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Background Postpartum home-based midwifery care is covered by basic health insurance in Switzerland for all families with newborns but must be self-organized. To ensure access for all, Familystart, a network of self-employed midwives, launched a new care model in 2012 by ensuring the transition from hospital to home through cooperation with maternity hospitals in the Basel area. It has particularly improved the access to follow-up care for families in vulnerable situations needing support beyond basic services. In 2018, the SORGSAM (Support at the Start of Life) project was initiated by Familystart to enhance parental resources for better postpartum health outcomes for mothers and children through offering improved assistance to psychosocially and economically disadvantaged families. First, midwives have access to first-line telephone support to discuss challenging situations and required actions. Second, the SORGSAM hardship fund provides financial compensation to midwives for services not covered by basic health insurance. Third, women receive financial emergency support from the hardship fund. Aim The aim was to explore how women living in vulnerable family situations experienced the new early postpartum home-based midwifery care model provided in the context of the SORGSAM project, and how they experienced its impact. Methods Findings are reported from the qualitative part of the mixed-methods evaluation of the SORGSAM project. They are based on the results of seven semi-structured interviews with women who, due to a vulnerable family postpartum situation at home, received the SORGSAM support. Data were analyzed following thematic analysis. Results Interviewed women experienced the early postpartum care at home, as “relieving and strengthening” in that midwives coordinated patient care that opened up access to appropriate community-based support services. The mothers expressed that they felt a reduction in stress, an increase in resilience, enhanced mothering skills, and greater parental resources. These were attributed to familiar and trusting relationships with their midwives where participants acknowledged deep gratitude. Conclusion The findings show the high acceptance of the new early postpartum midwifery care model. These indicate how such a care model can improve the well-being of women in vulnerable family situations and may prevent early chronic stress in children.

Late results in 278 consecutive patients with unilateral deep vein thrombosis treated with streptokinase or heparin/dicoumarol were analysed as to mortality rate, recurrent thrombo-embolism and incidence of postthrombotic syndrome (PTS). The five-year mortality rate was three times as high as that of the age-matched population. The overall mortality rate was 16%, more than half the patients dying of tumour, males largely of gastric or bronchial carcinoma, females of urogenital carcinoma. Thrombo-embolism had recurred in 14% of 204 patients who had been re-examined, in 9% thrombosis, in 3% pulmonary embolism, and in 2% both. A PTS without ulcer had developed in 16%, an ulcer in 8%. The PTS incidence correlated with the original extent of the thrombosis: no PTS if the thrombosis had been confined to the lower-leg axis, but 34% after four-level thrombosis. The data confirm the importance of thrombo-embolism prophylaxis, early diagnosis and subsequent treatment with anticoagulants and compression.

5 yr follow-up of 341 patients with special consideration of post-thrombotic syndrome (PTS) and methodolo-cigal difficulties.INTRODUCTIONMethodological difficulties responsable for lacking unité de doctrine: (a) Acute phase: random allocation taking into account DVT of different extent; assessment of effect of treatment (b) Follow-up: drop out definition of parameters of success esp. PTS, comparison of truely comparable groups, limited information about economic aspects.5 yr FOLLOW-UP PTS-INCIDENCE after ANTICOAGULATION (AC) or THROMBOLYSIS (TL)Method: 341 non-randomized, consecutive patients; unilateral DVT documented by initial and control-phlebo-gramm ( 10= PTSResults:1. Group with unchanged initial and control phlebogrammCorrelation between DVT-extent at entry and PTS-incidence (table). Consequently comparison of AC and TL must be made between subgroups with similar DVT-extent at entry.2. Subgroups with clearance ( + ) vs. non-clearance ( - ):Figures white PTS without ulcera, black leg ulcer

Although evidence for the heterogeneity of asthma accumulated, consensus for definitions of asthma phenotypes is still lacking. Obesity may have heterogeneous effects on various asthma phenotypes. We aimed to distinguish asthma phenotypes by latent class analysis and to investigate their associations with different obesity parameters in adults using a population-based Swiss cohort (SAPALDIA). We applied latent class analysis to 959 self-reported asthmatics using information on disease activity, atopy, and age of onset. Associations with obesity were examined by multinomial logistic regression, after adjustments for age, sex, smoking status, educational level, and study centre. Body mass index, percent body fat, waist hip ratio, waist height ratio, and waist circumference were used as obesity measure. Four asthma classes were identified, including persistent multiple symptom-presenting asthma (nÂ=Â122), symptom-presenting asthma (nÂ=Â290), symptom-free atopic asthma (nÂ=Â294), and symptom-free non-atopic asthma (nÂ=Â253). Obesity was positively associated with symptom-presenting asthma classes but not with symptom-free ones. Percent body fat showed the strongest association with the persistent multiple symptom-presenting asthma. We observed heterogeneity of associations with obesity across asthma classes, indicating different asthma aetiologies.