Peer and land-based approaches for fostering empowering and healthy relationships with Indigenous and northern young people in the Northwest Territories.

Indigenous and Northern women in Canada experience high rates of intimate partner violence (IPV), and this is particularly true in the Northwest Territories (NWT). Adolescents are also at increased risk of IPV, which has far-reaching, lifelong effects. Indigenous youth are particularly vulnerable to IPV due to ongoing effects of intergenerational trauma caused by colonialism, racism and residential school legacies. We explored attitudes towards IPV and the healthy relationship knowledge, skills, and experiences among participants of Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) Peer Leader Retreats in the NWT. Multi-method approaches included quantitative surveys youth completed before and immediately following retreats. Quantitative analysis from retreats (2018-2021) included 240 participants aged 12-19 (mean age 14.5) who reported ever having an intimate partner. Most were from the FOXY program (64.2%), Indigenous (69.6%) and heterosexual (66.4%). Qualitative methods included Focus Group Discussions (FGD) (n = 69) conducted with peer leaders and apprentices (n = 311) and youth and adult staff (n = 14 FGDs, n = 165 participants). We thematically analysed FGDs to explore healthy relationship knowledge and skills, alongside paired t-tests to examine pre/post retreat changes in attitudes towards IPV. Qualitative findings suggest that leadership and embodied learning were effective in equipping youth with violence prevention and healthy relationship skills. While young women were committed to sharing knowledge and skills about healthy relationships in their communities, young men resonated with values of respect and appreciated support to identify and express emotions. Participants across programmes demonstrated their belief that healthy intimate relationships have communal, relational and intergenerational benefits. Quantitatively, we found a statistically significant reduction in attitudes accepting of IPV among young women, but no changes were noted among young men. Findings contribute to emergent evidence on strengths-based, culturally-responsive IPV prevention programming. Components of effective IPV prevention programming with young men merit further exploration.

Patient-planetary health co-benefit prescribing in a circumpolar health region: a qualitative study of physician voices from the Northwest Territories, Canada.

BACKGROUND: Despite climate change being described as a code red for humanity, health systems have been particularly slow in both climate mitigation and adaptation responses. The effects of climate change on health and health systems will not be felt equally, with underserved and marginalised communities disproportionately impacted. The circumpolar region is warming at 3-4 times the global rate, amplifying already existing socioeconomic barriers and health inequities, with particular amplified effects for the substantial Indigenous population in the area. OBJECTIVES AND SETTING: We therefore sought to explore perspectives of physicians around patient-planetary health (P-PH) co-benefit prescribing in a circumpolar region in the Northwest Territories (NWT), Canada, known to be one of the ground zero levels for climate change. METHODS: Thirteen semi-structured physician interviews were carried out in the NWT region between May 2022 and March 2023 using purposive sampling. Interviews were transcribed verbatim and reflexive thematic analysis was carried out to identify key themes. RESULTS: There were three main themes identified including (1) current healthcare system does not support planetary health, (2) supporting patient-planetary health is currently difficult for clinicians and (3) considering change in the NWT to support patient-planetary health. Participants noted key opportunities to move planetary health forward, with the NWT having the potential to be an innovative model for planetary health-informed change for other health systems. CONCLUSION: The NWT health system has unique features due to its rural and remote nature and smaller population base. Despite this, our study identified some key opportunities for advancing P-PH co-benefit efforts. The identified opportunities may be considered in future intervention, organisational change and policy-making efforts with potential relevance in other settings.

Human immunodeficiency virus prevention outcomes associated with arts-based sexual health workshop participation among Northern and Indigenous adolescents in the Northwest Territories, Canada.

BACKGROUND: Contextually tailored, arts-based HIV prevention strategies hold potential to advance adolescent sexual health and wellbeing. We examined HIV prevention outcomes associated with arts-based sexual health workshop participation with Northern and Indigenous adolescents in the Northwest Territories (NWT), Canada. METHODS: An Indigenous community-based youth agency delivered arts-based workshops in school settings to adolescents aged 13-18 in 24 NWT communities. Pre and post-test surveys included socio-demographic characteristics, sexually infections (STI) knowledge, HIV/STI risk perception, sexual relationship equity, condom use self-efficacy, and safer sex efficacy (SSE). Latent change score models were conducted to assess pre-post differences and factors associated with these differences. RESULTS: Among participants (n = 344; mean age 14.3 years, SD: 1.3; Indigenous: 79%) most (66%) had previously attended this workshop. Latent change score models revealed a significant and large effect size for increased STI knowledge (ß = 2.10, SE = 0.48, p < .001) and significant and small effect sizes for increased HIV/STI risk perception (ß = 0.24, SE = 0.06, p < .001) and SSE (ß = 0.16, SE = 0.07, p = .02). The largest increases across several outcomes occurred with first time workshop participants; yet previous workshop participants continued to report increases in HIV/STI risk perception and SSE. CONCLUSION: Arts-based HIV prevention approaches show promise in advancing STI knowledge, risk perception, and SSE with Northern and Indigenous youth.

Nudging policymakers on gendered impacts of policy.

Despite the proliferation of nudge research in the last few decades, very little published work aims to nudge the behavior of policymakers. Here we explore the impact of a well-established nudge on policymakers in the Northwest Territories of Canada. In a pre-registered randomized controlled trial, we emailed an invitation to policymakers (N = 263) to attend an online briefing on gendered impacts of policy. In the treatment condition (N = 133), the invitation contained personal stories of two women whose lives were disproportionally impacted by public policies more than men. In the control condition (N = 130), the invitation did not contain such stories. After the briefing, we sent all participants in both conditions a link to a public pledge that they could sign. The pledge was to lead and advocate for equity-oriented policymaking. Contrary to our prediction, there was a small backfiring effect where policymakers in the treatment condition (3.0%) were less likely to attend the briefing than the control condition (7.7%). However, two policymakers (1.5%) in the treatment condition signed the public pledge compared to one (0.8%) in the control condition. The current findings reveal the limits of using personal stories as a nudge to influence policymakers. We discuss insights gained from this experiment and follow-up debriefings with policymakers on how to improve future behavioral interventions designed to nudge policymakers.

Envisioning Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital, Northwest Territories.

Background: To improve the quality of care for Indigenous patients, local Indigenous leaders in the Northwest Territories, Canada have called for more culturally responsive models for Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital.Objective: This study examined how Indigenous patients and biomedical healthcare providers envision Indigenous healing practices working successfully with biomedical hospital care at Stanton Territorial Hospital.Methods: We carried out a qualitative study from May 2018 - June 2022. The study was overseen by an Indigenous Community Advisory Committee and was made up of two methods: (1) interviews (n = 41) with Indigenous Elders, patient advocates, and healthcare providers, and (2) sharing circles with four Indigenous Elders.Results: Participants' responses revealed three conceptual models for Indigenous and biomedical healthcare collaboration: the (1) integration; (2) independence; and (2) revisioning relationship models. In this article, we describe participants' proposed models and examine the extent to which each model is likely to improve care for Indigenous patients at Stanton Territorial Hospital. By surfacing new models for Indigenous and biomedical healthcare collaboration, the study findings deepen and extend understandings of hospital-based Indigenous wellness services and illuminate directions for future research.

Permafrost thaw induces short-term increase in vegetation productivity in northwestern Canada.

Over the past several decades, various trends in vegetation productivity, from increases to decreases, have been observed throughout Arctic-Boreal ecosystems. While some of this variation can be explained by recent climate warming and increased disturbance, very little is known about the impacts of permafrost thaw on productivity across diverse vegetation communities. Active layer thickness data from 135 permafrost monitoring sites along a 10° latitudinal transect of the Northwest Territories, Canada, paired with a Landsat time series of normalized difference vegetation index from 1984 to 2019, were used to quantify the impacts of changing permafrost conditions on vegetation productivity. We found that active layer thickness contributed to the observed variation in vegetation productivity in recent decades in the northwestern Arctic-Boreal, with the highest rates of greening occurring at sites where the near-surface permafrost recently had thawed. However, the greening associated with permafrost thaw was not sustained after prolonged periods of thaw and appeared to diminish after the thaw front extended outside the plants' rooting zone. Highest rates of greening were found at the mid-transect sites, between 62.4° N and 65.2° N, suggesting that more southernly sites may have already surpassed the period of beneficial permafrost thaw, while more northern sites may have yet to reach a level of thaw that supports enhanced vegetation productivity. These results indicate that the response of vegetation productivity to permafrost thaw is highly dependent on the extent of active layer thickening and that increases in productivity may not continue in the coming decades.

Exploring uptake of HIV/STI knowledge and safer sex-efficacy in an arts-based sexual health workshop among Northern and Indigenous adolescents in the Northwest Territories, Canada.

ABSTRACTLimited research has evaluated sexual health promotion projects with adolescents living in Arctic regions. The study objective was to examine changes in STI knowledge and safer sex efficacy among youth in the Northwest Territories (NWT), Canada who participated in arts-based sexual health workshops. We used a pre/post-test design with a convenience sample of students aged 13-18 years recruited from 17 NWT communities. We conducted summary statistics and comparisons between pre and post-test scores using paired t-tests. Among participants (n = 610), we found statistically significant increases in STI knowledge overall (mean difference = 3.9; p < 0.001) and across gender and age stratifications. There were statistically significant increases in safer sex efficacy overall (mean difference = 0.9, p < 0.001), across genders, and among participants: aged <15 years, in rural communities, reporting food insecurity, reporting dating violence, and Indigenous youth. No statistically significant differences in safer sex efficacy were observed among participants who were aged ≥15, sexually active, reporting consistent condom use, and using drugs/alcohol. Findings signal the promise of youth-targeted, arts-based sexual health workshops for improving STI knowledge and safer sex efficacy among adolescents in the NWT. Further research can explore how safer sex efficacy may be shaped by age, substance use, and sexual experience to inform tailored interventions.

Yellowknife: Canada's First Circumpolar Family Medicine Residency Site.

PROBLEM: Canada's Northwest Territories (NWT), like other regions in the circumpolar north primarily inhabited by Indigenous peoples, faces challenges in recruiting and retaining physicians. Communities in this vast, diverse region depend largely on external medical professionals for health care. Consequently, these communities receive discontinuous medical care from physicians who lack local knowledge and are available only temporarily. The shortage of physicians for people residing in northern Canada requires a sustainable, long-term solution. APPROACH: The authors describe establishing Canada's first circumpolar family medicine residency training site in Yellowknife, NWT. The site was launched in 2020 as a partnership between the University of Alberta, Alberta Health Services, and 3 local health authorities in the NWT. The residency site, which bases residents in the local community, is expected to positively impact family physician recruitment and retention by allowing residents to build connections with local communities and identify as a northern physician. OUTCOMES: As of fall 2022, 4 residents had trained with the Yellowknife family medicine residency site. Two of these 4 residents graduated in 2022, both of whom plan to continue practicing medicine in the NWT. Residents have positively influenced medical care in the NWT, providing care in close to 20 small and remote communities. The presence of residents decreased appointment wait-times for some teams by as much as 60%, improved primary care screening, and enabled the provision of medical services at critical times. Furthermore, their presence has fostered academic spirit in the medical communities and had a positive impact on the communities as a whole. NEXT STEPS: The authors provide key insights and lessons learned from the establishment of the remote residency site. To develop and improve the site, continuous program evaluation is planned.

"Every day I grew stronger and stronger being there".: empowerment through land-and art-based Peer Leader retreats with Indigenous and Northern young people.

Indigenous adolescents in Canada are among those shouldering the impacts of colonialism and racism. Peer approaches and art-and-land-based programming have demonstrated promise to support empowerment and well-being, yet little is known about their efficacy with Northern and Indigenous adolescents in Canada or of how this group conceptualises empowerment. Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) conduct land-and-arts-based Peer Leader Retreats with adolescents from the Northwest Territories, Nunavut and the Yukon Territories. Retreats (2017-2019) included 286 participants (n=196 women [trans-inclusive], n=84 men [trans-inclusive], n=5 non-binary), aged 12-19, the majority of whom (n=235) were Indigenous. Participants completed surveys immediately before and following retreats and 6 months after. Focus group discussions (FGDs) (n=24) were conducted with participants (peer leaders and apprentices) (n=232) following the retreat, and youth staff members (peer facilitators) (aged 14-21, n=7 FGDs). Applying thematic analysis, we explored retreat experiences (FGDs), and Wilcoxon signed-rank tests to examine pre/post retreat changes in leadership, empowerment, and self-confidence (surveys). Quantitatively, there were statistically significant increases in leadership and empowerment in post-retreat scores compared to pre-retreat. Qualitatively, findings demonstrate how Peer Leader Retreats premised on land-and-art-based approaches can support empowerment, confidence, leadership, and social-connectedness.

Carbon and nitrogen cycling dynamics following permafrost thaw in the Northwest Territories, Canada.

Rapid climate warming across northern high latitudes is leading to permafrost thaw and ecosystem carbon release while simultaneously impacting other biogeochemical cycles including nitrogen. We used a two-year laboratory incubation study to quantify concomitant changes in carbon and nitrogen pool quantity and quality as drivers of potential CO2 production in thawed permafrost soils from eight soil cores collected across the southern Northwest Territories (NWT), Canada. These data were contextualized via in situ annual thaw depth measurements from 2015 to 2019 at 40 study sites that varied in burn history. We found with increasing time since experimental thaw the dissolved carbon and nitrogen pool quality significantly declined, indicating sustained microbial processing and selective immobilization across both pools. Piecewise structural equation modeling revealed CO2 trends were predominantly predicted by initial soil carbon content with minimal influence of dissolved phase carbon. Using these results, we provide a first-order estimate of potential near-surface permafrost soil losses of up to 80 g C m-2 over one year in southern NWT, exceeding regional historic mean primary productivity rates in some areas. Taken together, this research provides mechanistic knowledge needed to further constrain the permafrost­carbon feedback and parameterize Earth system models, while building on empirical evidence that permafrost soils are at high risk of becoming weaker carbon sinks or even significant carbon sources under a changing climate.

Breaking trail in the Northwest Territories: a qualitative study of Indigenous Peoples' experiences on the pathway to becoming a physician.

Currently, there is a lack of Indigenous physicians in the Northwest Territories (NWT), Canada. The goal of this qualitative study was to explore the underlying factors that influence the journey to becoming a medical doctor and returning home to practice for Indigenous students from the NWT. Eight qualitative, semi-structured interviews were conducted by phone or in-person. Participants represented Dene, Inuvialuit and Métis from the NWT and were at varying points in their journey into careers in medicine, from undergraduate university students through to practicing physicians. The main themes identified included access to high-school courses, the role of guidance counsellors, access to mentors and role models, a need to prioritise clinical experience in the NWT, influences of family and friends, diversity and inclusion, and finances. Interpretations: Significant barriers, some insurmountable, remain at every stage of the journey into medicine for aspiring Indigenous medical doctors from the NWT. These findings can inform policy development for pathway program that assist aspiring Indigenous physicians at each stage.

Informing the Co-Development of Culture-Centered Dietary Messaging in the Inuvialuit Settlement Region, Northwest Territories.

Northern Indigenous communities require collaborative approaches to health communication about food that are grounded in Indigenous knowledges and cultures; however, preferences and best methods for this process remain understudied. This participatory study discusses how Inuvialuit (Inuit from the Western Arctic) knowledge and the perspectives of territorial, regional, and local dietary message stakeholders can inform the co-development of culture-centered dietary messaging to support healthy, safe, and culturally appropriate diets in Tuktoyaktuk, NWT. A community researcher in Tuktoyaktuk conducted storytelling interviews with country food knowledge holders (n = 7) and community members (n = 3), and a talking circle with local public health dietary message disseminators (n = 2) in June-July 2021. The lead author conducted key informant telephone and videoconference interviews with territorial and regional dietary message disseminators (n = 5) in June 2021. Interviews were coded and analyzed thematically. Our findings indicate that participants at all levels support increased inclusion of cultural and community perspectives about food to develop regionally and locally tailored dietary messaging. While most dietary message stakeholders wish to be involved in co-development processes, some country food knowledge holders in Tuktoyaktuk expressed a desire to lead local communications about country foods. Informed by participants' experiences and needs, we provide recommendations for future community-led approaches to further (co-)develop and communicate effective, culturally meaningful dietary messaging that promotes Inuvialuit food sovereignty.

Hepatic fibrosis and mineralization in a free-ranging barren-ground caribou (Rangifer tarandus groenlandicus) from the Northwest Territories.

Due to concerns about the appearance of portions of liver from a harvested adult, male barren-ground caribou (Rangifer tarandus groenlandicus), samples were submitted for diagnostic investigation. The gross and histologic findings were consistent with severe hepatic fibrosis and mineralization. Concentrations of vitamin E in the liver were also deficient. Disease investigations in wildlife of detectable abnormalities such as this provide important information for understanding the role of disease as populations change, as well as for safety of human food sources.

Fibrose hépatique et minéralisation chez un caribou de la toundra ( Rangifer tarandus groenlandicus ) en liberté provenant des Territoires du Nord-Ouest. En raison de préoccupations concernant l'apparence de portions de foie provenant d'un caribou de la toundra mâle adulte (Rangifer tarandus groenlandicus), des échantillons ont été soumis à des fins d'enquête diagnostique. Les résultats macroscopiques et histologiques étaient compatibles avec une fibrose hépatique sévère et une minéralisation. Les concentrations de vitamine E dans le foie étaient également déficientes. Les enquêtes sur les maladies de la faune sauvage portant sur des anomalies détectables telles que celle-ci fournissent des informations importantes pour comprendre le rôle des maladies à mesure que les populations changent, ainsi que pour la sécurité des sources de nourriture humaine.(Traduit par Dr Serge Messier).

Dietary Intakes of Traditional Foods for Dene/Métis in the Dehcho and Sahtú Regions of the Northwest Territories.

A dietary transition away from traditional foods and toward a diet of the predominantly unhealthy market is a public health and sociocultural concern throughout Indigenous communities in Canada, including those in the sub-Arctic and remote regions of Dehcho and Sahtú of the Northwest Territories, Canada. The main aim of the present study is to describe dietary intakes for macronutrients and micronutrients in traditional and market food from the Mackenzie Valley study. We also show the trends of contributions and differences of dietary intakes over time from 1994 data collected and reported by the Centre for Indigenous People's Nutrition and Environment (CINE) in 1996. Based on 24-h dietary recall data, the study uses descriptive statistics to describe the observed dietary intake of the Dene First Nations communities in the Dehcho and Sahtú regions of the NWT. Indigenous people in Canada, like the sub-Arctic regions of Dehcho and Sahtú of the NWT, continue to consume traditional foods, although as a small percentage of their total dietary intake. The observed dietary intake calls for action to ensure that traditional food remains a staple as it is critical for the wellbeing of Dene in the Dehcho and Sahtú regions and across the territory.

Congenital cataract and spherophakia leading to starvation in a free-ranging muskox neonate from the Northwest Territories, Canada.

A muskox neonate (Ovibos moschatus) that died of starvation was diagnosed with congenital lenticular anomalies that included spherophakia and hypermature cataract associated with probable lens-induced lymphocytic uveitis and neutrophilic keratitis. Impaired sight as a result of cataract and associated inflammation likely contributed to abandonment and starvation, although maternal death cannot be excluded definitively. Ocular lesions, such as congenital cataracts and spherophakia in neonates, may be important factors affecting survival in free-ranging animals.

Hair to blood mercury concentration ratios and a retrospective hair segmental mercury analysis in the Northwest Territories, Canada.

Concentrations of total mercury were measured in blood and hair samples collected as part of a human biomonitoring project conducted in First Nations communities of the Mackenzie Valley, Northwest Territories, Canada. Hair (n = 443) and blood (n = 276) samples were obtained from six communities in the Dehcho region and three communities in the Sahtú region of the Mackenzie Valley. The aim of this paper was to calculate hair to blood mercury ratios (for matched samples) and determine if: 1) ratios differed significantly between the two regions; 2) ratios differed from the 250:1 ratio proposed by the WHO; and, 3) point estimates of hair to blood mercury ratios could be used to estimate blood mercury concentrations. In addition, this paper aims to determine if there were seasonal patterns in hair mercury concentrations in these regions and if so, if patterns were related to among-season variability in fish consumption. The majority of mercury levels in hair and blood were below relevant health-based guidance values. The geometric mean hair (most recent segment) to blood mercury ratio (stratified by region) was 619:1 for the Dehcho region and 1220:1 for the Sahtú region. Mean log-transformed hair to blood mercury ratios were statistically significantly different between the two regions. Hair to blood ratios calculated in this study were far higher (2-5 times higher) than those typically reported in the literature and there was a large amount of inter-individual variation in calculated ratios (range: 114:1 to 4290:1). Using the 250:1 ratio derived by the World Health Organisation to estimate blood mercury concentrations from hair mercury concentrations would substantially over-estimate blood mercury concentrations in the studied regions. However, geometric mean site-specific hair to blood mercury ratios can provide estimates of measures of central tendency for blood mercury concentrations from hair mercury concentrations at a population level. Mercury concentrations were determined in segments of long hair samples to examine exposure of participants to mercury over the past year. Hair segments were assigned to six time periods and the highest hair mercury concentrations were generally observed in hair segments that aligned with September/October and November/December, whereas the lowest hair mercury concentrations were aligned with March/April and May/June. Mean log-transformed hair mercury concentrations were statistically significantly different between time periods. Between time periods (e.g., September/October vs. March/April), the geometric mean mercury concentration in hair differed by up to 0.22 µg/g, and the upper margins of mercury exposure (e.g., 95th percentile of hair mercury) varied by up to 0.86 µg/g. Results from self-reported fish consumption frequency questionnaires (subset of participants; n = 170) showed total fish intake peaked in late summer, decreased during the winter, and then increased during the spring. Visual assessment of results indicated that mean hair mercury concentrations followed this same seasonal pattern. Results from mixed effects models, however, indicated that variability in hair mercury concentrations among time periods was not best explained by total fish consumption frequency. Instead, seasonal trends in hair mercury concentrations may be more related to the consumption of specific fish species (rather than total wild-harvested fish in general). Future work should examine whether seasonal changes in the consumption of specific fish species are associated with seasonal changes in hair mercury concentrations.

Occurrence and distribution of emerging contaminants in mine-impacted lake water and potential use as co-tracers of anthropogenic activity in the subarctic region, Northwest Territories, Canada.

The emerging contaminant (EC) perchlorate (ClO4-), a blasting agent widely used in mining and refining operations, has been used as a practical indicator of mining activities. Widespread occurrence of ECs, such as pharmaceutical compounds, artificial sweeteners, and perfluoroalkyl substances, and their use as co-tracers of wastewater associated with anthropogenic activities in the urban and Arctic environments have been previously investigated. However, limited studies have reported the occurrence of these ECs and the feasibility of their use as co-tracers of anthropogenic activities in pristine waterbodies (e.g., continuous permafrost region) that receive effluent from mine sites. In this study, water samples were collected from the surface of 10 lakes within the Coppermine and Lockhart Watersheds in the continuous permafrost region in the Northwest Territories, Canada during the open water seasons of 2016, 2017, and 2018. Concentrations of 16 ECs were determined to delineate the spatial and temporal distribution of these compounds in waterbodies receiving effluent from mine sites. Slightly elevated concentrations of ClO4- (100-700 ng L-1), caffeine (0.2-5.9 ng L-1), acesulfame-K (0.5-1.5 ng L-1), perfluorooctanoic acid (PFOA; 5-34 ng L-1), perfluorooctane sulfonic acid (PFOS; 11-40 ng L-1), chloride (1.5-2.3 mg L-1), and sulfate (1.0-3.6 mg L-1) were observed across the two investigated watersheds, especially downstream of the mining sites. The concurrence of elevated concentrations of these target ECs combined with other dissolved constituents (chloride and sulfate) may indicate the influence of mining activity on the receiving waterbodies and the potential use of these compounds as co-indicators of anthropogenic activity. Results from this study provide novel information on the distribution of 16 ECs in pristine waterbodies that receive effluents from mining sites in the Canadian subarctic in advance of more expansive human development and increased warming and melting of mine sites, including mine wastes.

Monitoring the dynamic vulnerability of an Arctic subsistence food system to climate change: The case of Ulukhaktok, NT.

Vulnerability to climate change is highly dynamic, varying between and within communities over different timescales. This paper draws upon complex adaptive systems thinking to develop an approach for capturing, understanding, and monitoring climate vulnerability in a case study from northern Canada, focusing on Inuit food systems. In the community of Ulukhaktok, Northwest Territories, we followed 10 hunters over a 2-year period, asking them to document their harvesting activities and discuss their lived experience of harvesting under changing environmental and societal conditions. GPS monitoring and participatory mapping sessions were used to document 23,996km of trails (n = 409), with conversational bi-weekly semi-structured interviews and secondary instrumental weather data used to contextualise climate change within a nexus of other socioeconomic, cultural, and political stressors that also affect harvesting. Our results demonstrate that climate change has considerable potential to affect harvesting activities, particularly when its impacts manifest as anomalous/extreme events. However, climate change impacts are not necessarily the most salient issues affecting harvesting on a day-to-day basis. Instead, factors relating to economics (particularly financial capital and the wage-based economy), social networks, and institutions are found to have a greater influence, either as standalone factors with cascading effects or when acting synchronously to augment the impacts of environmental change.

11 years of regular access to subsidized veterinary services is associated with improved dog health and welfare in remote northern communities.

Access to veterinary services can have positive impacts on animal health and welfare, and on human mental and physical health and well-being; however, many communities worldwide lack access to such services. At their request, the 5 communities of the Sahtu Settlement Area, Northwest Territories, Canada, have received annual access to preventive veterinary services through the University of Calgary's Northern Community Health Rotation since 2008. To determine the reach of the program, we conducted a dog census in 2017. We then conducted a chart review of 11 years of dog medical records from 2008 to 2018 to evaluate how the reach of the program, the uptake of veterinary services, and dog population demographics, health and welfare measures changed over the duration of the program. In the chart review, we used either multi-level logistic regression or generalized linear models, to determine how seven variables, including age, sex, breed, body condition, deworming, vaccination, and sterilization status upon clinic entry, changed over the course of program delivery. Our results suggest that program reach, veterinary service uptake, and dog demographic, health and welfare measures improved over time. We observed high rabies vaccination coverage in some communities (48 %-83 % of the dog population) and moderate overall sterilization status (25 %-56 % of the dog population) with female dog sterilization more common than male (75 % of dogs leaving the 2017 clinics, compared to 43 %). Several dog demographic, health, and welfare measures, including age, body condition, and vaccination, deworming, and sterilization status, were significantly better in later years of the program (all p < 0.001). Differences among communities, both in dog population numbers from the 2017 census (40-89 dogs) and in the uptake of veterinary services in 2017 (48 %-83 % of the dog population), were notable. Vaccination uptake was directly related to clinic attendance, but sterilization was impacted by additional factors, including community members' acceptance of the procedure. Some unintended consequences were noted, however, including the potential effect of sterilization on the availability of traditional dog breeds in the communities. Overall, our study findings demonstrate that subsidized veterinary services provided over a regular and extended period of time benefit animal population demographics, health and welfare, and could have positive impacts on human well-being. The framework of community collaboration and long-term commitment developed through this program serves as a model for achieving common health goals among communities in need and veterinary service providers.

The adaptation of the beyond cold water bootcamp course for Inuvialuit communities in Northwest Territories, Canada.

Boating-related fatalities in the Northwest Territories (NWT) are well above the national average. These fatalities are exacerbated by very cold water, and water and boating safety resources that lack relevance to residents of northern communities. We utilised an iterative, participatory approach to create a plain language, culturally and geographically adapted version of a cold water survival course, "Beyond Cold Water Bootcamp". The purpose of this research was to determine what adaptations are necessary to create appealing and pertinent boating safety interventions for Inuvialuit communities in the NWT and to demonstrate the value of generating such interventions. First, we conducted a focus group with boating safety experts to gain feedback on the first draft of the adapted course. We then subsequently completed a pilot of the course with community members in Tuktoyaktuk, NWT, and we obtained their feedback and suggestions. We then trained a local community member to deliver the course and conducted another focus group with residents. Using reflexive thematic analysis, our results demonstrated the value of culturally and geographically adapted boating safety interventions for Inuvialuit communities and the importance of relinquishing colonial power structures and enabling community members to independently adapt and disseminate knowledge.