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The evolution of the continental intraarc Taupo Rift in the North Island, New Zealand, is rapid, significantly faster than comparative intracontinental rifts such as the African Rifts. Based on our faulting data and published geological, geophysical, and borehole data, we show that activity in the ~2 Ma Taupo Rift has rapidly and asymmetrically narrowed via inward and eastward migration of faulting (at rates of approximately 30 km Myr−1 and 15 km Myr−1, respectively) and has propagated southward along its axis ~70 km in 350 kyr. The loci of voluminous volcanic eruptions and active faulting are correlated in time and space, suggesting that a controlling factor in the rapid rift narrowing is the presence of large shallow heterogeneities in the crust, such as large rhyolitic magma bodies generated by subduction processes, which weaken the crust and localize deformation. Eastward migration of faulting also follows the eastward migration of the volcanic arc which may be related to rollback of the Pacific crust slab at the Hikurangi subduction zone. Southward propagation of the rift is linked with southward migration of the Hikurangi Plateau/Chatham Rise subduction point and occurs episodically aided by stress changes associated with voluminous local volcanism. The large magma supply during early continental intraarc rift stages explains faster evolution (from tectonic to magmatic) than intracontinental rifts. However, the fast changes in magma supply from the subduction zone can also lead to evolution reversals (more evolved magmatic stages reverting to less evolved tectonic stages), rift cessation, and thus failed continental breakup. [ABSTRACT FROM AUTHOR]

At the eastern boundary of the south Taupo Rift, the NE-striking, rift-bounding Rangipo and the ENE-striking Wahianoa active normal faults intersect. We investigate their intersection at the Upper Waikato Stream to understand the kinematics of a rift termination in an active volcanic area. The Upper Waikato Stream Fault is a previously unrecognised seismogenic source also at the eastern boundary, capable of producing aMW6.5 and up toMW7.1 earthquake if it ruptures in conjunction with the Rangipo or Wahianoa faults. We found a minimum of 12 surface-rupturing earthquakes in the last 45.16 ka on the Upper Waikato Stream Fault (mean slip-rate c. 0.5 mm/yr), and a minimum of nine surface-rupturing earthquakes in the last 133 ka on the Wahianoa Fault (mean slip-rate c. 0.2 mm/yr). Periods of highest slip-rate on these faults may coincide in time with Taupo, Ruapehu or Tongariro eruptions, but, despite their intersection, movement was not coincident across all faults. The Upper Waikato Stream Fault responded to a major Taupo Volcano eruption, the Wahianoa to a major eruptive sequence from Mt Tongariro and the Rangipo to major explosive events from Mt Ruapehu. [ABSTRACT FROM PUBLISHER]

OBJECTIVES: To report on oral-health-related characteristics, beliefs, and behaviours among participants in a randomised control trial of an intervention to prevent early childhood caries (ECC) among Maori children, and to determine whether there were any systematic differences between the intervention and control groups at baseline. DESIGN: Baseline measurements from a randomised control trial (involving 222 pregnant Maori women allocated randomly to either Intervention or Delayed groups) which is currently underway. Setting: The rohe (tribal area) of Waikato-Tainui. METHODS: Self-report information collected on sociodemographic characteristics, pregnancy details, self-reported general and oral health and health-related behaviours, and oral health beliefs. RESULTS: Other than those in the Delayed group being slightly older, on average, there were no significant differences between the two groups. Some 37.0% were expecting their first child. Most reported good health; 43.6% were current smokers, and 26.4% had never smoked. Only 8.2% were current users of alcohol. Almost all were dentate, and 57.7% described their oral health as fair or poor. One in six had had toothache in the previous year; 33.8% reported being uncomfortable about the appearance of their teeth, and 27.7% reported difficulty in eating. Dental service-use was relatively low and symptom-related; 78.9% needed to see a dentist. Overall, most of the sample believed that it was important to avoid sweet foods, visit dentists and to brush the teeth, while about half thought that using fluoride toothpaste and using floss were important. Some 38.2% felt that drinking fluoridated water was important. Oral-health-related fatalism was apparent, with 74.2% believing that most people usually get dental problems, 58.6% believing that most people will need extractions at some stage, and that most children eventually get dental caries. CONCLUSIONS: Mothers' important role in nurturing the well-being of the young child includes the protection and maintenance of the growing child's oral health (or ukaipo niho). The findings provide important insights into Maori mothers' oral health knowledge, beliefs and practices. [ABSTRACT FROM AUTHOR]

Active fault traces are a surface expression of permanent deformation that accommodates the motion within and between adjacent tectonic plates. We present an updated national-scale model for active faulting in New Zealand, summarize the current understanding of fault kinematics in 15 tectonic domains, and undertake some brief kinematic analysis including comparison of fault slip rates with GPS velocities. The model contains 635 simplified faults with tabulated parameters of their attitude (dip and dip-direction) and kinematics (sense of movement and rake of slip vector), net slip rate and a quality code. Fault density and slip rates are, as expected, highest along the central plate boundary zone, but the model is undoubtedly incomplete, particularly in rapidly eroding mountainous areas and submarine areas with limited data. The active fault data presented are of value to a range of kinematic, active fault and seismic hazard studies. [ABSTRACT FROM AUTHOR]

The Canterbury earthquake sequence of 2010–2011 is the most significantly impacting event in New Zealand since World War II, consuming >15% of New Zealand's GDP. In Canterbury, geoscience information has contributed significantly to civil defence response management and more recently to the recovery effort coordinated through the Canterbury Earthquake Recovery Authority (CERA) and local authorities in Canterbury. The earthquakes have resulted in major social, community, education and economic disruption, and created considerable uncertainty in relation to the feasibility of land remediation in liquefaction-damaged areas. Analysis of voluminous geoscience, engineering and social science data has and will continue to underpin decisions on the appropriate time to begin infrastructure, residential and commercial rebuild and on whether building codes are appropriate to protect society from rare but potentially catastrophic events. [ABSTRACT FROM PUBLISHER]

The article discusses a study on the temporal associations between single volcanic eruptions from Okataina volcanic center (OVC) and normal fault ruptures in the northern sector of the Taupo rift in New Zealand. The researchers examined evidence for volcano-tectonic interactions. They reviewed the eruptive history of the OVC. They found associations between the timing of fall tephra on the fault scarp. They also observed that ruptures have no relationship with tephra deposition.

Coastlines that trend both parallel and normal to the Hikurangi subduction margin along the Raukumara Peninsula, New Zealand, provide a globally unique situation that enables study of the coastal deformation and its spatial variance across and along the forearc. The data suggest there is margin-parallel zoning of the forearc deformation processes across the Raukumara segment of the Hikurangi margin. On forearc promontories closest to the Hikurangi trench (within 80 km), Holocene marine and fluvial terraces record localised zones of intermittent uplift driven by large coseismic events on landward-dipping nearshore reverse faults. At greater distances from the trench (>100 km), Holocene and Pleistocene coastal stratigraphy and geomorphology suggest that surface uplift occurs by a gradual mechanism: either by frequent small earthquakes or by an aseismic process. In concurrence with geophysical models, we suggest the gradual uplift of this area is most likely driven by the buoyancy of underplated sediment with a contribution from subduction of the over-thickened crust of the Hikurangi Plateau. There is an intermediate zone at c. 80-100 km from the trench that is uplifted at low to moderate rates, probably by the effects of Hikurangi Plateau subduction with some contributions from outboard upper plate faulting and inboard sediment underplating. [ABSTRACT FROM AUTHOR]

Six trenches and additional exposures have been investigated along a 23 km length of the Pahiatua section of the Wellington Fault. The sites show a consistent fault rupture record for the last four surface-faulting events along the Pahiatua section. This multi-site record of events, supported by 28 radiocarbon ages that span the last c. 4500 yr, is the most complete paleoseismic record for the Wellington Fault. From southwest to northeast, the trenches are called death-1 and -2, Hughes-2 and -1, and ebbett-2 and -1, named after local farmers. Additional data come from an exposure at the Army Depot northeast of Ebbett-1 and a stream cutting near the Death-1 trench. Earthquake events are recognised on the basis of upward terminations of faults and stratigraphic evidence (unconformities; scarp-derived colluvial deposits; "co-seismically" generated, organic, poorly sorted units; and subsequent scarp-ponded units). On this basis, evidence for the most recent surface-faulting event is recognised at all sites (i.e., between death-1 and the army depot site) and has a timing of ad 1670-1800 (150-280 cal. yr BP). The penultimate faulting event has been recognised at all six trenches and occurred between ad 690 and 1170 (780-1260 cal. yr BP). Clear evidence, and datable material associated with events III and IV, is observed only in the older records of the Ebbett-1 and Hughes trenches. Event iii is bracketed by faulting and two ages on co-seismic deposits to the interval ad 65 to 400 BC (1885-2350 cal. yr BP). Event IV is bracketed by three key ages in the Hughes-1 trench to the interval 1600-2140 BC (3550-4090 cal. yr BP). The trench-derived recurrence interval based on these four events is c. 1200 ± 110 yr, which is consistent with, though longer than, an estimate of the recurrence interval based on slip rate (5.1-6.2 mm/yr) and single-event displacement (4.5 ± 1 m), which gave a range of 820 ± 260 yr. When the current paleoseismic data for the Wellington Fault are considered together, they suggest that: (1) the last four large earthquakes along the Pahiatua section have involved rupture of the entire section; (2) these events broadly correlate with other dated paleoearthquake events along the Wellington-Hutt Valley segment and Tararua section of the fault, and the southern end of the Mohaka Fault; (3) the most recent faulting event along the Pahiatua section is somewhat younger than for the Wellington-Hutt Valley segment or Tararua section; and (4) either single or dual segment/section rupture scenarios existed along these four fault sections. [ABSTRACT FROM AUTHOR]

To understand the tectonic evolution of the southern termination of the Taupo Volcanic Zone (TVZ), New Zealand, we compare the late Quaternary structure and kinematics of the southern part of the Taupo Rift or Taupo Fault Belt (Mt Ruapehu Graben) with central parts of the rift (Ngakuru Graben), and with the South Wanganui Basin. We also investigate the differences between displacements of Pliocene and late Quaternary markers within the southern Taupo Rift. Comparison of fault displacement rates derived from displacements of late Quaternary and Pliocene markers yields a preliminary estimate of <400 000 yr for fault initiation of the majority of faults in the southern Taupo Rift. The timing of the onset of faulting in the southern TVZ appears to be younger than central parts of the TVZ and may indicate a step-wise southward propagation of the rift. Faulting also appears to be less evolved in the south than in the central parts of the Taupo Rift (thicker seismogenic crust and hence wider fault spacing), reinforcing the impression of a recent incremental propagation of the Taupo Rift to the south. The onset of faulting coincides with independent observations of the initiation of volcanism in the southern TVZ. We propose that the termination of the TVZ, geographically short of the limit of the Hikurangi margin, may only be temporary, and it is most likely to propagate southward in association with future major perturbations in the subduction margin, such as the occurrence of large ignimbrite volcanism. [ABSTRACT FROM AUTHOR]

Late Quaternary structure and kinematics at the southern termination of the Taupo Rift are investigated by means of active fault mapping and estimates of fault displacement and extension rates. Active faults in the southern Taupo Rift are normal in sense and include three major structures: the NNE-trending Mt Ruapehu Graben; the E-W to ESE-WNW-trending Ohakune-Raetihi fault set; and the NE-trending Karioi fault set. Displacements of young geomorphic features, fault plane exposures in roadcuts, and trenches across faults show that all faults are active contemporaneously. The Mt Ruapehu Graben is the southern extension of the modern (i.e., <26 ka) Taupo Rift (or Taupo Fault Belt, TFB), and has developed as a result of backarc extension related to the Hikurangi subduction margin. Geologic extension rate for the Mt Ruapehu Graben is estimated here at 2.3 ± 1.2 mm/yr. The other two structures strike almost perpendicular to the Taupo Rift terminating the Mt Ruapehu Graben to the south. The co-existence of three normal fault sets in mutual crosscutting relations and with no significant strike-slip on any of them may be related to local reorientation of the minimum principal stress axis (σ3) or to a stress tensor where |σ3| ≈ |σ2|. Complicated strains at the southern termination of the Taupo Rift are related to block rotations in the Hikurangi subduction margin. [ABSTRACT FROM AUTHOR]

A sedimentary sequence that was highly sensitive to fault rupture-driven changes in water level and sediment supply has been used to extract a continuous record of 22 large earthquakes on the Alpine fault, the fastest-slipping fault in New Zealand. At Hokuri Creek, in South Westland, an 18 m thickness of Holocene sediments accumulated against the Alpine fault scarp from ca. A.D. 800 to 6000 B.C. We used geomorphological mapping, sedimentology, and paleoenvironmental reconstruction to investigate the relationship between these sediments and Alpine fault rupture. We found that repeated fault rupture is the most convincing mechanism for explaining all the features of the alternating peat and silt sedimentary sequence. Climate has contributed to sedimentation but is unlikely to be the driver of these cyclical changes in sediment type and paleoenvironment. Other nontectonic causes for the sedimentary alternations do not produce the incremental increase in basin accommodation space necessary to maintain the shallow-water environment for 6800 yr. Our detailed documentation of this near-fault sedimentary basin sequence highlights the advantages of extracting paleoearthquake records from such sites--the continuity of sedimentation, abundance of dateable material, and pristine preservation of older events. [ABSTRACT FROM AUTHOR]

Purpose: To describe health consequences associated with poor diet in persons with spinal cord injuries and disorders (SCI/D)., Materials/methods: Descriptive qualitative design using in-depth interviews with SCI/D health providers. Audio-recorded and transcribed verbatim transcripts were coded and analyzed using thematic analysis., Results: Participants ( n  = 12) were from 11 nationwide VA hospitals. Participants were male (75%), white (67%), 26-49 years of age, and most were dietitians (75%) and physiatrists (17%). Seven key themes identified consequences associated with poor diet in persons with SCI/D, including (1) Weight gain and body composition changes, (2) cardiometabolic conditions, (3) bowel dysfunction, (4) pressure injuries/wounds, (5) other SCI/D secondary conditions/complications (renal/kidney; immune function/susceptibility to infections; autonomic dysreflexia; bone health/osteoporosis; pain), (6) physical fatigue, and (7) poor mental health., Conclusions: Excess weight, cardiometabolic conditions, SCI/D secondary conditions/complications (e.g., bowel dysfunction, pressure injuries), and poor mental health were identified as health consequences of inadequate nutrition. Health providers should make individuals with SCI/D aware of the risks and health consequences to incentivize healthier dietary behaviors. Efforts to identify nutrition shortcomings and to develop interventions and tailored care plans are needed to improve a myriad of health consequences due to poor diet and nutrition in persons with SCI/D.

Background: Programs to improve student writing have been deployed widely in nursing graduate education, but few operational indicators exist for measuring their value., Problem: The challenge of measuring outcomes reflects the complexity of what transpires when graduate students write. Better understanding is needed of what it means to students to "learn" from writing support., Approach: A full-semester writing course was implemented in a nursing science PhD program. In formative course assessment activities, students identified problems in early drafts of their work, which they subsequently learned to detect and resolve. In this article, students report what was learned., Conclusion: Writing skills, like clinical skills, are intertwined with intellectual maturation and sense of professional identity. Writing, like clinical learning, requires an investment of time and labor far beyond what is typical in didactic approaches to classroom-based graduate education. Our experience suggests a need to reconceptualize writing pedagogy in nursing., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Anti-obesity medications (AOMs) may provide a viable option for obesity management. However, little is known about the use of AOMs in persons with SCI/D., Objective: Describe health care providers' (HCPs) views about barriers to AOM use in persons living with SCI/D., Methods: Descriptive qualitative design using in-depth interviews Descriptive statistics were used to calculate demographic and employment characteristics. Interviews were audio-recorded and transcribed verbatim. Transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases., Results: HCPs (n = 12) were from 11 different nationwide facilities. Most HCPs were male (75%), a large majority were white (67%), and most were 26-49 years of age. Participants were dietitians (75%), physicians (17%), and psychologists (8%). HCPs ranged from 1.5 to 15 years of providing SCI/D care. HCPs described four main thematic barriers to AOM use in persons with SCI/D: (1) AOM side effects that are especially concerning in persons with SCI/D; (2) AOMs contribute to poor eating habits; (3) availability, accessibility, and administration; and (4) lack of evidence, clinical agreement, and knowledge about AOM use in the SCI/D population., Conclusions: There are several potential barriers to AOM use in the SCI/D population. Barriers include AOM side effects which may cause or exacerbate conditions that are already concerns in persons with SCI/D, such as bowel and skin problems, and muscle loss. SCI/D HCPs reported a lack of evidence about AOM use in persons with SCI/D, but interest in obtaining more knowledge., Competing Interests: The authors do not have any conflicts of interest or commercial interests to disclose., (© 2024 The Author(s). Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.)

Context: The growing number of females entering the armed forces has led to an increase in the number of female Veterans with spinal cord injury and diseases (SCI/D) requiring mobility devices. Limited research exists that explores whether mobility devices meet their needs in terms of comfort, fit and design., Objective: To characterize respondents with SCI/D who use mobility devices and determine if these devices are meeting their daily needs., Design: Online survey., Settings: Veterans Health Administration., Participants: Female Veterans with SCI/D who received mobility devices in the past five years.Interventions: Participants completed an online survey regarding their challenges in obtaining and using mobility devices for their daily needs., Results: 101 women with SCI/D participated in a nation-wide online survey. Respondents were mainly in their 50s and 59% were not currently employed due to their disability. Most used manual (35%) or power wheelchairs (34%). Many female Veterans felt their devices were not made with female users in mind and some felt they did not meet their needs. Opportunities to improve the assessment, follow-up, maintenance and repair processes were identified., Conclusions: Given that some female Veterans with SCI/D felt their devices did not meet all their needs, it is important for researchers to engage women in user-centered design of mobility devices and for providers to be mindful of Veterans' daily needs within all steps of the provision process in order for mobility devices to support overall function and usability.

Purpose/objective: Individuals with spinal cord injuries and disorders (SCI/D) are at increased risk for experiencing loneliness and social isolation. The aim is to describe facilitators identified by individuals living with SCI/D to alleviate loneliness and perceived social isolation., Research Method/design: Descriptive qualitative design using in-depth interviews with veterans with SCI/D ( n = 23). Descriptive statistics was used to calculate demographic and injury characteristics. Audio-recorded and transcribed verbatim transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases., Results: Participants were male (70%), white (78%), and not currently married (35%), with an average age of 66 years (42-88). Participants had paraplegia (61%), with traumatic etiology (65%) and were injured 14 years (1-45) on average. Eight themes were identified by participants living with SCI/D that described facilitators to alleviate loneliness and perceived social isolation. (a) Engage in/pursue interests; (b) Interact with/spend time with others; (c) Embrace acceptance; (d) Take part in reciprocity; (e) Find a purpose/accomplish goals; (f) Get out of residence, get outside; (g) Connect with SCI/D community/SCI/D peers; and (h) Seek help from (mental) healthcare professionals., Conclusions/implications: Individuals with SCI/D identified facilitators to alleviate loneliness that encompasses changes in ways of thinking, actions to expand participation in life, and efforts focused on involving others. Findings can be used to guide healthcare delivery and develop interventions to target feelings of loneliness and social isolation in persons with SCI/D, which may be particularly impactful if they involve reciprocal interactions with peers with SCI/D. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To identify variables independently associated with moderate to high loneliness in individuals living with Spinal Cord Injuries or Disorders (SCI/D)., Design: A cross-sectional, national survey of a random sample of community-dwelling Veterans with SCI/D in the United States. Survey methodology was used to collect data on demographic and injury characteristics, general health, chronic and SCI-secondary conditions, and loneliness., Setting: The VHA SCI/D System of Care including 25 regional SCI/D Centers (or Hubs)., Participants: Among 2466 Veterans with SCI/D, 592 completed surveys (24%). Most participants were men (91%), white (81%), not currently married (42%), had tetraplegia (33%), and on average injured for 18 years at the time of data collection (N=562)., Interventions: Not applicable., Main Outcome Measure: The dependent variable, loneliness, was collected using the UCLA-3 instrument. Loneliness was dichotomized into never/low loneliness and moderate/high loneliness (UCLA score ≥ 4)., Results: Bivariate analyses assessed unadjusted associations in demographics, injury characteristics, chronic disease, and SCI-secondary conditions. Multivariable logistic regression was used to identify factors independently associated with moderate/high loneliness. Participants had a mean loneliness score of 5.04, SD=1.99. The point prevalence of moderate to high loneliness was 66%. Lower duration of injury, paraplegia, being unmarried, being in fair/poor general health, having dysfunctional sleep, and having a diagnosis of bowel dysfunction were each independently associated with greater odds of moderate/high loneliness., Conclusions: Findings suggest that interventions to reduce/manage loneliness in the Veteran SCI/D population should focus on those who are more newly injured, have paraplegia, currently unmarried, have bowel problems, and experience dysfunctional sleep., (Published by Elsevier Inc.)

Background: Providers in the Department of Veterans Affairs (VA) system are caught between two opposing sets of laws regarding cannabis and cannabidiol (CBD) use by their patients. As VA is a federal agency, it must abide by federal regulations, including that the Food and Drug Administration classifies cannabis as a Schedule 1 drug and therefore cannot recommend or help Veterans obtain it. Meanwhile, 38 states have passed legislation, legalizing medical use of cannabis. Objective: The goal of this project is to examine how VA providers understand state and federal laws, and VA policies about cannabis and CBD use, and to learn more about providers' experiences with patients who use cannabis and CBD within a legalized and nonlegalized state. Materials and Methods: We identified 432 health care providers from two VA facilities in northern Illinois (IL) where medical and recreational cannabis is legal, and two VA facilities in southern Wisconsin (WI) where medical and recreational cannabis is illegal. Participants were invited via e-mail to complete an anonymous online survey, including 31 closed- and open-ended questions about knowledge of state and federal laws and VA policies regarding cannabis and CBD oil, thoughts about the value of cannabis or CBD for treating medical conditions, and behaviors regarding cannabis use by their patients. Results: We received 50 responses (IL N =20, WI N =30). Providers in both states were knowledgeable about cannabis laws in their state but unsure whether they could recommend cannabis. There were more providers who were unclear if they could have a conversation about cannabis with their VA patients in WI compared with IL. Providers were more likely to agree than disagree that cannabis can be beneficial, χ 2 (1, 49)=4.74, p =0.030. Providers in both states (81.6%) believe cannabis use is acceptable for end-of-life care, but responses varied for other conditions and symptoms. Discussion: Findings suggest that VA providers could use more guidance on what is allowable within their VA facilities and how state laws affect their practice. Education about safety related to cannabis and other drug interactions would be helpful. There is limited information about possible interactions, warranting future research.

The N1, Tb, and P2 components of the event-related potential (ERP) are thought to reflect the sequential processing of auditory stimuli in the human brain. Despite their extensive use in biological, cognitive, and clinical neuroscience, there are no guidelines for how to appropriately power ERP studies using these components. In the present study, we investigated how the number of trials, number of participants, effect magnitude, and study design influenced statistical power. Using Monte Carlo simulations of ERP data from a passive listening task, we determined the probability of finding a statistically significant effect in 58,900 experiments repeated 1,000 times each. We found that as the number of trials, number of participants, and effect magnitude increased, so did statistical power. We also found that increasing the number of trials had a bigger effect on statistical power for within-subject designs than for between-subject designs, and that within-subject designs required a smaller number of trials and participants to provide the same level of statistical power for a given effect magnitude than between-subject designs. These results show that it is important to carefully consider these factors when designing ERP studies, rather than relying on tradition or anecdotal evidence. To improve the robustness and reproducibility of ERP research, we have built an online statistical power calculator (https://bradleynjack.shinyapps.io/ErpPowerCalculator), which we hope will allow researchers to estimate the statistical power of previous studies, as well as help them design appropriately-powered studies in the future., (© 2023 The Authors. Psychophysiology published by Wiley Periodicals LLC on behalf of Society for Psychophysiological Research.)

Contemplative practices are a staple of modern life and have historically been intertwined with morality. However, do these practices in fact improve our morality? The answer remains unclear because the science of contemplative practices has focused on unidimensional aspects of morality, which do not align with the type of interdependent moral functioning these practices aspire to cultivate. Here, we appeal to a multifactor construct, which allows the assessment of outcomes from a contemplative intervention across multiple dimensions of moral cognition and behavior. This offers an open-minded and empirically rigorous investigation into the impact of contemplative practices on moral actions. Using this framework, we gain insight into the effect of mindfulness meditation on morality, which we show does indeed have positive influences, but also some negative influences, distributed across our moral functioning., Competing Interests: Declaration of interests None declared by authors., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: The study aimed to describe the postmortem investigation patterns for perinatal deaths and compare the degree of investigation between stillbirths and early neonatal deaths., Study Design: We conducted a single-center retrospective review of all perinatal deaths from 2011 to 2017. Perinatal death was defined as intrauterine fetal death at ≥20 weeks' gestation, plus neonatal deaths within the first 7 days of life. Rates of postmortem investigation were compared., Results: There were 97 perinatal deaths, with 54 stillbirths (56%) and 43 neonatal deaths (44%). Stillbirths were significantly more likely to receive autopsy ( p  = 0.013) and postmortem genetic testing ( p  = 0.0004) when compared with neonatal deaths. Maternal testing was also more likely in stillbirths than neonatal deaths. A total of 32 deaths (33%) had no postmortem evaluation beyond placental pathology., Conclusion: Investigation following perinatal death is more likely in stillbirths than neonatal deaths. Methods to improve postmortem investigation following perinatal death are needed, particularly for neonatal deaths., Key Points: · Investigation into perinatal death is recommended.. · Rates of investigation remain low.. · Neonatal deaths with less investigation than stillbirths.., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: There is growing interest in palliative care within Indigenous communities, and within Aotearoa New Zealand, of the significant role that Māori (Indigenous people) families play in caring for older relatives. This study explored the centrality of culture in how Māori extended families ( whānau ) in Aotearoa New Zealand interpret and enact family-based care roles within the Māori world ( Te Ao Māori )., Methods: Applying Māori-centered and community-based participatory research principles, we examined 17 interviews with older Māori who shared experiences of palliative care for a partner or family member. The thematic analysis used a cultural-discursive framework incorporating Māori principles of wellbeing and values expressed within the care relationship., Results: The findings centered on three whānau roles in palliative care: whānau as (1) Holders and protectors of Māori knowledge; (2) Weavers of spiritual connection; and (3) Navigators in different worlds., Conclusion: The study problematizes the notion of a single 'primary caregiver', privileges whānau as an inter-woven relational, dynamic care network, and encourages health professionals to recognize the cultural embeddedness of dominant approaches to palliative care., Competing Interests: Competing interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2022.)

Often young indigenous women are framed in ways that problematize and pathologize them, which overlooks their strengths. We interviewed 16 young Indigenous Māori women aged 14 to 18 years about their understandings of safety, being safe, and how they kept themselves and their friends safe. Reflecting and Learning, aided by progressing age and maturity, is the process that mediated their feeling unsafe and keeping safe and resulted in being safe . Young Māori women's reflecting and learning facilitates relatively mature levels of resourcefulness for navigating being safe, including situations they encountered appear unsafe.

Excessive accumulation of misfolded proteins was recently demonstrated in preeclampsia. We examined levels and activity of circulatory proteasome and immunoproteasome (inflammatory subtype) in preeclampsia and hemolysis, elevated liver enzymes, and thrombocytopenia (HELLP) syndrome. We analyzed samples from women with hypertensive pregnancy disorders (n=115), including preeclampsia with severe features (sPE) and HELLP syndrome, and normotensive controls (n=45). Plasma proteasome and immunoproteasome immunoreactivity were determined by quantifying the α-subunit of the 20S core and β5i (proteasome subunit beta 8 [PSMB8]), respectively. Plasma proteasome activity was analyzed with fluorogenic substrates. MG132, lactacystin, and ONX0914 were used to inhibit the circulating proteasome and immunoproteasome, respectively. Plasma cytokine profiles were evaluated by multiplex immunoassay. Placental expression of β5 (constitutive proteasome) and β5i (immunoproteasome) was interrogated by immunohistochemistry. Women with sPE had increased plasma 20S levels ( P<0.001) and elevated lytic activities (chymotrypsin-like 7-fold, caspase-like 4.2-fold, trypsin-like 2.2-fold; P <0.001 for all) compared with pregnant controls. Women with features of HELLP displayed the highest plasma proteasome levels and activity, which correlated with decreased IFN-γ (interferon-γ), and increased IL (interleukin)-8 and IL-10. In sPE and HELLP, chymotrypsin-like activity was suppressed by proteasome inhibitors including ONX0914. Compared with gestational age-matched controls, sPE placentas harbored increased β5 and β5i immunostaining in trophoblasts. β5i signal was elevated in HELLP with predominant staining in villous core, extravillous trophoblasts in placental islands, and extracellular vesicles in intervillous spaces. Pregnancy represents a state of increased proteostatic stress. sPE and HELLP were characterized by significant upregulation in circulating levels and lytic activity of the proteasome that was partially explained by placental immunoproteasome upregulation.

Purpose: Observational studies suggest that dietary and serum calcium are risk factors for prostate cancer. However, such studies suffer from residual confounding (due to unmeasured or imprecisely measured confounders), undermining causal inference. Mendelian randomization uses randomly assigned (hence unconfounded and pre-disease onset) germline genetic variation to proxy for phenotypes and strengthen causal inference in observational studies. We tested the hypothesis that serum calcium is associated with an increased risk of overall and advanced prostate cancer., Methods: A genetic instrument was constructed using five single-nucleotide polymorphisms robustly associated with serum calcium in a genome-wide association study (n ≤ 61,079). This instrument was then used to test the effect of a 0.5 mg/dL increase (1 standard deviation, SD) in serum calcium on risk of prostate cancer in 72,729 men in the PRACTICAL (Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome) Consortium (44,825 cases, 27,904 controls) and risk of advanced prostate cancer in 33,498 men (6,263 cases, 27,235 controls)., Results: We found weak evidence for a protective effect of serum calcium on prostate cancer risk (odds ratio [OR] per 0.5 mg/dL increase in calcium: 0.83, 95% CI 0.63-1.08; p = 0.12). We did not find strong evidence for an effect of serum calcium on advanced prostate cancer (OR per 0.5 mg/dL increase in calcium: 0.98, 95% CI 0.57-1.70; p = 0.93)., Conclusions: Our Mendelian randomization analysis does not support the hypothesis that serum calcium increases risk of overall or advanced prostate cancer.

An adequate intake of vitamin B12 during pregnancy plays an important role in offspring neurodevelopment, potentially via epigenetic processes. We used a two-step Mendelian randomization approach to assess whether DNA methylation plays a mediating and causal role in associations between maternal vitamin B12 status and offspring's cognition. Firstly, we estimated the causal effect of maternal vitamin B12 levels on cord blood DNA methylation using the maternal FUT2 genotypes rs492602:A > G and rs1047781:A > T as proxies for circulating vitamin B12 levels in the Avon Longitudinal Study of Parents and Children (ALSPAC) and we tested the observed associations in a replication cohort. Secondly, we estimated the causal effect of DNA methylation on IQ using the offspring genotype at sites close to the methylated CpG site as a proxy for DNA methylation in ALSPAC and in a replication sample. The first step Mendelian randomization estimated that maternal vitamin B12 had a small causal effect on DNA methylation in offspring at three CpG sites, which was replicated for one of the sites. The second step Mendelian randomization found weak evidence of a causal effect of DNA methylation at two of these sites on childhood performance IQ which was replicated for one of the sites. The findings support a causal effect of maternal vitamin B12 levels on cord blood DNA methylation, and a causal effect of vitamin B12-responsive DNA methylation changes on children's cognition. Some limitations were identified and future studies using a similar approach should aim to overcome such issues., (© The Author 2017. Published by Oxford University Press.)

Low utilization of palliative care services by Māori remains despite increases in services designed to meet Māori needs. The purpose of this study is to explore palliative care information brochures in the context of Māori principles of well-being and communication protocols, and health literacy. We examined 99 brochures from palliative care services in New Zealand and held two focus groups with 12 Māori elders (kaumātua) and extended family (whanau) members. Taking a cultural-discursive approach incorporating Māori worldviews, we analysed textual and conceptual features of the brochures. The findings centred on cultural connection and disconnection within the brochures and serve as a critique of the prominent messages currently presented in these brochures. The findings raise questions about the capacity of agencies to convey culturally resonant messages to kaumātua and their whānau. We identify implications of palliative care brochures for health literacy of provider organizations as well as kaumātua and whanau., (© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Objectives: Relationships among cognitive and motivational factors in predicting medical help-seeking for Alzheimer's disease (AD) symptoms were tested., Method: Community residents awaiting jury service (N = 280) completed questionnaires, including responses to a vignette depicting prototypical early symptoms of AD in a hypothetical mother. Cognitive responses to the vignette included AD symptom identification and AD attribution. Affective-motivational responses to vignettes were symptom impact and behavior appraisals. General knowledge of AD was assessed. Intention to seek medical help was the dependent variable., Results: The impact and identification of AD symptoms, appraisals of risk, and attribution of the scenario to AD were modest, yet all contributed to prediction of medical-help-seeking intentions. The best fitting model had distinct but interrelated cognitive and motivational paths explaining 49% of the variability in medical help-seeking. Motivational variables had particularly important direct and indirect effects on help-seeking., Discussion: Findings are interpreted as evidence of the importance of motivational as well as cognitive aspects of perceptions of illness behavior in another person. The substantial impact of the tested variables on the desired outcome of medical help-seeking may suggest options for public health efforts to enhance early medical help-seeking for AD that sets the stage for early intervention., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The purpose of this study is to explore the cultural practices and communication tensions perceived among Māori kaumātua (elders) and their whānaunga (extended family) during the end-of-life journey. Further, the study aims to explore the manner in which the tensions are managed. The study was framed by relational dialectics theory and included interviews with 21 kaumātua and focus groups with 39 whānau members. The study identified three cultural practices (dying at home, prayer, and song) that helped to build connection among the family members and also helped to connect the dying person to the spiritual world. Further, four communication tensions were noted: (a) autonomy and connection; (b) conflict and connection; (c) isolation and connection; and (d) balancing the needs of self and other. To manage these tensions, the following strategies were used: (a) coordination conversations; (b) inclusion in decision-making conversations; (c) emotional support within the whānau; and (d) passing on lessons to the next generation.

Background: Maaori are the Indigenous people of New Zealand and do not enjoy the same oral health status as the non-Indigenous majority. To overcome oral health disparities, the life course approach affords a valid foundation on which to develop a process that will contribute to the protection of the oral health of young infants. The key to this process is the support that could be provided to the parents or care givers of Maaori infants during the pregnancy of the mother and the early years of the child. This study seeks to determine whether implementing a kaupapa Maaori (Maaori philosophical viewpoint) in an early childhood caries (ECC) intervention reduces dental disease burden among Maaori children. The intervention consists of four approaches to prevent early childhood caries: dental care provided during pregnancy, fluoride varnish application to the teeth of children, motivational interviewing, and anticipatory guidance., Methods/design: The participants are Maaori women who are expecting a child and who reside within the Maaori tribal area of Waikato-Tainui.This randomised-control trial will be undertaken utilising the principles of kaupapa Maaori research, which encompasses Maaori leadership, Maaori relationships, Maaori customary practices, etiquette and protocol. Participants will be monitored through clinical and self-reported information collected throughout the ECC intervention. Self-report information will be collected in a baseline questionnaire during pregnancy and when children are aged 24 and 36 months. Clinical oral health data will be collected during standardised examinations at ages 24 and 36 months by calibrated dental professionals. All participants receive the ECC intervention benefits, with the intervention delayed by 24 months for participants who are randomised to the control-delayed arm., Discussion: The development and evaluation of oral health interventions may produce evidence that supports the application of the principles of kaupapa Maaori research in the research processes. This study will assess an ECC intervention which could provide a meaningful approach for Maaori for the protection and maintenance of oral health for Maaori children and their family, thus reducing oral health disparities., Trial Registration: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000111976.

Potent and selective thrombin inhibitors have been prepared with a piperazinedione template and L-amino acids. Likewise, incorporation of D-amino acids led to potent inhibitors with a novel mode of binding. Herein, the structure activity relationships and structural aspects of these compounds will be described.

The synthesis and antithrombotic activity of a series of nonpeptide bicyclic thrombin inhibitors are described. We have explored the SAR around the P1' site. Modification of the P1' site has been found to affect potency and selectivity.

The synthesis and antithrombotic activity of a series of nonpeptide bicyclic thrombin inhibitors is described. We have explored the SAR with modifications to the P1 site. The introduction of arginine mimetics at the P1 site led to potent and selective thrombin inhibitors.

Peptidomimetic inhibitors of general structure 1 have been prepared. Optimization of the binding affinities of these compounds through variation of the P3 hydrophobic residue is described. Selected substituted bicylic lactams displayed interesting pharmacological profiles both in vitro and in vivo.