Swiss School of Archaeology in Greece
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Implementation of a prehabilitation program before abdominal wall surgery: a pilot and feasibility study.
No full textPrehabilitation in abdominal wall surgery (AWS) might improve postoperative outcomes, but current data are scant. A prehabilitation program before AWS, including specific hypopressive abdominal exercises, was recently implemented in our department. This study aimed to present the characteristics of the implemented program and to assess the adherence rate to hypopressive abdominal exercises.
A retrospective study of all consecutive patients included in the pathway from October 2021 to October 2024 was performed. The multimodal prehabilitation program included nutritional support, physical activities (cardiorespiratory training, muscular strengthening, hypopressive abdominal exercises, and relaxation), and psychological support. Adherence rate was defined as the number of patients who performed the proposed abdominal exercises divided by the total number of included patients.
A total of 103 patients were included (43% women, median age: 64, IQR 55-72, median body-mass index: 29 kg/m 2 , IQR 26-33). Most of them had a midline hernia (n = 79, 77%) and underwent a retromuscular mesh repair (n = 93, 90%). Ninety-six patients were adherent to the hypopressive abdominal exercises (adherence rate: 93%). Obese patients had a significantly lower adherence rate to hypopressive abdominal exercises than non-obese patients (29/34 = 85% vs. 67/69 = 97%, p = 0.025). Median length of hospital stay was 3 days (IQR 2-5) and postoperative complications occurred in 29 patients (28%).
The implementation of a prehabilitation program in AWS was feasible. Moreover, adherence to the hypopressive abdominal exercises was high. Obese patients might require more attention to improve their adherence to the program
Swiss Diabetes and Technology recommendations
No full textTechnological advancements have significantly reshaped diabetes care. Diabetes and technology now encompass the hardware, devices and software required to treat diabetes mellitus. In Switzerland, these technologies are being increasingly adopted, especially by people living with type 1 diabetes, where continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems are considered standards of care. This document provides a comprehensive overview of all diabetes-related technologies currently available in Switzerland. It details their technical specifications, indications for use across diverse populations, compatibility, reimbursement regulations and practical guidance for implementation. Recommendations extend to special populations: children and adolescents, pregnant women, older adults, and people with type 2 diabetes or other specific diabetes types (e.g. maturity-onset diabetes of the young [MODY] or pancreatogenic diabetes). In youth with type 1 diabetes, early adoption of continuous glucose monitoring and automated insulin delivery systems is strongly encouraged and is supported by the Swiss Society of Paediatric Endocrinology and Diabetology. During pregnancy, achieving and maintaining strict glycaemic targets is crucial for reducing pregnancy-related complications. Continuous glucose monitoring and automated insulin delivery improve glycaemic metrics and neonatal outcomes. In older adults, technologies can reduce hypoglycaemia risk and simplify management. For people with type 2 diabetes, continuous glucose monitoring and insulin pumps have shown benefits in glycaemic control, with growing evidence supporting the use of automated insulin delivery systems. The document also highlights the expanding role of telemedicine and remote monitoring. While offering greater accessibility and patient-centred care, these tools raise challenges in terms of digital literacy, interoperability and data protection. Finally, the integration of diabetes and technology into diabetes care requires structured education. Diabetes self-management education and support programmes such as Functional Insulin Therapy (FIT) are essential to help people acquire the knowledge and skills necessary to manage insulin therapy and use diabetes technology effectively and safely. Overall, these recommendations aim to support effective and equitable use of diabetes technology throughout Switzerland and to guide healthcare providers, patients and policymakers towards improving diabetes outcomes
Priorities for medical device regulatory approval: a report from the European Society of Cardiology Cardiovascular Round Table.
No full textThe European Union (EU) Medical Device Regulation increased regulatory scrutiny to improve the safety and performance of new medical devices. An equally important goal is providing timely access to innovative devices to benefit patient care. The European Society of Cardiology strongly advocates for the evolution of the Medical Device Regulation system to facilitate priority access for innovative devices for unmet needs and orphan cardiovascular (CV) medical devices in EU countries. Although device approval is currently executed by Notified Bodies in the EU, it will be advantageous in the mid-term to consider a single EU regulatory agency for devices. In the short term, steps can be taken to transform the current system into a more efficient, predictable, cost-effective, and user-friendly service. Key strategies include the following: enhancing predictability of the approval process through use of early scientific advice from regulators; establishing unique regulatory pathways for CV orphan, paediatric, and innovative devices; promoting more efficient (re)certification of essential legacy CV devices; improving transparency of sponsor interactions with Notified Bodies; expanding the roles of the Expert Panels to assist in the approval of CV devices; promoting global regulatory harmonization, considering streamlined authorization of CV medical technologies across selected jurisdictions; developing an efficient system to monitor device safety; and ensuring funding for data collection platforms. Some strategies that could help include considering a pilot programme for joint approval processes of selected devices in partnership with other regions (i.e. US Food and Drug Administration); developing priority pathways for accelerated access to innovative or orphan devices; and increasing recognition of the importance of early feasibility studies in the EU
Defining competence profiles in obstetrics and gynecology using the modified requirement tracking questionnaire.
No full textData about the competencies needed for physicians in obstetrics and gynecology (O&G) is currently insufficient. The aim of this study is to define the competence profile needed in this sector for daily professional activity, in order to account for these criteria in future recruitment.
The modified requirement-tracking questionnaire (R-track) was sent to 307 physicians working in the field of O&G with different training levels and practice locations. The R-track is designed to assess professional competence profiles and contains 66 items covering the following eight competence areas: "Mental abilities", "Social sensibility", "Psychomotor and multitasking abilities", "Solutions orientation", "Social interactive competences", "Personality traits", "Verbal competences" and "Resistance capacity". The mean scores of single items and competence areas were calculated. Results were compared between gender, training level, and place of practice.
The participation rate was 65.5%, with 201 physicians returning the questionnaire. In this sample, 50.2% of them were in training and 49.8% were practicing O&G specialists. The proportion of physicians working in a hospital setting was 64.7% while 30.3% worked in private practice. The competence areas "Social sensibility" and "Psychomotor & multitasking abilities" appear to be the most important for daily professional activity. At the item level, "Stress resistance", followed by "Workload management" and "Tactfulness" were considered as the most valuable characteristics. Differences between gender, level of training, and place of practice were not significant.
The identified competence profile could serve as a basis for developing a new method of O&G residency selection. In addition, such a profile could help medical students to decide on a professional specialization at a very early stage by comparing their personal competence profile with the one in the field or with their mentors
