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Older adults are at a high risk for loneliness, and community-based interventions can help reduce loneliness for all older adults in a community, regardless of their migration status. However, little research has investigated how older adults, including locals and migrants (in this case, internal newcomers and international expats) participate in these interventions. The “Neighbourhoods in Solidarity” (NS) are a series of community-based interventions that aim to increase social connectedness and reduce loneliness in older adults (55+) in the canton of Vaud, Switzerland. This longitudinal embedded mixed-methods study aimed to understand whether older adults (distinguishing between locals, newcomers, and expats) were aware of and participated in the NS, to assess whether participation was associated with changes in loneliness, and to identify relevant processes that could explain a reduction in loneliness. We combined a longitudinal pre/post survey (235 respondents) with ethnographic observations and informal interviews. Quantitative findings showed that individuals who participated in the NS did not have significant changes in loneliness. Qualitative findings showed that perceived migration played an important role in who participated, and that the community distinguished between two types of migrants: newcomers who spoke French fluently, and expats who did not. Individuals were only ‘local’ if they had ancestors from the town. Some newcomers and some locals used the NS as a platform to build a new sense of community within the NS, whereas expats rarely participated. This was due to linguistic and cultural determinants, institutional constraints, interpersonal relationships, and personal preferences.

Background The ongoing Syrian civil war has led to massive population displacements, leading to the reorganization of the asylum policies of several countries. Accordingly, like other European countries, the Swiss government has recently chosen to implement a specific resettlement program. This program is characterized by the fact that the whole nuclear family is granted a work and residence permit upon arrival, and benefits from enhanced integration services. The aim of the present project is to evaluate the effects of the Swiss resettlement program, with a special focus on mental health, while adopting a family perspective. Methods The outcomes of 15 Syrian families taking part in this program will be compared to those of 15 Syrian families that came to Switzerland through other means (i.e., following the usual asylum procedure, which is much more stressful and time consuming). Each family member above 8 years old will be invited to participate to a 3-wave longitudinal survey concerning the resettlement process: upon arrival in the collective shelters, six and 12 months later. Questionnaires will be used for the evaluation of participants’ mental health, risk behaviors, general health, romantic relationship, parent-child relationship, family functioning, parentification, social support, and social identities related to group belongingness. Discussion The findings of the present project will provide longitudinal information on Syrian refugees. A comprehensive approach will be adopted by screening potential difficulties that the sample may be faced with and potential strengths that participants may rely on. Accordingly, physical and mental health, as well as the quality of family functioning, the feeling of support and of belongingness to different groups will be evaluated. We will also compare the results of families who had the chance to immigrate through the Swiss resettlement program, to the results of families that did not. This comparison will allow the elaboration of hypotheses regarding adjusted asylum policies. Furthermore, it will enhance our knowledge regarding the impact of displacement on the family system. Indeed, although the role of the family for the well-being of adults and children has been established, surprisingly few studies have adopted this focus in the asylum field.

Frailty is a core concept in understanding vulnerability and adjustment to stress in older adults. Adopting the perspective provided by the transactional model of stress and coping (Lazarus and Folkman in Stress, appraisal, and coping, Springer, New York, 1984), the present study examined three aspects of frailty in older adults: (1) the link between frailty and perceived stress exposure (PSE); (2) the link between frailty and stress-related symptoms (SRS); and (3) the role of frailty in the link between PSE and SRS. Participants were 2711 adults aged between 64 and 101 years who were taking part in the Swiss Vivre/Leben/Vivere study. As well as assessing frailty, we measured PSE and SRS during the 4 weeks preceding the administration of the questionnaires, together with the covariates age, sex, educational attainment, language of the canton, and type of canton (urban vs. rural). Regression analyses revealed higher levels of PSE in frail older adults than in non-frail older adults. In addition, frail older adults reported more SRS than non-frail older adults. As expected, the association between PSE and SRS differed as a function of the frailty status: The positive relation between PSE and SRS being stronger for frail older adults than for non-frail older adults. These results suggest that frailty is related to perceived discrepancy between resources and demands, and to ability to cope with PSE. Our findings have implications for interventions to help frail older adults manage stress.

Patients' response to dual antiplatelet therapy (DAPT) is subject to variations and its monitoring allows to individualize this therapy. In this study, we evaluated if a strategy of tailored DAPT after platelet function testing could reduce high on-treatment platelet reactivity (HPR) and improve outcome of patients treated with stent implantation. In 257 patients undergoing percutaneous angioplasty, platelet function was measured by light transmittance aggregometry (LTA) using 10 µM/L adenosine-diphosphate (ADP) and 1 mM arachidonic acid (AA) as agonists. Patients with HPR by ADP (≥70%) were switched to double-dose clopidogrel, ticlopidine, prasugrel or ticagrelor; in patients with HPR by AA (≥20%) acetylsalicylic acid dose was increased if not contraindicated. Platelet function analysis was repeated 48 hours after therapy variation. At 20-month follow-up major adverse cardiovascular events (MACE) and bleedings were assessed. HPR was detected in 97/257 (37.7%) patients: 69/257 (26.8%) had HPR by ADP and 71/257 (27.6%) had HPR by AA. In patients with HPR by ADP or by AA, tailored DAPT determined a significant reduction in residual platelet reactivity. No significant difference in MACE or bleeding occurrence was documented in HPR patients treated with tailored DAPT vs. those without HPR. HPR patients treated with tailored DAPT had significant lower follow-up MACE and deaths vs. 139 HPR patients not switched, even after propensity score analysis. These results suggest that a DAPT tailored on platelet testing can improve antiplatelet response in HPR patients, possibly reducing their thrombotic events to a level similar to non-HPR patients, without increasing the risk of bleeding.

In March 2004 the French parliament controversially adopted legislation regulating the wearing of symbols indicating religious affiliation in public educational establishments. This note discusses several features of the new law indicating its origins, its rationale and its position within French constitutional discourse on religious freedom and secularity. It is based on a panel discussion held in April 2004 within the Gender Studies Programme at the Robert Schuman Centre for Advanced Studies, European University Institute, Florence. Placing the French legislative initiative in the context of recent developments in national and European case law (suggesting clear limitations to freedom of religion), the note explores the complexity of issues of gender, identity and difference in the present debate, especially when considered in the light of reactions to the law in Islamic countries.

Total or subtotal parathyroidectomy is considered the treatment of choice for multiple endocrine neoplasia type I (MEN-I)-associated primary hyperparathyroidism (HPT). However, persistent or recurrent HPT is frequently observed. The development of a rapid two-site immunoradiometric assay (IRMA) method for measuring intact parathormone (PTH) has provided a valuable tool for recognizing possible surgical failures. Our experience includes 16 MEN-I patients (10 females, 6 males) of mean age 35.5 years operated on between 1990 and 1996. Total parathyroidectomy (TPTX) with autotransplantation of parathyroid tissue was the standard treatment. Blood samples for PTH measurement were drawn at the induction of anesthesia (basal value), 10 and 20 minutes after the removal of each gland, and 60 minutes after TPTX. Rapid PTH measurement, which required only 15 minutes of incubation at 37 degrees C, showed a highly significant correlation (p0.0001) with the standard method. Circulating PTH levels exhibited a stepwise decrease during TPTX, reaching a mean value of 22.3% of the baseline 20 minutes after removal of the last gland. Two patients showed a prompt decrease of PTH after removal of the single enlarged gland, featuring the kinetics observed in the adenomas. One of these two patients was successfully treated with more conservative surgery. None of the patients showed persistence or recurrence of HPT. In our experience, intraoperative measurement of PTH seems to be a valuable adjunct in both the diagnosis of multiglandular involvement and the prediction of surgical treatment in patients with primary parathyroid hyperplasia.

A 32-year-old homosexual Caucasian male presented withan asymptomatic lesion in the right maxilla that he noticed6 monthsearlier.Hispastmedicalhistoryrevealeduntreatedhuman immunodeficiency virus (HIV) seropositivity detec-ted3 yearsearlier.Bloodteststakenatpresentationrevealeda high viral load (5.12 log10–131,300 copies/ml) and a lowCD4-T cell count (39 cells/mm

Photoautotrophic picoplankton is reported from some lakes located near the Italian Antarctic station of Terra Nova. Observations, carried out by both flow cytometry on water samples and electron microscopy on micro-organisms in cultures from each lake, have confirmed the occurrence in all the environments studied of this fraction accounting, in several cases, for more than the 50% of the phytoplankton, measured as chlorophyll. Cultures of the picoplankton fraction from these waters contained known prokaryotic (Synechococcus) and eukaryotic (Chlorella) genera as well as two unidentified entities, possibly prochlorophytes.