Life Course Perspective Research Articles

Physical activity promotion as intersectoral planning in Milan Health Protection Agency

Abstract Issue/problem Physical activity is a protective factor for preventing Noncommunicable diseases (NCDs) and, for this reason, it plays an important role in all the different guidelines for prevention and health promotion. The Italian Regional Prevention Plans and in particular the Lombardy one promote physical activity with a systemic approach, through both upstream and downstream actions to encourage the role of communities. Description of the problem Based on the regional plan, the Health Protection Agency (HPA) of the Metropolitan City of Milan developed locally validated actions and best practices for the promotion of physical activity, through the cross-sectoral involvement of different stakeholders (health system, companies, universities, local authorities, sports associations, etc.). Results Physical activity is embedded in all lines of health promotion activities in local planning documents. Sustainable and active mobility activities have been implemented in companies and schools with a comprehensive approach. Validated regional programs (Pedibus, Walking Groups, ecc.) have been implemented in the local community, along with the construction of permanent local laboratories for physical activity, structured through the development of specific territorial networks and providing for integration with the socio-sanitary setting. Lessons Promoting physical activity becomes an opportunity to both consolidate territorial networks and to develop evidence-based health promotion actions able to meet the different health needs of the population and to produce a structural change in living contexts. Key messages • Physical activity is both a protective factor for health promotion and a tool for implementing intersectoral and equity-oriented system actions from a life-course perspective. • Promoting physical activity becomes an opportunity to consolidate territorial networks.

Needs assessment to design a multidisciplinary training programme within the EU-PROMENS project

Abstract Background Mental health as a public health issue warrants a comprehensive prevention-oriented approach whereby capacity building as well as a multisectoral and life-course approach are crucial. The ‘Capacity-building on mental health: multidisciplinary training programme and exchange programme for health professionals,’ project enhances and improves the capacity of professionals across Europe in the field of mental health. Various professionals are targeted 1) health professionals working in the mental health sector, 2) teachers and educators working in the educational setting, 3) social workers working in various community settings and 4) prison staff. Objectives To understand the needs, gaps, obstacles in capacities, competencies, and to build upon existing programmes a mixed methods study, adopting a convergent parallel design is conducted to design and develop the programme. First, a literature review is conducted complemented with interviews, focus group discussions and a survey among various stakeholders to enrich the data. The training will be piloted in The Netherlands, Spain, Czech Republic, Croatia, Finland and Austria. Thereafter it will be rolled out in the 21 remaining EU countries as well as in Norway, Iceland and Ukraine. Results Various gaps and competencies identified from different perspectives build a solid fundament for a comprehensive multidisciplinary training programme tailored to the needs of various professionals within the mental health arena. Preliminary results show that 98 multidisciplinary training programmes exist, with about half containing training materials and limited reports on evaluation. Conclusions The comprehensive needs assessment will assure a multidisciplinary training programme is suitable and relevant for various professionals to ensure a well-designed capacity-building programme. Key messages • Various gaps and needs among various professionals exist. • A comprehensive study strengthens alignment of training to needs and gaps among various professionals.

10.O. Scientific session: Breaking Barriers: Advancing Vaccine Access for Newly Arrived Migrants in Europe

Abstract Health disparities are particularly evident in Europe among Newly Arrived Migrants (NAM), in accessing healthcare systems and navigating vaccination services. The AcToVax4NAM project emerged as a pioneering initiative aimed at identifying solutions to overcome system barriers, following a life-course approach. These solutions consist of a broader strategy to promote organisational vaccination literacy and enhance vaccine uptake among NAM. Employing a participatory approach, the project engaged with professionals FOR health (PFH) and ΝΑΜ to ensure the relevancy of the practices developed, along with the widespread acceptance of proposed solutions and tools tackling access to vaccination services. This workshop is not just about showcasing the outcomes and impact of the AcToVax4NAM project; it’s about equipping PFH with practical tools and strategies that are immediately applicable and will ultimately increase vaccine literacy and uptake. By delving into the challenges encountered, strategies employed, and recommendations formulated, the workshop offers invaluable insights for professionals seeking to address similar issues in their respective contexts. We believe that by sharing our experiences and best practices, we can empower others to make a real difference in their communities. The workshop will contain 5 presentations that follow the functional structure of the project, starting with a presentation on the General Conceptual Framework, the foundational element guiding project activities. Following this, we will discuss the development of a migrant-centered and migrant-sensitive tool aimed at improving the communication skills of PFH by providing definitions of vaccine-related terms in an easily digestible way. The third presentation will detail the development of action-oriented flowcharts across consortium countries validated through focus group discussions with PFH; the flowcharts are linked to a comprehensive repository of 359 tools. The workshop will then explore the consortium’s efforts in providing vaccine literacy and cultural competency training to more than 200 healthcare professionals. Finally, the outcomes of the pilots implemented in consortium countries will be presented, and recommendations will be made that summarize the evidence-based accumulation of improved access to vaccinations for NAM and, consequently, increase vaccine uptake. This workshop fosters dialogue among stakeholders and showcases collaborative efforts to promote vaccination literacy and uptake among NAMs in Europe. Sharing experiences and best practices empowers PFH to address similar challenges in their communities, offering insights into effective strategies for improving healthcare access and promoting health equity. Finally, insights from the presentations and discussions can inform evidence-based policymaking and shape the development of immunization public health strategies at the local, national, and European levels, inspiring real change in communities. Key messages • Equipping Professionals for Health with strategies to Enhance Vaccine Access for Newly Arrived Migrants. • Equity through Collaborative Efforts in Promoting Vaccination among Newly Arrived Migrants.

Developmental Timing of Associations Among Parenting, Brain Architecture, and Mental Health.

Parenting is associated with brain development and long-term health outcomes, although whether these associations depend on the developmental timing of exposure remains understudied. Identifying these sensitive periods can inform when and how parenting is associated with neurodevelopment and risk for mental illness. To characterize how harsh and warm parenting during early, middle, and late childhood are associated with brain architecture during adolescence and, in turn, psychiatric symptoms in early adulthood during the COVID-19 pandemic. This population-based, 21-year observational, longitudinal birth cohort study of low-income youths and families from Detroit, Michigan; Toledo, Ohio; and Chicago, Illinois, used data from the Future of Families and Child Well-being Study. Data were collected from February 1998 to June 2021. Analyses were conducted from May to October 2023. Parent-reported harsh parenting (psychological aggression or physical aggression) and observer-rated warm parenting (responsiveness) at ages 3, 5, and 9 years. The primary outcomes were brainwide (segregation, integration, and small-worldness), circuit (prefrontal cortex [PFC]-amygdala connectivity), and regional (betweenness centrality of amygdala and PFC) architecture at age 15 years, determined using functional magnetic resonance imaging, and youth-reported anxiety and depression symptoms at age 21 years. The structured life-course modeling approach was used to disentangle timing-dependent from cumulative associations between parenting and brain architecture. A total of 173 youths (mean [SD] age, 15.88 [0.53] years; 95 female [55%]) were included. Parental psychological aggression during early childhood was positively associated with brainwide segregation (β = 0.30; 95% CI, 0.14 to 0.45) and small-worldness (β = 0.17; 95% CI, 0.03 to 0.28), whereas parental psychological aggression during late childhood was negatively associated with PFC-amygdala connectivity (β = -0.37; 95% CI, -0.55 to -0.12). Warm parenting during middle childhood was positively associated with amygdala centrality (β = 0.23; 95% CI, 0.06 to 0.38) and negatively associated with PFC centrality (β = -0.18; 95% CI, -0.31 to -0.03). Warmer parenting during middle childhood was associated with reduced anxiety (β = -0.05; 95% CI -0.10 to -0.01) and depression (β = -0.05; 95% CI -0.10 to -0.003) during early adulthood via greater adolescent amygdala centrality. Neural associations with harsh parenting were widespread across the brain in early childhood but localized in late childhood. Neural associations with warm parenting were localized in middle childhood and, in turn, were associated with mental health during future stress. These developmentally contingent associations can inform the type and timing of interventions.

Joining forces to accelerate cancer and NCD prevention in Europe

Abstract JA PreventNCD, a Joint Action to prevent cancer and other non-communicable diseases (NCDs) aims to assist authorities in prioritizing the most effective prevention strategies and policies to reduce the burden of cancer and NCDs, focusing on both personal and societal risk factors. A key objective is to tackle social inequalities by addressing the root causes of NCD risk factors and adopting a life-course approach. Recognizing that health is created by policies in several sectors is key when addressing health determinants, including social and commercial determinants of health. Consolidated efforts across countries will be required to tackle some of these determinants. To achieve the project’s objectives, the JA PreventNCD will build a comprehensive European infrastructure for monitoring risk factors, disease burden, and the impact of policies and interventions. Rigorous evaluation will ensure that the project’s deliverables will have an impact at local, national and EU levels. Three technical work packages address common risk factors for NCDs through actions ranging from policies and structural measures at societal level to interventions targeting individuals. Another set of cross-cutting work packages address monitoring, social inequalities, and health in all policies. More than 100 partners across 25 countries are involved, with almost 100 pilots to be conducted over the course of the project’s four years. One way of ensuring sustainability of the project’s outcomes is the building of a sustainable governance structure through the establishment of an EU Consortium on Cancer Prevention. Furthermore, as a mechanism to ensure high policy relevance of this JA, a Policy Decision Maker’s Forum will be established to engage policymakers and ensure feasibility of the project’s recommended actions. Speakers/Panelists Claudia Habl Austrian National Public Health Institute, Vienna, Austria Ane Fullaondo Biosistemak, Bilbao, Spain Arnfinn Helleve Norwegian Institute of Public Health, Oslo, Norway

Empirical challenges in assessing the “leaky STEM pipeline”: how the research design affects the measurement of women’s underrepresentation in STEM

BackgroundDespite a well-documented underrepresentation of women in STEM majors and occupations, empirical evidence on whether there really is a “leaky STEM pipeline” is mixed due to a lack of methodological consistency. Studies vary by (1) the definition of STEM, (2) the decision to measure choices alone or to also include aspirations, and (3) the use of longitudinal or cross-sectional data.ResultsIn order to analyze how variations in the research design affect the measurement of women’s underrepresentation in the field of STEM, we critically reviewed relevant literature on the “leaky pipeline” and identified three central features in the designs of existing empirical studies. We illustrate how the variation of these affects the results by applying them to the German context. Our results support the “leakage” perspective for Germany only during the transition to the labor market. Changes in STEM aspirations between grades 9 and 12 do not follow a clear pattern. Indeed, a comparison of grade 12 aspirations to actual college major choices even shows an increasing share of women in STEM.ConclusionGermany does not exhibit a significant “leaky STEM pipeline”. Due to more men choosing STEM, gender gaps widen in higher education, while the pipeline remains stable. Therefore, we challenge the “leaky pipeline” metaphor, advocating a life-course perspective to better understand STEM trajectories. We call for refined measurement standards, emphasizing official STEM definitions, long-term observations from aspirations to career entry, and the use of longitudinal data.

Poverty Dynamics and Caries Status in Young Adolescents.

To investigate whether timing, accumulation and trajectories of poverty are associated with dental caries in young adolescents. The study was conducted within the Generation R Study, which is an ongoing population-based prospective cohort study conducted in Rotterdam, the Netherlands. This study included 2653 children. Information about household income and number of children and adults living in a household at six time points from pregnancy to 13 years old was retrieved from parental questionnaires to construct the poverty variable. Dental caries was assessed with the decayed, missing and filled teeth index through intraoral photographs at the age of 13 years. Sociodemographic and oral health-related characteristics were included as possible confounders. The association between poverty and dental caries was analysed on the basis of the three lifecourse theories, that is, critical period, cumulative risk and social mobility model. For the latter, we used latent class growth analysis (LCGA) to identify poverty trajectories over time. Next, the associations were studied with Hurdle Negative Binomial Models. Poverty at birth and intermittent poverty up to the age of 13 were significantly associated with dental caries at 13 years of age (OR 1.41, 95% CI 1.01-1.99; OR 1.36, 95% CI 1.01-1.83 respectively) and with an increased mean number of decayed teeth by 34% (95% CI 1.02-1.76; 95% CI 1.05-1.71, respectively). LCGA showed four trajectories for the probabilities of poverty. All trajectories were significantly associated with dental caries at 13 years of age, with the 'downward mobility' trajectory showing the strongest association with dental caries (OR 1.55, 95% CI 1.05-2.29) and an increasing mean number of decayed teeth by 58% (95% CI 1.18-2.12) than the 'stable absent' trajectory. Poverty at birth, intermittent poverty and downward poverty trajectory were associated with higher odds and higher mean number of decayed teeth at 13 years of age. The three lifecourse models influenced dental caries status during adolescence, hence strategies and policies targeted to improve socioeconomic conditions on deprived children should be implemented.

An Extension to the stress-buffering model: Timing of support across the lifecourse

Children and adolescents exposed to severe stressors exhibit poorer health across the lifespan. However, decades of research evaluating the Stress-Buffering model suggests that social support can attenuate stressors' negative impacts. Psychoneuroimmunology research in this area has shifted from asking whether support buffers stress to when and why support would succeed (or fail) to confer protection. This article takes a lifecourse perspective and proposes that timing of support may shape support's protective value by defining the type of protection that is provided and its operating mechanisms. Specifically, it considers three temporal scenarios: support that occurs during, after, or before stressor exposure. When support intervenes at the same developmental stage as the stressor (concurrent support), buffering effects occur wherein support prevents the development of intermediary mechanisms that reflect or increase disease risk; when support is present at a developmental stage before stressor exposure (prior support), banking effects occur such that support intervenes indirectly by fortifying the individual with resilience-promoting characteristics that in turn prevents the development of intermediary mechanisms; finally, when support arrives at a developmental stage after stressor exposure (later support), counteracting effects occur such that support offsets the impacts of intermediary mechanisms on diseases. It further posits that a match between timing of support and the linkage of interest (e.g., the stressor-mechanism path vs. the mechanism-disease path) is necessary for successful protection. The present paper discusses these postulations, reviews nascent evidence, and proposes future directions.

Childhood adversity and adolescent mental health: Examining cumulative and specificity effects across contexts and developmental timing.

Associations between adversity and youth psychopathology likely vary based on the types and timing of experiences. Major theories suggest that the impact of childhood adversity may either be cumulative in type (the more types of adversity, the worse outcomes) or in timing (the longer exposure, the worse outcomes) or, alternatively, specific concerning the type (e.g., parenting, home, neighborhood) or the timing of adversity (e.g., specific developmental periods). In a longitudinal sample from the Future of Families and Wellbeing Study (N = 4,210), we evaluated these competing hypotheses using a data-driven structured life-course modeling approach using risk factors examined at child age 1 (infancy), 3 (toddlerhood), 5 (early childhood), and 9 (middle childhood). Results showed that exposures to more types of adversity for longer durations (i.e., cumulative in both type and timing) best predicted youth psychopathology. Adversities that occurred at age 9 were better predictors of youth psychopathology as compared to those experienced earlier, except for neglect, which was predictive of internalizing symptoms when experienced at age 3. Throughout childhood (across ages 1-9), aside from the accumulation of all adversities, parental stressand low collective efficacy were the strongest predictors of internalizing symptoms, whereas psychological aggression was predictive of externalizing symptoms.

Maternal dietary practices during pregnancy and obesity of neonates: a machine learning approach towards hierarchical and nested relationships in a Tibet Plateau cohort study.

Studies on obesity and risk factors from a life-course perspective among residents in the Tibet Plateau with recent economic growth and increasing obesity are important and urgently needed. The birth cohort in this area provides a unique opportunity to examine the association between maternal dietary practice and neonatal obesity. The study aims to detect the prevalence of obesity among neonates, associated with maternal diet and other factors, supporting life-course strategies for obesity control. A cohort of pregnant women was enrolled in Tibet Plateau and followed till childbirth. Dietary practice during pregnancy was assessed using the Chinese FFQ - Tibet Plateau version, food items and other variables were associated with the risk for obesity of neonates followed by logistic regression, classification and regression trees (CART) and random forest. Of the total 1226 mother-neonate pairs, 40·5 % were Tibetan and 5·4 % of neonates with obesity. Consuming fruits as a protective factor for obesity of neonates with OR (95 % CI) = 0·61 (0·43, 0·87) from logistic regression; as well as OR = 0·20 (0·12, 0·35) for consuming fruits (≥ weekly) from CART. Removing fruit consumption to avoid overshadowing effects of other factors, the following were influential from CART: maternal education (more than middle school, OR = 0·22 (0·13, 0·37)) and consumption of Tibetan food (daily, OR = 3·44 (2·08, 5·69). Obesity among neonates is prevalent in the study population. Promoting healthy diets during pregnancy and strengthening maternal education should be part of the life-course strategies for obesity control.

Childhood Socioeconomic Status Affects Dental Pain in Later Life.

Lower socioeconomic status (SES) is associated with increased dental pain among children. Lower SES in childhood may also contribute to the experience of dental pain among older adults, regardless of the SES in later life. However, this association is still unclear. We used cross-sectional data from the 2019 Japan Gerontological Evaluation Study using self-administrated questionnaires to investigate the causal mediating pathways between childhood SES and dental pain in later life using several SES variables collected at older age as potential mediators. A total of 21,212 physically and cognitively independent participants aged 65 y or older were included in the analysis. The dependent variable was experiencing dental pain during the past 6 mo. The independent variable was the SES at the age of 15 y (low/middle/high). Ten covariates were selected covering demographics and other domains. Education, subjective current income, objective current income, objective current property ownership, and the number of remaining teeth were used as mediators. Prevalence ratios (PRs) and 95% confidence intervals (95% CIs) for dental pain by childhood SES were calculated using a modified Poisson regression model. The mean age of the study participants was 74.5 ± 6.2 y, and 47.5% were men. Of these, 6,222 participants (29.3%) experienced dental pain during the past 6 mo, and 8,537 participants (40.2%) were of low childhood SES. Adjusted for covariates and mediators, the participants with middle and high childhood SES had a lower PR of dental pain (PR = 0.93 [95%, CI 0.89-0.98], PR = 0.79 [95% CI, 0.73-0.85], respectively). Almost 40% of the association between childhood SES and dental pain at older age was mediated via SES in later life and the number of teeth. This study reemphasizes the importance of support for early-life SES to maintain favorable oral health outcomes at an older age. The results of this study can be used by policymakers to promote policies based on a life-course approach that supports children living in communities with low SES and helps them maintain favorable oral health outcomes into their older age.

Bringing Children to the Center of Migration Theory

Migration theory is adult-centric, failing to account for the experiences of children despite their increasingly important participation in migration flows. Using a life-course perspective and findings from research at the intersection of childhood studies and migration, this paper considers whether different migration theories apply to child migration as compared to adult migration. We examine this question using the Mexican Migration Project data to track the cross-border moves of 109,096 individuals relative to their family members. We find that theories from economics best explain migration among young adults, with some participation from older adolescents, while children of all ages are sensitive to educational opportunities and the behavior of their peers and role models. Insights from the cultural turn and feminist theorizing in migration studies explain migration for both groups. We find that adult and child migration is strongly conditioned on migrant networks and family dynamics, including ties to family members in destination and family structure and caretaking arrangements in origin. We argue that child-centered analyses advance migration theory by highlighting the role of age, the life-course, and intergenerational family dynamics as determinants of international migration.

Career agency of immigrants participating in employment interventions in Norway

ABSTRACT In this study, we apply a theoretical framework that combines the life-course perspective and the concept of temporality to explore the career agency of immigrants participating in employment interventions in Norway. Findings suggest that immigrants’ career agency is influenced by several factors, including the management of family duties and temporal asynchronies; career history and temporal liminality; and coping with past traumas and temporal suspension. Immigrants might overlook job opportunities due to family obligations or opt for low-skilled professions, seeking an exit from temporal liminality. The endured traumas, followed by temporal suspension, prompt the pursuit of the employment opportunities that are less mentally taxing. Our study highlights the need for employment counselling that acknowledges the effects of disrupted life courses and temporality on immigrants’ career agency. By comprehending clients’ experiences of temporal challenges, counsellors can create tailored strategies and advice that resonate with clients’ lived experiences and current social context.

Water fetching and musculoskeletal health across the life-course in Sub-Saharan Africa: A scoping review.

The world is experiencing a global water crisis and Sub-Saharan Africa (SSA) is expected to be a hotspot for increasing global water scarcity in years to come. Water is quintessentially a gendered issue; indeed, sociocultural norms hold women responsible for household water collection, requiring them to travel far distances while carrying water. This paper reports the findings of a scoping review of peer-reviewed and grey literature that examines the relationship between water fetching and the musculoskeletal (MSK) health of women in SSA. The work is informed by a gendered life-course perspective, and the authors follow the PRISMA-ScR guidelines. Results indicate a bidirectional relationship between water fetching and poor MSK health as chronic and acute incidences of water carrying are highly related to MSK pain and dysfunction. This has negative implications for the overall health and wellbeing of women and their households. Gaps in the literature are identified, including the experiences of elderly people and people with various vulnerabilities. Recommendations from the literature are compiled to outline potential avenues of future research and innovation to better support the MSK health of water fetchers in SSA.

Prevalence and socio-demographic factors associated with double and triple burden of malnutrition among mother-child pairs in India: Findings from a nationally representative survey (NFHS-5)

IntroductionImproper consumption of food leads to various forms of malnutrition such as undernutrition, overnutrition and micronutrient deficiency. The coexistence of various malnutrition forms in the same household is a public health concern in developing countries. Very little research has been done on exploring the burden and risk factors associated with double (DBM) and triple burden of malnutrition (TBM). MethodsSecondary analysis was done using data from India's National Family Health Survey-5 (NFHS-5), 2019-21. Mothers and under-five children were paired at the household level as a unit of analysis. DBM and TBM were interpreted from children's height-for-age, weight-for-height, weight-for-age and anaemia status and mothers' body-mass-index. Stratification and clustering in the sample design were accounted for during the analysis in STATA v14.2. DBM and TBM were summarized as weighted proportions with 95 % confidence interval (CI) and the risk factors associated were reported as adjusted odds ratio (aOR) with 95%CI using mixed effects logistic regression. ResultsWe included 167,380 mother-child pairs for analysis. In India, the prevalence of DBM was 7.7 % (95 % CI: 7.5–7.9 %) and TBM was 5.1 % (5.0–5.3 %) at the household level among mother-child dyads. Mothers' age, age at first birth, educational levels, current breastfeeding habits, mode of delivery, child's age, gender, twin birth, birth weight, geographical region, residence, caste and religion, and wealth index were associated with both DBM and TBM. ConclusionBoth DBM and TBM are public health concerns in India. Thus, scaling-up of health intervention, effective implementation of nutritional programmes and life-course approach are needed to control malnutrition.

Nutrition, Other Environmental Influences, and Genetics in the Determination of Human Stature.

Linear growth during three distinct stages of life determines attained stature in adulthood: namely, in utero, early postnatal life, and puberty and the adolescent period. Individual host factors, genetics, and the environment, including nutrition, influence attained human stature. Each period of physical growth has its specific biological and environmental considerations. Recent epidemiologic investigations reveal a strong influence of prenatal factors on linear size at birth that in turn influence the postnatal growth trajectory. Although average population height changes have been documented in high-income regions, stature as a complex human trait is not well understood or easily modified. This review summarizes the biology of linear growth and its major drivers including nutrition from a life-course perspective, the genetics of programmed growth patterns or height, and gene-environment interactions that determine human stature in toto over the life span. Implications for public health interventions and knowledge gaps are discussed.

Ovarian Cancer Risk Prediction - a Clinical Epidemiology Perspective.

Ovarian cancer is a rare and highly heterogeneous disease usually detected at late stages when outcomes are poor. Population-based screening approaches have not been successful at reducing ovarian cancer mortality, but preventive bilateral salpingo-oophorectomy is highly effective at preventing ovarian cancer in high-risk populations. Ovarian cancer risk prediction models may allow identification of populations at increased risk of ovarian cancer for preventive interventions or targeted early detection. We propose a life-course approach to ovarian cancer risk prediction based on the time at which a risk model should be applied and the risk factors that are available. The discriminative ability of ovarian cancer risk prediction models published so far is limited, with areas under the curve ranging from 0.58-0.65 for different combinations of risk factors and genetic susceptibility markers. Currently proposed absolute risk thresholds for preventive surgery are around 4% lifetime risk. The absolute risk predicted by ovarian cancer risk models ranges from 0.6-2.5% lifetime risk in the general population, highlighting the need to improve ovarian cancer risk prediction models and evaluating new preventive approaches that can be offered to individuals at lower risk.

Sugar-Sweetened Beverages and Diet Related Chronic Non-Communicable Diseases in Sub-Saharan Africa

abstract In Sub-Saharan Africa (SSA), diet-related chronic non-communicable diseases (DR-CNCDs) pose a growing public health threat, jeopardising progress towards achieving Sustainable Development Goal 3.4. One contributing factor to this rising threat is the recent surge in consumption of sugar-sweetened beverages (SSBs), across SSA in recent years. Using the socio-ecological model, this commentary explores the nexus between DR-NCDs and SSBs and offers interventions to address this public health challenge at the individual, interpersonal, community, organisational and policy levels. At the individual level, health education campaigns should target individuals and ensure an increase in awareness creation. The life-course approach underscores the importance of promoting healthier dietary choices from childhood to prevent diet-related non-communicable diseases in later life. Schools and workplaces enforcing local policies that discourage SSB consumption patterns will make a huge difference at the community and organisational levels. At the societal/policy level, comprehensive strategies such as sugar taxes, front-of-pack labelling, advertising restrictions and health education programmes are crucial.

Lifestyle, Cognitive, and Psychological Factors Associated With a Resilience Phenotype in Aging: A Multidimensional Approach on a Population-Based Sample of Oldest-Old (80+).

To investigate the determinants of resilience phenotype in aging, operationalized as the maintenance of cognitive, physical, and psychological health in very old individuals (80+), we investigated the structure and interrelated impact of the main resilience-enhancing factors, which are usually studied in separate research fields. Participants were older adults without dementia recruited for the fifth wave of the InveCe.Ab population-based cohort study (aged 83-87 years). Multidimensional evaluation comprised blood sampling, social and lifestyle survey, and geriatric and neuropsychological assessment. We classified resilient individuals as displaying normal cognition, functional independence, and mental health. First, we performed exploratory factor analysis (EFA) to examine the underlying structure of the relevant cognitive, lifestyle, physical, and psychological resilience-enhancing factors. The factors obtained were included as predictors of the resilience phenotype in the logistic regression model, controlling for sociodemographic and cumulative exposure to physical and psychosocial stressors, including COVID-19 infection. Among the 404 enrolled participants, 153 (38%) exhibited the resilience phenotype. EFA resulted in the identification of six factors (59% of variance): cognitive reserve, affective reserve, insecure attachment, current lifestyle, physical reserve, and avoidant attachment. Among these factors, cognitive reserve, affective reserve, and current lifestyle significantly and independently predicted resilience status, controlling for cumulative exposure to age-related stressors and COVID-19 infection. Our findings showed that, even in very old age, both early and late life modifiable factors affect individuals' ability to adapt to the aging process, thus confirming the importance of a life-course approach to improve health outcomes in the aged population. NCT01345110.

The English-language learning difficulties of older migrants in New Zealand: A life course perspective

ABSTRACT Older migrants are often later-life language learners by necessity. While the bulk of extant research on older language learners focuses on those who elect language learning as a constructive leisure pursuit, for older migrants with low proficiency in the dominant host country language, progress in language learning is a key factor that contributes to their independence, social inclusion, and well-being. Drawing on the life-course perspective, this article examines the language-learning difficulties (LLDs) of older Chinese migrants in New Zealand who have attended English courses, and who need basic communicative language ability in their daily lives. We identified three main life-course related factors that contribute to their language-learning difficulties and detract from their commitment to formal learning. These LLDs result from perceived shortcomings in individuals’ prior educational background, factors related to individuals’ current circumstances that impact their sense of agency, and unsatisfactory current formal learning experiences. We offer recommendations aimed at improving formal learning opportunities for this learner group.