Background Long COVID, marked by ongoing multi-systemic symptoms following COVID-19 infection, can impair ability to maintain employment. However, its relationship to workforce retention and working hours remains unclear. Methods Long COVID was defined as symptoms lasting ≥12 weeks post-infection. We analysed data from a late-2022 follow-up survey involving 45,864 participants of the Real-time Assessment of Community Transmission (REACT) Study in England (median follow-up: 23 months). Hierarchical clustering identified symptom groups. Multivariable regressions examined associations between Long COVID, being in paid work, and changes in working hours. Findings Of 45,864 participants employed at recruitment, 86% (N = 39,341) remained in paid work at follow-up and 11% (N = 4877) changed work hours. Approximately 4% (N = 1967/45,864) had unresolved Long COVID. Compared with participants with no/short (<4 weeks) symptoms, those with unresolved Long COVID had lower odds of being in paid work at follow-up (adjusted odds ratio [aOR]: 0.62, 95% confidence interval [CI]: 0.55, 0.70), and higher odds of changing work hours (aOR: 4.34, 95% CI: 3.88, 4.85). Three clusters were identified: multisystem severe, fatigue-predominant and anosmia-predominant Long COVID. Compared with the fatigue-predominant cluster, participants with multisystem severe Long COVID had lower odds of paid work (aOR: 0.63, 95% CI: 0.47, 0.84) and higher odds of changing work hours (aOR 2.76, 95% CI 2.21, 3.46). Interpretation Unresolved Long COVID was associated with worse employment outcomes. Symptom clusters highlighted the importance of considering heterogeneity in Long COVID when assessing workforce impacts and designing public health responses. Fundings National Institute for Health and Care Research, UK Research and Innovation.

Introduction:Dental operative procedures, by their interventive nature, impede the opportunity for peri-intervention verbal communication between patients and clinicians. This can impair trust, consent, and shared decision making with the potential of adversely affecting patient dignity, and potentially resulting in suboptimal clinical outcomes.This scoping review aims to interrogate the literature concerning non-verbal communication methods used in dental and medical practices during peri-interventive procedures, in aiding communication between clinician and patient. We will also ascertain how these align with the Limited Capacity Model of Motivated Mediated Message Processing (LC4MP) communication theory. Methods:The framework proposed by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews, will be used to guide this scoping review and reporting methodology. Selected electronic databases (Medline, Embase, Cochrane Library and Scopus), PsychInfo, CINAHL and grey literature sources will be searched.Inclusion criteria are: articles written in the English language, publications between 2000 and 2025, peer-reviewed empirical studies, with either qualitative or quantitative data, mixed methods, reviews, book chapters and grey literature with a principal focus on non-verbal communication in the healthcare setting.A narrative synthesis will be conducted, with results reported according to elements of LCM4P theory: cognitive load, motivated messaging, message processing and memory. Conclusion:This scoping review will contribute to our methodological and theoretical understanding of the use of non-verbal communication strategies in clinical settings.

Objectives: This literature review aims to assess the current state of the field linking neighborhood environments to later-life health and wellbeing. Methods: We used electronic databases (e.g., PubMed, Google Scholar, and ProQuest) to search for studies published between 2010 and 2022 examining associations between neighborhood built environmental variables and later-life physical, cognitive, mental, and social health outcomes. Results: Among 168 studies reviewed, the majority were quantitative (n = 144) and cross-sectional (n = 122). Neighborhood environmental variables significantly associated with later-life health outcomes included population density/rurality, walkability/street connectivity, access to services and amenities, neighborhood quality and disorder, and parks/green/blue/open space. Neighborhoods operated through behavioral and biological pathways including hazardous exposures, affective states (e.g., stress and restoration), and lifestyle (e.g., exercise, socialization, and diet). Discussion: Neighborhoods and healthy aging research is a burgeoning interdisciplinary and international area of scholarship. Findings can inform upstream community interventions and strengthen clinical care.

COVID-19 person-place disruptions may dislocate enabling resources and affect the short- and long-term wellbeing of individuals ageing-in-place. However, outcomes may vary according to individuals’ personal experiences and capabilities to put in place adaptive strategies. Underpinned by the Conservation of Resources (COR) Theory, this study aimed to identify shifts in older people’s relationships to place during the pandemic and to gain a deeper understanding of their adaptive strategies. We analysed data collected between April-May and October-November 2021 from the [Details omitted for double-blind reviewing], a qualitative investigation of community-dwellers based in Ireland and aged 65 years or over. Participants (n=57) completed written submissions, narrative interviews and/or go-along interviews detailing their experiences during the pandemic. The mean age of participants was 74.9 years, 53% were female, 46% lived alone, and 86% lived in areas with high urban influence. Our framework analysis identified three thematic categories: 1) Characterization of individuals experiencing flow or disruption of place-resources; 2) Effects of place-resource disruptions; and 3) Adaptive strategies to manage disruption. Findings suggest that during the pandemic individuals ageing-in-place experienced trajectories of resistant flow, resilient flow, chronic disruption, or delayed disruption of place-resources, Participants’ health and wellbeing was influenced in diverse ways by the threat of- and actual loss of material, social and affective resources. To compensate for disruptions, participants developed multiple adaptive strategies that highlight older people’s potential to transform themselves, others, and their environments during times of adversity. These findings showcase the processes by which health enabling places may be maintained and generated, and present areas of opportunity for public health interventions seeking to support ageing populations during public health emergencies and beyond.

During the pandemic, many older adults felt 'out of place' in their home, work, and community spaces with potentially long-term consequences for health and wellbeing. Using national data from the COVID-19 Coping Study, thematic analysis of online long-answer responses (n = 1171; mean age 68 years; 71% female; 93% non-Hispanic White; 86% with at least a 4-year college degree; data collected April-June 2022) identified four themes regarding why particular places are challenging since the pandemic onset: (1) viral exposure fears, (2) frustrating regulations, (3) uncomfortable and hostile social dynamics, and (4) 'out of place' negative emotions. Participants also shared how they continuously address or adapt to place-based challenges through lifestyle adjustments and coping strategies. Novel findings may inform multi-scalar policymaking and interventions to support wellbeing in later life in times of stress and instability.

Drawing on conceptual and empirical work in geographies of ageing and environmental gerontology, this study's aim is to explore the generation and maintenance of enabling places from the perspective of older community dwellers in the context of COVID-19. Findings are drawn from a qualitative thematic analysis of written submissions (n = 17), narrative interviews (n = 44) and go-along interviews (n = 5) with people ageing-in-place in Irish communities during the pandemic. The mean age of participants was 74.9 (SD = 7; range 65-96), 53% were female, 46% lived alone, and 86% lived in areas with high urban influence. Our results indicate that the COVID-19 public health restrictions curtailed participants' usual activities and influenced how they related to their homes, and a variety of public spaces where they had previously pursued valued activities. Transitions in their everyday geographies led to a wide array of affective and embodied experiences, and participants described diverse material and social emplaced-resources as enabling or hindering their health and well-being during COVID-19. Our core findings are summarised across three themes: (1) somewhere old, relates to emplacement in familiar places and the role of familiarity with place resources; (2) somewhere new, comprises the emergence of digital spaces and possible pathways to build place insideness; and (3) somewhere green, describes the negotiation and (re)turn to natural and outdoor environments during the pandemic. Results from this study contribute to identify the pathways through which enabling places for diverse older people may be generated and/or maintained, and provide evidence to support the development of enabling environments during times of social upheaval and beyond.

Population Medicine considers the following types of articles:• Research Papers -reports of data from original research or secondary dataset analyses.• Review Papers -comprehensive, authoritative, reviews within the journal's scope.These include both systematic reviews and narrative reviews.• Short Reports -brief reports of data from original research.• Policy Case Studies -brief articles on policy development at a regional or national level.• Study Protocols -articles describing a research protocol of a study.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.• Methodology Papers -papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation.

BackgroundEvidence indicates that older people with biological and social vulnerabilities are at high risk of short- and long-term consequences related to the COVID-19 pandemic. However, studies have also highlighted that the crisis may present opportunities for personal growth if older individuals are met with appropriate resources and support.ObjectiveThe aim of this study was to explore the perceptions of older people regarding how individual, social, and environmental factors have supported or hindered their well-being and health during COVID-19.MethodsWe analyzed data collected between April–May and October–November 2021 from the Well-being, Interventions and Support during Epidemics (WISE) study, a qualitative investigation of community-dwellers based in Ireland and aged 65 years or over. Participants (n = 57) completed written submissions, narrative interviews and/or go-along interviews detailing their experiences during the pandemic. Framework analysis was carried out in NVivo 12 to identify determinants, linkages, and explanations within Bronfenbrenner’s socio-ecological model.ResultsThe mean age of participants was 74.9 years, 53% were female, 45% lived alone, and 86% lived in areas with high urban influence. Our findings highlight the heterogeneous effect of COVID-19 across diverse older individuals who held distinct concerns, capabilities, and roles in society before and during the pandemic. Multi-scalar contextual characteristics such as individual’s living arrangements, neighborhood social and built environments, as well as social expectations about aging and help seeking, had an influential role in participants’ well-being and available supports. We identified mixed views regarding public health restrictions, but a consensus emerged questioning the suitability of one-size-fits-all approaches based on chronological age.ConclusionsOur results suggest that some negative pandemic consequences could have been avoided by increasing collaboration with older people and with the provision of clearer communications. The interdependencies identified between individual characteristics and socio-ecological factors that influenced participants’ availability of supports and development of adaptive strategies represent areas of opportunity for the development of age-friendly interventions during and beyond public health crises.

Abstract Background The COVID-19 pandemic called for innovation and leverage of existing age-friendly practices to promote older people's functional ability and enable them to contribute to their communities and enjoy life. Our aim was to explore the evidence available concerning the development, adaptation, and evaluation of age-friendly practices during the COVID-19 pandemic. Methods A review was conducted in line with the Joanna Briggs Institute scoping review methodology. We considered publications of practices across the 8 domains of the World Health Organization (WHO) age-friendly framework. Our search strategy comprised databases (PubMed, Web of Science, Scopus) and grey literature sources. Results Preliminary findings identified 37 practices by member organizations of the WHO network. The most targeted domains were community support and healthcare services; communication and information; and social participation; while the least targeted were transportation; housing; and outdoor spaces and buildings. Adaptive strategies often relied on remote delivery of information and services through digital or phone contact. Most practices were led by local authorities in collaboration with community organizations, universities, and healthcare practitioners. Opportunities for older people to contribute to the design and implementation of practices varied widely across settings. Enablers for adaptation or development included pre-existing collaborations between stakeholders, availability of contact details of older people in the community, and availability of human and material resources to implement changes. Challenges included limited literacy and access to digital technologies, and participants’ distrust of remote activities. Conclusions Findings emerging from the scoping review provide insights regarding age-friendly practices during COVID-19 and may inform the development of appropriate multi-stakeholder and participatory interventions during future public health crises. Key messages • Age-friendly practices may significantly contribute to meet older people’s material, social and affective needs during public health crises. • Opportunities to leverage age-friendly practices increase with the inclusion of older people’s voices, intergenerational solidarity, multi-stakeholder involvement and strong political will.

Abstract Background The COVID-19 pandemic has posed new and widespread challenges to experience the health and well-being benefits associated with person-place attachment, particularly among populations identified as vulnerable, such as older people. The aim of this study was to explore how individuals ageing-in-place have perceived and (re)negotiated their sense of place and place identities since the pandemic onset. Methods We thematically analysed open-ended responses (n = 1171) collected between April to June 2022 in the COVID-19 Coping Study, a national longitudinal study of the impacts of the pandemic among aging adults living in the US. Results Participants were on average 68 years old, with a majority of participants identifying as female (71%), non-Hispanic white (93%), living with others (72%), and retired (66%). We identified five themes, four regarding why particular places were challenging since the pandemic onset: (1) fear of viral exposure, (2) frustrating regulations, (3) uncomfortable and hostile social dynamics, and (4) ‘out of place’ negative emotions; and one regarding how participants addressed pandemic place-based challenges: (5) adjustments made to reframe expectations and behaviours. These findings prompt a critical exploration of how experiences taking place in micro and macro spaces have shifted during the pandemic and the potential wide-ranging and long-term implications they hold for participants’ later-life health and well-being. Conclusions Evidence emerging from this analysis highlights the potential of large well-ventilated public spaces that offer diverse opportunities to engage in educational, artistic, and recreational activities as a vehicle to (re)build disrupted place identities for older adults living through increasing social tensions and polarization regarding public health measures. Key messages • Changes to built and social environments driven by the COVID-19 pandemic and public health strategies are having lasting impacts on how older people engage with health promoting and enabling places. • Older people have addressed place-based challenges through antimicrobial precautions, daily routine adjustments, choosing online and outdoor activities, and/or withdrawing from places altogether.

Background: Actions focused on age-friendly environments contribute to promote and maintain older people’s functional ability and may enable them to contribute to their communities and enjoy life. As such, age-friendly practices require collaboration between diverse stakeholders across multiple sectors responsible for natural, built, and social environments, which can be particularly relevant during public health emergencies when socio-ecological vulnerabilities become more salient and may disproportionally affect older people. This paper presents a protocol for a scoping review aiming to investigate the breadth of evidence concerning the development, implementation, and evaluation of age-friendly practices during the COVID-19 pandemic. The protocol sets out the objectives, methods, and dissemination plans for the review. Methods: The scoping review will be conducted in line with the Joanna Briggs Institute (JBI) scoping review methodology. We will search databases (PubMed, Web of Science, Embase, CINAHL, Scopus, PsychNet) and grey literature sources. Publications relating to practices across the 8 domains of the World Health Organization’s age-friendly cities and communities’ framework will be included. A tabular data extraction tool will be used to facilitate a narrative synthesis of results. Ethics and dissemination: Ethical approval is not required as the methods proposed for this scoping review consist of collecting publicly available data. Findings will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) and submitted to a journal for academic dissemination. Lay dissemination plans include an infographic and a blog-style article presenting our core results. Conclusion: The publication of this protocol allows for transparency in the systematic process of a scoping review focused on age-friendly practices during COVID-19. Findings emerging from the scoping review will provide insights into the evidence available regarding age-friendly activities during COVID-19 and may inform future age-friendly practices during public health emergencies and beyond.

The role of parks and nature to support well-being during the COVID-19 pandemic is uncertain. To examine this topic, we used mixed-methods data collected in April-May 2020 from US adults aged >= 55 in the COVID-19 Coping Study. We quantitatively evaluated the associations between number of neighborhood parks and depression, anxiety, and loneliness; and conducted qualitative thematic analysis of participants' outdoor experiences. Among urban residents, depression and anxiety were inversely associated with the number of neighborhood parks. Thematic analysis identified diverse engagement in greenspaces that boosted physical, mental, and social well-being. The therapeutic potential of outdoor and greenspaces should be considered for interventions during future epidemics.

Therapeutic engagement with nature can support health and wellbeing among older adults. This may be particularly important to cope with adversities of the COVID-19 pandemic when public health measures have been particularly stringent for individuals in this age group. Utilizing therapeutic landscapes as a conceptual framework, we conducted a secondary thematic analysis of qualitative data to explore older adults’ everyday experiences (n = 769) with outdoor spaces and nature during the early months of the COVID-19 pandemic in the US. The data analyzed is part of the COVID-19 Coping Study baseline survey collected online between April and May 2020. Preliminary findings indicate that participants purposefully engaged with nature and outdoor spaces in diverse ways. This engagement provided opportunities for exercising and maintaining a routine at a safe physical distance from others, which promoted their physical, mental, and social well-being.

This paper addresses the role of living spaces, neighborhood environments, and access to nearby nature in shaping individual experiences of health and well-being during the first wave of the COVID-19 pandemic. Key data is drawn from the GreenCOVID study across Spain, England and Ireland. The survey gathered contextual information about home environments, neighborhood spaces, and access to nature elements, and standardized measures of health and wellbeing between April and July 2020 (n = 3,127). The paper used qualitative data from the survey to document flows between home and nearby nature. These were framed as barriers/mediators with specific focus on differing interpretations of home as both trap and refuge, with additional dimensions of loss, disruption and interruption shaping the broad responses to the pandemic. By contrast nearby nature was an enabler/moderator of health and wellbeing, offering healthy flows between home and nature as well as respite and additional health-enabling factors. Differences were identified between the three countries but important commonalities emerged too, recognising the role nature plays as an asset both within and immediately beyond the home. The use of flow as metaphor also recognises the importance of embodiment and the elastic nature of connections between home and nearby nature for wellbeing. More broadly, flow provides a valuable way to trace affective relational geographers to develop a wider understanding of assemblages of health during pandemics.

Given the impact of COVID-19 on populations, especially under lockdown conditions, there has been more attention than ever focused on the role of nature, including green and blue spaces, to act as a form of health-enabler across societies. Access to green space, with its potential for physical activity and mental health support has been specifically identified within the literature as an important asset for neighbourhood and citizen health and wellbeing. The established positive relationships between access to and benefits from green and blue space are variable over space, both in terms of the kinds of built environments in which people live, but also the availability nearby of natural assets like parks, coasts, rivers, etc.;as well as ease of access to those spaces for all citizens. With the advent of the COVID-19 pandemic, most countries have developed as part of their public health strategies, a series of lockdown measures in which citizens have either been confined to home, or at best, a small catchment area immediately surrounding their homes. As part of a flurry of recent research on such relationships, the GreenCOVID study was carried out by a group of researchers in Spain, the UK and Ireland, all broadly operating to a similar framework and collecting information from the general adult population in each of the three countries. This short commentary introduces the survey alongside preliminary Irish results specifically focused on household characteristics, access to nearby green space as well as a measure of psychological wellbeing.

Background: The coronavirus disease 2019 (COVID-19) pandemic has the potential to trigger multiple stress domains and lead to long-term repercussions in an individual’s quality of life, health, and well-being. Stressors from the pandemic are likely to be experienced in many ways by older adults with heterogeneous life experiences and supports available. In this context, it is necessary to tease out the underlying mechanisms leading to positive and negative well-being and mental health across interdependent individual, social and environmental factors. The aim of the present study is to explore community-dwelling older adults’ experiences during the COVID-19 pandemic, with a particular focus on mental health and psychosocial well-being. Methods: An exploratory longitudinal qualitative study will be conducted with data collected through written submissions, narrative interviews and go-along interviews with older adults living in Irish community settings. To enable the exploration of participants’ responses to the evolving social, economic and environmental circumstances, data collection will take during the implementation of public health restrictions and once these are eased and the vaccination program is rolled out. Framework analysis will be carried out to identify data themes, linkages, and explanations within Bronfenbrenner’s socio-ecological model. Ethics and dissemination: Ethical approval has been granted by the Royal College of Surgeons in Ireland, Research Ethics Committee (REC202011028). Findings will be disseminated through peer-reviewed journal publications, presentations at relevant conferences, and in consultation with Public and Patient Involvement (PPI) contributors. A lay summary of findings and infographic will be distributed to multiple stakeholders including our PPI panel, older people, caregivers, community organizations, charities, and media.

Background: The coronavirus disease 2019 (COVID-19) pandemic has the potential to trigger multiple stress domains and lead to long-term repercussions in an individual’s quality of life, health and well-being. Stressors from the pandemic are likely to be experienced in many ways by older adults with heterogeneous life experiences and supports available. In this context, it is necessary to tease out the underlying mechanisms leading to positive and negative well-being and mental health across interdependent individual, social and environmental factors. The aim of the present study is to explore community-dwelling older adults’ experiences during the COVID-19 pandemic, with a particular focus on mental health and psychosocial well-being. Methods: An exploratory longitudinal qualitative study will be conducted with data collected through written submissions, sitting interviews and walk along interviews with older adults living in Irish community settings. Data collection will take place 3 to 10 weeks apart to enable the exploration of individuals’ responses to the evolving social, economic and environmental circumstances derived from the COVID-19 pandemic in Ireland. An iterative thematic analysis will be carried out to identify data themes, linkages, and explanations within a socio-ecological framework. Ethics and dissemination: Ethical approval has been granted by the Royal College of Surgeons in Ireland, Research Ethics Committee (REC202011028). Findings will be disseminated through peer-reviewed journal publications, oral presentations at relevant conferences, and in consultation with Public and Patient Involvement (PPI) contributors. A lay summary of findings and infographic will be distributed to multiple stakeholders including our PPI panel, older people, caregivers, community organisations, charities and media.

Introduction: Over the past decades, children have been increasingly using screen devices, while at the same time their sleep duration has decreased. Both behaviors have been associated with excess weight, and it is possible they act as mutually reinforcing behaviors for weight gain. The aim of the study was to explore independent, prospective associations of screen time and sleep duration with incident overweight in a sample of European children. Methods: Data from 4,285 children of the IDEFICS/I.Family cohort who were followed up from 2009/2010 to 2013/2014 were analyzed. Hours per day of screen time and of sleep duration were reported by parents at baseline. Logistic regression analyses were carried out in separate and mutually adjusted models controlled for sex, age, European country region, parental level of education, and baseline BMI z-scores. Results: Among normal weight children at baseline (N = 3,734), separate models suggest that every hour increase in screen time and every hour decrease in sleep duration were associated with higher odds of the child becoming overweight or obese at follow-up (OR = 1.16, 95% CI: 1.02–1.32 and OR = 1.23, 95% CI: 1.05–1.43, respectively). In the mutually adjusted model, both associations were attenuated slightly ( screen time OR = 1.13, 95% CI: 0.99–1.28; sleep duration OR = 1.20, 95% CI: 1.03–1.40), being consistently somewhat stronger for sleep duration. Discussion/Conclusion: Both screen time and sleep duration increased the incidence of overweight or obesity by 13–20%. Interventions that include an emphasis on adequate sleep and minimal screen time are needed to establish their causal role in the prevention of overweight and obesity among European children.

Although different studies have evaluated the positive impacts of the COVID-19 pandemic and lockdown measures on reducing noise pollution and traffic levels and improving air quality, how populations have perceived such changes in the natural environment has not been adequately evaluated. The present study provides a more in-depth exploration of human population perception of enhanced natural exposure (to animal life and nature sounds) and reduced harmful exposure (by improved air quality and reduced traffic volume) as a result of the COVID-19 pandemic lockdown. The data is drawn from 3,109 unselected adults who participated in the GreenCOVID survey from April to July 2020 in England, Ireland, and Spain. The findings suggest that the positive impacts to the natural environment as a result of the lockdown have been better received by the population in Spain and Ireland, in comparison to England. Participants who resided in urban areas had better perceived improvements in nature sounds, air quality, and traffic volume compared to those in rural areas. Older populations and those with lower smoking and alcohol consumption were found to perceive this improvement the most. Furthermore, the greater perception of improvements in environmental elements was also associated with better self-perceived health and improved wellbeing. In the binary logistic regression, living in Ireland or Spain, urban areas, female gender, older age, and good overall wellbeing were associated with a greater perception of improvements in the natural environment, while the factors most associated with a greater perception of reduced harmful exposure were living in Spain, had a good self-perceived health status and older age.

Abstract Background For many older people around the globe, the COVID-19 pandemic has highlighted accessibility issues and pervasive inequalities across multiple social, economic and health dimensions. The aim of the present study is to explore older people's perspectives about what we should learn from this pandemic and how to build a better future. Methods The Well-being, Interventions and Support during Epidemics (WISE) study is an exploratory qualitative project that has collected information from 46 individuals aged 65+, who live in Irish community settings. Data collection included in-depth interviews over the phone or videoconference platforms. Analysis is ongoing utilizing NVivo12 to identify themes and linkages within a socio-ecological framework. Preliminary Results Findings indicate that at the macrosystems level, several participants expect policymakers and researchers to commit to challenging ageist misconceptions of a homogeneous aging experience- such as the notion that older people are merely recipients of care with a high degree of needs. Upon reflection of their experiences with shelter-in-place restrictions and its consequences, at the exosystem level, many respondents called for older voices to be consulted in public health decisions and included in decision-making bodies. Concerning the microsystem, participants referred policymakers should further develop natural and built environments that enable physical, mental and social well-being for all. Cutting across all levels, participants advised for stronger political will and accountability, as they recognized some of their concerns had been addressed in past policies but were not being implemented. Conclusions Our preliminary findings are applicable to the Irish context but also provide relevant insights for those interested in creating inclusive age-friendly societies across the globe. Embracing this shared vision would provide significant opportunities to address present and future public health challenges. Key messages Older people are very diverse, so it is necessary to move on from one size fits all approaches. Age-friendly societies are multifaceted endeavours that must include older voices at their core and build upon intergenerational solidarity.