Nutrient budgets and biogeochemical dynamics in the coastal regions of northern Beibu Gulf, South China Sea: Implication for the severe impact of human disturbance.

This study examined the nutrient budgets and biogeochemical dynamics in the coastal regions of northern Beibu Gulf (CNBG). Nutrient concentrations varied spatially and seasonally among the different bays. High nutrient levels were found in the regions with high riverine inputs and intensive mariculture. Using a three end-member mixing model, nutrient biogeochemistry within the ecosystem was estimated separately from complex physical mixing effects. Nutrient consumption dominated in most bays in summer, whereas nutrient regeneration dominated in winter, likely due to phytoplankton decomposition, vertical mixing and desorption. Through the Land-Ocean Interaction Coastal Zone (LOICZ) model, the robust nutrient budgets were constructed, indicating that the CNBG behaved as a sink of dissolved inorganic nitrogen, phosphorus and silicon. River-borne nutrient inputs were the dominant nutrient source, while residual flows and water exchange flows transported nutrient off the estuaries. This study could help us better understand nutrient cycles and nutrient sources/sinks in the CNBG.

Comparison of the wastewater treatment performance of continuously and discontinuously mixed high-rate algal ponds at Kingston on Murray.

High-rate algal ponds (HRAPs) incorporate shallow raceway designs and paddlewheel mixing. HRAPs use UV disinfection and the symbiotic environment between microalgal photosynthesis and heterotrophic bacteria for the assimilation of nutrients for efficient wastewater treatment. Mixing of a HRAP provides a homogenous environment and influences both the disinfection of pathogens and algal growth by exposing the wastewater to sunlight. Guidelines require continuous mixing of the HRAP. This study aimed to determine the effect of cessation of mixing for 10 days, on wastewater treatment by comparison with a continuously mixed pond operated over the same period. The period of 10 days was equivalent to the HRAP hydraulic retention time. Samples of inlet and HRAP-treated wastewater were collected from the HRAP at Kingston on Murray. Parameters measured were Escherichia coli, chlorophyll a, total suspended solids (TSS), NH4-N, NO2-N, NO3-N, PO4-P and biochemical oxygen demand (BOD5). The discontinuously mixed and the continuously mixed HRAPs complied with the wastewater effluent guidelines, of an E. coli concentration ≤104 MPN100 mL-1 and a BOD5 of <20 mg L-1. An E. coli log reduction value of >1 was also recorded. This study shows that cessation of mixing for 10 days had no significant effect on HRAP wastewater treatment performance.

Influences of extracellular polymeric substances (EPS) recovered from waste sludge on the ability of Jiaozhou Bay to self-remediate of diesel-polluted seawater.

The introduction of EPS recovered from waste sludge may have an impact on the process of microbial remediation of oil-contaminated seawater. This study investigated the effect of EPS on the self-remediation capacity of diesel-polluted seawater in Jiaozhou Bay. Hydrocarbon attenuation and microbial activity were monitored in seawater collected from five islands after diesel and N, P addition, with and without EPS, incubated under aerobic conditions. Compared to seawater without EPS, degradation of TPH (total petroleum hydrocarbon) doubled and improved degradation of non-volatile (C16-C24) hydrocarbons to some extent in EPS-added seawater. The introduction of EPS led to changes in microbiota richness and diversity, significantly stimulating the growth of Proteobacteria and Firmicutes phyla or Bacillus and Pseudomonas genera. RT-qPCR analysis indicated EPS caused higher increases in cytochrome P450 gene copies than alkB. Prediction of alkane decay genes from 16S rRNA sequencing data revealed that EPS addition obviously promoted genes related to ethanol dehydrogenation function in the microbial community. Additionally, EPS enhanced the enzymatic activities of alkane hydroxylase, ethanol dehydrogenase, phosphatase and lipase, but increased protease and catalase inconspicuously. The above outlook that environmental sustainability of EPS from waste sludge for diesel-contaminated seawater remediation may provide new perspectives for oil spill bioremediation.

Comparison of nutrients status in Liaodong Bay and Northern Yellow Sea, China: Controlling factors and nutrient budgets.

Under the dual stress of global warming and human interaction, Liaodong Bay (LDB) and northern Yellow Sea (NYS) are undergoing significant ecological changes. Little is known about the driving nutrients characteristics supporting fishery resource output in these areas. We carried out three field observations in 2019 to investigate nutrient status. Results showed that dissolved inorganic nitrogen (DIN), dissolved inorganic phosphorus (DIP), and dissolved silica (DSi) concentrations changed seasonally, with lowest values in spring, and highest values in autumn. High DIN, DIP, and DSi concentrations were detected in LDB and NYS's estuary areas. The Yellow Sea Cold Water Mass plays a role in the distribution and seasonal variation of nutrients. Exchanges across the sediment-water interface, SFGD, atmospheric deposition, and the adjacent sea input dominated DIN dynamics of these areas. DIP primarily came from the adjacent sea input and DSi mainly originated from sediment release and the adjacent sea input. NYS seawater invasion accounted for 13.8% of DIN, 63.4% of DIP, and 35.1% of DSi in LDB. These results provide new insights to better facilitate the formulation of nitrogen and phosphorus reduction and control policies in these marginal seas.

Fish community responses to restoration of a eutrophic coastal bay.

Interest in coastal restoration measures is increasing, but information about subsequent ecosystem recovery processes is limited. In Björnöfjärden on the Baltic Sea coast, Stockholm archipelago, a pioneering case study to reduce coastal eutrophication led to improvements and initially halved phosphorus levels. Here, we evaluate the effects of the restoration on the local fish assemblage over one decade after the measures. The study gives a unique possibility to evaluate responses of coastal fish to nutrient variables and abatement in a controlled natural setting. Cyprinid abundance decreased and perch partially increased with decreasing turbidity levels, while mean trophic level increased over time in the restored area. Responses were overall weak, likely attributed to an attenuation of the eutrophication abatement effect over time. The results suggest that nutrient reduction gives slow responses in fish compared to alternative measures such as fishing closures.

Effect of Inlet Air Temperature and Quinoa Starch/Gum Arabic Ratio on Nanoencapsulation of Bioactive Compounds from Andean Potato Cultivars by Spray-Drying.

Nanoencapsulation of native potato bioactive compounds by spray-drying improves their stability and bioavailability. The joint effect of the inlet temperature and the ratio of the encapsulant (quinoa starch/gum arabic) on the properties of the nanocapsules is unknown. The purpose of this study was to determine the best conditions for the nanoencapsulation of these compounds. The effects of two inlet temperatures (96 and 116 °C) and two ratios of the encapsulant (15 and 25% w/v) were evaluated using a factorial design during the spray-drying of native potato phenolic extracts. During the study, measurements of phenolic compounds, flavonoids, anthocyanins, antioxidant capacity, and various physical and structural properties were carried out. Higher inlet temperatures increased bioactive compounds and antioxidant capacity. However, a higher concentration of the encapsulant caused the dilution of polyphenols and anthocyanins. Instrumental analyses confirmed the effective encapsulation of the nuclei in the wall materials. Both factors, inlet temperature, and the encapsulant ratio, reduced the nanocapsules' humidity and water activity. Finally, the ideal conditions for the nanoencapsulation of native potato bioactive compounds were determined to be an inlet temperature of 116 °C and an encapsulant ratio of 15% w/v. The nanocapsules obtained show potential for application in the food industry.

Advanced HIV disease in Homa Bay County, Kenya: Characteristics of newly-diagnosed and antiretroviral therapy-experienced clients.

Advanced HIV disease (AHD) remains a significant burden, despite the widespread use of antiretroviral therapy (ART) programs. Individuals with AHD are at a high risk of death even after starting ART. We characterized treatment naïve and treatment experienced clients presenting with AHD in western Kenya to inform service delivery and program improvement. We conducted a retrospective study using routinely collected program data from October 2016 to September 2019 for AHD clients in eight facilities in Homa Bay County, Kenya. Demographic and clinical data were abstracted from the medical records of AHD clients, defined as HIV-positive clients aged ≥ 5 years with documented CD4 count < 200 cells/mm3 and/or WHO clinical stage II/IV. Associations were assessed using Pearson's chi-square and Mann-Whitney Rank-Sum tests at 5% level of significance. Of the 19,427 HIV clients at the eight facilities, 6649 (34%) had a CD4 count < 200 cells/mm3 or a WHO III/IV stage. Of these, 1845 were randomly selected for analysis. Over half (991) of participants were aged 45 + years and 1040 (56%) were female. The median age was 46.0 years (interquartile range: 39.2-54.5); 1553 (84%) were in care at county and sub-county hospitals; and 1460 (79%) were WHO stage III/IV at enrollment. At ART initiation, 241 (13%) had tuberculosis, 192 (10%) had chronic diarrhea, and 94 (5%) had Pneumocystis jiroveci pneumonia. At the time of data collection, 89 (5%) participants had died and 140 (8%) were lost to follow-up. Eighteen percent (330) of participants were ART-experienced (on ART for ≥ 3 months). The proportions of ART-experienced and -naïve clients regarding age, sex and marital status were similar. However, a higher proportion of ART-experienced clients received care at primary care facilities, (93(28%) vs. 199 (13%); P < .001); were WHO stage 3/4 at AHD diagnosis, 273 (84%) vs. 1187 (79%) (P = .041); and had died or been LTFU, (124 (38%) vs. 105 (7%); P < .001). With increasing prevalence of patients on ART, the proportion of AHD treatment-experienced clients may increase without effective interventions to ensure that these patients remain in care.

Effect of submarine groundwater discharge on nutrient distribution and eutrophication in Liaodong Bay, China.

Driven by the anthropogenic activities associated with coastal settlements, eutrophication has become a global issue. Submarine groundwater discharge (SGD) is a significant continuous pathway for transporting nutrients from land to coastal waters, but its influence on eutrophication in Liaodong Bay (LDB) has received limited attention. In this study, radium isotopes and nutrient data from coastal waters were analyzed to evaluate the SGD flux and its implications for potential eutrophication in LDB. We found that the mean concentrations of dissolved inorganic nitrogen (DIN), phosphorous (DIP), and silicate (DSi) in groundwater were higher than those of seawater and river water. Based on 223Ra and 228Ra mass balance models, the SGD fluxes were estimated to be (0.53-2.03) × 109 m3/d, of which the fresh SGD accounted for 4 %-15 %. SGD is a vital invisible source of nutrients, contributing more than 79 % of the total inputs of DIN, DIP, and DSi into LDB. With high DIN/DIP ratios (average=85.8) and large nutrient inputs, SGD may significantly drive the phosphorus limitation and eutrophication in LDB. This study shows that SGD-derived nutrient fluxes should be considered in the assessment of water eutrophication for the formulation of future environmental management protocols in coastal systems.

Contamination and ecological risk assessment of Cr, As, Cd and Pb in water and sediment of the southeastern Bay of Bengal coast in a developing country.

Safe levels of heavy metals in the surface water and sediment of the eastern Bay of Bengal coast have not been universally established. Current study characterized heavy metals such as arsenic (As), chromium (Cr), cadmium (Cd) and lead (Pb) in surface water and sediments of the most important fishing resource at the eastern Bay of Bengal coast, Bangladesh. Both water and sediment samples were analyzed using inductively coupled plasma mass spectrometer. Considering both of the seasons, the mean concentrations of Cr, As, Cd, and Pb in water samples were 33.25, 8.14, 0.48, and 21.14 µg/L, respectively and in sediment were 30.47, 4.48, 0.20, and 19.98 mg/kg, respectively. Heavy metals concentration in water samples surpassed the acceptable limits of usable water quality, indicating that water from this water resource is not safe for drinking, cooking, bathing, and any other uses. Enrichment factors also directed minor enrichment of heavy metals in sediment of the coast. Other indexes for ecological risk assessment such as pollution load index (PLI), contamination factor (CF), geoaccumulation index (Igeo), modified contamination degree (mCd), and potential ecological risk index (PERI) also indicated that sediment of the coastal watershed was low contamination. In-depth inventorying of heavy metals in both water and sediment of the study area are required to determine ecosystem health for holistic risk assessment and management.

Long-term phosphorus removal by Ca and Fe-rich drainage filter materials under variable flow and inlet concentrations.

Phosphorus (P) losses from tile-drained agricultural fields may degrade surface water quality by accelerating eutrophication. Among the different edge-of-field technologies, compact filter systems using different filter materials have been identified as potentially effective solutions for removing P from drainage water before discharge downstream. This study investigated the long-term (>696 days) P removal efficiency of 5 different filter materials in a column setup, using artificial drainage water (pH 6). Filter materials included two iron-based granulates (calcinated diatomaceous earth (CDE), ferric hydroxide granules (CFH)), and three calcium-based granulates (seashells, limestone, calcinated silicate/calcium oxide (Filtralite-P)). Experiments were performed under variable flow rates (0.037 and 1.52 L h-1; hydraulic retention time of 26-43 min and 18-30 h) and inlet P concentrations (0.14 and 0.7 mg L-1). An overall analysis revealed that the Fe-based materials achieved higher P retention than Ca-based materials. In particular, CFH was capable of retaining 99 and 98 % of the high and low inlet P concentrations, respectively. Conversely, limestone retained only 25 % of the high P load. CDE performed moderately well, independently of the inlet P concentration. Filtralite-P and Seashells performed well at high inlet P concentration but relatively poorly at low P concentration. The sensitivity of filter material P removal efficiency to variations in P loading was generally lowest for CFH and highest for limestone.

Nutrients transport behavior in inlet river in the Yellow River Delta in winter.

The nutrients such as dissolved inorganic nitrogen (DIN, NH4+-N, NO2--N, and NO3--N), dissolved inorganic phosphorus (DIP, PO43-) and dissolved SiO2 (DSi) funneled by the inlet river are the dominant factors to coastal eutrophication. This study investigated nutrient transport process in typical inlet rivers in the Yellow River Delta. The indicator of coastal eutrophication potential and concentration ratio between upstream and downstream stations were used to evaluate the influence of different sources to the nutrient risks. It showed that urban areas are the most important source of the nutrients in studied rivers. The harbor and mariculture would have greater risk because of their proximity close to the coastal area. Wetland was a vital conversion to eliminate the river nutrients, and the retention could reach 80 %. It is imperative to protect and construct wetlands to reduce the nutrient pollution in the inlet river.

Some metals and metalloids in the blood of three species of shorebirds increase while foraging during two-week migratory stopover in Delaware Bay, New Jersey.

Most migratory shorebird species are declining, some are endangered, and some may be vulnerable to contaminants on long distance travel between wintering grounds and high latitude breeding grounds. We examined whether shorebirds accumulated trace elements at the Delaware Bay (New Jersey) stopover by testing the null hypothesis that there was no difference in the levels of arsenic, cadmium, chromium, lead, mercury, and selenium in blood of three species of shorebirds collected early in their stopover compared to levels in blood collected about two weeks later near the end of the stopover, before departing for breeding grounds. There were significantly higher levels of all metals and metalloids in the blood of ruddy turnstone (Arenaria interpres) later in May than earlier. There were seasonal increases in blood levels of arsenic and selenium for all three species. Chromium and lead levels also increased in red knots (Calidris canutus). These increases occurred although the birds were only present for about two weeks. Levels of arsenic, mercury, and lead in knots and selenium in sanderlings (Calidrris alba), exceeded reported effects levels. These results have potential implications for studying the refueling physiology, energetics, and feeding behavior of migratory shorebirds. However, they also suggest cause for concern because the increased contaminant loads occur in a short period, and the high metal level bolus received all in a few days may result in adverse effects.

Geospatial and co-occurrence analysis of antibiotics, hormones, and UV filters in the Chesapeake Bay (USA) to confirm inputs from wastewater treatment plants, septic systems, and animal feeding operations.

Previous studies have reported select contaminants of emerging concern (CECs) in limited areas of the Chesapeake Bay (USA), but no comprehensive efforts have been conducted. In this work, 43 antibiotics, 9 hormones, 11 UV filters, and sucralose, were measured in matched water, sediment, and oyster samples from 58 sites. The highest sucralose concentration was 3051 ng L-1 in a subwatershed with 4.43 million liters of wastewater effluent per day (MLD) and 4385 septic systems. Although antibiotic occurrence was generally low in subwatersheds located in less populated areas, 102 ng L-1 ciprofloxacin was detected downstream of 0.58 MLD wastewater effluent and 10 animal feeding operations. Hormones were not regularly detected in water (2%) or oysters (37%), but the high detection frequencies in sediment (74%) were associated with septic systems. UV filters were ubiquitously detected in oysters, and octisalate exhibited the highest concentration (423 ng g-1). Oyster-phase oxybenzone and aqueous-phase sucralose concentrations were significantly correlated to wastewater effluent and septic systems, respectively. Toxicity outcomes were predicted for homosalate and octisalate throughout the Bay, and antimicrobial resistance concerns were noted for the Chester River. The geospatial and co-occurrence relationships constitute crucial advances to understanding CEC occurrence in the Chesapeake Bay and elsewhere.

Birthing process preparedness of first-time mothers at the Nelson Mandela Bay Municipality in South African: A qualitative research study.

Pregnancy or birthing brings with it hope of a new life. A woman who was well-prepared antenatally and who has a low-risk pregnancy has the possibility of enjoying her labour and birth. First-time mothers are at times deprived of this experience due to limited preparation for the birth. A qualitative research design using an exploratory, descriptive, and contextual approach was used to understand how first-time mothers experience birthing process preparedness. Data was collected from July to August 2020 by means of semi-structured interviews from sixteen purposively selected participants. Results revealed that participants are having varied experiences from factors that had influenced their birthing -process preparedness and thus provided suggestions for midwives to facilitate birthing process preparedness of first-time mothers in future. In conclusion the based on the results it is envisaged that a well-prepared pregnant woman is more likely to be less anxious during the birthing process.

Monthly dietary shifts in the jellyfish Nemopilema nomurai in Liaodong Bay, China.

Nemopilema nomurai is a frequently bloomed species in the China seas. Their feeding organ has an ontogenetic change when they grow up, but whether their diet changes along with it is unclear. A 5-month study on N. nomurai was conducted in Liaodong Bay, China to clarify the dietary shift and feeding effect of N. nomurai. Fatty acid biomarkers revealed the proportion of carnivorous food in the diet of N. nomurai decreased when their bell diameter increased. The isotope data revealed a similar story with δ15N dropping which indicated a decreased trophic level. The diet composition was dominated (74 %) by zooplankton >200 µm in May and then decreased to <32 % in July. In contrast, the proportion of particulate organic matter increased from <35 % to 68 %. This study revealed a monthly shift in the diet of N. nomurai and contributed to knowledge of trophic interactions between plankton and N. nomurai.

Multi-Inlet Spheroid Generator for High-Throughput Combinatorial Drug Screening Based on the Tumor Microenvironment.

Tumor spheroids are powerful tools for drug screening and understanding tumor physiology. Among spheroid formation methods, the hanging drop method is considered most suitable for high-throughput screening (HTS) of anticancer drugs because it does not require surface treatment. However, it still needs to increase the liquid-holding capacity because hanging drops often fall due to the increased pressure caused by the addition of drugs, cells, etc. Here, we report a multi-inlet spheroid generator (MSG) enabling the stable addition of liquid-containing drugs or cells into a spheroid through its side inlet. The MSG was able to load additional solutions through the side inlet without increasing the force applied to the hanging drop. The volume of the additional liquid was easily controlled by varying the diameter of the side inlet. Furthermore, the sequences of the solution injections were manipulated using multiple side inlets. The feasibility of the MSG in clinical application was demonstrated by testing the efficacy of drugs in patient-derived cancer (PDC) cells and controlling the stromal cell ratio in the tumor microenvironment (TME) containing spheroids. Our results suggest that the MSG is a versatile platform for HTS of anticancer drugs and recapitulating the TME.

Selenium in the liver facilitates the biodilution of mercury in the muscle of Planiliza haematocheilus in the Jiaozhou Bay, China.

There are increasing evidences that the biodilution effect can significantly reduce the biomagnification of mercury (Hg) in fish. The significant antagonism of selenium (Se) -Hg may have a potential diluting effect on Hg in fish; however, there is still lack of knowledge on such effect. To reveal the Se-Hg interaction and its role in controlling the biodilution effect of Hg, we investigated levels of Hg and Se in the muscle and liver of redlip mullet from Jiaozhou Bay, China, an urbanized semi-enclosed bay highly impacted by human activities. In general, Hg levels in fish muscle were significantly negatively correlated to the levels of Se in the liver and fish size for fish with a size of < 200 mm, indicating that the antagonistic effect of Se on Hg increased with fish growth. This relationship was not significant for fish with a size of > 200 mm, possibly because the normal metabolism of Hg in muscle was hindered by homeostatic regulation or physiological activities such as gonadal development in vivo. Furthermore, the molar ratio of Se in the liver/Hg in the muscle was significantly increasing with Se/Hg in the liver, suggesting that the liver may be the key organ involved in Se-Hg antagonism. Moreover, both ratios continued to decrease with increasing fish size, implying that the antagonistic effect weakens with fish growth. These results indicate that Hg sequestration by liver may be a key mechanism of Se-Hg antagonism in fish and function as a driver for the biodilution effect of Hg, especially at a size of < 200 mm. These findings are further supported by the established linear model of Se-Hg antagonism at different developmental stages.

[Effect of Spartina alterniflora Invasion on Soil C:N:P Stoichiometry in Coastal Wetland of Hangzhou Bay].

The invasion of Spartina alterniflora poses a great threat to coastal wetland ecosystems. In this study, the stoichiometric characteristics of soil carbon, nitrogen, and phosphorus under a Spartina alterniflora invasion were explored using ANOVA in a coastal wetland in Hangzhou Bay, and the driving coupling relationship between soil environmental factors and soil C:N:P stoichiometric characteristics of the coastal wetland were further explored based on the redundancy analysis (RDA), boosted regression tree (BRT), and partial least squares-structural equation (PLS-SEM) model. The results showed that:① after the invasion of Spartina alterniflora, soil N:P and total nitrogen (TN) in the wetland increased significantly, and with the increase in invasion time, TN and N:P decreased significantly, whereas soil organic carbon (SOC), C:N, and C:P increased significantly. ② The RDA model revealed that the main factors affecting the stoichiometric characteristics of topsoil C:N:P were SOC>electrical conductivity (EC)>TN in winter and SOC>bulk density (BD)>TN in summer. ③ The BRT model showed that under the invasion of Spartina alterniflora, TN was the key factor affecting soil C:N and N:P, and SOC was the key factor affecting C:P. ④ The PLS-SEM model showed that clay and water content directly affected SOC, thus affecting C:N and C:P; the clay and EC directly affected total phosphorus (TP), thus affecting N:P and C:P; and the EC directly affected TN, thus affecting C:N and N:P. In conclusion, the invasion of Spartina alterniflora had a significant impact on soil C:N:P stoichiometric characteristics in the study area. Soil physical properties and nutrient content directly or indirectly affected soil C:N:P stoichiometric characteristics to varying degrees.

Impact of petroleum refinery on aquatic ecosystem of Skikda Bay (Algeria): Diversity and abundance of viable bacterial strains.

This paper reports a study on the impact of petroleum refinery effluents on the bacterial load and diversity of the aquatic ecosystem in Skikda Bay (Algeria). The results showed a large spatiotemporal variation in the isolated bacterial species. This difference between stations and seasons could be attributed to environmental factors and to the pollution rate at the different sampling sites. Statistical analysis results showed that physicochemical parameters such as pH, electrical conductivity and salinity have a very significant effect on the microbial load (p < 0.001), while hydrocarbon pollution has a significant effect on the diversity of bacterial species (p < 0.05). In total 75 bacteria were isolated from six sampling sites during the four seasons. A significant spatiotemporal richness and diversity was observed in water samples. A total of 42 strains belonging to 18 bacterial genera were identified. Most of these genera belong to the class of Proteobacteria.

Looking beyond the individual-The importance of accessing health and cultural services for Indigenous women in Thunder Bay, Ontario.

Access to cultural activities and culturally relevant healthcare has always been significant for achieving holistic Indigenous health and continues to be a key factor in shaping the health journey of Indigenous individuals and communities. Previous research has indicated the importance of cultural practices and services in sustaining cultural identity for Indigenous peoples, which is a major influence on their wellbeing. This study marks the first phase in a project aimed at establishing an Indigenous healing program and uses a qualitative research approach to understand the health and cultural services that Indigenous women want and require in Thunder Bay, Ontario. During interviews, participants (n = 22) answered questions around their understandings of health and wellbeing, and how they are able to incorporate cultural practices into their circle of care. Thematic analysis was performed on interview transcripts, and 4 key themes were identified: 'independence and self-care', 'external barriers to accessing services', 'finding comfort in the familiar' and 'sense of community'. Together these themes illustrate how Indigenous women feel a strong sense of personal responsibility for maintaining their health despite the multiple environmental factors that may act as barriers or supports. Furthermore, the necessity of embedding cultural practices into Indigenous women's circle of care is highlighted by the participants as they describe the mental, spiritual, social, and emotional health benefits of engaging in cultural activities within their community. The findings demonstrate the need for current modes of care to look beyond the individual and consider the impacts that socio-environmental factors have on Indigenous women. To accomplish this, we hope to increase access to health and cultural services through the creation of an Indigenous healing program that can be adequately incorporated into Indigenous women's circle of care if they wish to do so.