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Children's exposure to intimate partner violence (IPV) is a widespread phenomenon that can have detrimental consequences on their health and well-being. This study examined how clinical forensic consultation data of adult victims of IPV might provide information on the potential suffering of children exposed to IPV, the duration of exposure and the knowledge of the situation by the professionals with whom those children were in contact. Data were collected from the consultation files of 112 adult victims of IPV who consulted the Violence Medical Unit at the Lausanne University Hospital (Switzerland) in 2014, and who were parents of children aged 0 through 12. Descriptive quantitative and qualitative analyses were performed. Symptoms of suffering, such as dysregulation of instinctual functions and developmental, behavioral or emotional difficulties, were reported for nearly one-third of the victims' children. Children's exposure to IPV often started around their birth and about four in 10 children had been exposed for three years or more. Health and childhood professionals were unaware of the exposure for the vast majority of the children. Clinical forensic data can be useful in providing information on the suffering and care of children exposed to IPV. Their suffering took the form of a non-specific posttraumatic symptomatology and therefore might be difficult to detect. It is necessary to make professionals and parents aware of the fact that IPV can have a harmful impact on children's health and well-being, and to encourage health professionals to consider the possibility of IPV when facing such symptoms.

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BACKGROUND: The activity theory posits that productive activities are beneficial to older people's well-being. This study examined how quality of life (QoL), globally and in its different dimensions, may be affected by stopping or initiating volunteering, and which psychosocial mechanisms might be at work in such associations. METHOD: This study used an explicative sequential mixed method design: analyses of 2011 and 2016 data from participants to the Lausanne cohort 65+ (n = 1,976, age 68-77 years in 2011) were followed by qualitative analyses of focus groups made of volunteers participating in the same cohort. Quantitative and qualitative results were then integrated to search for explanations of the former by the latter. RESULTS: Stopping (versus maintaining) volunteering was independently associated with higher odds of a decrease in global QoL and in the "self-esteem and recognition" and "autonomy" dimensions. Observed associations were mediated by the satisfaction of transmitting skills and knowledge, of witnessing the progress of the people being helped, and of feeling useful. Volunteering gave participants a sense of structure and taught them new skills. Initiating volunteering (versus not participating) was independently associated with lower odds of a decrease in the "material resources" dimension and experiencing financial problems was believed to hinder volunteering. CONCLUSION: Our findings show a positive impact of volunteering on the self-esteem and autonomy of older adults, suggesting that they should be supported in maintaining their volunteer activities. Further exploration of the relationship between material resources and opportunities to volunteer is needed.

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BACKGROUND: Legal dispositions for advance care planning (ACP) are available but used by a minority of older adults in Switzerland. Some studies found that knowledge of and perception of those dispositions are positively associated with their higher usage. The objective of the present study is to test the hypothesis of an association between increased knowledge of ACP dispositions and a more positive perception of them. METHODS: Data collected in 2014 among 2125 Swiss community-dwellers aged 71 to 80 of the Lausanne cohort 65+ (Lc65+), a population-based longitudinal study on aging and frailty. Data collection was conducted through a questionnaire on knowledge, use and perception of lasting power of attorney, advance directives and designation of a health care proxy. Covariables were extracted from the Lc65+ database. Bivariable and multivariable regression analyses assessed the association between level of knowledge and perception. RESULTS: Half the participants did not know about legal dispositions for ACP; filing rates were 14% for advance directives, 11% for health care proxy and 6% for lasting power of attorney. Level of knowledge about the dispositions was associated with a more positive perception of them, even when adjusting for confounding factors. CONCLUSION: Although the direction of the association's causality needs more investigation, results indicate that better knowledge on ACP dispositions could improve the perception older people have of them. Communication on dispositions should take into account individual knowledge levels and address commonly enunciated barriers that seem to diminish with increased knowledge.

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OBJECTIVES: To examine differences in access to home- and community-based service (HCBS) information among older adults of different functional status. METHODS: Cross-sectional survey of 5435 out of 11,000 randomly selected Swiss older community dwellers from the state of Vaud. Analyses stratified by functional status examined characteristics associated with limited access to HCBS information, based on self-reported knowledge on where to find information on 13 HCBS. RESULTS: Proportionally, more individuals did not know where to look for information in the functionally vulnerable group than in the robust and dependent ones for virtually each service. Among robust individuals, males and persons with low financial status had increased odds of limited access. Low financial status was also negatively associated with access to information among vulnerable people. Belonging to the youngest group increased the odds of limited access for dependent individuals. CONCLUSIONS: Efforts should be made to improve elders' access to HCBS information by developing specific strategies relevant to each functional status group. Further studies on access to HCBS information should be conducted using complex conceptual frameworks as it has been done for HCBS use.

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