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National and state governments in settler colonial countries are increasingly committing to policies and practices aimed at strengthening Indigenous frameworks, programmes and leadership in child protection services. However, research‐based information on Indigenous child welfare services and programmes is sparse. This qualitative literature review explores and documents key features of Indigenous child welfare and protection models and/or frameworks in an international context, with a specific focus on Indigenous children, young people, families, and communities. Twenty‐four publications meeting the inclusion criteria were included in the analysis. Published frameworks, models, services, interventions and/or programmes within the broader area of child welfare and children protection that are Indigenous‐designed and/or led or developed in partnership or collaboration with Indigenous peoples were identified. The review highlights 11 key dimensions that underpin the frameworks, models, services, interventions and/or programmes. Findings of the review also reveal commonalities across Indigenous cultures and contexts that from an Indigenous perspective are considered fundamental to supporting Indigenous children, young people and families involved with child protective services. Additionally, the findings point to the critical need for ongoing advocacy for Indigenous‐designed and led services and programmes, including support for Indigenous research, evaluation and intellectual leadership. [ABSTRACT FROM AUTHOR]

Children, tamariki, adolescents, rangatahi, youth, health, hauora, mental health, wellbeing, nutrition, health equity, oral health, Kaupapa Maori, indigenous Keywords: Children; tamariki, adolescents; rangatahi; youth; health; hauora; mental health; wellbeing; nutrition; health equity; oral health, Kaupapa Maori; indigenous EN Children tamariki, adolescents rangatahi youth health hauora mental health wellbeing nutrition health equity oral health, Kaupapa Maori indigenous 549 552 4 07/14/23 20231001 NES 231001 Optimizing maximal health and wellbeing outcomes for all children and young people in Aotearoa New Zealand is a societal responsibility. Several of the manuscripts collated within this special issue place emphasis on social determinants of health and wellbeing, and their impacts on equitable outcomes for children and young people in Aotearoa New Zealand. [Extracted from the article]

Several of the manuscripts included in this special issue demonstrate how positive transformative actions across policy and practice can influence the health and wellbeing outcomes of children and young people. The links between colonisation and significant health inequities that occur for Indigenous peoples compared with non-Indigenous is well described internationally and in Aotearoa New Zealand. Childhood and young adulthood are important stages of growing, learning and development. As part of this, we have ensured that there is rangatahi Maori representation on the guest editorial team for this special issue, as well as inclusion of rangatahi Maori and other young people as authors of its constituent manuscripts. [Extracted from the article]

Mokopuna Māori and their whānau have the right to be involved meaningfully in the health and disability system, through genuine commitments to participation and self-determination. This Kaupapa Māori qualitative study explored mokopuna Māori concepts of wellbeing in relation to health and disability services, contextualised within broader tāngata whenua rights to health and wellbeing, and continued Crown failure to recognise these rights. Informed by a Kaupapa Māori research paradigm privileging worldviews and experiential knowledge of mokopuna Māori, we carried out focus group interviews with 26 mokopuna aged 6 to 13 years. Using thematic analyses we identified ten themes from the data analysis: (1) Aro ki te hā; (2) Kupu; (3) Mātauranga; (4) Mauri; (5) Utu; (6) Mana motuhake; (7) Hau Ora; (8) Kaitiakitanga; (9) Ūkaipō; and (10) Tika. The narratives of mokopuna Māori in this study reaffirm the critical importance of recognising mokopuna as knowledge holders, creators, and makers of meaning to participate in, and articulate their views on, their own wellbeing, their environments, and other matters important to them. Privileging their views and perspectives supports mokopuna to navigate their own processes of self-determination and sovereignty for themselves, their whānau and their communities. Glossary of Māori words: Aotearoa: Māori name for the North Island of New Zealand, often used as a name for New Zealand; Aro ki te hā: the awareness of the essence of one's breath; Hau Ora: healthy, well; He Wakaputanga o te Rangatiratanga o Nu Tīreni: the Declaration of Independence of the United Tribes of New Zealand; Hinapōuri: to be very dark, very sad; Iwi: extended kinship group, tribe, nation, people, bone; Kai: to eat, food, meal; Kaitiakitanga: guardianship; Kākāriki: be green (in colour); Karaka: be orange (in colour); Kaupapa Māori: Māori agenda, Māori principles, Māori ideology; a philosophical doctrine, incorporating the knowledge, skills, attitudes, and values of Māori society; Kia ora: be well, hello, cheers, best wishes; Koha: gift, offering; Kōrero: speak, speech, address; Kōwhai: be yellow (in colour); Kupu: word, saying, utterance; Mana Motuhake: authority and capacity to be autonomous; Māori: name for Indigenous peoples of New Zealand; Mātauranga: knowledge, wisdom; Mauri: life principle, life force, vital essence; Māwhero: be pink (in colour); Mokopuna: grandchild, grandchildren, descendant; Oranga: health, wellbeing, vitality; Pākehā: foreign; Papatūānuku: Earth Mother; Pēpi: baby, infant; Rangatahi: younger generation: Rangatira: chief/chieftainess; Rohe: boundary, territory; Rongoā: remedy, medicine; Tamariki: children; Tāngata whenua: people born of the land; Taniwha: powerful creature; Taonga: treasure, anything prized; Te Ao Māori: the Māori world; Te Komiti Rakahau ki Kāi Tahu: Kāi Tahu Research Consultation Committee; Te Kore: The Void, realm of potential being; Te reo Māori: the Māori language; Te Tiriti o Waitangi 1840: the Māori version of the Treaty of Waitangi; forms the foundation of the contractual relationship between two internationally recognised sovereign nations, Māori, as tāngata whenua (people of the land), and the British Crown; Tika: what is right/good for any particular situation; Tikanga Māori: customary system of values and practices developed over time; Tūpuna: ancestors; Ūkaipō: the suckling of a child on their mother's breast at night, one's ancestral land; Utu: balance, reciprocity; Waiata: song; Wairua: spirit; Wānanga: to meet, discuss, deliberate, consider; Whaikōrero: oratory; Whakairo: carving; Whakapapa: ancestry, familial relationships; Whānau: to be born, extended family, family group; Whanaunga: relative, relation; Whenua: placenta, ground, land. [ABSTRACT FROM AUTHOR]

The editorial focuses on the adverse impacts of racism and whiteness on indigenous health, emphasizing the experiences of M'etis individuals. Topics include the protective but identity-damaging practice of passing as White, the systemic influence of whiteness in perpetuating coloniality, and recommendations for culturally safe healthcare practices rooted in Indigenous perspectives.

This article presents a case study of the use of the Official Information Act 1982 (OIA), for research commissioned by the Waitangi Tribunal in 2018 into disability-related issues for Mäori. The responses of Crown organisations to OIA requests examined in this research highlight both issues with inconsistent application of the OIA, and limited access to information held and made available by Crown agencies for Mäori with lived experience of disability.1 The statutory time frame for responses to OIA requests was rarely met. Organisations also resisted providing information, while crucial information for ensuring equity for Mäori with lived experience of disability was often not able to be released because it was not collected at all. The impact of these limitations is discussed, particularly pertaining to core government roles of performance monitoring and ensuring accountability. In addition to querying who benefits from, and is privileged by, the OIA and its application, questions are raised around the necessary components of a legislation rewrite in order to deliver on a modern approach to official information that ensures equitable, high-performing and truly democratic public administration. [ABSTRACT FROM AUTHOR]

The article draws upon intersectionality as an analytical tool for understanding how the adverse impact of the COVID-19 pandemic are likely to be compounded for Indigenous Maori with lived experience of disability and their families. Topics discussed include racism, ableism, historical injustices, and resource allocation in the New Zealand government's response to the pandemic. A framework that guarantees self-determination is presented.

We describe the sampling of sixty-three uncultured hospital air samples collected over a six-month period and analysis using shotgun metagenomic sequencing. Our primary goals were to determine the longitudinal metagenomic variability of this environment, identify and characterize genomes of potential pathogens and determine whether they are atypical to the hospital airborne metagenome. Air samples were collected from eight locations which included patient wards, the main lobby and outside. The resulting DNA libraries produced 972 million sequences representing 51 gigabases. Hierarchical clustering of samples by the most abundant 50 microbial orders generated three major nodes which primarily clustered by type of location. Because the indoor locations were longitudinally consistent, episodic relative increases in microbial genomic signatures related to the opportunistic pathogens Aspergillus, Penicillium and Stenotrophomonas were identified as outliers at specific locations. Further analysis of microbial reads specific for Stenotrophomonas maltophilia indicated homology to a sequenced multi-drug resistant clinical strain and we observed broad sequence coverage of resistance genes. We demonstrate that a shotgun metagenomic sequencing approach can be used to characterize the resistance determinants of pathogen genomes that are uncharacteristic for an otherwise consistent hospital air microbial metagenomic profile. [ABSTRACT FROM AUTHOR]

Abstract: Studies have demonstrated that thickened mucous layers in the lungs of cystic fibrosis (CF) patients contain areas of low oxygen tension. These microaerophilic environments may reduce the activity of aerosol antibiotics used in the management of chronic infection in CF. The aim of this study was to compare the MICs of levofloxacin, tobramycin, amikacin, and aztreonam against Pseudomonas aeruginosa under reference and anaerobic conditions and evaluate the in vitro pharmacodynamics of levofloxacin under aerobic and hypoxic testing conditions. The MICs for 114 isolates of P. aeruginosa from CF patients were determined in cation-adjusted Mueller Hinton broth alone or supplemented with 1% potassium nitrate for anaerobic testing. Levofloxacin time–kill curves were performed under aerobic and hypoxic conditions using strains of P. aeruginosa with elevated efflux pump overexpression and/or target mutations. The MICs of nonmucoid or mucoid P. aeruginosa isolates to levofloxacin incubated under aerobic and anaerobic conditions were similar. In contrast, anaerobic incubation resulted in higher MICs for tobramycin, amikacin, and aztreonam among nonmucoid or mucoid isolates, with ≥4-fold increase in MICs for over 40% of the isolates. Time–kill curves performed in aerobic and hypoxic environments with levofloxacin concentrations attained in CF sputum demonstrated similar activity, approaching a maximum bactericidal effect within 10 min of exposure. Together, these results indicate that the activity of some antibiotics against P. aeruginosa is significantly reduced under conditions relevant to the CF lung environment. In contrast, levofloxacin maintains activity against P. aeruginosa under anaerobic or hypoxic conditions similar to those found in CF microaerophilic environments. [Copyright &y& Elsevier]

Patients with community-acquired pneumonia, cellulitis, or urinary tract infection may be treated either in the hospital or as outpatients, depending on the severity of their disease, comorbidities, and Karnofsky performance status. To more efficiently use hospital beds, we discharge many moderately to severely ill patients with acute infections directly from the emergency department or early in the course of hospitalization. To insure satisfactory clinical outcomes, we use telemedicine in the home to monitor patients who would normally be hospitalized. Patients treated with telemedicine have satisfactory clinical outcomes, and their recovery appears to be more rapid than comparable hospitalized patients. Telemedicine in the home results in considerable savings by averting or shortening hospital stays. [ABSTRACT FROM AUTHOR]

This paper provides an overview of 'Kia Tika, Kia Pono – Honouring Truths' (Te Rōpū Arotahi 2022), an ethical framework to guide engagement with tamariki (children) and rangatahi (young people) who are care experienced (that is, who currently or at some stage in their lives have been in foster or residential care). Centring the voices and priorities of rangatahi with care experience, 'Kia Tika, Kia Pono' is intended for use by organisations and others working across the range of sectors and services that seek to engage tamariki and rangatahi who are care experienced in governance, policy making, service design, media or research. Its purpose is to ensure that these efforts are ethical, meaningful, and culturally safe. Grounded in Te Tiriti o Waitangi and participatory rights frameworks, 'Kia Tika, Kia Pono' is responsive to the cultural context of New Zealand. It is also distinctive in its centring of rangatahi with care experience as both knowledge-holders and knowledge-creators. In summarising the key elements of the 'Kia Tika, Kia Pono' framework, we also draw upon our insights from the research process regarding participatory practice with rangatahi with care experience. Kupu Māori/glossary of Māori words: Aroha: love, compassion, empathy; hapū: kinship group, sub-tribe, sub-nation, to be pregnant; hui: gathering, meeting, assembly, seminar, conference; iwi: extended kinship group, tribe, nation, people, bone; kai: food, meal; karakia: incantation; a set form of words to state or make effective a ritual activity; kaupapa: purpose, agenda; koha gift; especially one maintaining social relationships and has connotations of reciprocity; korowai: ornamented cloak; mana: spiritually sanctioned or endorsed influence, power, and authority; manaakitanga: showing and receiving care, respect, kindness, and hospitality; māramatanga: enlightenment, insight, understanding; mauri: life principle, life force, vital essence; pono: to be absolutely true, unfeigned, genuine; rangatahi: younger generation; rangatira: chiefly, esteemed, leader; tamariki: children; Te Tiriti o Waitangi: the Māori version of the Treaty of Waitangi; tika: what is right/good for any particular situation; tikanga Māori: customary system of values and practices that have been developed over time and are deeply embedded in the social context; tūāpapa: foundation, platform; ūkaipō: a place of nurturing and of spiritual and emotional strength; wairuatanga: spirituality; wānanga: to meet, discuss, deliberate, consider; whanau: to be born, extended family, family group; whanaungatanga: relationship, kinship, sense of family connection; a relationship through shared experiences and working together which provides people with a sense of belonging [ABSTRACT FROM AUTHOR]

In response to the rapidly evolving coronavirus disease 2019 (COVID-19) pandemic, the All of Us Research Program longitudinal cohort study developed the COVID-19 Participant Experience (COPE) survey to better understand the pandemic experiences and health impacts of COVID-19 on diverse populations within the United States. Six survey versions were deployed between May 2020 and March 2021, covering mental health, loneliness, activity, substance use, and discrimination, as well as COVID-19 symptoms, testing, treatment, and vaccination. A total of 104,910 All of Us Research Program participants, of whom over 73% were from communities traditionally underrepresented in biomedical research, completed 275,201 surveys; 9,693 completed all 6 surveys. Response rates varied widely among demographic groups and were lower among participants from certain racial and ethnic minority populations, participants with low income or educational attainment, and participants with a Spanish language preference. Survey modifications improved participant response rates between the first and last surveys (13.9% to 16.1%, P  < 0.001). This paper describes a data set with longitudinal COVID-19 survey data in a large, diverse population that will enable researchers to address important questions related to the pandemic, a data set that is of additional scientific value when combined with the program's other data sources. [ABSTRACT FROM AUTHOR]

Prostate-specific antigen (PSA) is a serine protease and one of the most abundant proteins secreted by the human prostate epithelium. PSA is used as a well-established marker of prostate cancer. The involvement of PSA in several early events leading to the development of malignant prostate tumors has made it a target for prevention and intervention. It is thought that PSA cleaves insulin-like growth factor binding protein-3 (IGFBP-3), providing increased local levels of IGF-1, leading to tumor growth. Separately, there are data that suggest an enzymatic regulatory role for dietary boron, which is a serine protease inhibitor. In this study we have addressed the use of boric acid as a PSA inhibitor in an animal study. We have previously reported that low concentrations (6 ug/mL) of boric acid can partially inhibit the proteolytic activity of purified PSA towards a synthetic fluorogenic substrate. Also, by Western blot we have followed the degradation of fibronectin by enzymatically active PSA and have found significant inhibition in the presence of boric acid. We proposed that dietary supplementation with boric acid would inhibit PSA and reduce the development and proliferation of prostate carcinomas in an animal model. We tested this hypothesis using nude mice implanted subcutaneously with LNCaP cells in Matrigel. Two groups (10 animals/group) were dosed with boric acid solutions (1.7, 9.0 mgB/kg/day) by gavage. Control group received only water. Tumor sizes were measured weekly for 8 weeks. Serum PSA and IGF-1 levels were determined at terminal sacrifice. The size of tumors was decreased in mice exposed to the low and high dose of boric acid by 38% and 25%, respectively. Serum PSA levels decreased by 88.6% and 86.4%, respectively, as compared to the control group. There were morphological differences between the tumors in control and boron-dosed animals, including a significantly lower incidence of mitotic figures in the boron-supplemented groups. Circulating IGF-1 levels were not different among groups, though expression of IGF-1 in the tumors was markedly reduced by boron treatment, which we have shown by immunohistochemistry. These data indicate that low-level dietary boron supplementation reduced tumor size and content of a tumor trophic factor, IGF-1.This promising model is being evaluated in further studies. [ABSTRACT FROM AUTHOR]

SUMMARY Doppler ultrasound grading of internal carotid artery (ICA) stenosis using the two parameters of spectral analysis and internal carotid to common carotid artery peak systolic velocity (ICA/CCA PSV) ratio is well established. The improvements in B-Mode ultrasound image quality now make direct ultrasound NASCET-style stenosis measurement possible. We demonstrate that longitudinal B-mode imaging can produce accurate North American Symptomatic Carotid Endarterectomy Trial (NASCET) style measurements which have good correlation with angiographic images. Ultrasound B-mode stenosis measurement provides a third parameter which can be used in conjunction with the two Doppler parameters for the assessment of ICA stenosis. Taking the highest grade of stenosis of the three parameters produces a sensitivity of 100% for the detection of greater than 50% and greater than 80% stenosis with specificity of 66 and 90%, respectively. The performance of satisfactory B-mode imaging against digital subtraction angiography (DSA) was very encouraging. When the B-mode stenosis measurement showed a normal ICA, the positive predictive value (PPV) of the DSA being normal was 94%. When the B-mode stenosis measurement was 35% or less, the PPV of the DSA stenosis being 35% or less was 93%. These excellent results support the use of good quality B-Mode NASCET style stenosis measurement as the initial ultrasound measurement, with Doppler ultrasound only being performed when the B-mode stenosis measurement is greater than 35% or if the B-mode image is unsatisfactory. This approach would save considerable time enabling better utilization of ultrasound resources. [ABSTRACT FROM AUTHOR]

SUMMARY The purpose of the present paper was to assess whether conventional renal Doppler ultrasound and the commonly used parameters of peak systolic velocity and renal aortic ratio may be an appropriate modality for the follow-up of renal artery stents. A total of 19 arteries in 15 patients was examined with both renal Doppler ultrasound and angiography for the presence or absence of recurrent renal artery stenosis. Disease was considered present on angiography if the arterial diameter was more than 60% stenotic. Doppler criteria for stenosis were either a peak systolic velocity of > 180 cm/s or a renal aortic ratio of > 3.0. Echo enhancement with Levovist (Schering, Berlin, Germany) was used if studies were technically unsuccessful or to improve diagnostic confidence. Renal Doppler ultrasound detected 100% of renal artery stenoses. The specificity was 75%, the positive predictive value was 67% and the negative predictive value was 100%. Echo enhancement improved the technical success rate from 89 to 95% and also increased diagnostic confidence in six examinations. The present limited study suggests that similar renal Doppler parameters as used for the study of unstented renal arteries may be applied to the examination of renal arteries with renal stents in situ. It therefore suggests that Doppler ultrasound may provide an adequate non-invasive means of renal artery stent follow-up, particularly when combined with echo-enhancing agents. Further study is warranted to confirm these initial conclusions. [ABSTRACT FROM AUTHOR]

We describe continuing work to develop restriction endonucleases as tools to enrich targeted genomes of interest from diverse populations. Two approaches were developed in parallel to segregate genomic DNA based on cytosine methylation. First, the methyl-sensitive endonuclease HpaII was used to bind non-CG methylated DNA. Second, a truncated fragment of McrB was used to bind CpG methylated DNA. Enrichment levels of microbial genomes can exceed 100-fold with HpaII allowing improved genomic detection and coverage of otherwise trace microbial genomes from sputum. Additionally, we observe interesting enrichment results that correlate with the methylation states not only of bacteria, but of fungi, viruses, a protist and plants. The methods presented here offer promise for testing biological samples for pathogens and global analysis of population methylomes. [ABSTRACT FROM AUTHOR]

To improve the metagenomic analysis of complex microbiomes, we have repurposed restriction endonucleases as methyl specific DNA binding proteins. As an example, we use DpnI immobilized on magnetic beads. The ten minute extraction technique allows specific binding of genomes containing the DpnI Gm6ATC motif common in the genomic DNA of many bacteria including γ-proteobacteria. Using synthetic genome mixtures, we demonstrate 80% recovery of Escherichia coli genomic DNA even when only femtogram quantities are spiked into 10 µg of human DNA background. Binding is very specific with less than 0.5% of human DNA bound. Next Generation Sequencing of input and enriched synthetic mixtures results in over 100-fold enrichment of target genomes relative to human and plant DNA. We also show comparable enrichment when sequencing complex microbiomes such as those from creek water and human saliva. The technique can be broadened to other restriction enzymes allowing for the selective enrichment of trace and unculturable organisms from complex microbiomes and the stratification of organisms according to restriction enzyme enrichment. [ABSTRACT FROM AUTHOR]

Summary To address the need for new approaches to antibiotic drug development, we have identified a large number of essential genes for the bacterial pathogen, Staphylococcus aureus , using a rapid shotgun antisense RNA method. Staphylococcus aureus chromosomal DNA fragments were cloned into a xylose-inducible expression plasmid and transformed into S. aureus . Homology comparisons between 658 S. aureus genes identified in this particular antisense screen and the Mycoplasma genitalium genome, which contains 517 genes in total, yielded 168 conserved genes, many of which appear to be essential in M. genitalium and other bacteria. Examples are presented in which expression of an antisense RNA specifically reduces its cognate mRNA. A cell-based, drug-screening assay is also described, wherein expression of an antisense RNA confers specific sensitivity to compounds targeting that gene product. This approach enables facile assay development for high throughput screening for any essential gene, independent of its biochemical function, thereby greatly facilitating the search for new antibiotics. [ABSTRACT FROM AUTHOR]