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THE PIED PIPERS

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Sayali Bharambe

Samuil Botev

Luca Pialini

Parth Garg

Ittikom Chanaritichai

Mechanical Engineer, India

Furniture Designer, Bulgaria

Communication Designer, Italy

Software Engineer, India

Interior Designer, Thailand

The Team FINAL SYNTHESIS LAB Product Service System Design 3


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Social media awareness campaign about postpartum depression as launch event of our project

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Our identity, Solution, our wearable and service, stakeholder matrix and competitors.

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Defination of the problem statement and the project theme.

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Online research and field research with interview transcripts.

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How our concepts evolved through time and our last design brief.

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Insights from prototyping sessions with our user and professionals.

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Scenario, Personas and market analysis to position and enhance our concept.

Strategy to enter the market and how we plan to spend our fundings.

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I N T R O D U C T I O N

This booklet contains the design journey of a semester. A number of intese weeks dedicated to researching, discussing, failing and learning the practice of design on its true battlefield -Real life- with all its complexities and contradictions. The topic selected by the professors to frame the challenge, was everything but limiting. Talking about ‘the future of work, work of the future’ is an issue at the very core of innovation and one which is able to kindle ideas even in most uninspiring settings. Its concreteness, its impact on people’s lives is what fires up any creative mind, regardless of whether it is that of a designer or an engineer. For this reason, one of the first cha lenges -and one which took the team a long time to resolve- was that of defining a brief ourselves. Finding a common path to walk, in a universe of possible directions, was in a sense daunting and chaotic, because many people were involved in it. Nevertheless, driving our decisions with our passions in mind, we tried to explore different areas of life, using different perspectives and methodologies with the aim of solving real problems, while keeping an eye on future evolutions empowered by revolutionary emerging technologies. This work is a condensation of such a journey and an exclusive inside view through the eyes of the people who were directly involved in it. In the first part, you will find an overview of the process, to show why and how we came to the definitive concept. The rest of the booklet will be dedicated to the stories that inspired the design of Blumi. We hope you’ll learn from them as much as we did. Enjoy.

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T H E

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P R O J E C T

The topic of emotions seemed to be relevant in topics as depression, which we framed even further to the size of postpartum depression (PPD from here onwards), a serious condition affecting new mothers. The research, brought the team to explore the underlying topics of motherhood, mental illness and the design challenges associated with them.


D I S C O V E R

The research phase was conducted adopting an integrated approach, with online and field research alternating over time. We aimed at checking how clinical problems would translate to design challenges in real life.

Desk Research

Field Research 13


O N L I N E

Postpartum depression is a condition which appears to affect 1 in 8 women, with only 15% of them receiving medical attention. It must be differentiated from ‘Baby Blues’ which is a physiological mood swing due to hormonal changes occurring throughout pregnancy. For this reason, PPD is hard to detect beforehand. Hospitals still try to do it by analyzing risk factors like previous depressive experiences, social relationships and more but the results are ‘not satisfactory’. Baby Blues symptoms usually stabilize and resolve in a few weeks but requires constant medical attention, as they can be considered a signal of a possible depression. Depending on countless -still scientifically unclear- variables (genetic, environmental, social and personal) women might see a worsening of the condition, which could be referred to as PPD after at least three consecutive weeks (according to the DSM-5).

Reliable Sources. The data we collected come either from official statistics web pages, or from websites concerning worldwide surveys and analysis. We also took some interesting quotes from important associations and also from eminent people from the past (for example, from the World Health Organization official page, or, for italian data, ISTAT.com).

SYMPTOMS

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The symptoms of PPD are similar to those in other form of depression, like a deep, negative, persisting feeling of apathy and constant tiredness. Mothers also feel indifferent to the circumstances, report high levels of anxiety and fear to hurt their babies, oftentimes refusing any contact (breastfeeding rejection). It is important to note how these feelings are all strongly related to a strong contact with the surroundings, which clinically discriminates PPD from the most extreme form of psychosis (dissociation with reality), which may even lead to infanticide or suicide. We have learnt that these occurrences are extremely rare and oftentimes wrongly reported by the

Irrelevant topics. Getting in touch with so many data is dispersive and quite often we had to remind us all which the real purposes of researching were. We discovered, by issue, which are the most relevant factors of mortality and we got focused on them.


media as the consequence of PPD. For this reasons, during research we felt the need to constantly validate new information with expert psychologists (with different specializations) and psychiatrists, who helped us clear up the most controversial topics, often contradicting information found online. One of them is that PPD only affects mothers. Actually, PPD is affecting everyone around her. - the baby, who is exposed to an increased risk to develop behavioral, cognitive and emotional difficulties later in life; - the husband who could experience PPD symptoms himself, as well as going through a whirlwind of feelings and whose education is so crucial in the early detection of PPD; - the family whose concern about the health of everyone involved might cause an additional stressful burden upon the mother, who is left feeling unable to accomplish her role. TREATMENT The treatment of PPD is usually performed through psychotherapy. Depending on the position on the patient over the side-effects (no breastfeeding), this could be combined with a pharmacological support (antidepressants). This means that depending on the treatment a mother chooses to undertake, different professionals might come into play. Psychologists and Psychiatrists. They can be reached through public services (hospital) or independently (private clinic, studio). If not treated on time, PPD worsens, as more symptoms of depression start to come into play, possibly opening up the doors of psychosis.

Avoid Contradictions. Contradiction is one of the most common mistake that a data analyst could fall into. It is quite common to compare numbers related to different years, to the same years but collected in different periods of time, or even related to a local survey against a national one. As we discovered while getting deeply into research, at first it is useful looking for quantity, but what should come as the final output has to be much more quality oriented.

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F I E L D

Throughout the research, the team has been meeting people, moms and PPD experts (psychologists and psychiatrists). Their contribution was instrumental to the concept creation and a strategic planning of the research allowed us to get the most out of their information. MOMS Moms were asked about their pre and postpartum experience, their habits and needs as well as their knowledge of PPD, which was often accompanied by stories.

Every qualitative sentiment analysis starts talking with people belonging to the age group defined before. We chit chatted with them about gossip, their daily life, their passions and most of all we listened stories about their past and their desires for the future: what they want to be and how.

EXPERTS

Facebook and Instagram Pages.

Psychologists and Psychiatrists were involved to provide a solid scientific base upon which to design. Their help was essential to understand their science, the role they play, the therapy they perform as well as to discuss about education.

It is really important to understand people’s feeling about their normal days and their desires. Facebook is such a good platform where we can always find this kind of staff as people use Facebook to record joys and sorrows of their life.Even for people who seldom use it we can also find clues from the background or simple sentences and statements.

PPD FAMILIES We also had the chance to meet the families who had experienced PPD, which helped in understanding the struggle, the importance of raising awareness and the dangers raised by social stigma and unawareness. In the following pages, you can read the interviews and the insights we got out of them.

Social Media trends. People create and share information, ideas, career interests and other forms of expression by virtual communities and networks. Basing on applications, social media are interactive Web 2.0 Internet now which more convenient for people to record their emotion and almost everything. The information we find there maybe have more persuasion than what we get from other channels.

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I N T E R V I E W -

M O M

Can you tell us a bit about your 9 months of pregnancy? Why? I didn’t have any major problem. I am a freelance so I can mange my own work and troubleshoot very easily, according to how I was feeling. I was happy and free. Against the advice of my gynecologist (I had a private one because I wanted a more personal attention), I attended a pre-partum course (6-7 meetings) at the hospital, but I found it pretty useless. For two reasons. Firstly, they are too theoretical and completely eschew the emotional part. (They had some meeting with the psychologist, but they were optional and were held at very difficult times for me to attend.) Secondly, they are with people you don’t know and professionals that only talk about the bright side, so you don’t really feel comfortable to bring certain topic forward. How did you realize you were going through PPD? I was feeling too bad for too long. I was afraid to be alone with my baby, I was afraid to hurt her, I was constantly tired. After three months I decided to look up online and found the ONDA network website, that made me realize I needed help. So I found online a that Niguarda had a dedicated free service for PPD mothers and started my therapy there. Can you tell us about the experience at the hospital PPD unit? It was a liberating experience. I felt at home, and for the first time, I met someone who would listen to me without judging me. The psychologist was incredibly nice. I went to the hospital twice a week, for two consecutive years. That would be more than the average time spent in therapy, but in the meantime I had another daughter and that brought me back down again.

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“I was feeling too bad for too long. I was afraid to be alone with my baby, I was afraid to hurt her, I was constantly tired.”

What do you think was the key to overcoming PPD? Therapy. Reaching out for help was the right decision. It made me reflect more about myself and my relationships with other people, it exposed problems I had never considered before. I also started the blog when I was undergoing psychotherapy: I think it’s given me a great emotional outlet, allowing me to say what I wanted to say. Also listening to other people’s voices was helpful. It felt relieving and empowering at the same time. Did you have any ritual, any activity you liked to do that you believe has helped you? Not really. Maybe walks. I remember many walks with my baby. Those were precious. What was your husband’s role in overcoming PPD? Half of my healing process is due to him. He showed an incredible support throughout, and I will forever be grateful to him for that.


Did you look for support outside therapy? I don’t like counseling services. I’ve had negative experiences with those, because the psychologists were not prepared for supporting people with PPD. I thing it would be the same with any doctor… they would probably not be able to tell if a person has PPD at its early stages. See, it’s hard to detect. People can hide their feelings very well. There’s no specific sign. You need to have experience in these things. You have to see beyond. Did you ever meet other moms? No, I didn’t attend any mommy group. I had my digital community with me. Would you compare digital communities and physical ones? I believe the digital world is often much better than the real oneWhen you’re depressed you feel like the real world doesn’t understand you, and you’re more willing to look for support online. There you can find people that talk openly about these difficult topics, and you’re free to tell the truth.

“I don’t like counseling services. I’ve had negative experiences with those, because the psychologists were not prepared for supporting people with PPD.”

Valentina is the mother of 2 kids. She went through PPD after giving birth to her daughter. She knows the struggle and that’s how she founded her blog named “post-partum.it”. She helps other mothers understand that it is natural, and makes them sure they are not alone in this.

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I N T E R V I E W -

E X P E R T

What is postpartum depression? Postpartum depression is a mental condition that affects 13% of women after birth. At the moment there is not much scientific literature to support this topic, but it seems to be related to many different causes, both genetic and environmental. It shouldn’t be confused with the baby blues, which is a physiological (normal) condition related to hormonal changes, which affects over 85% of women and is accompanied by a variation in the mood. It usually disappears, but in case it doesn’t it can be considered a red flag for possible PPD events in the near future. Is postpartum depression just like every other depression? According to the latest (5th) version of the DSM (the Diagnostic and Statistical Manual of Mental Disorders, the medical standard for mental illness detection and treatment) it is the same. It is characterized by the same symptoms. Symptoms are persistent (last for more than a week) and shows up around the first month after birth. From a clinical perspective, though, there are some differences. For example, the symptoms are the reflection of a specific kind of problems of the past. Do you check PPD mothers in advance? Yes, but is not very effective. You see, it’s very difficult to anticipate, because in that period women undergo an emotional turmoil and the signs are similar. If you add to this the stigma of mental illness, which pushes women to hide any visible sign of depression, you can easily un-

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“PPD is very difficult to anticipate, because in that period women undergo an emotional turmoil.”

derstand why it is so difficult to foresee whether a mother will develop PPD. What we do is try to look for ‘risk factors’. These could be personal: previous depression cases, self-pity; social/environmental: changes in one’s environment, sudden death of a dear person; gynecological: abortions, traumatic labor/delivery, breastfeeding issues... Is there a physical measure of depression? Yes. We use different kinds of scales in combination in order to have a more complete view of the patient’s emotional situation. The Edinburgh natal depression scale, the Beck scale (which we share with general depression) and the STAI which was designed for structural anxiety. These tests are the standard in behavioral psychology, which only go so far as exposing the risk, but then we collaborate with psychiatrists for making better, more informed decisions.


How does the relationship with the baby change during PPD? Mothers can show avoiding behaviors (little physical or eye contact), or on the opposite intrusive or excessively stimulant behaviors. There is no dialogue with the baby, that invisible rhythm goes off, that magical dance is broken. What is the therapy like? Therapy goes deep. It is a walk in the mind the patient, much like Virgilio and Dante in Inferno. We help them see and support the articulation of difficult or shameful problems. It can be done individually, in couples, with other moms or with the baby. The objective is to reduce shame and worthlessness, while helping the patient be aware of her emotional state, to elaborate, accept her feelings. Are only women suffering from PPD? What is the role of family and friends in the healing process? What if the woman is alone? A number of men can go through PPD as well, especially if the subject is mentally unstable. Family and friends are incredibly important: these people simply can’t be left alone.

“A number of men can go through PPD as well, especially if the subject is mentally unstable.” Umberto Mazza is Clinical psycologist at Ospedale Niguarda. He is the cheif of Psychiatict department.

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E X P E R T

As a private psychologist, have you ever dealt with PPD cases? Yes, and it is a very delicate topic. Most of PPD screenings today are based on cognitive- behavioral psychology tests, but to me it’s really important that you understand those tools are very superficial, and do not offer any help in problem-identification. As an experienced psychoanalyst, I believe PPD actually arises when the patient has suffered from traumatic experiences.

“You don’t want people to know you’re feeling depressed when you’re supposed to be enthusiastic.”

What kind of traumas cause PPD? What should women do at this stage? Most of the times is the identification with one’s own mother. Maybe they had a very repressive or on the contrary absent maternal figure, which is now affecting one’s sense of connection with such a fundamental role. It’s that deep. Mothers go through a lot, but very rarely we talk about the mental processes that play an incredibly powerful role in our behaviors.

Talk with a specialist (still a stigma, apparently) and maybe also meet other new moms whom to share PPD stories with. They have to know that it’s ok not to be ok and that everything will be fine. The hardest part is to get them there. After they see they’re not alone, they feel empowered.

How do women feel during PPD? It’s a tough time for them. Having a baby is something beautiful, that everyone speaks positively about; so when they start feeling sad, or having neutral or negative thoughts about the baby they start to hide it. You don’t want people to know you’re feeling depressed when you’re supposed to be enthusiastic. You feel like you’re wrong and start questioning yourself as a mother.

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Gioia Gabelleri Bargagli is analytical psycologist and works in her private studio in Rome. She mostly handles extreme psycological cases.


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E X P E R T

Why are moms coming here? What can you do for them? Because sometimes problems regarding our own relationships, feelings and family life can create psychological relationship or parental problems which are difficult to resolve alone. Problems can sometimes gain such for portions they have significant effect on a person’s quality-of-life well-being and family. The family planning center staff psychologist and other professionals you can turn into a message times of crisis first session of consultation for other forms of health which can be individual, as a couple arrest family group. These activities can help you gain more perspective on the problems, open up to a different way of seeing our problems and use new skills: in short, overcome the crisis by transforming it into an opportunity for personal, relationship and family growth. Are these services free or paid for the user? It depends. Some of them, like those for postpartum are free. But the visits, the psychotherapy and a few other things have a price tag. Much less than private sessions, though. It’s still a public service.

Do counseling services always have to report to the hospital? Yes. We don’t have the technical capabilities to serve those kind of patients. If a mom comes in and tells you she thought of committing suicide, there’s no time to waste. For example, most of the time these people require antidepressants and the psychiatrists is the only one who can do that.

“Most of the time these people require antidepressants and the psychiatrists is the only one who can do that..”

So you have experience with PPD? Well, yes, but we can’t do anything for them. If there are patients that according to us are ‘at risk’ we just open a case and help them in finding expert support at the hospital. In our case it would be Niguarda. They have a dedicated unit for perinatal issues, and PPD is their specialty.

Paola Volonte is behavourial psychlogist working at Consultorio Via Brivio in Milan. Paola is working and organiziing workshops and seminars in Consultorio for new moms and family.

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E X P E R T

What is the role of psychiatrist in the treatment of PPD? We side with psychologist to support the mental health of patients, also by prescribing antidepressants. We are usually summoned either from an internal call coming from gynecologists (both before or after partum) or from the department of mental health (although there are less cases from that channel because of stigma related to mental health).

“We can only ask if they felt or did anything different, we see the improvements between one session and the next.”

How often do you recur to a pharmacological support? Pretty often. I regard PPD cases with the utmost seriousness and I think there is no time to lose. Also because of the risk to which the baby is exposed. I always tell my patients of the risks and the fact that they won’t be able to breastfeed anymore. I think it’s always better than dealing with how bad PPD can get. It’s a preventive action. How long do pharmacological therapies last? Do they overlap with the therapy?

What happens during a therapy session? Objective tests are filled in. A new equilibrium is drawn. Moms have to find another stability in an otherwise ever-evolving scenario in which the baby is growing an they are becoming older mothers. Can hospitals take initiative and partner with companies? No, at the moment everything comes through the SSN.

It depends, usually more than a year. The therapists might opt for an integrated approach that mixes weekly sessions to an antidepressant. How much does the therapy cost to the patient? The general visit is 30 euros. The second 20 euros. The psychological support is 30 euros for first-timers and then sells for 8-sessions packs for 40 euros (5 euros per session). It’s paid, but you can decide to go to the counseling services for the therapy, where it is free.

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How is feedback from therapies collected today? We can only ask if they felt or did anything different, we see the improvements between one session and the next. This is how we work with patients. Dr. Sabatino Trotta is a psychiatrist at Ospedale Civile in Pescara. He deals with PPD patients on regular basis.


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E X P E R T

Do you have a dedicated PPD center? Yes, we have 2. One inside the hospital and another one is the mental health department. They are positioned to best serve the citizenship. They deal with PPD cases everyday. How much do people with PPD stay in therapy? Depending on the case, it could run from 1 to 5 years. I know it sounds a lot, but it depends on the quantity of sessions and how one reacts which in turn is affected by many variables . How much does therapy cost? It’s a free service, paid by the National Healthcare System (SSN). But this would change on a geographical basis. It depends on the region.

“Depending on the case, sessions could run from 1 to 5 years.”

Does different specializations of the psychologist (therapist) affect the therapy? Well, they affect the orientation, the technique if you will. Depending on whom you ask they’ll probably tell you that their version is the most effective. The truth is that no, there is not a better specialization, but depending on the patient, you might get a better result depending on whether they had a cognitive or an analytical psychologist. But they all have the same objective: helping patients deal with their issues.

Paola Ruggeri is systemic relational psycholgist working in Commune di Pescara. She deals with family problems and issues arised due to family relationships.

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F A T H E R

Did you know PPD before the experience of your wife? Yes, but just like everyone else. You know just the information you hear from the tv or read on newspapers, which -by the way- is often wrong. How did you realize that Valentina had PPD? I didn’t. I knew that after birth emotional turmoil is normal, so I wasn’t very worried. I started getting suspicious when she was reacting strangely at things. There was always something wrong in her face, a veil of sadness. But the turning point for me was when she didn’t want to get out of bed in the morning. That was shocking. At the time I was frightened because I didn’t see the light at the end of the tunnel. I didn’t know what to do. Did you attend any daddy course? Yes, I went with Valentina to a couple pre-partum courses, but they weren’t very useful. They gave us very little information on the emotional side and based most of their classes on cliches, like the one that ‘everything is beautiful, everyone is happy’.

families and the problems we kept hiding from one another all popped up. I think therapy strengthened us both in that sense. In general the therapy made me realize that all those small signals at the beginning were connected to PPD. Like the fact she refused to breastfeed on the first day, the constant tiredness, which was psychological more than physical. How long did it take for you to start see the benefit of the therapy? Even after the first session, I could see her relieved. The mood is still fluctuating and there would still be highs and lows, but that’s all part of the treatment. They tell you something is happening. Did you have the chance to meet any PPD dad?

Did you help her in finding support? No, actually she helped herself in that sense. She went online and found a hospital that could take care of her. I supported her throughout. I drove her to the sessions and waited outside as I wasn’t allowed to get in. I did a few couple-sessions with her, anyways.

No. But I had discussed the topic with friends and I must admit that there is a general ignorance around the topic. As well as a lot of stereotypes (woman takes care of the baby, daddy is working), which I am surprised to hear even from very highly educated people. I reflected a lot on the superficiality of my peers, it’s just embarrassing.

What happens during a couple session? Nothing special. In the first one the psychologist was asking a lot of questions, as I was the patient. During the second one we talked about our

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Francesco is Valentina’s husband and helped her get over PPD by understanding and supporting her all along..


“I was feeling too bad for too long. I was afraid to be alone with my baby, I was afraid to hurt her, I

“PPD is very difficult to anticipate, because

was constantly tired.”

in that period women undergo an emotional turmoil.”

“I don’t like counseling services. I’ve had negative experiences with those, because the psychologists were not prepared for supporting people with PPD.” “Depending on the case, sessions could run from 1 to 5 years.”

“A number of men can go through PPD as well, especially if the subject is mentally unstable.” “We can only ask if they felt or did anything different, we see the improvements between one session and the next.”

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D E F I N E

The research has presented an unusually complex panorama, where the perception of the problem seems as important to tackle as the problem itself. We collected identified four key problems: stigma, unawareness, disinformation and lack of support. STIGMA Like all mental health issues, PPD is still a taboo in modern society. And when it comes to the darkness of depression, the striking clash with the brightness of motherhood comes with an additional layer of shame and disgrace. Mothers are seen as the epitome of happiness: bearing a children and bringing it to the world is associated with positive images and powerful emotions. But the truth is that becoming a mother is a very difficult process, both physically and psychologically. Nobody ever speaks about this, everyone ignores the pink elephant in the room. This way, new mothers do feel inadeguate, unable to fill up the role they spent much time preparing for. They enter a vortex of self-pity and self-denial, which helps them hide their true feelings and worsens PPD conditions. UNAWARENESS Even though people know what PPD is, very few of them know how to recognize the signs and help those who suffer from it. This can be said for everyone, but has a particular preeminence when it comes to families who are suffering from PPD.

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Creating awareness is not only important for mothers to know but especially for fathers. Too many times, their role is under considered, leaving the space for stereotypes to wreak havoc. If PPD husbands are not educated, they might blame it on her incapacity to be a mother, which could bring additional stress and tension in the family. DISINFORMATION Many people find support online, because it’s a more private and secure space where to share such a delicate and complex feeling. Even though there are many official resources, the risk to being exposed to extreme content is very much concrete. News and other media also play a key role in this sense. LACK OF SUPPORT Lack of social relationship is one of the key ‘risk-factors’ for depression defined by the DSM-5. This situation might be related to mental issues (asocial behaviors) but can also be due to other experiences as moving to a new city. In any case, people suffering from PPD tend to withdraw from society, frightened by the judgment of other people. It is therefore very important to find the courage to reach out for support with a professional to prevent isolation from fueling self-destructive thoughts.


D E V E L O P

Research made it clear that the solution would have to be something to help mothers deal with PPD. We decided to keep them also as target as it would have given us more freedom. So we started shaping the solution by using design tools to define scenarios and personas, as well as business tools to analyze the competitive landscape.

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S C E N A R I O

Possible Scenarios: 1. Mom> Dead End 2. Mom> Psychologist 3. Mom> Consultori> Hospital

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By analyzing the directions mom take when dealing with PPD, we laid out a map that highlights the relationship between the stakeholders and started drawing the six possible scenarios:

4. Mom>Hospital 5. Mom> Physician> Dead End 6. Mom> Physician> Hospital 7. Mom> Physician> Psychologist


P E R S O N A S

Personas were drawn from clustering scenarios in three PPD experiences: a less extreme one (wealthy mom), a regular one (millennial mom) and a more extreme one (lonely mom).

MILLENNIAL MOM

LONELY MOM

Mom> Consultori> Hospital Mom> Hospital Mom> Physician> Hospital

Mom> Dead End Mom> Physician> Dead End

Name: Carla Children: 1 Age: 29 Years

Name: Giulia Children: 1 Age: 31 Years

Carla is a young mother, who is unaware of many things about motherhood. She reads whatever she can find about it online. She wants to know everything before she goes through the situation herself. She was screened by psychologists before her delivery but the results came negative and thus she was off the hook for psychologists and hospitals. After the delivery she was having extreme mood swings and was not feeling herself. Before the delivery she expected her to be the most happy women on earth but going through this extremes now, she was confused and scared. Being a paranoid new mother (which is usually very common in new moms) she went to the counseling service in vicinity. After two sessions at the counseling service she was sent to the hospital for a screening which advised a PPD therapy with antidepressants.

Giulia is new in town. Her husband is usually on business trips every other week and she moved to Milan far from her family. She just had a baby before moving and now she has to take care of the baby and all the house chores herself. She has no friends in this new city, her family is far away to help her. Just like millennial mom, she relies mostly on internet and reads stuff from forums, even though she has just started feeling the symptoms of PPD, she reads lots of extreme stuff from the internet and believes it. Reading about psychosis and extreme cases of it, she got scared and became worried if she could become a danger for her own kids. She didn’t know whom to talk to and what to do because she was afraid to be labeled as ‘crazy’. It was too much for her to handle and to prevent any negative thing from happening she decided to commit suicide.

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P E R S O N A S

THE WEALTHY MOM Mom> Psychologist Mom> Physician> Psychologist

Name: Sarah Children: 1 Age: 34 Years Sarah is a former model. Because of her lifestyle she had earned a lot and was still earning from loyalties of her works. She gave birth to her first child, Bruno. She had delivered him in private clinic in Milan with all the amenities. After Bruno turned a month old she realized something was wrong with her and she talked with her friends about the same. Her friends were of great help, as they suggested her to go to her physician and talk with him. She followed the suggestion and went to her private physician, who then refered her to a psychologist with experience in the topic.

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M A R K E T

A N A L Y S I S

The competitive landscape of PPD is saturated by institutional services (private and public) which provide psychotherapy. As previously discussed, Hospitals and Private Experts are all offering solutions in the ‘PPD treatment’ business. Other competitors could be the counseling services (who offer a selection of therapies for little money depending on the region). We analyzed pros and cons of each solution to try to understand the position of the concept.

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D E L I V E R

DOUBLE JOURNEY MAP Connecting the dots, we realized we couldn’t offer a product for PPD, as this would not only make it hard to market it, but it would achieve the opposite result: increasing stigma by making people recognizable for it. The intention is to market Blumi as a service dedicated to all new mothers, to help them emotionally (new) as well as physically (existing).

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Because of this ‘double target’ the app would monitor live information and provide only relevant content in a specific moment for that specific person. We can see this in action in this double journey map, where the experience of a healthy mom and one affected by PPD are shown together, alongside the activities which have been designed and validated with experts for them.


I D E N T I T Y

The identity of Blumi is inspired by calm hues and pastel colors, which inspire serenity. White, pink and blue. The butterfly logo was chosen as a symbol of femininity and grace. Its rounded outline reflects softness and comfort. The logotype was chosen to match the identity and is a modern serif font: ‘Intro’ with strongly reduced kerning and custom ligatures.

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S O L U T I O N

Blumi is a service to support new mothers emotionally and physically. It would be given by hospitals to all mothers (no stigma) after birth. The system would consist of a band to monitor physical reactions and an app connected to it.

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B L U M I

B A N D

The band was designed to be comfortably worn on the wrist, matching any outfit you’re wearing and adding to it an elegant touch. With its light, seamless design and elastic mesh, it can easily be taken off or on without any mechanical part. The band is manufactured with a silicone elastomer with composite LSR rubber to ensure comfort, flexibility, durability and resistance to everyday use. Blumi is built to be heat and water resistant and does not require any charging, because its battery can last up to 12 months (the average duration of a PPD therapy). When it’s time to change the battery, you can bring it back to your hospital for a free replacement. The band would be available in three colors (milky blue, milky pink and milky white) and three sizes (xs,s,m), so as to fit every women’s wrist perfectly. MATERIALS Blumi is made out silicone elastomers with integrated fiberreinforced liquid silicone rubber (LSR) which enhances the ergonomics and aesthetics of wearable medical devices. Silicone elastomers are well accepted in the healthcare industry. They meet biocompatibility standards and have advantageous properties like purity, clarity, strength, and chemical compatibility, as well as relatively easy processing. Adding fibers made of various materials can enhance a part’s performance, increasing strength, impact resistance and toughness. The materials are well suited for wearable medical devices. Combining silicone elastomer flexibility with the high strength of fiber-reinforced LSR are especially useful in applications where high torsional stiffness is required, such as in devices with a wrist band. The inherent properties of silicone elastomers can provide good wearability, comfort against the skin, and resistance to skin oils. In addition, such devices can be manufactured in a variety of colors.

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T E C H N O L O G Y

The magic happens inside the band, where two smart sensors work together to paint an accurate picture of your emotional state. The Emotional Monitoring System tracks physical changes related to the emotional state and can open up a completely new universe of interactions with the users, especially in specific scenarios, like PPD. TRACKING EMOTIONS Physiological changes according to exciting emotions can be observed on changes heartbeat if listened carefully. Few people realize, but many traditional fitness tracking wearables use outdated technologies such as optical sensors that end up only having about a 70% accuracy in measuring your heart’s activities. The bottom line is that these sensors track pulse waves, which are phenomena caused by the heartbeat but which also have many other, unrelated factors that affect their frequency. Every emotion causes your heart to beat in a slightly different way. All our emotions leave a unique footprint in this constant battle between sympathetic and parasympathetic control. Think about how differently your heart beats when you are agitated versus when you are in a calm state. These, tiny changes in the heart rate are untraceable with traditional wearables. These footprints can be read using heart rate variability (HRV) analysis of ECG data. ECG analysis is 250 times more precise that existing fitness trackers and smart watches and Platform 24 is researching on the technology to make this possible on one wrist. With this patent pending technology’s unique ability to analyze heart rate variability, it can track 64 different emotions and

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bodily states in you and your loved ones. Specifically, it can track 2 flavors (intensity levels) of each of the 32 emotions found below in Plutchik’s Wheel of Emotions, a standard emotional reference tool in medicine and psychology.


T E C H N O L O G Y

EMOTION MONITERING ENGINE EKG Meter: Accelerometer:

Blood Volume Pulse and Heart Rate Variability To detect motion of the user.

WHY? A new EKG technology developed by Platform24 research center is efficient in detecting two flavours of 32 emotions precisely as that of medical grade ECG Machines.This technology can also detect blood pressure. It has to be in contact with skin all the time to work correctly.

Accelerometer simply tracks the movements of the person. Since whether you are stationary or moving also affects your emotions in one way or another. This data can also be used in determining the physical activity of the person. HOW IT WORKS? The emotions are recognized as per the data flow shown below. The EKG engine tracks the heartrate variability and compares it with your mean heart rate, algorithm synthesies this data into the emotion and you see the visual cues on your app screen.

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T E C H N O L O G Y

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T E C H N O L O G Y

Why these technologies over all other technologies: With integration of sensors like temperature, heart rate, accelerometer and sound sensors the emotion recognition rate is 41.9%, which means every two signals it receives once it is correct. But with precise ECG graphs we can do the same with more precision and it can detect more spectrum of the emotions (64). According to the research a technology called EKG by Planexta is able to detect the ECG signals precisely as medical grade ECG monitors. They are also developing this technology for medical applications for stress and cardiac diseases. Specifications: 25mm x 8mm x 15mm (refer appendix A for teardown references for sizes) Price: 99 Euros per band

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S E R V I C E

The second part of the system is composed by an app, that collects the data from the device using bluetooth technology. Users can navigate 4 core areas: status, resources, activities and community. STATUS The home page shows a simple overview of vitals and a wave that represent the emotional state. The app can notify the user if there are measurements to identify and they will show as dots on the wave. They can be tapped for more information. RESOURCES The resources section provides useful content for new mothers divided by type (videos, articles, books, shows and podcasts) or topic (baby care, health, stress). These resources seem to be very popular with mothers as they are inquisitive about every aspect of the life with their newborn. ACTIVITIES The panel provides a series of activities like meditation, exercises, nutritional advice and games that can be also suggested by the app when feeling sad or down.

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COMMUNITY As seen from the research, community appears to be very important because in PPD cases, as it allows mothers to understand that their story is like that of many other. Digital community provides a simple and immediate way to ask for help using the dedicated threads on baby help, parent help and medical help. Each of these features 24/7 medical support with expert psychologist, gynecologist, obstetricians, psychiatrists and pediatricians).


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S T A K E H O L D E R S

Why will the hospitals/ clinics collabrate? Blumi is a product that saves money and time both to mother and hospitals. With an investment of 99 Euros hospitals can start saving money and time. After the therapy mothers return the product to the hospital and the hospital sends it back to Blumi for replacement of the band. The average PPD therapy consists of 1 or 2 90min sessions per week for at least 12 months and the avarage price per visit is 30 Euros. Refer the calculation done in the table below.

Expenses: For patients : therapy: 20 Euros/hour For Hospitals: Average Phsychologyst payrate: 15-25 Euros/hour Administration, Facilities, Electricity etc. : 5-15 Euros/hour

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S T A K E H O L D E R S

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S T A K E H O L D E R S

H

BRINGS TO

MOTHERS

HOSPITALS

C

PRIVATE CLINICS

COUNSELING

PHYCHOLOGIST

PHYSICIAN

MOTHERS

Physical and digital Community, Support, Calmness, Healty live

Money

Money

Community Money

Money

Money

HOSPITALS

Therapy, Information

Visibility , Innovation, Save money, Remote diagnose

Patients Information Insights

Support Care for patients

Knowledge and insgihts

Patients

Therapy, Information

Support by taking patients

Visibility Innovation More patients

Support by taking patients

Support by taking patients

Support by taking patients

Community Support Consultation

Help patients with problems Help patients with problems in the in the initial phase initial phase

Help the community aspect phyiscally and digitally

Help patients` problems in the initial phase

Insgihts

Therapy, Information

Support by taking patients

Support by taking patients

Support by taking patients

Visibility Innovation Acurate remote dignose

Knowledge and insgihts

Help with the physical condition and healt

Insgihts Information

Patients

Knowledge and insgihts

Knowledge and insgihts

Patterns of the pysical activities of the patient

PRIVATE CLINICS

COUNSELING PHYCHOLOGIST PHYSICIAN

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C O M P E T I T O R S

To better position Blumi, another market analysis has been conducted to understand if there are wearables dedicated to depression and more specifically for PPD. APPS We determined some health-related apps like fitness apps and nutrition apps. We found out that it is a huge business and continuously growing. As of December 2017, there are over 97.000 health & wealth related apps on Google Play right now. The most downloaded is a meditation app called Headspace, WEARABLES The wearable business is constantly growing, with over 102.4 million units shipped in 2016 alone. Blumi would occupy a very specific part of such business, that of health wearables and, more specifically, that of medical wearables, which is said to be one of the most disruptive applications for the future.

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C O M P E T I T O R S

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C A M P A I G N

In order to support the launch of the product, we thought it would be important to start a social campaign. The hashtag is #talkshareact, which are the three key steps to fight stigma and unawareness, the two monsters of PPD. As a matter of fact, we wanted to create a discussion on the topic (talk), help people speak up about their experiences with others (share) and helping mothers who are not feeling well (act). In order to show mutual support in the PPD community, we established partnerships with PPD influencers likes @psnafrica (endorsed by famous celebrity figures to create awareness of PPD in African women), @postpartum supportive online community of women where they share their stories and get help, @momswhometoo this is where moms share their problems not just PPD but general new mom problems and get help.

#Talkshareact #ppdawareness #ppd

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P R O T O T Y P I N G

During the prototyping session at Mamusca, we tried to structure a program around these steps. We first presented the topic and opened up a roundtable with all the participants; then we asked people to share 2 experiences (a good and a bad one) and finally, we all took a photo and uploaded it with the hashtag to tell others about the experience. The event provided many insights, amongst which we like to remember the suggestion to look at the ‘adoption scenario’ and the ‘multicultural scenario’ for additional research. We also heard interesting stories. Here are three quotes fromthe afternoon. ‘when a mother is born, a woman dies’ When you have a baby it’s always hard to let go of who used to be in order to embrace the new and unfamiliar role of the mother. Women are free to put themselves before anything else. For a mother, the baby’s always the number one thought.’ ‘counseling literally saved my life Finding the courage to reach out was the hardest part. My family has never been morally supportive, so I had to find somebody else to talk to. When I started attending counseling, I started meeting people who had my same problems. I realized I was not alone, and that you can get out of that dark place.’

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‘Being a mother is not just difficult. It’s utterly complex. Chemistry, emotions, environments are factors that are personal, unpredictable and totally personal. Everyone makes sense in a different way and perceives the same situation with drastically different feelings. The key to the solution is not one, but a Swiss army knife of customizable settings tailored around the user and its personality.’

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P R O T O T Y P I N G

We believe bringing emotion tracking in the business of psychotherapy could help in creating a better, more effective experience both for the patient and the therapist. To understand how they would use the technology, we spoke with many professionals and asked for opinions. They were enthusiastic but also skeptical. Bridging the gap between one session and another seems promising to most therapists, especially when the user acts a ‘sense maker’ to the raw data by interacting with the app. Psychologists spoke of Blumi as a ‘daily companion’ for their work, a ‘conversation starter’, an ‘pattern detector’ to foresee possible chronic behaviors. But also a tool to have an ‘objective overview’ of the situation. Some people raised doubts about the ‘mechanization of emotions’, and pointed out the inextricable connection between emotions and relationships which unlike physical signals can’t be detected by the app. Overall, all the four professionals interviewed shared a feeling curiosity, which could convince them in entering the pilot testing program.

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I I

Yes, if it is something continuous and reliable. It could show the emotional state of a patient over time and would enable me to see ‘patterns’.”


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S T R A T E G Y

Hospitals are a common touchpoint for moms but also an ambitious goal to achieve. To get there, we further expanded one key aspect of the project: the testing.

T E S T I N G

Product launch will be preceded by an extensive beta testing. For technical reasons we would partner with private clinics, as it would be too complex to start a deal with the SSN for testing. Such structures provide the same personnel, but a much leaner structure as well as a private financial management system. We believe they could gain visibility with this program, raising number of patients served and therefore their revenues, as well as showing a strong commitment toward innovation and service experience.

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F U N D I N G S

Studying all the existing medical wearable startup models and talking with engineering people to develop our technology in real life, we have made an estimate of required funding to start working and developing the required components and technology.

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https://www.instagram.com/__blumi__/ https://www.facebook.com/thepiedpiper0/ https://www.instagram.com/__blumi__/

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