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                  <text>Multigenerational Legacies of Trauma of Indigenous Canadians (First Nations, Métis, Inuit)</text>
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              <text>Of the 1.8 million Indigenous Peoples residing on the lands known as Canada, nearly half live in urban areas. Urban spaces themselves are built on traditional Indigenous territory. In some cases, Indigenous Peoples are born and raised in cities that exist on their territories, in other cases, Indigenous Peoples may have migrated to cities or were born there, away from their own&#13;
ancestral lands. Being an urban Indigenous Person often means that our ties to cultural&#13;
connection have been disrupted to some degree (Barker 2019). Studies have shown that&#13;
Indigenous People are overrepresented in several key mortality related measures, such as violent death and premature death. Given this information, this study examines urban Indigenous experiences of colonization, culture, and grief to determine what impacts colonization and culture have had on meaningful and culturally relevant healing experiences. The study collaboratively works with 15 self-identified urban Indigenous Peoples from age 21-84, located in or near amiskwaciwâskahikan (Edmonton). It uses qualitative and Indigenous methodologies to answer the following primary questions: how do urban Indigenous Peoples experience grief and what support systems exist for them, if any? Sub-questions that we addressed were: do people have access to culturally relevant grief support? If yes, what does that look like and if no, how can we enable it? Findings indicate that urban Indigenous experiences of grief are influenced in complex ways by colonization, unresolved trauma, and culture. Within the psychological and sociological literature on grief, the study shows how urban Indigenous experiences of grief can be understood as ‘disenfranchised,’ using Kenneth Doka’s concept of disenfranchised grief.</text>
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                <text>A Mind Spread Out on the Ground:” Urban Indigenous Experiences of Grief and Bereavement</text>
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              <text>&lt;a href="https://doi.org/10.1038/s41591-025-04080-0"&gt;https://doi.org/10.1038/s41591-025-04080-0&lt;/a&gt;</text>
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              <text>Hanna Huber, Laia Montoliu-Gaya, Wagner S. Brum, Jakub Vávra, Yara Yakoub, Haley Weninger, Luisa Sophie Braun-Wohlfahrt, Joel Simrén, Mercé Boada, Agustín Ruiz, Amanda Cano, Adelina Orellana, Sergi Valero, Laia Cañada, Natalia Tantinya, Ana Belen Nogales, Pilar Sanz-Cartagena, Anna Dittrich, Ingmar Skoog, Millie Sander-Long, Clive Ballard, Megan Richards, Mary O’Leary, Frederikke Kragh Clemmensen, Hannah H. D. Wandall, Daniele Altomare, Valentina Cantoni, Erik Stomrud, Sebastian Palmqvist, Alberto Lleo, Daniel Alcolea, Maria Carmona Iragui, Aida Sanjuan Hernandez, Bessy Benejam, Laura Videla Toro, Alpana Singh, Marisa N. Denkinger, Anja Hviid Simonsen, Silke Kern, Anne Corbett, Juan Fortea, Lee Honigberg, Barbara Borroni, Oskar Hansson, Xavier Morató, Kaj Blennow, Henrik Zetterberg, Nicholas J. Ashton</text>
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              <text>Blood biomarkers have emerged as accurate tools for detecting Alzheimer’s disease (AD) pathology, offering a minimally invasive alternative to traditional diagnostic methods such as imaging and cerebrospinal fluid (CSF) analysis. Yet, the logistics surrounding venipuncture for blood collection, although considerably simpler than the acquisition of imaging and CSF, require precise processing and storage specific to AD biomarkers that are still guided by medical personnel. Consequently, limitations in their widescale use in research and broader clinical implementation exist. The DROP-AD project investigates the potential of dried plasma spot (DPS) and dried blood spot (DBS) analysis, derived from capillary blood, for detecting AD biomarkers, including phosphorylated tau at amino acid 217 (p-tau217), glial fibrillary acidic protein and neurofilament light. Here, 337 participants from 7 centers were included, with 304 participants providing paired capillary DPS or DBS and venous plasma samples. We observed strong correlations between DPS p-tau217 and venous plasma p-tau217 (rS = 0.74, P &lt; 0.001). DPS p-tau217 progressively increased with increasing disease severity, and showed good accuracy in predicting CSF biomarker positivity (area under the curve = 0.864). Similarly, we demonstrated the successful detection of glial fibrillary acidic protein and neurofilament light with strong correlations between DBS and DPS, respectively, using paired venous plasma samples. Notably, the method was also effective in individuals with Down syndrome, a population at high genetic risk for AD but in whom standard blood sampling by venipuncture may be more complicated, revealing elevated biomarkers in those with dementia compared with asymptomatic individuals. The study also explored unsupervised blood collection, finding high concordance between supervised and self-collected samples. These findings underscore the potential of dried blood collection and capillary blood as a minimally invasive, scalable approach for AD biomarker testing in research settings. Yet, further refinement of collection and analytical protocols is needed to fully translate this approach to be viable and useful as a clinical tool.</text>
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              <text>&lt;a href="https://dx.doi.org/10.14288/1.0449851"&gt;https://dx.doi.org/10.14288/1.0449851&lt;/a&gt;</text>
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              <text>Lateral violence, a prevalent issue within Indigenous communities, encompasses a complex and harmful set of behaviours that individuals and groups perpetuate amongst themselves and within the collective as a result of systemic oppression and historical trauma. This phenomenon remains poorly understood and was only recently named. Its intergenerational impacts are devastating at both individual and community levels, deeply harming the collective psyche. To help find solutions and strategies to dismantle this harm, I dedicated my thesis to its study as an effort to deepen our understanding of its origins, impacts, and possible solutions. Grounded in personal, familial, and community stories, this mixed-methods study combined quantitative surveys, narrative inquiry, and sharing circles rooted in Indigenous ways of knowing. Together, these methods revealed how lateral violence is perpetuated, internalized, and normalized within communities, and how it erodes cultural identity, wellness, and belonging. Participants shared powerful stories of how colonial legacies, such as blood quantum, language loss, and internalized bias, continue to divide families and communities. My hope is that this work serves as a starting point for deeper understanding and meaningful action, rooted in community truths and personal testimony. This thesis is my personal effort to bring a damaging phenomenon out of the shadows and into collective understanding, offering insights and culturally grounded strategies for healing, resilience, wholistic wellness, and the revitalization of Indigenous identity and community cohesion. The importance of this research extends beyond personal reflection, offering both academic and community relevance.</text>
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              <text>&lt;a href="https://doi.org/10.1038/s41586-025-08800-x"&gt;https://doi.org/10.1038/s41586-025-08800-x&lt;/a&gt;</text>
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              <text>2025</text>
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              <text>Neurotropic herpesviruses may be implicated in the development of dementia. Moreover, vaccines may have important off-target immunological effects. Here we aim to determine the effect of live-attenuated herpes zoster vaccination on the occurrence of dementia diagnoses. To provide causal as opposed to correlational evidence, we take advantage of the fact that, in Wales, eligibility for the zoster vaccine was determined on the basis of an individual’s exact date of birth. Those born before 2 September 1933 were ineligible and remained ineligible for life, whereas those born on or after 2 September 1933 were eligible for at least 1 year to receive the vaccine. Using large-scale electronic health record data, we first show that the percentage of adults who received the vaccine increased from 0.01% among patients who were merely 1 week too old to be eligible, to 47.2% among those who were just 1 week younger. Apart from this large difference in the probability of ever receiving the zoster vaccine, individuals born just 1 week before 2 September 1933 are unlikely to differ systematically from those born 1 week later. Using these comparison groups in a regression discontinuity design, we show that receiving the zoster vaccine reduced&#13;
the probability of a new dementia diagnosis over a follow-up period of 7 years by 3.5 percentage points (95% confidence interval (CI) = 0.6–7.1, P = 0.019), corresponding to a 20.0% (95% CI = 6.5–33.4) relative reduction.</text>
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              <text>In Brazil, this evidence has been translated into public policy through the Dietary Guidelines for the Brazilian Population (hereinafter called Guide), a document developed by the Ministry of Health that provides dietary recommendations tailored to the Brazilian population. The Guide, now in its tenth year, emphasizes the message “always prefer natural and minimally processed foods and their culinary preparations over ultra-processed foods”, encouraging the traditional Brazilian diet, rich in staples like rice and beans, to form the foundation of our diet. Moreover, the Guide moves away from recommendations based on quantities and portions, operating on the understanding that, except in specific cases, our natural mechanisms of hunger and satiety are sufficient to regulate food intake once ultra-processed foods, which are designed to be consumed in excess, are excluded.</text>
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              <text>While previous research often emphasizes the negative impacts of colonization on First Nations People, the focus of this work was on highlighting cultural strengths and resilience, especially among youth facing the challenge of transitioning into adulthood. Despite existing theories like positive youth development, our understanding of positive development among ethnic minority groups, including First Nations youth, remains limited. We review factors associated with resilience and protective factors, suggesting strategies to enhance positive development. We summarize a cross-national study on Indigenous and non-Indigenous youth in Australia and the United States, emphasizing the protective effect of community engagement and volunteering. We then overview a pilot employment and mentoring program designed for First Nations People in Victoria, Australia, focusing on community aspirations, cultural engagement, and wellbeing outcomes. The program showed positive effects on goal attainment, employment, and cultural involvement. We conclude by discussing how our findings can be applied in mentoring programs, school curricula, and efforts within broader communities to promote positive development outcomes for young First Nations People throughout the world.</text>
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                <text>A Professional Mentoring Program for Australian First Nations People</text>
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              <text>Background&#13;
Suicide among young people in Alaska Native (AN) communities was nearly unheard of through the establishment of statehood in 1959, but from 1960–1995, the suicide rate increased by approximately 500% during this period of rapid, imposed social transition. These disruptions increased conditions associated with suicide risk (e.g., substance use disorders, cultural disconnection), and challenged the community-level social safety net of youth protective factors. The purpose of this paper is to outline development and evaluation methodology for a comparative effectiveness trial of two virtual, culturally grounded, brief interventions to address suicide prevention among AN young people. The proposed study addresses significant gaps in culturally appropriate evidence-based programming to address suicide prevention among AN young people by comparing effectiveness of these two interventions. Findings from this study have potential to expand the range of accessible, critically important services to this population.&#13;
&#13;
Methods&#13;
Our interventions will be targeted toward AN young people ages 14–24 who present with suicide attempt, ideation, or associated risk behaviors, including alcohol-related injury in the Yukon-Kuskokwim region or the Interior of Alaska. In this randomized controlled comparative effectiveness trial, 14–24-year-old AN individuals will receive either BeWeL (Because We Love You) which will comprise a 45-min virtual wisdom talk addressing family strengths and increasing protective factors (n = 185), or BeWeL + MISN (plus motivational interviewing about social networks), which will include an additional 15 min focused on discussion of the individual’s social networks (n = 185). Both interventions will have two follow-up visits at 2 and 6 weeks. We will evaluate changes in both intervention groups from the baseline survey at 3, 6, and 12 months on primary outcomes of suicide-intent risk, depression, anxiety, frequency of alcohol use, and alcohol consequences and compare effectiveness between the two interventions. In our secondary aim, we will evaluate changes in both groups from the baseline survey at 3, 6, and 12 months on individual and community protective factors, social networks, and awareness of connectedness and compare effectiveness between the two interventions.&#13;
&#13;
Discussion&#13;
This project has the potential to expand the range and effectiveness of suicide prevention services for AN young people and will help meet the need in Alaska to link clinical behavioral health services to AN community-based networks, and to engage local cultural resources in aftercare for individuals at risk for suicide. Findings have potential to provide practical information to advance the field of suicide prevention and enhance protective factors and resiliency among this population.&#13;
&#13;
Trial registration&#13;
ClinicalTrials.gov Identifier: NCT05360888; Registered December 22, 2022. https://clinicaltrials.gov/study/NCT05360888.</text>
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              <text>Julia Arizono</text>
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                <text>A Protocol for a Randomized Controlled Comparative Effectiveness Trial of Two Brief Interventions Focused on Social and Cultural Connectedness to Reduce Risk for Suicide and Substance Misuse in Young Alaska Native People</text>
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              <text>&lt;a href="https://doi.org/10.1186/s12889-026-26248-0"&gt;https://doi.org/10.1186/s12889-026-26248-0&lt;/a&gt;</text>
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            <elementText elementTextId="9022">
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              <text>Background&#13;
Evidence suggests that the uptake of pediatric guidelines for screen use is generally low, which highlights a need to better understand the familial factors shaping children’s digital media use. This study aimed to explore parents’ perspectives regarding digital media use guidelines, including the factors that influence adherence to recommendations.&#13;
&#13;
Methods&#13;
Semi-structured interviews with 28 parents of young children were analyzed using thematic analysis. Purposive and snowball sampling were employed to recruit parents through notices posted at grocery stores, libraries, preschools, and a university database.&#13;
&#13;
Results&#13;
Three overarching themes emerged: (1) influences and variations on digital media use in families; (2) views regarding guidelines; and (3) recommendations for disseminating and improving uptake of guidelines. Sub-themes included parental attitudes, family context, child characteristics, lack of information, parenting stress, and knowledge dissemination strategies.&#13;
&#13;
Conclusions&#13;
Parental views regarding guidelines are shaped by personal attitudes, family context, child characteristics, availability of information, and societal influences. Recommendations include highlighting the developmental impacts on children, the effects of different types of screen activities, and strategies for limiting digital media use. Dissemination of information should use a multi-faceted approach that involves different sectors such as health and education, providing follow-up assessments, and building supportive environments.</text>
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                <text>A Qualitative Study Examining Household Context and Parental Perspectives on Preschoolers’ Digital Media Use Guidelines</text>
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              <text>&lt;a href="https://doi.org/10.1080/10826084.2025.2562455"&gt;https://doi.org/10.1080/10826084.2025.2562455&lt;/a&gt;</text>
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              <text>Hridika Shah, Sara Whaley, Isha K. Desai, Minna Song, Avery Meyer, Omeid Heidari, Sean T. Allen, Noa Krawczyk, Susan G. Sherman, Brendan Saloner, Samantha J. Harris</text>
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The COVID-19 pandemic had a devastating impact on people who use drugs (PWUD). Reductions in access to harm reduction tools and treatment services elevated rates of fatal overdose for many. We explore the mechanism through which these factors influenced the rise in overdose mortality during COVID-19 from the perspective of people with overdose encounters.&#13;
&#13;
Methods&#13;
We conducted in-depth, semi-structured, 60-minute telephone-based interviews with 43 overdose survivors and witnesses between January and May 2022. Participants were from nine states (ME, MI, MD, NJ, NY, NM, PA, TN, WV) and Washington, DC. Data were analyzed thematically following the Continuum of Overdose Risk.&#13;
&#13;
Results&#13;
Most reported worsening mental health and increasing substance use during COVID-19. Isolation due to quarantining measures, coping behaviors, despair, and traumatic grief contributed to resumptions in drug use and risky behaviors. Some discussed how these stressors, combined with the rapid availability of financial resources led to increased use. Participants also attributed increased overdose risk to the increasingly toxic drug supply and stifled harm reduction access. Accounts of methadone treatment varied, however several expressed inconsistent access to take-home methadone, potentially contributing to resumed use.&#13;
&#13;
Conclusions&#13;
Numerous micro- and macro-social factors, as well as the drug supply and treatment disruptions contributed to the acceleration in overdose risk. Increased funding and policy reform are needed to reduce overdose mortality in future public health emergencies, including improving harm reduction and treatment service adaptations to fit the needs of clients, as well as upholding and expanding novel methadone treatment delivery models.</text>
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                <text>A Qualitative Study on the Impact of COVID-19 on Overdose Risk from the Perspective of Survivors and Witnesses of Drug Overdose: Lessons for Future Public Health Emergencies</text>
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              <text>Background&#13;
Prevention of alcohol-exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at-risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian/Alaska Native (AI/AN) women.&#13;
&#13;
Methods&#13;
AI/AN women aged 18–44 who were at-risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group. Native CHOICES comprised two sessions of motivational interviewing and an elective contraception counseling session. Data were collected at baseline, and 6 weeks, 3 months, and 6 months postbaseline. Due to the pandemic, the intervention was at times delivered remotely.&#13;
&#13;
Results&#13;
A total of 404 women participated: 199 in the control group and 205 in the intervention group. Sixty-seven percent of the intervention group received the intervention in-person, and 33% participated by telephone or video call. Sixty-four percent of women completed all follow-up visits. At the six-month follow-up, the intervention did not demonstrate a significant impact on AEP risk compared with the control arm when analyzing all the data (RR = 0.94; 95% confidence interval [CI]: 0.83–1.07). However, an exploratory subgroup analysis showed evidence of a reduction in AEP risk among participants who completed the study in-person before the COVID-19 pandemic (RR = 0.79; 95% CI: 0.63–0.98), which was not observed during or after the pandemic (RR = 1.06; 95% CI: 0.91–1.24).&#13;
&#13;
Conclusions&#13;
The Native CHOICES intervention did not show evidence of effectiveness overall. However, exploratory analyses offer some evidence that the intervention was effective prior to the pandemic.</text>
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