From planning to practice: building the national network for the surveillance of severe maternal morbidity

Background: Improving maternal health is one of the Millennium Development Goals for 2015. Recently some progress has been achieved in reducing mortality. On the other hand, in developed regions, maternal death is a relatively rare event compared to the number of cases of morbidity; hence studying maternal morbidity has become more relevant. Electronic surveillance systems may improve research by facilitating complete data reporting and reducing the time required for data collection and analysis. Therefore the purpose of this study was to describe the methods used in elaborating and implementing the National Network for the Surveillance of Severe Maternal Morbidity in Brazil. Methods: The project consisted of a multicenter, cross-sectional study for the surveillance of severe maternal morbidity including near-miss, in Brazil. Results: Following the development of a conceptual framework, centers were selected for inclusion in the network, consensus meetings were held among the centers, an electronic data collection system was identified, specific software and hardware tools were developed, research material was prepared, and the implementation process was initiated and analyzed. Conclusion: The conceptual framework developed for this network was based on the experience acquired in various studies carried out in the area over recent years and encompasses maternal and perinatal health. It is innovative especially in the context of a developing country. The implementation of the project represents the first step towards this planned management. The system online elaborated for this surveillance network may be used in further studies in reproductive and perinatal health

Interactive Feedforward for Improving Performance and Maintaining Intrinsic Motivation in VR Exergaming

Exergames commonly use low to moderate intensity exercise protocols. Their effectiveness in implementing high intensity protocols remains uncertain. We propose a method for improving performance while maintaining intrinsic motivation in high intensity VR exergaming. Our method is based on an interactive adaptation of the feedforward method: a psychophysical training technique achieving rapid improvement in performance by exposing participants to self models showing previously unachieved performance levels. We evaluated our method in a cycling-based exergame. Participants competed against (i) a self model which represented their previous speed; (ii) a self model representing their previous speed but increased resistance therefore requiring higher performance to keep up; or (iii) a virtual competitor at the same two levels of performance. We varied participants' awareness of these differences. Interactive feedforward led to improved performance while maintaining intrinsic motivation even when participants were aware of the interventions, and was superior to competing against a virtual competitor