Percepções e ações da equipe multiprofissional em saúde sobre a medicina tradicional indígena / Perceptions and actions of the multi-professional health team on traditional indigenous medicine / Percepciones y acciones del equipo multidisciplinario de salud sobre la medicina tradicional indígena

Objetivo: compreender as percepções e as ações de uma equipe multiprofissional em saúde quanto à prática da medicina tradicional indígena em uma Casa de Atenção à Saúde Indígena. Método: estudo qualitativo descritivo, realizado em uma de Casa de Apoio à Saúde Indígena em um município do Pará, que incluiu oito profissionais de uma equipe multiprofissional. A coleta de dados foi realizada no ano de 2018 e estes foram examinados pelo método da análise de conteúdo. Resultados: inserção e prática do cristianismo; ritos e lideranças xamânicas; e postura da equipe de multidisciplinar foram as categorias elencadas, que apontam os entendimentos e atuações da equipe multiprofissional e da organização espacial da Casa de Saúde do município. Considerações finais: há novos costumes e valores entre as etnias, em virtude da aproximação de grupos religiosos, cujas ações foram registradas e apreendidas pela equipe de trabalhadores em saúde.

Objective: understanding the perceptions and actions of a multi-professional health team regarding the practice of traditional indigenous medicine in an Indigenous Health Care Center. Method: this is a descriptive qualitative study carried out in an Indigenous Health Support Center in a municipality in the state of Pará, which included eight professionals from a multi-professional team. Data was collected in 2018 and examined using the content analysis method. Results: insertion and practice of Christianity; shamanic rites and leadership; and the attitude of the multidisciplinary team were the categories listed, which point to the understandings and actions of the multi-professional team and the spatial organization of the Health Center in the municipality. Final considerations: there are new customs and values among ethnic groups, due to the approach of religious groups, whose actions were recorded and apprehended by the team of health workers.

Objetivo: comprender las percepciones y acciones de un equipo multidisciplinario de salud sobre la práctica de la medicina tradicional indígena en una Casa de Atención para la Salud Indígena. Método: estudio descriptivo cualitativo, realizado en una Casa de Apoyo a la Salud Indígena de un municipio de Pará, que incluyó ocho profesionales de un equipo multidisciplinario. La recolección de datos se realizó en 2018 y los datos fueron sometidos al método de análisis de contenido. Resultados: inserción y práctica del cristianismo; ritos y líderes chamánicos; y actitud del equipo multidisciplinario fueron las categorías enumeradas, que indican la percepción y las acciones del equipo multidisciplinario y la organización espacial de la Casa de Salud del municipio. Consideraciones finales: existen nuevas costumbres y valores entre las etnias, debido a la presencia de grupos religiosos, el equipo de los trabajadores de la salud registró y aprendió las acciones de los indígenas.

Genotyping and Phenotyping of Indigenous Saccharomyces cerevisiae from a New Zealand Organic Winery and Commercial Sources Using Inter-Delta and MALDI-TOF MS Typing.

We used inter-delta typing (IDT) and MALDI-TOF profiling to characterize the genetic and phenotypic diversity of 45 commercially available winemaking Saccharomyces cerevisiae strains and 60 isolates from an organic winemaker from Waipara, New Zealand, as a stratified approach for predicting the commercial potential of indigenous isolates. A total of 35 IDTs were identified from the commercial strains, with another 17 novel types defined among the Waipara isolates. IDT 3 was a common type among strains associated with champagne production, and the only type in commercial strains also observed in indigenous isolates. MALDI-TOF MS also demonstrated its potential in S. cerevisiae typing, particularly when the high-mass region (m/z 2000-20,000) was used, with most indigenous strains from each of two fermentation systems distinguished. Furthermore, the comparison between commercial strains and indigenous isolates assigned to IDT 3 revealed a correlation between the low-mass data (m/z 500-4000) analysis and the recommended use of commercial winemaking strains. Both IDT and MALDI-TOF analyses offer useful insights into the genotypic and phenotypic diversity of S. cerevisiae, with MALDI-TOF offering potential advantages for the prediction of applications for novel, locally isolated strains that may be valuable for product development and diversification.

Occurrence and Persistence of Saccharomyces cerevisiae Population in Spontaneous Fermentation and the Relation with "Winery Effect".

The yeast Saccharomyces cerevisiae ensures successful fermentation in winemaking, although the persistent use of commercial strains lead to the loss of aroma complexity of wines. Hence, the research of indigenous S. cerevisiae with proper oenological features and well adapted to specific wine-growing areas become of great interest for winemakers. Here, 206 pure cultures of S. cerevisiae were isolated from two wineries during a two-year sampling campaign and bio-typed through interdelta sequences analyses with the aim to evaluate the occurrence and persistence of the S. cerevisiae wild population linked to each winery. Both wineries belong to the same Verdicchio DOC wine area (Castelli di Jesi), and never used commercial yeasts during fermentation. Results showed 19 different biotypes with a specific population of S. cerevisiae in each winery, without cross-contamination with each other and with commercial starter strains. Moreover, inside each winery a persistence of some dominant biotypes was observed over time (three biotypes in winery 1; 95% of isolates in the two years and one biotype in winery 2; 20% of isolates in the two years), indicating a sort of "winery-effect". The evaluation of S. cerevisiae populations for the oenological characters by microfermentations showed a proper and well distinct aromatic imprinting on the resulted wines supporting the concept of "winery effect".

Indigenous Medicinal Plants Used in the Management of Diabetes in Africa: 5 Years (2019-2024) in Perspective.

(1) Background: The utilization of medicinal plants in the management of diabetes is of great importance to the health of the indigenous population on the African continent. The high cost of orthodox conventional medicines coupled with the perceived side effects encourages the high patronage of indigenous medicinal plants in the management of this metabolic disorder. We conducted a review on the indigenous African medicinal plants that could be useful in preclinical and clinical trials in the field of diabetes mellitus research. (2) Methods: Data were mined from research articles published and associated with the use of medicinal plants in the management of diabetes on the African continent (from January 2019 to March 2024). Literature from ethnobotanical studies on the African continent was searched from the Google Scholar, SCOPUS, Medline, Web of Science and PubMed databases. We employed the following keywords: "indigenous plants", "diabetes in Africa" and "antidiabetic effect of medicinal plants". (3) Results: A total of 52 medicinal plants belonging to 31 families were recorded in this study. Amaryllidaceae (14.28%), Fabaceae (9.52%) and Asteraceae (9.52%) were the most cited plant families. The frequently used indigenous medicinal plants on the African continent were Allium sativum L. (n = 6), Olea europaea L. (n = 6), Azadirachta indica A. Juss (n = 5), Allium cepa L. (n = 5) and Moringa oleifera Lam. (n = 5). The highly cited parts of the plant used in the management of diabetes were the leaves (45.55%), bark (14.44%) and bulbs (12.22%). The preferred methods of the preparation of herbal medicines were decoction (45.23%) and infusion (25%). Oral (52.32%) was the preferred route of the administration of herbal medicine on the African continent. (4) Conclusions: The data revealed some similarities in the way countries on the African continent manage diabetes. This interesting observation will assist in our quest towards obtaining a standardized protocol using indigenous medicinal plants to combat diseases on the African continent.

SIP-Metagenomics Reveals Key Drivers of Rhizospheric Benzo[a]pyrene Bioremediation via Bioaugmentation with Indigenous Soil Microbes.

Rhizoremediation and bioaugmentation have proven effective in promoting benzo[a]pyrene (BaP) degradation in contaminated soils. However, the mechanism underlying bioaugmented rhizospheric BaP degradation with native microbes is poorly understood. In this study, an indigenous BaP degrader (Stenotrophomonas BaP-1) isolated from petroleum-contaminated soil was introduced into ryegrass rhizosphere to investigate the relationship between indigenous degraders and rhizospheric BaP degradation. Stable isotope probing and 16S rRNA gene amplicon sequencing subsequently revealed 15 BaP degraders, 8 of which were directly associated with BaP degradation including Bradyrhizobium and Streptomyces. Bioaugmentation with strain BaP-1 significantly enhanced rhizospheric BaP degradation and shaped the microbial community structure. A correlation of BaP degraders, BaP degradation efficiency, and functional genes identified active degraders and genes encoding polycyclic aromatic hydrocarbon-ring hydroxylating dioxygenase (PAH-RHD) genes as the primary drivers of rhizospheric BaP degradation. Furthermore, strain BaP-1 was shown to not only engage in BaP metabolism but also to increase the abundance of other BaP degraders and PAH-RHD genes, resulting in enhanced rhizospheric BaP degradation. Metagenomic and correlation analyses indicated a significant positive relationship between glyoxylate and dicarboxylate metabolism and BaP degradation, suggesting a role for these pathways in rhizospheric BaP biodegradation. By identifying BaP degraders and characterizing their metabolic characteristics within intricate microbial communities, our study offers valuable insights into the mechanisms of bioaugmented rhizoremediation with indigenous bacteria for high-molecular-weight PAHs in petroleum-contaminated soils.

Multimorbidity among the Indigenous population: a systematic review and meta-analysis.

BACKGROUND: Multimorbidity, the concurrent presence of multiple chronic health conditions in an individual, represents a mounting public health challenge. Chronic illnesses are prevalent in the Indigenous populations, which contributes to multimorbidity. However, the epidemiology of multimorbidity in this population is not well studied. This review aimed to elucidate the extent, determinants, consequences, and prevention of multimorbidity within Indigenous populations globally, contrasting findings with non-Indigenous populations. METHODS: Adhering to the PRISMA guidelines, this systematic review assimilated peer-reviewed articles and grey literature, focusing on the prevalence, determinants, implications, and preventive strategies of multimorbidity in global Indigenous populations. Emphasis was given to original, English-language, full-text articles, excluding editorials, and conference abstracts. FINDINGS: Of the 444 articles identified, 13 met the inclusion criteria. Five studies are from Australia, and the rest are from the USA, Canada, New Zealand, and India. The study indicated a higher multimorbidity prevalence among Indigenous populations, with consistent disparities observed across various age groups. Particularly, Indigenous individuals exhibited a 2-times higher likelihood of multimorbidity compared to non-Indigenous populations. Noteworthy findings underscored the elevated severity of certain comorbid conditions, especially strokes, within Indigenous groups, with further revelations highlighting their significant pairing with conditions such as heart diseases and diabetes. INTERPRETATION: The findings affirm the elevated burden of multimorbidity among Indigenous populations. Prevalence and risk of developing multimorbidity are significantly higher in this population compared to their non-Indigenous counterparts. Future research should prioritize harmonized research methodologies, fostering insights into the multimorbidity landscape, and promoting strategies to address health disparities in Indigenous populations.

The seroconversion history to SARS-CoV-2 in Indigenous people from Brazil - the interplay between exposure, vaccination, and tuberculosis.

The COVID-19 pandemic caused a significant loss of human lives and a worldwide decline in quality of life. Although our understanding of the pandemic has improved significantly since the beginning, the natural history of COVID-19 and its impacts on under-represented populations, such as Indigenous people from America, remain largely unknown. We performed a retrospective serological survey with two Brazilian Indigenous populations (n=624), Tupiniquim and Guarani-Mbyá. Samples were collected between September 2020 and July 2021: a period comprising the dissemination of SARS-CoV-2 variants and the beginning of COVID-19 vaccination in Brazil. Seroconversions against S and N antigens were assessed using three different commercially available ELISA kits. Samples were also used to assess the prevalence of tuberculosis (TB) in the same population (n=529). Seroconversion against SARS-CoV-2 antigens was considered positive if at least one of the three ELISA kits detected levels of specific antibodies above the threshold specified by the manufacturer. In this sense, we report 56.0% (n=349/623) of seroconverted individuals. Relative seroconversion peaked after introduction of the Coronavac vaccine in February 2021. Vaccination increased the production of anti-S IgG from 3.9% to 48.6%. Our results also indicated that 11.0% (n=46/417) of all individuals were positive for TB. Seroconversion to SARS-CoV-2 was similar between individuals with positive tuberculosis test results to those with negative test results. Most vaccinated individuals seroconverted to SARS-CoV-2, indicating that Coronavac may be as protective in individuals from these indigenous groups as observed in the general Brazilian population. COVID-19 severity was minimal regardless of incomplete vaccine coverage, suggesting that vaccination may not be the only factor protecting individuals from severe COVID-19. Tuberculosis is highly prevalent and not associated with increased seroconversion to SARS-CoV-2.

The economic evaluation of a housing maintenance project to improve the health of Aboriginal housing tenants in NSW: A scoping literature review and protocol for an economic analysis.

Considerable evidence exists regarding the role housing plays in the determination of health and well-being outcomes. Despite the scale of health concerns arising from housing considerations, there are very few economic analyses of housing programs that seek to improve health outcomes by addressing the physical infrastructure of the living environment. The NSW Housing for Health (HfH) program is an environmental health initiative funded and administered by NSW Health, that addresses health-related hardware in residential accommodation to ensure the home environment supports healthy living practices to ultimately improve health outcomes for residents. This study reviews the economic methods that have been applied to comparable programs and identifies relevant costs and benefits that should be addressed. Founded on the requirement from decision makers, and the insights from the review, the paper outlines a protocol for a cost-benefit analysis that accounts for the disparate health, social, economic and intangible benefits generated from the HfH program and the resources utilised to realise these outcomes.

A psychometric analysis of the adapted historical loss scale and historical loss associated symptoms scale among native Hawaiian adults.

Objectives: The Historical Loss Scale (HLS) and Historical Loss Associated Symptoms Scale (HLASS) are standardized measures that have been accepted and previously validated among North American Indigenous communities and allow researchers to measure the impact of Historical Loss. Evidence of the psychometric properties of this instrument have not been assessed for Native Hawaiians, the Indigenous peoples of Hawai'i. The purpose of this study is to investigate the psychometric properties of the adapted HLS (aHLS) and HLASS for adults from multiple Hawaiian Homestead Communities throughout Hawai'i. Methods: Data are based on cross-sectional surveys administered between 2014 and 2020. The final sample included 491 Native Hawaiian adults who were predominantly female (67.3%) and between the ages of 18-90 years, who were part of the larger study entitled the Hawaiian Homestead Health Survey. Factor analyses were conducted to determine the final model structures of each scale. Reliability and correlation matrices of items are also reported. Results: The final factor structure of the aHLS model suggested 3 factors: (1) General loss of culture or cultural loss, (2) Intergenerational loss, and (3) Distrust and destruction of traditional foods. The final HLASS model also suggested 3 factors: (1) Depression and Anger, (2) Shame and Anxiety, and (3) Re-experiencing, fear, and avoidance. Conclusion: These findings have implications for future research, practice, and education that explores the role of Historical Loss and associated symptoms in Native Hawaiians and Indigenous communities at large. In particular, measuring historical loss and associated symptoms in Hawaiian Homestead communities paves the way for quantitative assessments of historical trauma and healing in these communities.

The prevalence and risk factors of Helicobacter pylori infection and cagA virulence gene carriage in adults in the Navajo Nation.

Background: American Indian and Alaska Native people in the United States experience high rates of stomach cancer. Helicobacter pylori infection is a significant risk factor for stomach cancer, and H. pylori strains that carry the cagA gene are linked to greater gastrointestinal disease severity. Yet, little is known about H. pylori and cagA infections in American Indian and Alaska Native people, particularly at the tribal level. We assessed the prevalence and risk factors of H. pylori infection and cagA gene carriage in tribal members from the Navajo Nation. Materials and Methods: We conducted a cross-sectional study with adults from the Navajo Nation. Stool samples collected from participants were analyzed with droplet digital PCR for H. pylori 16S ribosomal and cagA virulence genes. Self-administered health and food questionnaires were mailed to participants to collect information on sociodemographic, health, lifestyle, and environmental risk factors for H. pylori infection. Logistic regression assessed the association between risk factors and H. pylori infection and cagA gene carriage. Results: Among 99 adults, the median age was 45 (age range: 18 to 79 years), and 73.7% were female. About 56.6% (95% CI: 46.2-66.5) of participants were infected with H. pylori. Of H. pylori-infected participants, 78.6% (95% CI: 65.6-88.4) were cagA-gene positive. No significant associations of relevant risk factors with H. pylori and cagA-gene positive infections were noted. Conclusions: In a community-based study population, a substantial proportion of adult tribal members had H. pylori and cagA-gene positive infections. Given these high proportions, culturally appropriate prevention strategies and interventions addressing H. pylori infections present an avenue for additional research and stomach cancer prevention in the Navajo Nation.

The Association of Socio-Economic Factors and Indigenous Crops on the Food Security Status of Farming Households in KwaZulu-Natal Province.

Indigenous crops have been proposed as part of a solution for household food security and sustainable farming systems. However, they have been overlooked and underutilised by households and farmers despite their potential contribution to household food security. The objective of this paper was to determine the association of socio-economic factors and indigenous crops with the household food security of farming households. About 260 farming households were selected using a simple random sampling procedure. The food security status was measured through the use of the Household Food Insecurity Access Scale (HFIAS). The Chi-square test and extended ordered probit regression model assessed the relationship of socio-economic factors and indigenous crops with household food security status. The results from the HFIAS showed that farming households were largely in the mildly and moderately food-insecure categories, with 34.2% and 36.2% of the sampled farmers found in these categories, respectively. The Chi-square test showed a statistically significant relationship between food security status and socio-economic factors. Young men and everyone were perceived to be the ones likely to consume indigenous crops. Consumption of indigenous crops was perceived to be associated with food security. The results also showed that farming experience is likely to positively contribute to the food security status of the farming households. Selling indigenous crops in a formal market is perceived to be associated with food security compared to selling in an informal market. This study concludes that consuming indigenous crops is likely associated with improved food security. Identifying an appropriate market for sales of indigenous crops is imperative. Government, extension officers, and nutritionists must conduct training workshops to encourage households to grow, market and buy indigenous crops. Government and policymakers need to include indigenous crops in the national food and nutrition security policy and create formal markets for indigenous crops.

Assessing receptivity to malaria using case surveillance and forest data in a near-elimination setting in northeast Thailand.

BACKGROUND: Thailand aimed to eliminate malaria by 2024, and as such is planning for future prevention of re-establishment in malaria free provinces. Understanding the receptivity of local areas to malaria allows the appropriate targeting of interventions. Current approaches to assessing receptivity involve collecting entomological data. Forest coverage is known to be associated with malaria risk, as an environment conducive to both vector breeding and high-risk human behaviours. METHODS: Geolocated, anonymized, individual-level surveillance data from 2011 to 2021 from the Thai Division of Vector-Borne Disease (DVBD) was used to calculate incidence and estimated Rc at village level. Forest cover was calculated using raster maps of tree crown cover density and year of forest loss from the publicly available Hansen dataset. Incidence and forest cover were compared graphically and using Spearman's rho. The current foci classification system was applied to data from the last 5 years (2017-2021) and forest cover for 2021 compared between the classifications. A simple risk score was developed to identify villages with high receptivity. RESULTS: There was a non-linear decrease in annual cases by 96.6% (1061 to 36) across the two provinces from 2011 to 2021. Indigenous Annual Parasite Index (API) and approximated Rc were higher in villages in highly forested subdistricts, and with higher forest cover within 5 km. Forest cover was also higher in malaria foci which consistently reported malaria cases each year than those which did not. An Rc > 1 was only reported in villages in subdistricts with > 25% forest cover. When applying a simple risk score using forest cover and recent case history, the classifications were comparable to those of the risk stratification system currently used by the DVBD. CONCLUSIONS: There was a positive association between forest coverage around a village and indigenous malaria cases. Most local transmission was observed in the heavily forested subdistricts on the international borders with Laos and Cambodia, which are where the most receptive villages are located. These areas are at greater risk of importation of malaria due to population mobility and forest-going activities. Combining forest cover and recent case surveillance data with measures of vulnerability may be useful for prediction of malaria recurrence risk.

Ethnobotanical study of wild edible plants in Arsi Robe district of East Arsi Zone, Ethiopia.

BACKGROUND: Wild edible plants (WEPs) are usually considered to constitute all plant resources that are neither cultivated nor domesticated but are used as nutritional supplements by local people. WEPs play a vital role in ensuring food and livelihood security for countless families and communities around the world. The objective of the study was to assess and document wild edible plants used by communities in the Arsi Robe district as food. METHODS: Semi-structured interviews, market surveys, and guided field walks were employed as data collection tools. The data were analyzed using preference ranking, direct matrix ranking, and Jaccard's similarity index. RESULTS: The present study revealed various types of wild edible plants consumed by local communities in the Arsi Robe district of the East Arsi Zone. This could be justified by the documentation of 36 different wild edible plants in the study area. These WEPs belong to 31 genera and 25 families. Most of the growth forms of the edible wild plants in the district were shrubs (16, 44.44%) and trees (14, 38.88%). Amaranthus caudatus and Bridelia micrantha are the most preferred WEPs in the study area. The finding of the study also revealed that Lepidotrichilia volkensii and Premna schimperi are among the novel WEPs that had not before been documented as food items in other areas. Olea europaea subsp. cuspidata, Ficus sycomorus, Cordia africana, and Ficus sur are species with multiple uses. Agricultural expansion, charcoal production, the construction of different materials, making agricultural tools, deforestation, and other factors were the top prioritized threats affecting the abundance and diversity of wild edible plants. CONCLUSION: Along with the sustainable utilization and conservation of the existing WEPs of the study district, priority should be given to the urgent collection, domestication, and cultivation of multiuse wild edible plant species such as Olea europaea subsp. cuspidata, Ficus sycomorus, Cordia africana, and Ficus sur in the study area.

Effect of Education on Adherence to Recommended Prenatal Practices among Indigenous Ngäbe-Buglé Communities of Panama.

Background and Objectives: The primary objective of this study was to assess the adherence of Ngäbe-Buglé women to WHO-recommended prenatal practices. The secondary objective was to compare adherence levels between women who received prenatal education from official medical providers and those educated through traditional or community-based sources within Ngäbe-Buglé communities. Materials and Methods: An eight-question survey was verbally administered to 137 Ngäbe-Buglé women at clinics set up by the non-profit NGO Floating Doctors in eight communities. A two-sided Fisher's Exact test with a p = 0.05 was used to compare the results of mothers who received prenatal education from evidence-based sources to other groups. Results: Out of the 137 surveyed women, 65 reported taking prenatal vitamins, 21 had prenatal check-ups, 136 avoided alcohol, 31 increased caloric intake, and 102 maintained their activity levels. Significant differences were observed in prenatal vitamin adherence between those educated by official sources versus unofficial sources (p = 0.0029) and official sources compared to those with no prenatal education (p < 0.0001). The difference was also significant for education from an unofficial source versus no education (p = 0.0056). However, no significant differences were found in other prenatal practices based on education sources. Conclusions: Our findings highlight deficiencies in both prenatal education and adherence to recommended practices among Ngäbe-Buglé women. Prenatal education significantly improved adherence to taking prenatal vitamins, suggesting its effectiveness as an intervention. Future interventions should prioritize culturally competent prenatal education and address barriers to accessing prenatal healthcare in Ngäbe-Buglé communities.

Breeding practice of indigenous village chickens, and traits and breed preferences of smallholder farmers.

BACKGROUND: Indigenous village chickens, or (IVCs), significantly contribute to rural livelihoods. Although natural selection has a disproportionate impact on the genetic structure of IVCs, farmers have developed locally tailored breeding practices to get the most out of their flocks. OBJECTIVES: Small-scale farmers' insights on trait breed preferences and family flock breeding practices are presented in this cross-sectional study. METHODS: A cross-sectional study was conducted in two agroecological zones using face-to-face individual interviews with 119 general informants. RESULTS: Farmers prefer IVCs because they are multipurpose birds. Unlike policymakers, who usually underestimate the importance of IVCs, small-scale farmers acknowledge the coexistence of local and commercial chickens. Only 15.7% of farmers recruited homegrown cocks, whereas 47.9% outsourced breeding cocks from local markets and 36.4% from neighbours (χ-squared = 15.976, df = 2, p = 0.0003395). About 49.2% of small-scale farmers believed that consanguineous mating-induced inbreeding has only trivial effects. High flock turnover significantly reduces inbreeding. Regardless of the low production capacity, small-scale farmers prefer local (rank = 1.47) chickens to commercial (rank = 1.61). For cocks, fertility and growth traits were highly sought after, whereas for hens, maternal instincts and laying performance were prioritized. Compared to the highlands, the lowlands had a longer egg storage period (t = 2.677, df = 117, p = 0.009, 95% CI: -3.7607, -0.5622). CONCLUSIONS: This study documented the wisdom of small-scale farmers and encouraged the incorporation of their insights into a sustainable genetic improvement program.

A Typology of National Park Co-management Agreements in the Era of Reconciliation in Canada.

Parks Canada, in response to commitments undertaken towards reconciliation, has signaled its readiness to reassess the participation of Indigenous peoples in the co-management of national parks, national park reserves, and national marine conservation areas (NMCAs). However, the effectiveness of co-management, as the established framework underpinning these and other longstanding partnerships between the state and Indigenous groups, has been disputed, based on an uneven track record in meeting the needs, interests, and aspirations of Indigenous communities. This paper explores the potential of co-management to facilitate reconciliation within national parks, reserves and NMCAs by developing a typology of various types of co-management agreements. Addressing a critical knowledge gap in co-management governance, we provide a comprehensive review of 23 negotiated co-management agreements involving the state and Indigenous groups in a national park context. The resulting typology categorizes these agreements according to contextual factors and governance arrangements, offering insights into the feasibility of shared governance approaches with Parks Canada. Moreover, it identifies the strengths and weaknesses of co-management agreements in fulfilling reconciliation commitments. Our findings indicate that, although Parks Canada has implemented innovative approaches to co-management and shown a willingness to support Indigenous-led conservation efforts, true shared governance with Indigenous groups, as defined by international standards, is limited by the Canadian government's evident reluctance to amend the foundational legislation to effectively share authority in national parks.

Normative data for executive function tests in an Ecuadorian Waranka minority population.

Objective: To generate normative data (ND) for executive functions tests in the Waranka minority population of Ecuador. Method: Four-hundred participants aged 6-17 completed the Symbol-Digit Modalities Test (SDMT), Trail-Making Test (TMT), Modified-Wisconsin Card Sorting Test (M-WCST), and Test of Colors-Words (STROOP). Scores were normed using multiple linear regressions, including age, age2, natural logarithm of mean parent education (MPE), sex, bilingualism, and two-way interactions as predictors. Results: Age by MPE and Age2 by MPE interactions arose for SDMT, so that children with illiterate parents scored lower than those with literate parents. Girls scored higher in SDMT. All TMT and M-WCST scores were influenced by age2. Age by MPE interaction was found for TMT-A, so that children with higher MPE went faster; and age by bilingualism interaction for TMT-B, so that more bilingual children needed less time. Stroop-Word and Color were influenced by age2 by MPE interaction, so that children, while older, scored higher, especially those with higher MPE. Also, age2 by sex interaction arose, so that girls increased scores curvilinearly while boys linearly. Word-Color was influenced by age, while Stroop-interference by age2. Age by MPE interaction was found for MCST-Categories and Perseveration, so that perseverations decreased to then increased, especially in those with illiterate parents. M-WCST-Category scores increased to then decrease later on age in children with illiterate parents. Z-scores calculated through indigenous ND were significantly lower than generated through non-indigenous norms. Conclusions: ND for minority populations are critical since Waranka sample performed worse when using non-indigenous norms for z-score calculation.

Towards precision cancer medicine for Aboriginal and Torres Strait Islander cancer health equity.

Delivering cancer control at scale for Aboriginal and Torres Strait Islander communities is a national priority that requires Aboriginal and Torres Strait Islander leadership and codesign, as well as significant involvement of the Aboriginal community-controlled health sector. The unique genomic variation observed among Aboriginal and Torres Strait Islander peoples may have implications for standard and precision medicine. Yet, Aboriginal and Torres Strait Islander peoples are absent from, or under-represented within, human reference genome resources, genomic studies, cancer studies, cancer cell lines, patient-derived xenografts and cancer clinical trials. Genomics-guided precision cancer medicine offers an opportunity to reduce cancer health disparities experienced by Aboriginal and Torres Strait Islander peoples through personalising prevention, diagnosis, treatment and long term management. Here, we describe what is required to ensure that Aboriginal and Torres Strait Islander peoples can receive the benefits of precision cancer medicine. Equity of access to care, an Aboriginal and Torres Strait Islander cancer workforce, and appropriate genome reference resources are important for safe and effective cancer medicine. Building Indigenous data sovereignty principles and Aboriginal and Torres Strait Islander governance into research is required to protect Aboriginal and Torres Strait Islander rights and collective interests. Aboriginal and Torres Strait Islander community engagement should be undertaken to develop an understanding of the unique cultural and ethical considerations for precision cancer research. Local and national genomic health research guidelines are needed to define a consensus best practice in genomics research with Aboriginal and Torres Strait Islander peoples.