Linked lives: intergenerational transmission of labour-market pathways between parent dyads and children.

While a vast number of studies confirm the transmission of labour-market disadvantages from one generation to the next, less is known about how parents' interconnected labour-market pathways co-evolve and shape the opportunities and obstacles for their children's future careers. This study uses a multidimensional view of intergenerational transmission by describing the most typical pathways of parents' occupational careers and assesses how these patterns are associated with their children's labour-market outcomes. Drawing on Swedish longitudinal register data, we used multichannel sequence analysis to follow a cohort of people born in 1985 (n = 72,409) and their parents across 26 years. We identified four parental earning models, differentiating between (1) dual earners with high wages, (2) dual earners with low-wage, (3) one-and-a-half-earners and (4) mother as the main breadwinner. Regression analysis shows strong intergenerational transmission among the most advantageous trajectories, with education as a key determinant for young people to become less dependent on family resources. This study stresses the importance of intra-couple perspectives in life course research to understand how inequalities are shaped and preserved across generations.

Active aging and health among older adults in China: a perspective based on downward intergenerational economic support.

Introduction: In China, the rapid progression of population aging presents significant challenges to society and the economy, drawing widespread attention to the health conditions of older adults. While aging is often seen as a societal burden, the phenomenon of intergenerational economic support reveals the potential for older adults to continue playing an active role within their families. This study delves into how older parents' financial support to their children can reciprocally influence their own health, exploring the potential non-linear relationships involved. Methods: This research, utilizing data from the 2018 China Health and Retirement Longitudinal Study, employs instrumental variable techniques and cross-sectional threshold models to examine how financial support provided by older adults to their children affects their health. It particularly highlights the varied impacts of economic support on older adults' health at different levels of support. Results: The findings indicate that moderate intergenerational economic support significantly enhances the health of older adults, while either minimal or excessive financial support does not demonstrate the same positive effect. Additionally, subjective life expectancy plays a mediating role between intergenerational economic support and the health of older adults, further emphasizing the beneficial impact of economic support. Discussion: The study underscores the importance of moderate intergenerational economic support in improving the health of older adults amidst aging challenges. Future policies and practices should consider how to encourage and optimize such support to address the challenges of an aging society, enhance the welfare of older adults, and promote healthy aging.

Education disrupts the intergenerational transmission of health disadvantage across three generations in China.

This article utilizes survey data from the China Family Panel Studies (CFPS) to examine whether grandparents' health disadvantage have both direct and indirect effects on the health disadvantage of their grandchildren, and whether the completion of compulsory education by parents disrupts these intergenerational transmissions in China. The findings suggest that grandparents' health disadvantage significantly increases the probability of grandchildren's health disadvantage with and without controlling parental health disadvantage and other characteristics. Moreover, the study identifies a disruptive influence of parental education on this transmission process. Rigorous robustness tests, including the use of the Compulsory Education Law as an instrumental variable to control for unobserved factors, validate these results. Mechanism analysis shows that parents completing compulsory education contribute to improving their nutritional balance and adopting healthy behaviors, attaining higher social status, earning higher income, which ultimately reduce the probability of health disadvantage for both themselves and their children. These findings highlight the persistent intergenerational transmission of health disparities within families and emphasize the importance of enhancing individuals' education levels to disrupt this transmission. By doing so, it may be possible to mitigate health inequalities and disparities across the population.

Impact of Intergenerational Shokuiku (Food and Nutrition Education) Programs on Alleviating Loneliness in Japanese Communities across Ages.

As loneliness is a risk factor for mental and physical health problems in various age groups, this study aimed to explore the impact of the intergenerational Shokuiku (food and nutrition education) program (IGSP) on loneliness in a Japanese community. This single-arm intervention study conducted between 2022 and 2023 included children (n = 21), guardians (n = 16), university students (n = 3), and older adults (n = 6). The IGSP was a one-day program that included participants making and eating their own bread, butter, and sorbet. Loneliness was measured using the Five-item Loneliness Scale for Children (Five-LSC; Japanese) and the three-item UCLA Loneliness Scale (Japanese; for adults) with other direct questions. Social capital, including civic participation, social cohesion, and reciprocity, was assessed using a self-administered questionnaire. The Five-LSC score significantly decreased post-intervention (p = 0.04). There was a significant increase in adults who reported not feeling lonely (p = 0.001). However, the UCLA Loneliness Scale scores did not show any significant changes. A positive change in social cohesion, including community contribution (p = 0.001) and attachment (p = 0.002), was observed among adults. This study suggests that IGSPs have a positive impact on loneliness in children and a partly positive one in adults. These findings emphasize the potential of intergenerational programs to reduce loneliness in communities.

Aging with her garden: Mutual care across species and generations.

What can caring for, and being cared for by, a garden teach us about aging well? This article is a narrative exploration of care, aging, and wellbeing in later life through conversations with an older woman and her garden in Toronto, Canada during the months of the COVID-19 pandemic. The focus is on the interconnectedness of care across generations and species. Moving away from conventional generational scripts, the article expands notions of care and aging with an intersectional, feminist and decolonial approach to relationality across time and space. The article uses interviews, photovoice-inspired sessions, and autoethnography, to look at aging and wellbeing as relational and more-than-human relationality. It extends the ethics of care beyond traditional boundaries, embracing perspectives that challenge normative assumptions of gender, age, and interspecies relations. The article aims to contribute to the current debates around colonial research logics, though a critical feminist understanding of relationality and embodied learning. It emphasizes the importance of connecting across generations, seeing land as a way to restore human and more-than-human relations while prefiguring a more care-full present.

Medicaid Enrollment and Intergenerational Transfers of Wealth Among Older Adults.

BACKGROUND AND OBJECTIVES: Medicaid look-back periods are meant to prevent Medicaid applicants from gifting assets to meet eligibility requirements. These policies have the potential to affect families across generations given their ability to restrict the transfer of assets between parent and child. RESEARCH DESIGN AND METHODS: Using 2008-2018 data from the Health and Retirement Study, this study analyzed the estate planning and familial wealth transfer behaviors of a cohort of older adults aged 65 and older who became Medicaid recipients during a 10-year period. RESULTS: There were 8,347 respondents aged 65 and older in 2008 and 11.96% of respondents who were not Medicaid recipients at baseline became recipients over the study period. A little more than one third (36.47%) of Medicaid recipients participated in estate planning and asset transfer prior to becoming a recipient, with significant differences among select demographic characteristics. Married recipients were more likely to transfer money compared to their widowed counterparts (51.69% compared to 36.44%; p < .001) and transferred larger amounts compared to those unmarried ($16,286.94 compared to 5,379.13). White, well-educated, married, men participated in higher rates of estate planning, likely a reflection of who has access to resources to make necessary arrangements early. DISCUSSION AND IMPLICATIONS: This analysis concludes that more structurally advantaged groups are more likely to engage in estate planning prior to Medicaid enrollment. This analysis demonstrates that some individuals may circumvent Medicaid policies like look-back periods and estate recovery, while others cannot. Policymakers should consider policies that promote the financial health of low-income families.

Impact of an intergenerational program to improve loneliness and social isolation in older adults initiated at the time of emergency department discharge: study protocol for a three-arm randomized clinical trial.

BACKGROUND: Social isolation and loneliness (SIL) worsens mortality and other outcomes among older adults as much as smoking. We previously tested the impact of the HOW R U? intervention using peer support from similar-aged volunteers and demonstrated reduced SIL among older adults discharged from the emergency department (ED). Generativity, defined as "the interest in establishing and guiding the next generation," can provide an alternative theoretical basis for reducing SIL via intergenerational programs between members of younger and older generations. The current protocol will examine the impact of younger intergenerational volunteers providing the HOW RU? METHODS: In this randomized clinical trial, we will compare the following three arms: (1) the standard same-generation peer support HOW R U? intervention, (2) HOW R U? intervention delivered by intergenerational volunteers, and (3) a common wait-list control group. Outcome assessors will be blinded to the intervention. Trained volunteers will deliver 12 weekly telephone support calls. We will recruit participants ≥ 70 years of age with baseline loneliness (six-item De Jong loneliness score of 2 or greater) from two EDs. Research staff will assess SIL, depression, quality of life, functional status, generativity, and perceived benefit at baseline, at 12 weeks, and 24 weeks post-intervention. DISCUSSION: We hypothesize participants receiving the intergenerational intervention will show improved outcomes compared to the control group and peer support HOW R U? INTERVENTION: We also hypothesize that participants with higher perceptions of generativity will have greater reductions in SIL than their lower generativity counterparts. Aging is experienced diversely, and social interventions combatting associated SIL should reflect that diversity. As part of a program of research following the Obesity-Related Behavioral Intervention Trials (ORBIT) model, the findings of this RCT will be used to define which intervention characteristics are most effective in reducing SIL. TRIAL REGISTRATION: ClinicalTrials.gov NCT05998343 Protocol ID:21-0074E. Registered on 24 July 2023.

What really matters for global intergenerational mobility?

This study investigates the genuine impacts of education expansion, education inequality, and parental dependency on intergenerational mobility. It utilizes data from the Global Database on Intergenerational Mobility for 153 countries and cohorts born between the 1940s and 1980s. By employing a causal machine learning approach to address confounding problems, this research reveals that education expansion can promote intergenerational mobility to a certain extent. However, its effectiveness is partially diminished by education inequality and may be ineffective if parental dependency exists at a high level. Furthermore, this study also indicates that while gender inequality in intergenerational mobility still exists, its degree has been significantly reduced across generations. When compared to parental dependency, gender effects are far less important. Therefore, there is a need to reassess the roles of parental dependency and gender bias in intergenerational mobility, especially when parental dependency is currently underestimated, and gender bias is overemphasized.

The impact of intergenerational support on social participation patterns of older adults in rural China.

Objectives: This study aimed to examine the association between different dimensions of bi-directional intergenerational support and the social participation patterns of rural older adults, while also exploring the heterogeneity of these older adults by gender and age. Methods: Based on longitudinal survey data from the 'Well-Being of Older People in Anhui Province (WESAP)' in 2018 and 2021, this study used latent class analysis to identify social participation patterns and used multinomial logistic regressions to explore the relationship between intergenerational support and social participation patterns among rural older adults. Results: First, the social participation patterns of rural older persons can be divided into four categories: leisure type (9%), work type (11%), housekeeping type (57.9%) and family labor type (22.1%). Second, there is heterogeneity in the relationship between intergenerational support and social participation patterns in older people, among them, receiving financial support decreased the likelihood of older adults being categorized as work type and family labor type by 14 and 7.7%, respectively, while providing financial support increased the likelihood of older adults belonging to the family labor type by 7.5%; receiving caring support increased the likelihood of older parents being categorized as leisure type by 6%, while providing caring support decreased the likelihood of older parents being categorized as leisure type by 10%; emotional support is related to all patterns of social participation among older adults. Third, the effects of intergenerational support vary across subgroups based on gender and age. Conclusion: Two-way intergenerational support was significantly associated with social participation among rural older adults, and there was significant heterogeneity in this association. Children and older persons should be encouraged to strengthen two-way intergenerational mobility to give full play to the positive impact of different dimensions of intergenerational support on the social participation of older persons in rural areas, ultimately enhancing the quality of life for rural older adults.

The transition of eldercare responsibility and traditional filial piety concepts and its urban-rural differences in China: an age-period-cohort analysis from 2006 to 2017.

BACKGROUND: With rapid urbanization, massive migration, and non-family-based eldercare involvement, Chinese concepts of eldercare responsibility and filial piety are shifting. We performed age-period-cohort (APC) analyses to assess the transition of old-age pension coverage, eldercare responsibility, and filial piety concepts and its urban-rural differences among Chinese adults using data from the China General Social Survey (2006-2017). METHODS: Old-age pension coverage (yes/no) and primary eldercare responsibility (government/offspring/self/sharing) were investigated in 2010, 2012, 2013, 2015, and 2017. Filial piety was evaluated using customized questionnaires in 2006 and 2017. The APC effects were estimated using mixed effects and generalized additive models. RESULTS: Among 66,182 eligible participants (mean age: 48.8 years, females: 51.7%) in the six waves, APC analyses indicated that old-age pension coverage increased with aging and over time. Across cohort groups, it grew as the cohort was younger in urban residents but decreased in rural residents. The concept of offspring-based (> 50%) and government/self/offspring-shared eldercare (> 30%) predominated. APC analyses revealed that the offspring-based concept declined with aging (OR = 0.81, 95% CI: 0.79-0.84), whereas the government-based (OR = 1.37, 95% CI: 1.33-1.41) and self-based (OR = 1.55, 95% CI: 1.47-1.63) concepts increased with aging. People born around the 1940s have a comparatively higher possibility to perceive that the primary eldercare responsibility should be undertaken by the government and elder parents. In contrast, people born in the younger cohort were more likely to perceive that adult children are responsible for their parents' primary eldercare. Filial piety score slightly increased with aging (ß = 0.18, SD: 0.05) but decreased as the birth cohort was younger. In addition, rural participants were more likely to perceive offspring-based eldercare and maintain filial piety, and the related urban-rural difference was intensified by aging. CONCLUSIONS: The traditional concept that eldercare solely relies on offspring has changed to relying on multiple entities, including the government and self-reliance. Diluted filial piety in people born in the young cohort requires reinforcement. Moreover, future healthy aging policies need to focus more on urban-rural disparities to promote equity in social well-being.

Barriers and enablers to promoting grandchildren's physical activity and reducing screen time: a qualitative study with Australian grandparents.

BACKGROUND: With an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children's engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children's physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children's physical activity and reducing screen time. The present study sought to explore these perceptions. METHODS: Semi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis. RESULTS: Key reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents' age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children's fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view). CONCLUSIONS: Findings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents' age and health status, as well as any environmental barriers, are likely to be well-received.

How do question-answer exchanges among generations matter for children's happiness?

Intergenerational exchange plays an increasing role in realizing sustainable societies. Question-answer exchanges are the trigger for individuals to initiate some intergenerational relations, and the literature has established that inquisitiveness (curiosity about something and someone different) contributes to people's generativity and happiness. However, little is known about how children's inquisitiveness influences their generative concern and happiness. We claim that inquisitiveness is essential for children to enhance their happiness and hypothesize that those who receive a positive response from adults tend to be inquisitive and express the signs of generativity. To empirically examine the hypothesis, we have statistically characterized inquisitiveness in relation to adult-child interaction, generativity (offering care for people and the natural environment) and happiness, using the data from a survey of 511 Japanese children between 9 and 14 years and by applying the revised generativity concern scale (GCS-R). The results show that inquisitiveness correlates with generativity and happiness, primarily that a positive response by adults to children's inquiries promotes their inquisitiveness through adult-child interactions. Our analysis shows that children's inquisitiveness, encouraged by adults' positive responses, is more significant in happiness than the generativity concern during childhood. Overall, the results suggest that adults responding positively to children's questions is essential for promoting inquisitiveness and increasing happiness.

Through the eyes of grandparents: an in-depth exploration of the nexus between grandchild caring and the psychological well-being of older grandparents.

BACKGROUND: Grandchild caring has positive as well as negative impact on the grandparents' psychological well-being and the findings are varied by culture and country. METHODS: Present study was intended to understand the relationship between caring for grandchildren and psychological well-being of grandparents living in skipped (SGH) and multi-generational households (MGH) in Indian demographical context. The present research involved In-depth Interviews (IDI) focusing on grandparents above 60 and grandchildren below 18, where the elder played a crucial role in caregiving. The study area was Malda, a district of West Bengal in India. Purposively 24 IDIs were selected. Psychological well-being was measured using open-ended questions. Thematic and content analyses were adopted to understand the perspective of grandparents. RESULTS: Most of the grandparents from SGH reported depression word frequently, while grandparents from MGH reported happy. In the content analysis, grandparents from SGH expressed tension, mental turmoil, and worry about grandchild's future. On the contrary, grandparents from MGH expressed happy, companionship, and worry about grandchild's future. Further, full time caring, compulsive reason behind grandchild caring, and working status were linked with living in SGH and grandchild caring, which were in turn connected with deteriorate psychological health. However, in MGH, a different scenario was observed, most grandparents were partially and non-compulsively engaged in grandchild caring and had expressed positive mental health. CONCLUSIONS: The Findings provide an intervention implication, particularly in the context of India's ageing population and their well-being by acknowledging the influence of household structure, caring intensity, motive behind grandchild caring, and working status on their psychological health. Understanding the importance of these key factors may help the policy maker and the individual to incorporate the most effective intervention to achieve sustainable development goal 3 and healthy ageing.

The influence of progeny-Parents family travel on the well-being of the elderly in filial piety culture.

Grounded in the cultural context of Chinese filial piety, this study employs structural equation model to analyze survey data from elderly participants. It explores the effect and path of progeny-parents family travel on the elderly's sense of well-being and examines the mediating roles of generational interaction, optimistic emotion, and psychological resilience. The findings indicate that progeny-parents family travel positively influences the well-being of the elderly, with generational interaction, optimistic emotion, and psychological resilience serving as intermediary roles. Theoretically, this study enriches the localized perspective of family travel's psychological and behavioral impact on the elderly. It elucidates the spillover effects of family travel within the framework of filial piety culture, delineates the mechanisms by which family travel enhances elderly well-being, and offers theoretical insights for businesses to develop customized family travel products and services.

"I am adhering to HIV treatment so that I can live to support her": A qualitative study of upward intergenerational support in South Africa.

Background: Intergenerational family care, which was upended by the HIV epidemic in sub-Saharan Africa (SSA), may return to a pre-HIV era arrangement as access to antiretroviral therapy (ART) expands and treated adults can once again provide support for older household members. Empirical research has demonstrated positive 'spillover effects' of ART uptake from treated adults to younger generations, yet much less is known about the nature and breadth of such effects to older generations. This study explores the role and lived experiences among adults who take up ART and those of an older generation with whom they live. Methods: We conducted a qualitative study consisting of semi-structured interviews (n = 46) embedded in the Agincourt Health and Demographic Surveillance System (HDSS) in rural South Africa, between July and September 2022. We purposefully sampled two respondent categories: (i) young or middle-aged adults on ART (aged 18-59 years old); and (ii) older adults (aged ≥60 years old) who were affiliated with a young or middle-aged adult on ART. We used thematic content analysis to extract, code, and categorise relevant text by types of upward spillover effects from ART in younger adults to older adults. Quantitative data was extracted from the existing Agincourt HDSS database and matched to qualitative interview data based on Clinic link unique identifiers of study participants. Results: Mean age was 41 years among young or middle-aged adults (n = 29) and 72 years among older adults (n = 17). Among younger adults, time on ART ranged from five months to more than 21 years. Both young or middle-aged adults on ART and older adults reported positive spillover effects for older adults across five main tiers: caregiving, financial support, physical and mental health, living arrangements and household relationships, and stigma and reputation. Spillover challenges included financial costs and caregiving responsibilities following ART initiation of young or middle-aged adults, although these additional caregiving responsibilities were generally not perceived as particularly burdensome. Conclusions: ART is likely to benefit older adults in South Africa whose families are affected by HIV. This study identified a wide range of perceived spillover effects from ART in younger adults to older adults, including improvements to upward intergenerational support. These qualitative findings offer a guide to researchers, policymakers, and donors to capitalise on the broader societal effects of a large-scale health intervention to further support family structures and meet the needs of a growing older population.

Do multigenerational homes moderate the intergenerational transmission of maternal adverse childhood experiences?

ABSTRACTBackground: Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.Objective: This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children's behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.Participants and setting: Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.Methods: Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children's behavioural problems. This study used a moderated mediation model.Results: The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children's behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children's behaviour problems via psychological distress.Conclusion: Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.

Psychological distress and corporal punishment have parallel mediating roles in the associations between maternal adverse childhood experiences and offspring behavioural problems.Mothers with more adverse childhood experiences and in multigenerational homes were more likely to use corporal punishment.Multigenerational homes did not moderate the indirect relationship via psychological distress.

The impact of long-term care insurance on family care for older adults: The mediating role of intergenerational financial support.

Rapid population aging has been placing heavy tolls on Chinese family caregivers. Previous empirical evidence from multiple countries have shown that establishing national long-term care insurance was effective in reducing family care burdens. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) wave 2011 to 2018, this study examined the effects of implementing the pilot long-term care insurance program on family care received by the Chinese older adults, by using a time-varying Difference-in-Differences (DID) method. The results showed that: (1) the implementation of the pilot long-term care insurance program has led to a 17.2% decline in general for family care received by the Chinese older adults. (2) The effect of participating in the pilot program on family care received differed by respondent's household registration, health status, marital status, and possesion of retirement pension, and were specifically pronounced among those who were urban residents, having spouse, living with disabilities, and living with no retirement pension. (3) Further results from the mechanism analyses showed that the pilot long-term care insurance program decreased the level of family care by reducing the dual intergenerational financial support between older adults and their adult children. (4) Although participating in the pilot program decreased older adult's dependence on their adult children, their physical and mental health status were not negatively affected. This study contributes to the existing literature by evaluating the effects of implementing the pilot long-term care insurance program on family care received by the Chinese older adults, and lends supports to the previous studies that participating in long-term care insurance significantly reduces old adults' demand for family care, but not in sacrifice of their physical and mental well-being.

Grandmother-grandchild physiological synchrony in Chinese three-generation families: Links with child emotion regulation.

The current study examined the characteristics of physiological synchrony between grandmothers and grandchildren in Chinese three-generation families, and the associations between physiological synchrony and child emotion regulation. The participants included 92 children (age 8-10-year old) and their grandmothers. Respiratory sinus arrhythmia (RSA) was collected from both grandmothers and their grandchildren throughout a collaborative drawing task and a conflict discussion task. Child emotion regulation was measured using the Children's Emotional Management Scale. We found no evidence for an overall pattern of concordant or discordant synchrony within dyads. Instead, there was great variability in patterns of synchrony across dyads. During the collaborative drawing task, concordance in grandmother's RSA and grandchildren's subsequent RSA was linked with better emotion regulation. During the conflict discussion, concordance in grandmother's RSA and grandchildren's simultaneous RSA was linked with poorer emotion regulation. These results suggest that grandmother-grandchild synchrony in different directions, time lags, and contexts has different influences on children's emotion regulation. The findings of this study highlight the importance of contextual physiological co-regulation between Chinese children and their grandmothers for children's social-emotional development.

Insights from end-of-career general practitioners on changing working conditions and generational differences: considerations for future strategies.

The landscape of general practice has experienced notable transformations in recent decades, profoundly influencing the working conditions of general practitioners (GPs). This study aimed to examine the most salient changes affecting GPs' daily practices. Through semi-structured qualitative interviews with 15 end-of-career GPs, the study explored how these changes affected work organization, equipment, working hours, work-life balance, job satisfaction, training, patient relationships, and reputation. The interviews revealed that these changes were perceived as barriers, opportunities, or a complex interplay of both for general practice. While the interviewed GPs valued technological advancements and reported positive developments in working conditions, challenges included a gradual reduction in the range of tasks, growing administrative burdens, and less practical training for young physicians. Other changes, such as new doctor-patient dynamics, the transition from single to group practice, and differing professional expectations of the younger generation, were seen as both challenging and strengthening for general practice. By combining these factors and trade-offs observed by end-of-career GPs in our study over the past few decades with general societal changes, we provide ideas for the design of future framework conditions in general practice that might enhance the attractiveness of the profession. These insights offer key considerations that can guide future strategies for general practice and medical education.