Open
Abstract
The jugular venous pulse (JVP) is a one of the crucial parameters of efficient cardiovascular function. Nowadays, limited data are available regarding the response of JVP to exercise because of its complex and/or invasive assessment procedure. The aim of the present work is to test the feasibility of a non-invasive JVP plethysmography system to monitor different submaximal exercise condition. Twenty (20) healthy subjects (13M/7F mean age 25 ± 3, BMI 21 ± 2) underwent cervical strain-gauge plethysmography, acquired synchronously with the electrocardiogram, while they were carrying out different activities: stand supine, upright, and during the execution of aerobic exercise (2 km walking test) and leg-press machine exercise (submaximal 6 RM test). Peaks a and x of the JVP waveform were investigated since they reflect the volume of cardiac filling. To this aim, the Δax parameter was introduced, representing the amplitude differences between a and x peaks. Significant differences in the values of a, x, and Δax were found between static and exercise conditions (p < 0.0001, p < 0.0001, p < 0.0001), respectively. Particularly, the Δax value for the leg press was approximately three times higher than the supine, and during walking was even nine times higher. The exercise monitoring by means of the novel JVP plethysmography system is feasible during submaximal exercise, and it provides additional parameters on cardiac filling and cerebral venous drainage to the widely used heartbeat rate value.
Collapse
Affiliation(s)
- Erica Menegatti
- Department of Environmental Science and Prevention, University of Ferrara, 44123 Ferrara, Italy
| | - Antonino Proto
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44123 Ferrara, Italy
- Correspondence: ; Tel.: +39-0532-974375
| | - Gianfranco Paternò
- Department of Physics and Earth Sciences, University of Ferrara, 44122 Ferrara, Italy
| | - Giacomo Gadda
- Department of Physics and Earth Sciences, University of Ferrara, 44122 Ferrara, Italy
| | - Sergio Gianesini
- Department of Translational Medicine, University of Ferrara, 44123 Ferrara, Italy
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Andrea Raisi
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44123 Ferrara, Italy
| | - Anselmo Pagani
- Department of Translational Medicine, University of Ferrara, 44123 Ferrara, Italy
| | - Tommaso Piva
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44123 Ferrara, Italy
| | - Valentina Zerbini
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44123 Ferrara, Italy
| | - Gianni Mazzoni
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44123 Ferrara, Italy
| | - Giovanni Grazzi
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44123 Ferrara, Italy
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL 60612, USA
| | - Angelo Taibi
- Department of Physics and Earth Sciences, University of Ferrara, 44122 Ferrara, Italy
| | - Paolo Zamboni
- Department of Translational Medicine, University of Ferrara, 44123 Ferrara, Italy
| | - Simona Mandini
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44123 Ferrara, Italy
| |
Collapse
|