Search Results (42)

Mother’s own milk (MOM) offers the highest protection for preterm and low birth weight infants. However, breastfeeding can be challenging during neonatal hospitalization. When MOM is unavailable, donor human milk (DHM) is the recommended alternative for feeding vulnerable neonates. Human milk banks (HMBs) collect, process, and deliver DHM, playing a key role in lactation support and promoting MOM availability. Although HMBs are expanding globally, scale-up remains hindered, restricting equitable DHM access. In Switzerland, despite the existence of eight HMBs, the western region lacked such a facility until 2022. To address this gap, an interdisciplinary team from the Lausanne University Hospital (CHUV) and the Swiss Red Cross Interregional Blood Transfusion Centre (TIR) collaborated to establish a regional HMB. This partnership leveraged both institutions’ available expertise, infrastructure, and resources. After two years of preparation, the CHUV Lactarium launched in 2022 with the support of the Department of Health and Social Action (DSAS) of the Canton of Vaud. This novel human milk bank–blood bank model is fully integrated into the hospital’s neonatal care, nutrition, and breastfeeding programs, operating under a strict quality and coordination system. Since its implementation, the HMB has met 100% of DHM needs, with an 80% breastfeeding bridging rate. It has had a positive impact on neonatal care, family engagement, professional interest, and community awareness of human milk. This case study illustrates how synergistic collaboration can help bridge gaps in establishing a safe, efficient, and equitable HMB model. It also offers a scalable framework adaptable to other settings. Full article

Sarcomas, a rare and complex group of cancers, require multidisciplinary care across multiple healthcare settings, often leading to delays, redundant testing, and fragmented data. This fragmented care landscape obstructs the implementation of Value-Based Healthcare (VBHC), where care efficiency is tied to measurable patient outcomes.ShapeHub, an interoperable digital platform, aims to streamline sarcoma care by centralizing patient data across providers, akin to a logistics system tracking an item through each stage of delivery. ShapeHub integrates diagnostics, treatment records, and specialist consultations into a unified dataset accessible to all care providers, enabling timely decision-making and reducing diagnostic delays. In a case study within the Swiss Sarcoma Network, ShapeHub has shown substantial impact, improving diagnostic pathways, reducing unplanned surgeries, and optimizing radiotherapy protocols. Through AI-driven natural language processing, Fast Healthcare Interoperability Resources, and Health Information Exchanges, HIEs, the platform transforms unstructured records into real-time, actionable insights, enhancing multidisciplinary collaboration and clinical outcomes. By identifying redundancies, ShapeHub also contributes to cost efficiency, benchmarking treatment costs across institutions and optimizing care pathways. This data-driven approach creates a foundation for precision medicine applications, including digital twin technology, to predict treatment responses and personalize care plans. ShapeHub offers a scalable model for managing rare cancers and complex diseases, harmonizing care pathways, improving precision oncology, and transforming VBHC into a reality. This article outlines the potential of ShapeHub to overcome fragmented data barriers and improve patient-centered care. Full article

Background: While the well-being and working conditions of healthcare professionals are increasingly scrutinized, there remains a critical research gap regarding the quality of life and job satisfaction of plastic surgeons in Switzerland. No prior national study has systematically examined these aspects within this specialty. Objective: This study aims to address this gap by evaluating workload, career satisfaction, and quality of life among Swiss plastic surgeons and trainees, thereby providing evidence to inform systemic improvements in the profession. Methods: A national, multilingual online survey was distributed to all members of the Swiss Society for Plastic Surgery and the Association of Young Plastic Surgeons. A total of 102 plastic surgeons responded (response rate: 22.7%). The survey assessed contractual versus actual working hours, work performed during personal time, mental health indicators (e.g., burnout), and career satisfaction. Descriptive and correlational analyses were conducted. Results: The respondents reported an average of 58 actual versus 49 contractual working hours per week, with an additional 8.1 h spent working during leisure time. Burnout symptoms were present in 29%, and 63% experienced work-related stress during their free time. While 42% wished to reduce their workload, 88.7% would still choose the profession again. Career satisfaction averaged 3.66/5, although 35% rated their salary as inadequate. Notably, 79.8% reported work negatively affecting private relationships, despite 82.65% feeling supported by their environment. Conclusion: This first nationwide assessment highlights the high workload and psychological strain faced by Swiss plastic surgeons. Key priorities include targeted burnout prevention, structural workload reduction, enhanced support for work–life integration (especially among women and younger surgeons), and improved compensation. These measures are essential to sustain the well-being of practitioners and ensure long-term quality in surgical care. Full article

Agricultural prosumption is a transformative pathway, enabling individuals to reconnect to nature whilst producing food for their own consumption. Allotment gardens (AGs) and community-supported agriculture (CSA) are two main types of this practice, forming opposing sides on a continuous prosumption scale, ranging from prosumption-as-consumption (p-a-c), as in consumption focused CSA initiatives, to prosumption-as-production (p-a-p), as in the production-orientated AGs. Using a survey completed by Swiss CSA (n = 250) and AG members (n = 201), this study shows how prosumers perceive the benefits of their activity, how these experiences shape their likeliness to continue and how differently they rate the effects of prosumption on individuals, communities and society. In addition, it provides an outlook on associated societal developments, regarding these activities as forms of contributive economy. Although the two groups differed in their socio-demographics, their attitudes and experiences were similar. P-a-p organisations (AGs) enhance production-related individual benefits, while p-a-c organisations foster positive experiences around consumption activities. AG continuation is driven by the experienced health and food-related benefits, while CSAs rely on the communal and organisational involvement of their members. While AG members focus on individual benefits, CSA members strive to be part of a food system change, using their communal structures to create a social movement. This demonstrates the wide range and potential of food prosumption in fostering diverse forms of engagement, offering insights into its potential for sustaining participation and contributing to alternative economic models. Full article

The COVID-19 pandemic has widened the gap in mortality between different population groups. While socioeconomic status has been shown to be an important determinant of mortality, the relationship between migration status and mortality risk remains unclear. The objective of this paper is to explain whether and why foreign populations had a higher risk of mortality than Swiss nationals during the initial outbreak of the COVID-19 pandemic in Switzerland. We use original linked data to measure the risk of COVID-19 mortality for different groups of foreigners, compared to Swiss nationals, using logistic regression. We find that the risk of death from COVID-19 in 2020 was significantly higher for some groups of foreign nationals—but not all groups—compared to Swiss nationals. Increased mortality is observed among foreign communities who have been living in Switzerland for more than 20 years, notably, Italians, people of Balkan origin, and Latin Americans. For these three communities, we suggest that high mortality is due to a combination of overexposure, for socioeconomic reasons, and reduced access to health systems. These findings contribute to the understanding of migrant health disparities during pandemics and inform future public health interventions. Full article

Background/Objectives: In recent years, the number of cancer survivors has rapidly increased in Switzerland, as well as worldwide. As cancer increasingly becomes a chronic condition, numerous bio-psycho-social and spiritual challenges emerge, leading to significant needs for this population. The aims of this study were to determine the experiences of Swiss cancer survivors with two domains, i.e., health-related information and healthcare systems, and their risk factors, and to see whether these experiences align with the needs identified in the literature. Methods: Data from the cross-sectional multicentred survey Swiss Cancer Patient Experiences were analysed. A total of 1870 adult Swiss cancer survivors were included in the analysis. For each domain, an overall score ranging between 0 (poor experience) and 10 (excellent experience) was constructed including 11 and 10 questions, respectively. The questions that highlighted non-positive experiences by patients were grouped to calculate so-called “problematic” scores for each domain; linear and logistic regressions were conducted to identify the variables influencing these problematic scores needs. Results: The mean overall and “problematic” scores were 7.5 (SD 2.6) and 6.8 (SD 3.2), respectively, for health-related information, and 8.0 (SD 2.4) and 7.0 (SD 3.6), respectively, for the healthcare system. Four variables were found to be associated with the problematic scores: geographical location, foregoing care, self-assessed health, and level of health literacy. Conclusions: Swiss cancer survivors reported problematic experiences in the domains of information and healthcare systems which could lead to unmet needs. The systematic assessment of these needs is recommended to improve patients’ experiences and provide more effective and supportive follow-up care. Full article

Lactation in dairy cows implies comprehensive endocrine and metabolic changes including a systemic electrolytic reaction. Previous studies have rarely considered these specific demands due to the influence of lactation periods. Therefore, this study aimed to assess the effects of early, middle, and late lactation phases on the dynamic changes in serum concentrations of progesterone (P4), 17β-oestradiol (E2), cortisol, and some electrolytes (Ca⁺⁺, Mg⁺⁺, Na⁺, K⁺, Cl⁻, Pi) and biochemical parameters (alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), total bilirubin, urea, and iron (Fe⁺⁺) in 10 Holstein, 10 Brown Swiss, and 10 Modicana multiparous healthy dairy cows (4.2 ± 1.7 years of age) sampled at 60-day intervals throughout lactation. Lactation induced significant changes in the concentrations of P4, which peaked at >120–180 days, decreased at >240–300 days, and increased again after 300 days. Cortisol showed an opposite trend to P4, with concentrations progressively decreasing, except for the phase between >240 and 300 days, and a steep drop at >300 days compared to previous phases. Na⁺ concentrations showed the lowest values at 0–60 d and the highest ones at >180–240 days, whereas Mg⁺⁺ showed the highest values at >60–120 d and the lowest at >300 d. Significant correlations were found between P4 with cortisol, Cl⁻ and K⁺, and cortisol with Ca⁺⁺ and LDH. Significant differences in average concentrations of AST, ALT, LDH, Ca⁺⁺, Mg⁺⁺, and Fe⁺⁺ were observed among different dairy cow breeds. Understanding the dynamic changes in hormone levels, electrolytes, and biochemical parameters during different lactation phases, while considering breed differences in dairy cows, is crucial for improving herd health management and milk production in commercial dairy farms. Full article

Background/Objectives: This study aims to investigate differences in cancer diagnosis based on absolute case numbers and age-standardized incidence rate ratios (IRRs) in the pre-Coronavirus disease 2019 (COVID-19) years (2018/19) and the first two years of the COVID-19 pandemic (2020, 2021) in two Swiss cantons. Methods: Data of the Swiss cantonal cancer registry of the cantons of Zurich (ZH) and Zug (ZG) were used to descriptively investigate differences in annual and monthly absolute numbers regarding all-cancer and the five most common cancer types. Directly age-standardized monthly incidence rates (IRs) were calculated. Multivariate Quasipoisson regression models were fitted to determine the IRRs with 95% confidence intervals (95% CI). Results: Annual absolute numbers of all investigated cancers were similar in 2018/19, 2020, and 2021, except for prostate cancer (increase of 20.8% in 2021 compared to 2018/19). In 2020, there were generally more cancer diagnoses in January and February followed by a decrease in April and May. Compared to the pre-COVID-19 period, lower IRs were observed in 2020 for all-cancer (IRR = 0.96 [95% CI 0.96, 0.97]) and female breast cancer (0.92 [0.89, 0.96]), whereas higher IRs were observed in 2021 for all-cancer (1.02 [1.02, 1.02]) and prostate cancer (1.23 [1.18, 1.28]). Conclusions: Cancer detection and diagnoses decreased during the first year of the pandemic, especially during the most stringent lockdown phase in April. The findings of this study may inform the decisions of policymakers and public health system during future pandemics. Full article

We explored the outcomes and challenges encountered during a 12-year collaborative development endeavor in Tanzania, focused on enhancing the healthcare system. The Health Promotion and System Strengthening (HPSS) project, supported by the Swiss Government and implemented by the Swiss Tropical and Public Health Institute (Swiss TPH) from 2011 to 2023, aimed to strengthen various aspects of Tanzania’s healthcare landscape. This included reforms in health insurance through the improved Community Health Fund (iCHF), the establishment of a public–private partnership to optimize the health commodity supply chain via a Prime Vendor System (Jazia PVS), the implementation of health technology management innovations, and the facilitation of participatory community and school health promotion initiatives. Operating in a multisectoral, interdisciplinary, and systemic manner, the HPSS project employed a variety of interconnected strategies, focusing on key entry points within the Tanzanian health system, starting from district level to national policies. These efforts followed a three-stages approach to reach a sustainable adoption of the innovations, going through the process of service and product innovation, integration into service delivery systems, and finally their adoption in the respective institutional policies. Each stage presented distinct frameworks and challenges, detailed in this article. The development of innovative concepts was complemented by capacity building through on-the-job training, establishment of new accredited training programs for pre-service trainings, and the development of new IT systems integrated into the governmental IT environment, as well as efforts to improve transparency, accountability, and governance. Activities in these fields were guided by operational research, following the translational approach of Swiss TPH to go from innovation and validation to application. The example of the HPSS project highlights the cycle of developing and testing innovations at the community and district level, followed by endeavoring national-level integration and policy adjustments, consequently resulting in improved service delivery at the district and community level. Full article

The utilization of food as a therapeutic measure for various ailments has been a prevalent practice throughout history and across different cultures. This is exemplified in societies where substances like Hibiscus sabdariffa have been employed to manage health conditions like hypertension and elevated blood glucose levels. The inherent bioactive compounds found in this plant, namely, delphinidin-3-sambubioside (DS3), quercetin (QRC), and hibiscus acid (HA), have been linked to various health benefits. Despite receiving individual attention, the specific molecular targets for these compounds remain unclear. In this study, computational analysis was conducted using bioinformatics tools such as Swiss Target Prediction, ShinnyGo 0.77, KEGG, and Stringdb to identify the molecular targets, pathways, and hub genes. Supplementary results were obtained through a thorough literature search in PubMed. DS3 analysis revealed potential genetic alterations related to the metabolism of nitrogen and glucose, inflammation, angiogenesis, and cell proliferation, particularly impacting the PI3K-AKT signaling pathway. QRC analysis demonstrated interconnected targets spanning multiple pathways, with some overlap with DS3 analysis and a particular focus on pathways related to cancer. HA analysis revealed distinct targets, especially those associated with pathways related to the nervous system. These findings emphasize the necessity for focused research on the molecular effects of DS3, QRC, and HA, thereby providing valuable insights into potential therapeutic pathways. Full article

The first aim of this study was to calculate the prevalence of painful lesions of the digits (“alarm” lesions; ALs) in Swiss dairy herds and cow–calf operations over a three-year study period. The following ALs were included in the calculation: the M2 stage of digital dermatitis (DD M2), ulcers (U), white line fissures (WLF) of moderate and high severity, white line abscesses (WLA), interdigital phlegmon (IP) and swelling of the coronet and/or bulb (SW). Between February 2020 and February 2023, digit disorders were electronically recorded during routine trimmings by 40 specially trained hoof trimmers on Swiss cattle farms participating in the national claw health programme. The data set used consisted of over 35,000 observations from almost 25,000 cows from 702 herds. While at the herd-level, the predominant AL documented in 2022 was U with 50.3% followed by WLF with 38.1%, at the cow-level, in 2022, it was DD M2 with 5.4% followed by U with 3.7%. During the study period, within-herd prevalences of ALs ranged from 0.0% to a maximum of 66.1% in 2020. The second aim of this study was to determine herd- and cow-level risk factors associated with digital dermatitis (DD), U and white line disease (WL) in dairy cows using data from 2022. While for DD, analysed herd-level factors appeared to have a greater effect on the probability of its occurrence, the presence of U and WL was mainly associated with the analysed cow-level factors. The risk for DD increased with a higher herd trimming frequency. Herds kept in tie stalls had a lower risk for DD and WL and a higher risk for U compared to herds kept in loose housing systems. Herds with predominantly Holstein Friesian cows as well as Holstein Friesian cows had a higher risk for the occurrence of DD compared to herds and cows of other breeds. With increasing parity, cows had a higher risk of developing U and WL, whereas for DD, parity was negatively associated with prevalence. Cows trimmed during the grazing period had a higher risk of U and WL than cows trimmed during the housing period. These findings may contribute to improve management measures affecting the health of the digits in farms with structures similar to those evaluated in the current study, such as small herds with frequent access to pasture. Further research is warranted to demonstrate how measures addressing the current results combined with those of individual herd risk assessments might contribute to an improvement in the health of the digits in the respective dairy herds. Full article

The human intake of selenium (Se), which is an essential element in animals and humans, can be increased through the consumption of vegetables that have been biofortified during cultivation. There is increasing interest in wild edible plants (WEPs) due to their positive effects on health. In fact, many WEPs are rich in microelements, vitamins, dietary fibers, and several antioxidant compounds. Among WEPs, sea beet (Beta vulgaris ssp. maritima) is the wild ancestor of Swiss chard (Beta vulgaris var. cicla). The present study investigated the potential of fortifying Swiss chard and sea beet with Se. The two subspecies were cultivated in a floating system with a nutrient solution enriched with four concentrations of Se (0, 1, 3, and 5 mg L⁻¹), and the production and quality of the baby leaves were evaluated. The addition of Se to the nutrient solution resulted in a higher leaf concentration of this microelement in both subspecies, with a positive effect on the yield (+20%) and leaf chlorophyll concentration (+25%) at the Se concentration of 1 mg L⁻¹. The leaf concentration of nitrates was reduced by the Se treatment in sea beet regardless of the Se concentration (−24%, on average). Selenium biofortification was more effective in sea beet plants than in Swiss chard due to the higher ability of the wild species to acquire readily available minerals from the hydroponic nutrient solution. In conclusion, both subspecies accumulated a significant amount of Se without negative effects on yield or leaf quality, thus proving them to be suitable for the production of Se-enriched baby leaves. Full article

Background: Healthcare labor market shortages due to migration, inadequate investments, and lack of continuous training are essential concerns in the Eastern European region. This article aims to describe and reflect on the experience with the implementation of continuous medical education among mother-and-child healthcare providers in Ukraine, including achievements, challenges, and barriers. We analyze this case based on two international collaboration initiatives: the Swiss–Ukrainian program in mother-and-child health that ran from 2000 to 2015, supplemented by the recent Ukrainian–Swiss project “Medical education development” in 2018–2023. Methods: We use a case study approach as the methodology for our study. We collected data from documents (project reports reviews) and in-depth interviews with stakeholders. We apply the method of directed qualitative content analysis. Results: As a result of the Swiss–Ukrainian collaborations, the knowledge and awareness of medical personnel were greatly improved. Modern clinical concepts not well understood at the outset became commonplace and were incorporated into clinical activities. Nevertheless, obstacles to the implementation and rapid uptake of changes were found in the lack of knowledge of the English language among medical doctors, the fear of changes, and the lack of openness and readiness for novel evidence-based clinical practices. However, primary healthcare practitioners in this new project seem to be more inclined to change. Conclusions: A modernized continuous medical education which is based on the values of openness, respect, dialogue, and professionalism can be implemented with the input of an international assistance program despite the resistance of the system towards change. Full article

This study analyzed the chemical composition of Cymbopogon citratus essential oil from Puebla, México, assessed its antioxidant activity, and evaluated in silico protein–compound interactions related to central nervous system (CNS) physiology. GC–MS analysis identified myrcene (8.76%), Z-geranial (27.58%), and E-geranial (38.62%) as the main components, with 45 other compounds present, which depends on the region and growing conditions. DPPH and Folin–Ciocalteu assays using the leaves extract show a promising antioxidant effect (EC₅₀ = 48.5 µL EO/mL), reducing reactive oxygen species. The bioinformatic tool SwissTargetPrediction (STP) shows 10 proteins as potential targets associated with CNS physiology. Moreover, protein–protein interaction diagrams suggest that muscarinic and dopamine receptors are related to each other through a third party. Molecular docking reveals that Z-geranial has higher binding energy than M1 commercial blocker and blocks M2, but not M4 muscarinic acetylcholine receptors, whereas β-pinene and myrcene block M1, M2, and M4 receptors. These actions may positively affect cardiovascular activity, memory, Alzheimer’s disease, and schizophrenia. This study highlights the significance of understanding natural product interactions with physiological systems to uncover potential therapeutic agents and advanced knowledge on their benefits for human health. Full article

Swiss health and social care system is complex and is based on universal coverage. However, discontinuity in health and social path and repeated access to emergency units are symptoms of inequity. The aim of this paper is to highlight the interactions between vulnerable patients with socio-sanitary actors to propose some innovative solutions to promote social justice. A six-month ethnography of 15 vulnerable patients’ health and social transitions in the region of Ticino Canton in Switzerland gives new insight into conflict situations in assistance relationships, where reciprocal stereotyping between professionals and patients undermines continuity of care. The cultural dimension of health and social institutions is identified in the problem-solving approach which is legitimized as the only one for dealing with complex situations. The analysis shows how clinical vulnerability relates strongly to an unmanaged so-called liminality phase. Culture is an invisible dimension in care, but its effects on equity are major. Two possible interventions are discussed, which are culturally informed reorganization of the care network and collaboration with a sociosanitary cultural mediator. Full article