E-learning for research capacity strengthening in sexual and reproductive health: the experience of the Geneva Foundation for Medical Education and Research and the Department of Reproductive Health and Research, World Health Organization.

Technological advancement has resulted in the increasing use of e-learning and online education, initially in high-income countries and increasingly in low- and middle-income countries. BACKGROUND: In 2010, the Geneva Foundation for Medical Education and Research, in collaboration with the World Health Organization and partner institutions, developed an online postgraduate course "From Research to Practice: Training Course in Sexual and Reproductive Health Research". This course takes advantage of the advancing Internet technology to provide training opportunities to health professionals mostly from low- and middle-income countries whose access to quality education is constrained by time, financial resources, or both. CASE PRESENTATION: To assess the outcomes of the course, an evaluation was conducted by sending a self-administered questionnaire to graduates of the 2010-2012 programme. The objectives were to determine if the graduates had applied the knowledge gained from the course to their work and whether they had implemented their research project developed during the course. The evaluation also appraised the number of graduates who participated in the design or implementation of a new research project since the course concluded and whether the course had contributed to advancement in their careers. A total of 175 of 219 course graduates answered the questionnaire. The evaluation revealed that the majority of respondents (98%) had utilized the knowledge acquired, with nearly half of them (47%) having published a scientific paper as author or co-author. About a third of respondents (39%) had implemented their course research project and about three quarters of them (74%) have been involved in the design or implementation of a research project after completing the course. Over three quarters (81%) of respondents opined that the course had contributed to their career advancement and almost half of them (46%) had a career promotion as a direct or indirect benefit of the course. CONCLUSION: We surmise that the course positively impacted the participants' knowledge and understanding of sexual and reproductive health, which they applied in their professional work, as well as strengthened their research capacity. Success factors for the e-learning programme include tailor-made content to meet participants' needs, flexibility of access, and ongoing engagement/personal interactivity with course coaches.

[Assisted suicide in Switzerland, a model in the international discussion about medical aid in dying: framework conditions and long-term development of a new societal and medical-ethical phenomenon]. / Der assistierte Suizid in der Schweiz, ein Modell in der internationalen Diskussion zum Thema "Assisted dying".

In the observation period between 1999 and 2022, the Swiss Federal Statistical Office recorded 14 170 assisted suicide (AS) cases. During this 24-year period, the annual number of cases increased significantly: While only 63 cases were observed in 1999, the number of cases in 2022 amounted to almost 1600, corresponding to 2.1 % of all deaths in Switzerland. The most common underlying disease group for AS was cancer, accounting for 40 % of cases. AS is mainly chosen by women (unchanged over time at 58 % of cases) and is primarily a geriatric phenomenon: In 2022, the median age of those who opted for assisted dying was 81 years; the median age of those who chose AS due to cancer was 77 years, while the median age of those who died with non-cancer-related AS was 84 years.

Monitoring the Postnatal Growth of Preterm Infants: A Paradigm Change.

There is no consensus regarding how the growth of preterm infants should be monitored or what constitutes their ideal pattern of growth, especially after term-corrected age. The concept that the growth of preterm infants should match that of healthy fetuses is not substantiated by data and, in practice, is seldom attained, particularly for very preterm infants. Hence, by hospital discharge, many preterm infants are classified as postnatal growth-restricted. In a recent systematic review, 61 longitudinal reference charts were identified, most with considerable limitations in the quality of gestational age estimation, anthropometric measures, feeding regimens, and how morbidities were described. We suggest that the correct comparator for assessing the growth of preterm infants, especially those who are moderately or late preterm, is a cohort of preterm newborns (not fetuses or term infants) with an uncomplicated intrauterine life and low neonatal and infant morbidity. Such growth monitoring should be comprehensive, as recommended for term infants, and should include assessments of postnatal length, head circumference, weight/length ratio, and, if possible, fat and fat-free mass. Preterm postnatal growth standards meeting these criteria are now available and may be used to assess preterm infants until 64 weeks' postmenstrual age (6 months' corrected age), the time at which they overlap, without the need for any adjustment, with the World Health Organization Child Growth Standards for term newborns. Despite remaining nutritional gaps, 90% of preterm newborns (ie, moderate to late preterm infants) can be monitored by using the International Fetal and Newborn Growth Consortium for the 21st Century Preterm Postnatal Growth Standards from birth until life at home.