Lifelong Health Research Articles

200 Reflections on Ireland’s Physical Literacy Journey

Abstract Purpose Recognition of the importance of physical literacy (PL) in promoting lifelong physical activity, health, and well-being stems from the early beginnings of work in the early 2000s. This paper aims to explore the development of physical literacy in Ireland and Northern Ireland over the past 20 years. Policy Description Since the early 2000s, on the Island of Ireland, education, sport bodies, local authorities and researchers were progressive and innovative in developing a range of physical literacy (PL) projects. Work was initially disjointed. In 2009, collaboration between Sport Ireland and Sport NI established the Lifelong Involvement in Sport and Physical Activity framework and the cross sectoral PL Task and Finish Group marked a more strategic, evidenced-based and cooperative approach to PL developments. More recently, several university-based PL research initiatives have developed and evaluated programmes, including Y-Path, Project FLAME, and Moving Well-Being Well. The Active School Programme and Curriculum Sport Programmes in Northern Ireland gained traction. Unfortunately, PL developments continue to be hampered by a lack of cross-sectoral coordination and sustainable funding, leading to some flagship developments being stalled. Latterly, attempts have been made to integrate PL into national and regional policies related to education, health, and sport e.g. Active Living - the new Sport and Physical Activity Strategy for Northern Ireland (Department of Communities NI) and The Healthy Ireland – ‘Get Ireland Active’, National Activity Plan for Ireland. Most recently, a key milestone was the development of the All-Island Physical Literacy Consensus Statement, the first of its kind in Europe and uniquely covers two jurisdictions. This statement provides opportunities for implementation at an individual, organisational, and systemic levels to promote effective advocacy and development of PL in Ireland and Northern Ireland. Conclusions By examining the background, early policy, research, programmes, the process of developing a consensus statement, the current position in policy, and the challenges for implementation, this paper aims to contribute to the understanding of physical literacy promotion in the region. It also offers valuable insights and recommendations for future efforts to enhance physical literacy and improve the health and well-being of individuals in Ireland and Northern Ireland.

The ontogeny of human fetal trabecular bone architecture occurs in a limb-specific manner

Gestational growth and development of bone is an understudied process compared to soft tissues and has implications for lifelong health. This study investigated growth and development of human fetal limb bone trabecular architecture using 3D digital histomorphometry of microcomputed tomography data from the femora and humeri of 35 skeletons (17 female and 18 male) with gestational ages between 4 and 9 months. Ontogenetic data revealed: (i) fetal trabecular architecture is similar between sexes; (ii) the proximal femoral metaphysis is physically larger, with thicker trabeculae and greater bone volume fraction relative to the humerus, but other aspects of trabecular architecture are similar between the bones; (iii) between 4 and 9 months gestation there is no apparent sexual or limb dimorphism in patterns of growth, but the size of the humerus and femur diverges early in development. Additionally, both bones exhibit significant increases in mean trabecular thickness (and for the femur alone, bone volume fraction) but minimal trabecular reorganisation (i.e., no significant changes in degree of anisotropy, connectivity density, or fractal dimension). Overall, these data suggest that in contrast to data from the axial skeleton, prenatal growth of long bones in the limbs is characterised by size increase, without major reorganizational changes in trabecular architecture.

A mixed methods study of early childhood providers’ perceptions of the acceptability and feasibility of parenting for lifelong Health tip sheets in Ontario, Canada

BackgroundUniversal parenting campaigns are efficient, cost-effective and can eliminate barriers to accessing conventional, face-to-face parenting interventions. The aims of the CHAMPP4KIDS study were to assess Canadian early childhood providers’ perceptions of the acceptability and feasibility of implementing a universal parenting resource, the Parenting for Lifelong Health tip sheets.MethodsUsing a convergent mixed method design, an online survey of providers working with families with young children in Ontario, Canada was followed by focus group discussions with a subset of providers to explore their perceptions of using the tip sheets in their professional practice.ResultsProviders generally perceived the tip sheets to be acceptable but had reservations with respect to the feasibility of distributing the sheets to their clients as standalone, universal parenting resources. Providers agreed the tip sheets covered topics pertinent to caregivers’ concerns, offered useful strategies and, therefore, had the potential to be valuable, engaging resources for families. However, many providers said the sheets would only be effective as complementary resources to facilitated in-person sessions, especially for high-needs families.ConclusionProviders suggested that future iterations of these resources take into consideration more accessible design and formatting, literacy levels, word choice and further cultural adaptation. Insight into the nuances and potential divergence between provider perceptions of universal materials’ acceptability and feasibility can help adapt materials to pre-emptively respond to potential implementation barriers, facilitate intervention fidelity and, ultimately, increase the likelihood of intervention acceptability and feasibility of both providers and caregivers.

Preterm birth risk stratification through longitudinal heart rate and HRV monitoring in daily life

Preterm birth (PTB) remains a global health concern, impacting neonatal mortality and lifelong health consequences. Traditional methods for estimating PTB rely on electronic health records or biomedical signals, limited to short-term assessments in clinical settings. Recent studies have leveraged wearable technologies for in-home maternal health monitoring, offering continuous assessment of maternal autonomic nervous system (ANS) activity and facilitating the exploration of PTB risk. In this paper, we conduct a longitudinal study to assess the risk of PTB by examining maternal ANS activity through heart rate (HR) and heart rate variability (HRV). To achieve this, we collect long-term raw photoplethysmogram (PPG) signals from 58 pregnant women (including seven preterm cases) from gestational weeks 12–15 to three months post-delivery using smartwatches in daily life settings. We employ a PPG processing pipeline to accurately extract HR and HRV, and an autoencoder machine learning model with SHAP analysis to generate explainable abnormality scores indicative of PTB risk. Our results reveal distinctive patterns in PTB abnormality scores during the second pregnancy trimester, indicating the potential for early PTB risk estimation. Moreover, we find that HR, average of interbeat intervals (AVNN), SD1SD2 ratio, and standard deviation of interbeat intervals (SDNN) emerge as significant PTB indicators.

Balancing Acts: Tackling Data Imbalance in Machine Learning for Predicting Myocardial Infarction in Type 2 Diabetes.

Type 2 Diabetes (T2D) is a prevalent lifelong health condition. It is predicted that over 500 million adults will be diagnosed with T2D by 2040. T2D can develop at any age, and if it progresses, it may cause serious comorbidities. One of the most critical T2D-related comorbidities is Myocardial Infarction (MI), known as heart attack. MI is a life-threatening medical emergency, and it is important to predict it and intervene in a timely manner. The use of Machine Learning (ML) for clinical prediction is gaining pace, but the class imbalance in predictive models is a key challenge for establishing a trustworthy deployment of the technology. This may lead to bias and overfitting in the ML models, and it may cause misleading interpretations of the ML outputs. In our study, we showed how systematic use of Class Imbalance Handling (CIH) techniques may improve the performance of the ML models. We used the Connected Bradford dataset, consisting of over one million real-world health records. Three commonly used CIH techniques, Oversampling, Undersampling, and Class Weighting (CW) have been used for Naive Bayes (NB), Neural Network (NN), Random Forest (RF), Support Vector Machine (SVM), and Ensemble models. We report that CW overperforms among the other techniques with the highest Accuracy and F1 values of 0.9948 and 0.9556, respectively. Applying the most appropriate CIH techniques for the ML models using real-world healthcare data provides promising results for helping to reduce the risk of MI in patients with T2D.

Effectiveness of Different Oral Health Interventions on Plaque and Gingivitis Incidence in Children Under Seven Years of Age: A Systematic Review and Meta-Analysis.

Oral health is crucial for young children, yet plaque and gingivitis pose significant challenges. This review evaluates oral health interventions for children under seven years to identify effective strategies. A systematic review was conducted across multiple databases using predefined criteria. Thirteen thousand five hundred records were identified, with 13 studies meeting the inclusion criteria. Various interventions were assessed, including tactile models, digital tools, fluoride varnish, and education programs. The meta-analysis showed heterogeneity in outcomes, with some interventions significantly reducing plaque and gingivitis. Tactile models and digital tools demonstrated effectiveness, particularly among children who were visually impaired and had congenital heart defects. However, fluoride varnish showed mixed results. School-based interventions and advanced toothbrushing technologies effectively reduce early childhood caries and plaque. Despite publication bias, a low risk of bias was observed across studies. The findings underscore the importance of tailored interventions and collaboration among stakeholders. Comprehensive oral health education, innovative digital tools, and multifaceted approaches are recommended to promote lifelong oral health habits. Further research is needed to standardize protocols and assess long-term effectiveness. Evidence-based interventions can significantly improve oral health outcomes for children under seven, laying the foundation for lifelong oral health.

Abstract 26: Influence of Blood Type in Umbilical Cord Blood Immune Cell Profile

Abstract Introduction Human immune system undergoes a remarkable journey from embryonic stages to infancy, marked by a gradual transition from reliance on innate immunity, which is genetically encoded, to the development of adaptive responses. Variations in immune cell numbers across different blood type (BT) can suggest a potential influence of ABO antigens on early immune cell composition. This interplay between genetic factors, maternal influence, and BT lays the foundation for lifelong immune health and disease susceptibility. ABO BT system, primarily known for its relevance in blood transfusions and organ transplants, has been the research subject exploring its associations with several diseases. As an early source of biological material, umbilical cord blood (UCB), it has been proven ideal for several diseases’ treatment, research, and diagnostic purposes. UCB also provides a pure sample for studying how genetic and maternal influences shape early immune system characteristics. Objectives This study focused on the relationship between BT and the immune system, aiming to understand the influence of BT on the number of nucleated cells, WBC, neutrophils, monocytes, lymphocytes, NRBC, and platelets from UCB samples. Methods It was used data from 910 cryopreserved UCB samples from BebéVida, a cryopreservation laboratory in Porto. To compare ABO groups, it was used the Kruskal-Wallis test. Statistically significance was considered for p-value <0.05. Results Results revealed significant increases in nucleated cells, WBC, NRBC, neutrophils, and monocytes in AB compared to A, and in O compared to AB. Regarding platelet, group A had more content than O group. Lymphocytes did not significantly differ between all BT tested. Discussion This study demonstrated the differences in immune system cells number between the different BT in UCB samples. This could be linked to A and B antigens presence/absence, however more research is needed to clarify. There are potential links between ABO blood groups and different diseases. This study demonstrated there is different patterns in the immune cells BT regarding UCB-BT, which could represent an important tool to help understand the onset of several diseases or predispositions. Elucidating these relationships, it can advance personalized medicine approaches and improve our understanding of disease predisposition across diverse populations.

Adverse event assessment in a parenting programme: experiences from a multisite randomised controlled trial

BackgroundClinicians and researchers should consider the expected benefits and potential harms of an intervention. Parenting programmes are a widely used evidence-based intervention for child behaviour problems. However, few data are available on potential negative effects. The aims of this paper were to increase systematic knowledge of adverse event (AE) assessment in parenting programmes and to provide an AE assessment tool.MethodsAs part of the RISE project (prevention of child mental health problems in South-eastern Europe—adapt, optimise, test and extend parenting for lifelong health), we developed and tested an AE assessment procedure in three sequential studies for parents of children with child behaviour problems aged 2 to 9 years in North Macedonia, Republic of Moldova, and Romania. This paper reports on the development of the assessment tool in phase 1 (N = 140), phase 2 (N = 835), and the final experiences with using the optimised procedures in phase 3 (multisite randomised controlled trial, N = 823) in which AEs were assessed before, three times during intervention delivery, and at 1 year follow-up. At each time point, the participants completed a 12-item AE checklist. If moderate-to-severe problems of parent or child were reported, a structured follow-up interview was conducted.ResultsThe response rate on the AE assessment tool increased from 6% (phase 1) to 100% (phase 3) indicating improvement in collecting these data based on the experiences of each phase. Results of the RCT (phase 3) showed generally low (S)AE frequencies with the finally optimised procedure: During the intervention, no serious adverse events (SAE) were registered; at least one AE was reported by 10% (after the first session), 7% (after the third session), and 4% (after the last fifth session) of participants. None of the identified (S)AEs was causally related to the study or intervention. Cost–benefit considerations are needed to determine the best way to ensure participant safety in parenting programmes.ConclusionThe applied active AE assessment procedure provides a comprehensive AE assessment tool that can be used by others—with adaptations for the specific context, if needed. Based on our experiences, we outline recommendations for future studies.Trial registrationClinicalTrials.gov, registration number phase 1: NCT03552250; phase 2: NCT03865485, phase 3: NCT04721730. Registered on 13 January 2021.

The Association Between Food Insecurity, Parental Stress, and Child Development.

It is recognized that development in the 0-to-5-year period is predictive of lifelong health and well-being and that early childhood development is influenced by parental mental health. Social stressors such as food insecurity can exacerbate parental mental health issues. To improve understanding of this complex interplay, a primary care pediatric practice designed an innovative meal and grocery delivery program for families experiencing food insecurity with at least one child aged 0-5years. As part of the program, food insecurity, parental mental health, and child development were assessed. Food insecurity was found to be correlated with increased stress in the parent-child system, and increased stress was found to be strongly correlated with delays in early childhood developmental progress. These findings suggest that changes in the parent-child relationship resulting from increased parental stress due to food insecurity can play a role in influencing early childhood development.

Socioeconomic and psychosocial outcomes of parents with children in out-of-home care: A scoping review

Socioeconomic and psychosocial outcomes of parents with children in out-of-home care: A scoping review

Developing an Educational Resource Aimed at Improving Adolescent Digital Health Literacy: Using Co-Design as Research Methodology

BackgroundAdolescence is a key developmental period that affects lifelong health and is impacted by adolescents regularly engaging with digital health information. Adolescents need digital health literacy (DHL) to effectively evaluate the quality and credibility of such information, and to navigate an increasingly complex digital health environment. Few educational resources exist to improve DHL, and few have involved adolescents during design. The co-design approach may hold utility through developing interventions with participants as design partners.ObjectiveThis project aimed to explore the co-design approach in developing an educational resource to improve adolescents’ DHL.MethodsAdolescents (12-17 years old) attended 4 interactive co-design workshops (June 2021-April 2022). Participant perspectives were gathered on DHL and the design of educational resources to improve it. Data generated were analyzed through content analysis to inform educational resource development.ResultsIn total, 27 participants from diverse backgrounds attended the workshops. Insight was gained into participants’ relationship with digital health information, including acceptance of its benefits and relevance, coupled with awareness of misinformation issues, revealing areas of DHL need. Participants provided suggestions for educational resource development that incorporated the most useful aspects of digital formats to develop skills across these domains. The following 4 themes were derived from participant perspectives: ease of access to digital health information, personal and social factors that impacted use, impacts of the plethora of digital information, and anonymity offered by digital sources. Initial participant evaluation of the developed educational resource was largely positive, including useful suggestions for improvement.ConclusionsCo-design elicited and translated authentic adolescent perspectives and design ideas into a functional educational resource. Insight into adolescents’ DHL needs generated targeted educational resource content, with engaging formats, designs, and storylines. Co-design holds promise as an important and empowering tool for developing interventions to improve adolescents’ DHL.

Innovations in Preconception Care: Optimizing Health for All Individuals.

Optimizing the overall health of individuals prior to pregnancy can improve both pregnancy and lifelong health outcomes. Despite extremely high financial expenditure on birth in the United States, maternal and infant mortality rates continue to rise. Moreover, significant racial and ethnic disparities persist in perinatal health outcomes. Preconception care, or health care provided before or between pregnancies, has the capacity to meet these challenges. Preconception care can be integrated into every health care visit, including visits with primary care, reproductive health, and mental health care clinicians. Increasing awareness among clinicians of the benefits of preconception care and equipping them with innovative strategies to implement this care into practice, the number of people receiving optimal care could be increased. Recent innovations in preconception care include group care, health applications (apps), reminders in electronic health records, social marketing campaigns, social media movements, community-based partnerships, health care policy and access, and improving public and clinician education on preconception health topics. Ultimately, improving preconception health is best done in partnership between the consumer and clinician. Midwives, whose care is person-centered and partnership-focused, are well positioned to champion the innovation and implementation of equitable preconception care. The purpose of this State of the Science review, therefore, is to synthesize the literature on recent evidence-based innovations that may be used to improve preconception health and counseling.

Gestational PFAS exposure and newborn size: The modifying effect of cord blood fatty acids

Per- and polyfluoroalkyl substances (PFASs) can disrupt lipid metabolism, and changes in cord blood fatty acid composition have been observed in small newborns. Emerging evidence suggests that exposure to PFASs during pregnancy is linked to decreased newborn size, although the evidence is not consistent. The modifying effect of fatty acids on the associations of gestational PFAS exposure with newborn size is still unknown. Here we show that the nutritional status of the fetus, as indicated by the level of fatty acids in the cord blood, mitigates the adverse effects of gestational PFAS exposure on the size of the newborn. Our study confirms the adverse developmental effects of PFASs and identifies emerging short-chain PFASs as the primary drivers of reduced newborn size, despite their lower exposure burden compared to legacy PFASs. Additionally, we find the protective role of cord blood fatty acids, suggesting potential strategies for mitigating the detrimental effects of emerging environmental exposures on human health. Our findings provide new evidence of the potential toxicity of emerging PFASs and call for further toxicity evaluations of these pollutants for regulatory purposes. Future studies should consider the complex interaction between exposure and nutrition within the human body, particularly during the first thousand days of life, to promote lifelong health.

The vital role of the placenta in determining pregnancy outcomes and life-long health

The vital role of the placenta in determining pregnancy outcomes and life-long health

What Does 'Preconception Health' Mean to People? A Public Consultation on Awareness and Use of Language.

There is growing scientific and policy recognition that optimising health before a potential pregnancy (preconception health) improves reproductive outcomes and the lifelong health of future children. However, public awareness on this topic is low. We conducted a public consultation to develop language recommendations and identify and prioritise approaches to inform research and improve public awareness of preconception health. A public consultation was undertaken with people of any gender aged 18-50 years living in the United Kingdom who were not currently expecting a child. Public contributors were recruited through patient and public involvement, community and support groups, an existing cohort study, and an LGBTQ+ charity. An initial round of online group discussions (February/March 2021) explored public contributors' knowledge of preconception health, their recommendations for appropriate language, and ideas about public health approaches. In a subsequent discussion round (May 2021), language recommendations were refined and suggested approaches prioritised. Discussions were summarised based on notes taken by two researchers. Fifty-fourpeople joined the initial discussion round (66% women, 21% men, 13% nonbinary or transgender; 55% aged 18-30 years, 30% 31-40 years, 15% 41-50 years). Of these, 36 people (67%) participated in the subsequent round. Very few had heard the term 'preconception health', understood what it means, or why and for whom it is important. They recommended avoiding unfamiliar terms without further explanation (e.g., preconception health, medical terms), using language that is positive, encouraging and gender-sensitive where possible, and using messages that are specific, nonjudgmental and realistic. The phrases 'health and well-being during the childbearing years', 'health and well-being before pregnancy and parenthood' and 'planning for parenthood' resonated with most public contributors. School-based education, social media campaigns and the National Health Service emerged as priority approaches/settings for raising awareness. This public consultation produced recommendations from a diverse group of people of reproductive age in the United Kingdom to improve language and prioritise approaches that increase public understanding of preconception health in ways that are relevant and appropriate to them. This should begin in schools and will require adaptation of curricula, alongside co-development of public awareness campaigns and guidance for healthcare professionals. This public consultation included a diverse group of members of the public. They were not involved in the original design of the project, but following the initial round of online group discussions, they contributed to the interpretation and refinement of the emerging concepts in a subsequent round of group meetings. After the consultation activity, public contributors formed a Public Advisory Group and have subsequently been involved in other studies on the same topic. Two public contributors (E.R. and F.F.) provided critical input in the preparation and revision of this manuscript and are co-authors of the paper.

Sex-specific associations between childhood trauma and adult systemic inflammation in daily life.

Childhood trauma may contribute to lifelong health through chronic systemic inflammation. However, associations between childhood trauma and inflammation are mixed, indicating that distinct types of childhood trauma may relate to inflammation differently. Moreover, most studies use a single assessment of inflammatory markers that may not reliably estimate stable interindividual differences. The current study is the first to examine relationships between childhood trauma and an ecologically valid measure of inflammation derived from repeated assessments of interleukin (IL)-6 in daily life. We also examine the possibility that glucocorticoid sensitivity and patterns of daily cortisol may contribute to observed associations. Finally, we explore whether biological sex moderates relationships between childhood trauma and IL-6. Participants were 283 healthy adults aged 40-64 (57% female, 23% Black, Indigenous, and People of Color) who completed the Childhood Trauma Questionnaire and self-collected dried blood spots at home on 4 days to measure IL-6. Measures of salivary cortisol and blood-based glucocorticoid sensitivity were also assessed. Childhood trauma was not associated with IL-6 in the sample as a whole. However, exploratory analyses showed that childhood trauma related to IL-6 differently for males and females, such that total trauma and emotional neglect predicted higher IL-6 for males but not females. Results persisted after adjustment for covariates. There was no evidence for indirect effects via cortisol or glucocorticoid sensitivity. Childhood trauma and, specifically, emotional neglect were associated with IL-6 in daily life among middle-aged males. Additional research is needed to elucidate biological and behavioral pathways underlying these associations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reading for life-long health.

There is a strong, positive relationship between childhood literacy and physical and mental health outcomes in adulthood. Through primary care-based literacy interventions, pediatricians reach children and their families long before they enter traditional education venues. In so doing, pediatricians play a key role in children's school readiness and in turn health outcomes. The current state of childhood literacy in United States defines an increasingly urgent platform for the healthcare profession generally, and pediatricians specifically, to embrace. Through reviewing the existing literature on the impact of childhood literacy on physical, mental, and social-emotional health outcomes, we hope to highlight the need for increased collaboration between the education and medical fields to further promote the literacy interventions in pediatric healthcare settings.

Lipid Screening in Children and Adolescents—A Missed Opportunity to Improve Lifelong Health

Lipid Screening in Children and Adolescents—A Missed Opportunity to Improve Lifelong Health

Cognitive Brain of Homo sapiens: Stress, Emotions, Health, Hormones, Longevity

Replication of new discoveries in the field of genetics and epigenetics, the scientific union of neurobiology and neurophysiology of the quantum brain HOMO SAPIENS of the 21st century, the achievements of biophysics, hybrid neuroimaging and nuclear medicine, the introduction of nutritionology and bioelementology technologies, the 5P of MEDICINE and 5G TECHNOLOGY, compliance of art medicine and modern psychoanalysis, - will allow control the cognitive brain of a 21st century HUMAN. Scientific progress and 33 years of experimental experience of biophysics in the field of neurogeriatrics and neurocardiology, neuroendocrinology and psychoneuroimmunology - made it possible to argue that "nerve cells are restored," the quantum human brain is CONTROLLED, high-quality and healthy LONGEVITY HOMO SAPIENS of the 21st century is achievable. Children who experience chronic stressors are vulnerable to lifelong emotional and physical health problems. Cognitive and mental health affects a person's ability to cope with stress, maintain a relationship paradigm, make healthy choices and lead a fulfilling life. An increase in the expected and average life expectancy of a person is realizable/achievable/feasible when creating conditions/tools/algorithms/technologies for active and high-quality longevity.

Curriculum Decision-Making for Students with Severe Intellectual Disabilities or Profound and Multiple Learning Difficulties

ABSTRACT Students with severe intellectual disabilities or profound and multiple learning difficulties (S/PMLD) have the highest complexity of needs of any student cohort. Decisions regarding curriculum inclusions for these students predominantly fall to their classroom teachers. These decisions directly correlate with students’ everyday learning experiences and have an influence on their life-long socio-economic, health, and well-being outcomes. This scoping review presents an overview of the factors that teachers consider when making these important choices. Online databases were used to identify peer-reviewed research undertaken internationally between 2011 and 2021 with 11 articles identified for inclusion. Results are presented using four key themes, (1) teacher as guardian, (2) teacher as educator, (3) teacher as employee and (4) teacher as (non)academic. Within, it details a paucity of research into understanding the decision-making schema of teachers of students with S/PMLD, revealing a lack of practical guidance or appropriate professional learning opportunities. Recommendations for future research and practice initiatives are detailed.