The influence of supportive work environment on work-related stress and conflict management style among emergency care nurses: A descriptive correlational study.

BACKGROUND: Stress and conflict in emergency departments are inevitable but can be managed. A supportive work environment is key to helping emergency care providers, especially nurses, constructively manage work-related stress and conflict. AIM: The aim of this study was to assess the influence of supportive work environments on work-related stress and conflict management style among emergency care nurses. METHODS: A descriptive correlational research design was utilized. Data were collected from 221 staff nurses recruited from two university hospital emergency departments in Alexandria, Egypt. Three instruments were used: (1) perceived organizational support scale, (2) nurses' occupational stressors scale, and (3) conflict management style inventory. RESULTS: There was a highly significant correlation between supportive work environments and work-related stress (p = .000) and a significant correlation between supportive work environments and conflict management style (p = .026). Supportive work environments had a significant inverse negative relationship with work-related stress experienced by nurses (p = .001) and accounted for 51% of variance in work-related stress. Meanwhile, supportive work environments had a significant positive relationship with conflict management styles of nurses (p = .026). Work-related stress had a significant relationship with nurses' conflict management style (p = .000) and accounted for 45% of the variance in conflict management style. LINKING EVIDENCE TO ACTION: The style of conflict management modeled by staff within emergency departments can positively or negatively influence the work environment and level of work-related stress. There is a necessity to cultivate a supportive culture for nurses in emergency departments to develop skills for constructive conflict management styles to reduce work-related stress.

[The supportive environment in SRH: characteristics that promote self-determination]. / L'environnement soutenant en SSR : les caractéristiques qui favorisent l'autodétermination.

Hospitalization is an important stage in the life of the elderly. All too often, this experience is accompanied by both physical and psychological decline. Based on self-determination theory, the aim was to qualitatively characterize support for self-determination in follow-up care and rehabilitation services (behaviours and attitudes of healthcare professionals, and patients' perception of them).

Building an empowerment program to improve the health of patients with severe mental disorders / Exemple de coconstruction d'un programme d'empowerment en faveur de la santé des personnes vivant avec des troubles psychiques

Introduction: Risk factors and cardiovascular diseases are overrepresented in people with severe and persistent mental disorders. A person diagnosed with schizophrenia or bipolar disorder is two to three times more likely to die of cardiovascular disease than the general population. Purpose of research: An empowerment program has been co-created to reduce these health inequalities. It is one part of the COPsyCAT project. The people-centered approach has been used. The participation of the patients, caregivers, and health professionals was decisive. Results: Stakeholders redefined the objectives of the program. The aim is to improve quality of life, rather than reducing cardiovascular risk. Existing tools -that have been evaluated for their usability - were selected to allow for self-directed patient orientation, so that the constraints between psychiatry and primary care could be circumvented. The program is based on the pooling of existing resources in a territory. The individual power of action and the organization of healthy offers are thus designed to reinforce each other. Conclusions: This article concretely describes the steps through to which the COPsyCAT empowerment program was designed, in co-construction by the researchers of the study, the users and user associations and healthcare professionals at based on their experiential knowledge. The feasibility of the program and the appropriation of tools in real situations will soon be evaluated. The measure of the program's effectiveness on cardiovascular risk will come in second time.

Introduction: Au sein de la population présentant des troubles psychiques sévères et persistants, on observe une surreprésentation des facteurs de risque et des pathologies cardiovasculaires. Une personne chez qui un diagnostic de schizophrénie ou de troubles bipolaires a été porté aurait deux à trois fois plus de risque de mourir d'une maladie cardiovasculaire que la population générale. But de l'étude: Dans le cadre du projet « Collaboration patient-soignant pour une meilleure prise en charge des troubles cardiovasculaires des patients souffrant de troubles psychiques au long cours ¼ (COPsyCAT), un programme d'empowerment a été coconstruit pour réduire ces inégalités de santé. La prise en compte de l'expérience et des besoins des patients, de leurs aidants et des professionnels de santé est au cœur de chacune des étapes méthodologiques suivies pour la création du programme. Résultats: Les parties prenantes ont défini le programme comme devant viser l'amélioration de la qualité de vie et non la réduction du risque cardiovasculaire. Des outils ont été sélectionnés selon leur maniabilité pour permettre l'orientation autogérée des patients, de telle sorte que les contraintes inhérentes aux cloisonnements entre psychiatrie et soins primaires soient contournées. Le programme se base sur la mutualisation des ressources existantes sur un territoire. Pouvoir d'agir individuel et construction de contexte favorable à la santé sont ainsi pensés pour se renforcer mutuellement et agir sur des leviers réformateurs. Conclusions: Cet article décrit concrètement les étapes grâce auxquelles le programme d'empowerment COPsyCAT a été conçu, en coconstruction par les chercheurs de l'étude, les usagers et associations d'usagers et les professionnels de santé à partir de leurs savoirs expérientiels. La faisabilité du programme et l'appropriation des outils en situation réelle va être prochainement évaluée. La mesure de l'efficacité du programme sur le risque cardiovasculaire viendra dans un second temps.

The link between LGBTQ-supportive communities, progressive political climate, and suicidality among sexual minority adolescents in Canada.

Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada. Data were from the 2013 British Columbia Adolescent Health Survey, a cluster-stratified random cross-sectional survey of public school students in BC, Canada; We sampled 2678 self-identified LGB and mostly heterosexual students (69% girls) from 274 schools, representing an estimated provincial population of 24,624 sexual minority students in weighted models. Student reports of past-year suicidal ideation, suicidal attempts, and self-harm behaviors were merged with community-level data assessing diverse aspects of LGBTQ-supportive resources and progressive political climates in communities surrounding the schools. Adjusted multilevel models showed that for sexual minority adolescent girls, higher community LGBTQ-supportiveness predicted marginally significant lower suicidal ideation (aOR = 0.94, 95% CI [0.88, 1.01]) and suicidal attempts (aOR = 0.91, 95% CI [0.83, 1.00]) and significantly lower self-harm behaviors (aOR = 0.91, 95% CI [0.85, 0.98]). Further, progressive political climates predicted marginally significant lower suicidal ideation (aOR = 0.89, 95% CI [0.78, 1.02]) and significantly lower self-harm behaviors (aOR = 0.87, 95% CI [0.77, 0.99]). For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys.

Satisfaction of doctors with their training: evidence from UK.

BACKGROUND: This study considers the primary training environment factors affecting the satisfaction of doctors in training with their training. METHODS: An OLS multiple regression analysis was performed on responses given by doctors in training (trainees) to General Medical Council (UK) National Trainee Survey annually from 2012 to 2015. Two different research models investigate the determinant of trainee doctor satisfaction. The first model includes clinical supervision, feedback, workload, and gender as explanatory variables. The second model adds supportive environment to the first model. RESULTS: The GMC survey response rate is 97%. Our analysis shows the key factors that determine trainee satisfaction are strong clinical supervision, frequent and useful feedback meetings, an adequate workload and a supportive environment. CONCLUSIONS: It is suggested focus on clinical supervision, feedback, workload and supportive environment would increase trainee satisfaction, improve the quality of training and morale, and hopefully, therefore, the quality of care patients receive.

Learning to ensure patient safety in clinical settings: comparing Finnish and British nursing students' perceptions.

AIMS AND OBJECTIVES: To explore and compare Finnish and British nursing students' perceptions of their learning about patient safety in clinical settings. BACKGROUND: Patient safety culture and practices in different health care organisations and clinical units varies, posing challenges for nursing students' learning about patient safety during their clinical placements. Patient safety as a growing international concern has challenged health care professionals globally requiring a comprehensive review. International studies comparing nursing education about patient safety are lacking. DESIGN: A cross-sectional comparative study. METHOD: The participants were final year preregistration nursing students from two universities of applied sciences in Finland (n = 195) and from two universities in England, UK (n = 158). The data were collected with the Patient Safety in Nursing Education Questionnaire and analysed with principal component analysis, Pearson Chi-Square and Mann-Whitney U tests and logistic regression. RESULTS: Finnish nursing students had significantly more critical perceptions on their learning about patient safety in clinical settings than their British peers. A strong predictor for differences was supportive and systems-based approaches in learning to ensure patient safety. Notably, fewer Finnish students had practiced reporting of incidents in clinical settings compared to British students. In both countries, the students held learning about patient safety in higher esteem compared to their learning experiences in clinical settings. CONCLUSIONS: Nursing students appear to want more learning opportunities related to patient safety compared to the reality in clinical settings. Learning systematically from errors in a supportive environment and having systems-based approaches to ensure patient safety are essential elements for nursing students' learning about safe practice. Finnish students seem to experience more barriers in learning about safe practices and to report errors than the British students. RELEVANCE TO CLINICAL PRACTICE: Health care organisations and professionals with responsibilities for patient safety should seek to standardise the preparation of nursing students incorporating requisite international standards and benchmarks.

A systematic review: Which psycho-social-environmental factors do autistic students identify as being important for positive experiences in mainstream secondary school?

LAY ABSTRACT: Research has shown that many autistic students do not thrive in mainstream secondary schools. Often studies focus on the challenges autistic people face rather than what supports thriving. We reviewed published articles, exploring what factors helped autistic people create a positive experience in school from their own perspective. We identified 36 studies and analysed the direct quotes made by autistic adolescents and adults in these studies. Factors important for positive experience included the autistic student feeling understood and accepted by adults and peers in school, being able to shape sensory and social environments in ways that suited them and accessing engaging activities. This review highlighted ways in which schools can become more inclusive and positive environments for autistic students.

Validation of the Korean Version of the Health Care Climate Questionnaire among Cancer Survivors.

Healthcare professionals should support autonomy in their patients in order for them to maintain the motivation to cope actively with their conditions. The Health Care Climate Questionnaire (HCCQ) is useful for assessing patients' perceptions of the autonomy support provided to them. We aimed to validate the psychometric properties of the Korean version of the HCCQ (HCCQ-K) among Korean cancer survivors. This study evaluated the factor structure, concurrent validity, and internal consistency. Data from 367 cancer survivors were analyzed using confirmatory factor analysis (CFA), Pearson's correlations, and Cronbach's α values. The CFA validated that the single-factor structure of the HCCQ-K had an excellent fit that was consistent with that of the original English version. Concurrent validity was confirmed by moderate correlations between the HCCQ-K and both psychological well-being and self-management. Reliability was verified by satisfactory internal consistency, with a Cronbach's α value of 0.91 and strong item-total and inter-item correlations. The HCCQ-K is therefore a valid and reliable tool for assessing autonomy support provided by healthcare professionals to Korean cancer survivors. The HCCQ-K may help healthcare professionals understand their patients' needs for autonomy support and develop strategies to motivate active coping behaviors.

Toward a Future Orientation: A Supportive Mental Health Facility Environment.

BACKGROUND: The provision of supportive environments is essential in clinical and environmental psychology. Mental health disorders are a major issue, and the experience of being at a mental health facility is affected by numerous factors related to the building's design. AIM: The aim of this study is to explore the expectations of a mental health facility planning group regarding the potential impact of a supportive design on patients' mental health and staff's therapeutic practices when planning and designing a new mental health facility. METHODS: The new mental health facility is a case study and data were collected through qualitative in-depth interviews with nine participants and analyzed using a thematic analysis. The participants came from a mental health facility planning group in a new mental health facility in Norway. RESULTS: The overall expectation of the new building was related to a future orientation to support patients' mental health and therapeutic practices. Three main themes were identified: toward a future orientation, supportive building design, and work environment. CONCLUSIONS: Supportive environments are expected to influence patients' mental health and staff's therapeutic practices, including providing options for novel treatment needs in contrast to older and more outdated buildings that are perceived as hindering appropriate treatment conditions.

The Design of Health Promoting Outdoor Environments for People with Young-Onset Dementia-A Study from a Rehabilitation Garden.

Health-promoting outdoor environments designed for people living with dementia (PLwD) has proved to be an effective non-pharmacological intervention for treatment of symptoms and improved well-being. However, for individuals with Young-Onset Dementia (YOD), who have particular symptoms and needs, the content and design of these environments are underexplored. This study aimed to explore the needs of individuals with YOD in a garden setting, to generate design-related knowledge for 'dementia-friendly' outdoor environments, while contributing to the field of Evidence-Based Design (EBD). An 8-week long nature-based program was carried out in Alnarp's rehabilitation garden, a specifically developed garden based on research from e.g., landscape architecture, environmental psychology and medical science. The study used a triangulation of qualitative methods including six participants with YOD and a multidisciplinary team of five staff members. Content analysis was used for all gathered data, including 17 semi-structured interviews with participants with YOD and with staff. Data collection and analysis was performed based on the evidence-based Quality Evaluation Tool (QET). The study led to a target group adapted version of the QET for people with YOD containing 20 developed environmental qualities for designers to pursue in therapeutic gardens, including the additional quality of Calmness. A progression was noted, as a result of perceived positive effects during the intervention, indicating possible change and development of the group's needs and preferences in the outdoors.

Critical Lessons in Tailoring Interventions: Listening to WISEWOMAN Participants.

PURPOSE: To explore perspectives of participants in the WISEWOMAN program in Pennsylvania (PA-WISE) on challenges and facilitators of reducing cardiovascular disease risk as low-income and un-/under-insured middle-aged women. APPROACH: Researchers conducted this 2 year qualitative data collection as one component of a broader, 5 year PA-WISE process and outcome evaluation. SETTING: Women from across Pennsylvania, primarily from rural communities. PARTICIPANTS: Interviewees were low-income, un-/under-insured women aged 40-64 years who had recently participated in PA-WISE-facilitated health coaching and lifestyle programs (HC/LSPs). METHODS ­ DATA COLLECTION AND ANALYSIS: Researchers conducted individual telephone interviews with 38 women from four discrete samples of PA-WISE participants at 4 time points. Three researchers used grounded theory, and an iterative process of line-by-line coding, data display, and reanalysis to identify emerging themes, sub-themes, and their relationships. RESULTS: Participants shared the important benefits of specific PA-WISE program traits. However, participants described significant financial constraints, difficult schedules, caregiving responsibilities, and insufficient social support as persistent challenges in their lives, making lifestyle changes in general, and program participation specifically, difficult. CONCLUSION: The challenges that low-income and un-/under-insured women identified amplify the importance of having interventions that offer flexibility, options, and tailoring of supports and resources. The timeless challenges articulated by participants in this study completed just before the COVID-19 pandemic, remain relevant to be addressed through the pandemic and beyond.

Influence of Participation in a Medical-Themed Science Café on Patient Activation.

Purpose: This study aims to investigate the impact of a Science Café (SC) dealing with medical topics on participants' patient activation (PA), a concept that refers to patients' involvement in managing their own health, working with their healthcare providers, and maintaining their health. Material and Methods: Semi-structured interviews were conducted with patients who had participated in a medical SC (n = 10) to identify the medical SC-associated factors that influenced PA. Through a questionnaire of medical SC participants (n = 23), the impact on PA and correlations with relevant psychological measures were quantitatively assessed. Results: The interviews revealed three factors: "Experience & acceptance of chronic conditions", "Features of medical SC" and "Changes as a result of participation." The questionnaire results showed a positive correlation between PA and resilience and a negative correlation with decision regret. Conclusions: Participation in a medical SC by people with illnesses can improve PA by improving knowledge and skills for self-management and increasing self-awareness of illness in a supportive environment. The study highlights the potential benefits of using medical SC as a strategy for healthcare providers to improve PA and health outcomes.

Evaluation of Measurement Properties of Supportive Environment Assessment Scales for Dementia Special Care Units: A COSMIN Systematic Review.

OBJECTIVES: To identify, critically appraise, compare, and summarize the measurement properties of existing instruments that assess the supportive environment of dementia special care units (DSCUs). DESIGN: Systematic review of measurement properties consistent with Consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines. SETTINGS AND PARTICIPANTS: PubMed, Embase, Web of Science, CINAHL, CNKI, Wanfang, VIP, and SinoMed were searched from inception to July 21, 2023. Studies that (1) measured the supportive environment for DSCUs using any type of assessment instrument and (2) evaluated 1 or more psychometric properties of a DSCU's supportive environment assessment instruments were included. METHODS: Two reviewers independently screened, selected, extracted data, and assessed risk of bias. RESULTS: Fourteen studies were identified that reported the psychometric properties of 8 assessment instruments. The Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH) exhibited relatively better results on methodological risk of bias and quality of the psychometric properties. None of the instruments reported the evaluations on hypothesis testing, cross-cultural validity/measurement invariance, measurement error, or responsiveness. Based on the summary of 32 dimensions from 8 assessment instruments, this review established 7 functional constructs for the supportive environment for DSCUs: safety maintenance, space design, external resources, sensory stimulation, humanistic care, residual function development, and professional care. In addition, this study also initially developed a conceptual framework for the supportive environment of DSCUs. CONCLUSION AND IMPLICATIONS: TESS-NH received the rating of "best methodological quality" and outperformed other weakly recommended scales. Further studies should pay attention to developing or revalidating scales for assessing the supportive environment of DSCUs in large multicenter samples following the COSMIN methodology. Furthermore, the conceptual framework for the DSCU supportive environment will provide a theoretical reference for facilitating their hierarchical establishment and governance within diverse long-term care facilities by state authorities.

The Wildman Programme - Experiences from a first implementation of a nature-based intervention designed for men with stress and chronic illnesses.

BACKGROUND AND PURPOSE: In Denmark attractive rehabilitation offers for men are lacking. Consequently, more men than women say no to participate in and more often drop out of rehabilitation programs. Therefore, a nature-based rehabilitation program called the 'Wildman Programme' has been designed to men. The 'Wildman Programme' combines nature experiences, body awareness training, mind relaxation, and supporting community spirit. The method is called Nature-Body-Mind-Community (NBMC). The aim of this study was to assess the implementability and effect of the 'Wildman Programme' on the participants' quality of life and symptoms of stress. MATERIALS AND METHODS: The 'Wildman Programme' was explored as a quasi-experimental study. The study included 20 men with psychological stress and diminished quality of life due to mental health challenges and chronic illnesses. The primary outcome was quality of life and the secondary outcome was stress level. All outcomes were measured at baseline (T1) and at the end of the 'Wildman Programme' (T2). RESULTS: The study showed the 'Wildman Programme' has potential to reduce stress symptoms (15.40%) and enhance quality of life (10.07%) among the male participants. Furthermore, physical health (13.92%) and psychological health (16.88%) in relation to quality of life increased during the program. CONCLUSION: The study showed that the 'Wildman Programme' is implementable in a Danish healthcare center. It was well received by the health professionals and the method was in demand by the target group of men. However, a larger study should be conducted to further investigate the findings of this study.

The Environment Encouraging COVID-19 Response at Public Health Centers and Future Challenges in Japan.

The coronavirus disease 2019 (COVID-19) pandemic has triggered the implementation of public health measures globally. The health department of local governments has played a critical role in confronting COVID-19. In Japan, public health centers (PHCs) are focal points for COVID-19 response. Understanding the response to COVID-19 in local areas is critical to ensure adequate preparation for future emergencies. Therefore, the purpose of this study is to clarify how the COVID-19 operations by PHCs in Japan were managed and facilitated at the beginning of the infection spread, and their future challenges. We designed a case study that included two PHCs with a population of approximately 400,000 in Japan. Semi-structured focus group interviews with public health nurses from these two PHCs were conducted in September and October 2020. The data were analyzed using chronological time-series analysis. The switch to crisis response was encouraged by the business continuity plan. Their operations for the prevention of COVID-19 in the community were facilitated by the existing network. Further, strengthening the knowledge and skill regarding infectious disease control and management skills during infectious disease-related health emergencies were recommended. It is important to ensure that the environment facilitates emergency response and that people-and-community-centered health promotion activities are conducted, during an emergency situation, with more innovative action and leadership.

The Psychological Supportive Design Features in Hospitals: Case of a Public Jordanian Hospital in Amman.

PURPOSE: The purpose of this study is to develop a practical framework that combines the psychological supportive design features in hospitals' healing environments, also, to examine the implementation of these features in a Jordanian public hospital. BACKGROUND: Positive psychological feelings are the hidden powerful treatment in hospitals. Although that Jordan represents a third-world country, it is counted as one of the most sought-after healthcare locations in the Middle East for its distinguished healthcare serveries (Private Hospitals Association, 2019). Nevertheless, the architectural and interior design of the healthcare facilities in Jordan usually ignores the inpatients' psychological needs. Also, there is an absence of practicing a set of psychological supportive design features to guide the hospitals' design in Jordan. METHOD: Design features are obtained from the main theories in the field of supportive healing environments. A large Jordanian public hospital was selected to be assessed in terms of these features within the developed practical framework. This study adopts a mixed methodology; data are collected using different methods, mainly literature review, site inventory, and inpatients' questionnaire. RESULTS: The studied hospital remains moderately considerable in terms of the psychologically supportive design features. However, the nature connectivity aspect is not satisfactorily considered in the studied hospital design. CONCLUSION: This study suggests a responsive design that fosters interaction and integration with surrounding nature in order to increase levels of connectivity with nature. The studied design features in this study could work as guiding principles for Jordanian hospitals' designers.

Learning and Expertise in Mineral Exploration Decision-Making: An Ecological Dynamics Perspective.

The declining discovery rate of world-class ore deposits represents a significant obstacle to future global metal supply. To counter this trend, there is a requirement for mineral exploration to be conducted in increasingly challenging, uncertain, and remote environments. Faced with such increases in task and environmental complexity, an important concern in exploratory activities are the behavioural challenges of information perception, interpretation and decision-making by geoscientists tasked with discovering the next generation of deposits. Here, we outline the Dynamics model, as a diagnostic tool for situational analysis and a guiding framework for designing working and training environments to maximise exploration performance. The Dynamics model is based on an Ecological Dynamics framework, combining Newell's Constraints model, Self Determination Theory, and including feedback loops to define an autopoietic system. By implication of the Dynamics model, several areas are highlighted as being important for improving the quality of exploration. These include: (a) provision of needs-supportive working environments that promote appropriate degrees of effort, autonomy, creativity and technical risk-taking; (b) an understanding of the wider motivational context, particularly the influence of tradition, culture and other 'forms of life' that constrain behaviour; (c) relevant goal-setting in the design of corporate strategies to direct exploration activities; and (d) development of practical, representative scenario-based training interventions, providing effective learning environments, with digital media and technologies presenting decision-outcome feedback, to assist in the development of expertise in mineral exploration targeting.

The Study on Spatial Elements of Health-Supportive Environment in Residential Streets Promoting Residents' Walking Trips.

Residents' walking trips are a kind of natural motion that promotes health and wellbeing by modifying individual behavior. The purpose of this study was to evaluate the major influence of the spatial elements of a health-supportive environment on residents' walking trips. This study analyzes residents' walking trips' elements based on the spatiotemporal characteristics of walking trips, as well as the spatial elements of a health-supportive environment in residential streets based on residential health needs. To obtain the spatial elements that promote residents' walking trips and to build an ordered logistic regression model, two methods-a correlation analysis and a logistic regression analysis-were applied to analyze the elements of residents' walking trips as well as the spatial elements of a health-supportive environment in residential streets by means of SPSS software, using on-site survey results of ten residential streets and 2738 pieces of research data. The research showed that the nine kinds of spatial elements that significantly affect residents' walking trips are density of pedestrian access, density of bus routes, near-line rate of roadside buildings, average pedestrian access distance, square area within a 500 m walking distance, distance to the nearest garden, green shade ratio, density of street intersections, and the mixed proportion of differently aged residential buildings. In order to construct a spatial environment that promotes walking trips, it is necessary to improve the convenience of residents' walking trips, to increase the safety of roadside buildings and pedestrian access, to expand the comfort of "getting out to the nature", and to enrich the diversity of different architectural styles and street density.

Transitions in the Careers of Competitive Swimmers: To Continue or Finish with Elite Sport?

An athletic career is a succession of stages and transitions (normative and non-normative), which may have decisive effects on either maintaining a satisfactory and/or successful course or deciding about premature career termination. The main purpose of this study was to identify differences between swimmers (Mage = 21.32, SD = 2.62) who after undergoing the transition from junior to senior level either: (a) continued their career hoping to improve their performance regardless of low success at the elite level-Group I; or (b) decided on premature athletic career termination-Group II. The criteria for inclusion included having undergone the transition from junior to senior level and having competed at elite level for at least a year (M = 4.14 years, SD = 1.74). The participants were administered a demographic survey and a structured interview. The results revealed differences in developmental stages. The exploration phase was longer (MGroup I = 5.8 yrs, SD = 2.04, MGroup II = 4.6 yrs, SD = 2.4; Z = -1.902, p = 0.057); the commitment phase was shorter (MGroup I = 3.6 yrs, SD = 1.3; MGroup II = 4.6 yrs, SD = 1.7; Z = -1.735, p = 0.083); the number of hours of structured practice were (MGroup I = 5975, SD = 2474; MGroup II = 7623, SD = 2660, Z = -1.928, p = 0.054); the number of perceived costs were (Group I = 22, Group II = 34; Z = -2.209, p = 0.0027); and the most often pointed benefits of a sporting career were (Group I-94% health & physical fitness; Group II-88% personal growth & life skills). Furthermore, essential inhibitors and facilitators of athletes' development were identified. The findings of the study have practical applications for athletes, coaches, parents and sport psychology professionals. For instance, appropriate social support can help to prevent elite athletes' premature career termination from professional sport during and after their normative transition from junior to senior level.

The Wildman Programme. A Nature-Based Rehabilitation Programme Enhancing Quality of Life for Men on Long-Term Sick Leave: Study Protocol for a Matched Controlled Study In Denmark.

Many men have poor mental health and need help to recover. However, designing a rehabilitation intervention that appeals to men is challenging. This study protocol aims to describe the 'Wildman Programme', which will be a nature-based rehabilitation programme for men on long-term sick leave due to health problems such as stress, anxiety, depression, post-cancer and chronic cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, or diabetes type II. The programme will be a nature-based rehabilitation initiative combining nature experiences, attention training, body awareness training, and supporting community spirit. The aim of the study will be to examine whether the 'Wildman Programme' can help to increase quality of life and reduce stress among men with health problems compared to treatment as usual. The study will be a matched control study where an intervention group (number of respondents, N = 52) participating in a 12-week nature-based intervention will be compared to a control group (N = 52) receiving treatment as usual. Outcomes are measured at baseline (T1), post-treatment (T2), and at follow up 6 months post-intervention (T3). The results of this study will be important to state whether the method in the 'Wildman Programme' can be implemented as a rehabilitation offer in the Danish Healthcare System to help men with different health problems.