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              <text>&lt;a href="https://doi.org/10.20945/2359-4292-2024-0446"&gt;https://doi.org/10.20945/2359-4292-2024-0446&lt;/a&gt;</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>A Paradigm Shift in Nutritional Clinical Practice: filling a gap on the implementation of the Dietary Guidelines for the Brazilian Population</text>
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              <text>Bolivia ranks among the world’s most biologically diverse countries, and spans ecosystems that range from the Amazon rainforest to the Andes, Cerrado, Chaco and Chiquitano forests. This extraordinary mosaic harbours exceptional species, habitat and ecosystem diversity. Yet Bolivia’s biodiversity now stands at a critical juncture. Over the past two decades, accelerating deforestation, infrastructure expansion, agribusiness, illegal mining and wildlife trade have driven many ecosystems towards collapse, which has had far-reaching consequences for human well-being, Indigenous livelihoods and climate resilience. The change of government following the 19 October 2025 general elections marks a political turning point and a historic opportunity to redefine Bolivia’s environmental trajectory.</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>Stacy Rasmus, Elizabeth J. D'Amico, James Allen, Cynthia Nation, Simeon John, Victor Joseph, Anthony Rodriguez, Gabriela Alvarado, Allyson D. Gittens, Alina I. Palimaru, Ryan A. Brown, David P. Kennedy, Michael K. Woodward, Jennifer Parker, Keisha McDonald</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>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>The present study explored how racism-related stress was characterized by respondents&#13;
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2) Intergroup, 3) Bicultural, and 4) Intragroup. Race-related coping strategies, which&#13;
included the cognitive, emotional and behavioral strategies respondents used to reduce&#13;
and/or manage their experiences of racism, were also explored. Eight overarching coping&#13;
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findings indicated that for this sample of Native American older adults the welfare of the&#13;
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influenced coping behaviors. These findings suggest that appropriate and effective&#13;
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importance of belongingness/interconnectedness. However given that this study did not&#13;
specifically ask about racism, future studies will need to employ a more direct line of&#13;
questioning since it is quite possible that specific questions regarding respondents‘&#13;
experiences with racism could lead to different and/or more complete responses.</text>
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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>Aboriginal Australians experience a high prevalence of chronic obstructive pulmonary disease (COPD), with high rates of potentially preventable hospitalisations. However, little is known about Aboriginal peoples’ experiences of living with COPD and how they navigate health care systems. This study used thematic analysis and Aboriginal methodology to explore Aboriginal peoples’ lived experiences of COPD, their health care journey from receiving a diagnosis of COPD to the clinical management, and the impact of COPD on their daily lives. We conducted in-depth semi-structured interviews over a 6-month period with 18 Aboriginal adults diagnosed with COPD from four Aboriginal Community Controlled Health Services (ACCHS) in New South Wales, Australia. Reflexive thematic analysis was employed to ensure rigour. The findings revealed deeply personal and reflective stories shaped by historical, social, and cultural realities of Aboriginal peoples living with COPD. Four themes were identified characterising their experiences. Based on the findings, the following guidance is provided on future COPD care for Aboriginal peoples: Better alignment of existing COPD management with Aboriginal peoples’ cultural contexts and perspectives to improve access to culturally safe care; Increased funding for ACCHS to enhance COPD management, such as early detection through case finding and access to ACCHS-led pulmonary rehabilitation; Engaging family members in COPD management and providing culturally centred COPD education that facilitates discussions and builds health literacy and self-management skills; Implementing health promotion initiatives to increase awareness and counteract fear and shame to improve early COPD detection.</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>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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                <text>A Randomized Controlled Trial of Native CHOICES: Impact on alcohol-exposed pregnancy risk reduction among American Indian and Alaska Native women</text>
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              <text>Paul B. Rosenberg, Halima Amjad, Haroon Burhanullah, Milap Nowrangi, Ryan Vandrey, Mersania Jn Pierre, John D. Outen, Meghan Schultz, Christopher Marano, Marc Agronin, James M. Wilkins, David Harper, Todd Laffaye, Eilis Reardon, Kathryn Turner, Rosain Ozonsi, Mia Drury, Andre Nguyen, Tuna Hasoğlu, Julia Cromwell, Jeannie-Marie Leoutsakos, Brent P. Forester</text>
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              <text>2026</text>
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              <text>Importance&#13;
Agitation in Alzheimer’s disease (AD) is a great source of distress for patients and caregivers and a major public health burden. Current treatments are only modestly effective and many have safety issues including mortality risk. Novel therapeutic options are needed. There is preliminary evidence for the safety and efficacy of dronabinol (tetrahydrocannabinol, THC) for agitation in AD.&#13;
&#13;
Objective&#13;
Assess the safety and efficacy of dronabinol (THC) to decrease agitation in AD.&#13;
&#13;
Design&#13;
THC-AD was a 3-week randomized parallel double-blind placebo-controlled clinical trial, conducted between 2017 and 2024.&#13;
&#13;
Setting&#13;
5 inpatient and outpatient academic clinical research centers in the Eastern U.S.&#13;
&#13;
Participants&#13;
Volunteer sample of 75 participants meeting inclusion criteria for agitation of AD (International Psychogeriatric Association Provision Criteria) with Neuropsychiatric Inventory Clinician Version Agitation or Aggression (NPI-C A/A) domains total score of 4 or greater. Major exclusion criteria included seizure disorder, delirium, and non-AD dementia.&#13;
&#13;
Interventions&#13;
3 weeks dronabinol vs. placebo titrated up to target dose of 10 mg daily in divided twice-daily.&#13;
&#13;
Main Outcomes and Measures&#13;
Prespecified co-primary agitation outcomes were the Pittsburgh Agitation Scale (PAS) and NPI-C A/A total score.&#13;
&#13;
Results&#13;
The majority of participants were female and were taking concomitant psychotropic medications (antidepressants and antipsychotics) at baseline. Study participants were moderately agitated at baseline, were diverse in ethnic background (9% Black, 11% Hispanic/Latina/Latino), and had severe cognitive impairment evidenced by MMSE or SIB-8. 84% completed the 3-week trial. Dronabinol decreased agitation on both primary outcomes greater than placebo to a clinically relevant extent. The fitted between-arm difference in PAS decline/week was −0.74 (SE 0.3, p = 0.015, effect size = 0.53) and for NPI-C A/A the decline was not significant at −1.26 (SE 0.67, p = 0.094, effect size = 0.36). No secondary outcomes differed between treatment arms including sleep, activities of daily living, Cohen-Mansfield Agitation Inventory (CMAI), cognition, intoxication, or use of ‘as-needed’ lorazepam or trazodone. Dronabinol treatment was not associated with greater intoxication nor with other adverse events (AEs) except for somnolence.&#13;
&#13;
Conclusions and Relevance&#13;
Adjunctive dronabinol treatment was safe and effective for treating agitation in AD.&#13;
&#13;
Clinical Trials Registration&#13;
NCT02792257</text>
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                <text>A Randomized Controlled Trial of the Safety and Efficacy of Dronabinol for Agitation in Alzheimer’s Disease</text>
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              <text>English</text>
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          <name>Abstract</name>
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              <text>Purpose: The purpose of this research is to better understand what is known about the&#13;
experiences of non-Indigenous educators in the Health Sciences who are tasked with developing and/or delivering Indigenous health curriculum. There are challenges and barriers faced by nonIndigenous educators in the health sciences which impact their ability and/or willingness to implement Indigenous health content within their respective faculties. Acquiring a more comprehensive understanding of the obstacles would benefit the future implementation of Indigenous health content in the Health Sciences.&#13;
&#13;
Methods: This research employed a two-eyed seeing approach, comprising a scoping review and Keeoukaywin (The visiting way). The scoping review will provide a framework to categorize, synthesize, and understand existing literature. The Keeoukaywin (The visiting way) will use Indigenous methods to guide the researcher in interpreting the themes and incorporating stakeholder knowledges, aligning with the investigator's way of knowing. First, a scoping review was carried out to understand what available research evidence exists on the topic of nonIndigenous educators working in the Health Sciences who have been working to develop and/or deliver Indigenous health content. The scoping review followed the five stages as outlined by Arksey and O’Malley: clarifying and linking the purpose and research question; balancing feasibility with breadth and comprehensiveness of the scoping process; using an iterative approach to selecting studies and extracting data; incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research. Followed by contextualizing the findings through utilizing the Keeoukaywin, an Indigenous methodology, with non-Indigenous educators working in the Health Sciences who have experience implementing Indigenous health content.&#13;
&#13;
Results: 27 items were included in the scoping review, and using thematic analysis, the&#13;
following themes were identified: Reconciliation, reflection and reflexive practice, discomfort, accountability and responsibility, allyship and finally community involvement. This was contextualized by the experiences of two non-Indigenous educators working in the Health Sciences, utilizing a visiting methodology. The visit highlighted similar themes of selfreflexivity, responsibility, accountability, community, positionality, relationship, and gratitude, with responsible allyship underlined in all areas.&#13;
&#13;
Conclusions: The scoping review and the experiences shared through Keeoukaywin (The&#13;
visiting way) by non-Indigenous educators working to develop and/or deliver Indigenous health content in the health sciences highlight challenges and areas of support that could be addressed to further the work of non-Indigenous educators who are attempting to enact reconciliatory practices within health science education.</text>
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              <text>Julia Arizono</text>
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                <text>A Scoping Review and Keeoukaywin; Exploring Non-Indigenous Health Educators Experiences Implementing Indigenous Health Content in Health Science Curriculum</text>
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                <text>Health education--Curricula</text>
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              <text>&lt;a href="https://doi.org/10.1016/j.drugalcdep.2025.112597"&gt;https://doi.org/10.1016/j.drugalcdep.2025.112597&lt;/a&gt;</text>
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              <text>Camille Zolopa, Seema L. Clifasefi, Sophia Dobischok, Natalia Gala, Hannah Fraser-Purdy, Morgan Kahentonni Phillips, Sophie Blackmore, Dennis C. Wendt</text>
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              <text>Drug and Alcohol Dependence</text>
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              <text>2025</text>
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              <text>18790046</text>
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              <text>Open Access </text>
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              <text>Background&#13;
There is a great diversity of traditions, practices, and experiences among the Indigenous Peoples of North America and Oceania. However, Indigenous Peoples across these regions are affected by the historical and ongoing violence of settler colonialism, resulting in disproportionately heightened drug-related harms. ‘Harm reduction’ refers to both an ethos and a set of strategies intended to lessen negative social and/or health effects associated with drug use. While harm reduction could therefore be valuable to Indigenous people who use drugs, important concerns remain regarding the culturally specific implementation and outcomes of such strategies. A clearer picture of research regarding harm reduction in Indigenous communities is needed.&#13;
&#13;
Method&#13;
We conducted a scoping review of primary studies regarding drug use harm reduction approaches among Indigenous communities in Australia, Canada, New Zealand, and the United States. We included studies that (1) reported on harm reduction principles or strategies; and (2) either reported disaggregated results for Indigenous participants or were based on a sample in which at least half of the participants identified as Indigenous. Medline and PsycINFO were searched in March 2024; screening by two independent reviewers was completed in April 2024.&#13;
&#13;
Findings&#13;
Screening 578 references generated a corpus of 28 studies, 16 (57 %) of which were conducted in Canada. Indigenous people who use drugs generally reported favourable attitudes towards harm reduction initiatives; other community members and healthcare providers were more hesitant. A variety of harm reduction strategies were discussed, most commonly needle-syringe programs (n = 8, 29 %). Barriers included the availability and acceptability of harm reduction services. Community members expressed concerns regarding cultural appropriateness, but also offered possibilities for improved integration of harm reduction into Indigenous traditions and practices.&#13;
&#13;
Interpretation&#13;
This review indicated an emerging, wide-ranging, and somewhat disparate body of literature. While barriers remain, there are promising possibilities for reconceptualizing harm reduction from an Indigenous ethos.</text>
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              <text>Julia Arizono</text>
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                <text>A Scoping Review of Harm Reduction Practices and Possibilities Among Indigenous Populations in Australia, Canada, and the United States</text>
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          </element>
          <element elementId="49">
            <name>Subject</name>
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                <text>Harm reduction</text>
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        <name>Psychiatry</name>
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