Refocusing on nature: the role of nature reintegration in environmental, mental, and societal wellbeing.

This perspective paper investigates the dynamic interplay between wealth, materialism, environmental degradation, and mental health amid escalating challenges of climate change. The paper critically examines how affluence, often a buffer against climate impacts, paradoxically leads to higher consumption and carbon footprints, exacerbating environmental problems. A societal emphasis on materialism contributes to an estrangement from nature, with significant implications for mental health and environmental sustainability. The paper proposes a fundamental shift in addressing these intertwined challenges through reintegration with nature. The paper recommends integrating urban planning, education, mental health, and community engagement strategies to build a sustainable, mentally resilient society more integrated with nature. This approach, supported by future research directions, aims to create a more balanced, environmentally conscious, and mentally healthy world.

Telemedicine in Sports under Extreme Conditions: Data Transmission, Remote Medical Consultations, and Diagnostic Imaging.

Telemedical technologies provide significant benefits in sports for performance monitoring and early recognition of many medical issues, especially when sports are practised outside a regulated playing field, where participants are exposed to rapidly changing environmental conditions or specialised medical assistance is unavailable. We provide a review of the medical literature on the use of telemedicine in adventure and extreme sports. Out of 2715 unique sport citations from 4 scientific databases 16 papers met the criteria, which included all research papers exploring the use of telemedicine for monitoring performance and health status in extreme environments. Their quality was assessed by a double-anonymised review with a specifically designed four-item scoring system. Telemedicine was used in high-mountain sports (37.5%; n = 6), winter sports (18.7%; n = 3), water sports (25%; n = 4), and long-distance land sports (18.7%; n = 3). Telemedicine was used for data transfer, teleconsulting, and the execution of remote-controlled procedures, including imaging diagnostics. Telemedical technologies were also used to diagnose and treat sport-related and environmentally impacted injuries, including emergencies in three extreme conditions: high mountains, ultraendurance activities, and in/under the water. By highlighting sport-specific movement patterns or physiological and pathological responses in extreme climatic conditions and environments, telemedicine may result in better preparation and development of strategies for an in-depth understanding of the stress of the metabolic, cardiorespiratory, biomechanical, or neuromuscular system, potentially resulting in performance improvement and injury prevention.

Social prescribing of nature therapy for adults with mental illness living in the community: A scoping review of peer-reviewed international evidence.

Social prescribing of nature therapy "green social prescribing" facilitates access to local nature-based activities that improve biopsychosocial wellbeing outcomes, are affordable, accessible, and can be adapted to context. These are becoming increasingly popular and gray literature is emerging, however, peer-reviewed scientific evidence is exiguous. This scoping review aimed to identify and critique peer-reviewed evidence for green social prescribing interventions and develop recommendations for research and clinical practice. Included studies were published in peer-reviewed journals in English on/after 1 January 2000. Participants were community-living adults with mental illness; Intervention was any green social prescribing program; Comparator was not restricted/required; Outcomes were any biopsychosocial measures; and any/all Study Designs were included. Twelve databases were searched on 15 October 2022; these were Academic Search Premier, APA PsycArticles, APA PsycINFO, CINAHL, Cochrane Library, Google Scholar, JSTOR, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Mixed Methods Appraisal Tool was used to assess quality. Seven publications describing 6 unique studies (5 UK, 1 Australia) were identified including 3 mixed-methods, 2 qualitative, and 1 RCT. Participants included 334 adults (45% female, aged 35-70 years); sample sizes ranged from 9 to 164. All studies showed improvements in biopsychosocial wellbeing, and participants from most studies (n = 5) reported increased connection to the earth and intention to further access nature. Participant demographics and diagnoses were poorly reported, and intervention activities and assessments varied considerably. However, MMAT scores were good overall suggesting these studies may reliably demonstrate intervention outcomes. We conclude that socially prescribed nature therapy can improve biopsychosocial wellbeing and is a potentially important intervention for mental illness. Recommendations for research and clinical practice are provided.

An ecological dynamics perspective on designing urban nature environments for wellbeing and health-enhancing physical activity.

The latest World Health Organization report on green and blue space and mental health (2021) calls for greater, and better, urban nature environments, i. e., "wilder" urban parks, tree-laden sidewalks, and overall presence of nature in the urban environment. Evidence shows that living close to and interacting with nature promotes benefits to numerous health and well-being indicators. The present article narratively reviews what are the aspects of urban nature environments that enhance health and wellbeing markers, which aspects are preferred among users and visitors of urban nature environments, and how can the benefits for health and wellbeing be understood from a theoretical perspective. Finally, guided by the ecological dynamics framework, suggestions are put forward on how designers and planners of urban nature environments can consider affordances to promote physical activity behavior, health and wellbeing; and how exercise and health researchers and professionals may channel the interaction of individuals with the nature environment in their interventions and programs.

What Is an Extreme Sports Healthcare Provider: An Auto-Ethnographic Study of the Development of an Extreme Sports Medicine Training Program.

"I remember when sex was safe and skydiving was dangerous" read a popular bumper sticker during the HIV crisis. Popular perceptions of extreme sport (ES) often include the descriptor 'dangerous'. Therefore, why is the popularity of ES increasing exponentially with "dedicated TV channels, internet sites, high-rating competitions, and high-profile sponsors drawing more participants"? More importantly, how should health practitioners respond to the influx of ES athletes with novel injuries, enquiries and attitudes. This paper describes the results of a collaborative auto-ethnographic approach to answering "what is an extreme sports medicine health care provider and what are the components of an effective Extreme Sports Medicine (ESM) training program?" The study was conducted following the first ESM university course offered in Australia with the intention of assessing the learning design and reflecting on the development and practice of ES health practitioners. We explicated three overarching themes common to both the ES health practitioner and for the effective training of healthcare providers in the support of ES endeavors and athletes. These themes were individual, task and environmental factors. The impacts of these findings confirm that ESM courses are vital and should be designed specifically to ensure that practitioners are effectively supported to develop the unique skills necessary for practice in real world extreme sports events.

Learning clinical skills: an ecological perspective.

The pedagogy underpinning clinical psychology training is often reliant upon the acquisition and transmission of knowledge and the practice of skills. The dominant paradigm in the training of clinical psychologists emphasises competence-based training drawing upon a scientist practitioner model of practice, often underpinned by knowledge of evidence-based interventions. Little has changed over the past 40 years. Training is predicated upon the assumption that effective therapy is attributed to the therapist's skills to implement specific therapeutic processes and her or his capacity to form an effective working alliance with the client or patient. We provide an argument for an alternative paradigm in which ecological principles are privileged with a view to enhancing clinical training of psychologists in health settings responsive to the trainee as well as the broader societal context in which they practice, by adopting a pedagogy which prioritizes the relationship between the person and the environment. The proposed approach brings an ecological set of assumptions to the learning experience in clinical contexts. Key principles, drawn from an ecological perspective includes: affordances, the emergence of self-organisation in clinical learning, constraints and rate limiters. The approach is supported by examples applied to clinical learning contexts. Implications for clinical training are discussed. The ways in which an ecological approach may contribute to more effective learning outcomes through the use of representative learning contexts may inform learning design, how learning is actioned in clinical psychology as well as future research on the pedagogy of clinical training.

Getting Out of the Classroom and Into Nature: A Systematic Review of Nature-Specific Outdoor Learning on School Children's Learning and Development.

Background: The value of natural environments for developing children's self-identity and social skills has been known for some time, and more recently the potential of nature-specific (i.e., excluding built environments) outdoor learning for achieving academic outcomes has been explored. Connecting children with natural spaces has been shown to benefit their physical and mental health; however, the utility of nature-specific outdoor environments as a setting for curricular and non-curricular learning has yet to be clearly established. Our aim was to undertake a narrative synthesis of international evidence of nature-specific outdoor learning and its benefits for personal and social development, wellbeing and academic progress. Methods: This systematic review searched publications between 2000 and 2020 in nine academic databases for evidence of socio-emotional and academic benefits of nature-specific outdoor learning in school-aged educational settings, using concise search criteria registered with PROSPERO. The total search results of 17,886 records were initially screened by title, and then two reviewers made blind reviews of the title and abstract of 1,019 records. Results: 147 original research studies meeting the criteria were identified. Learning settings ranged across outdoor adventure education, school gardens, field trips, and traditional school subjects taught in natural environments. Study characteristics were summarized, and risk-of-bias tools assessed quality of research as generally moderate, although with a wide range. The reported benefits of learning in natural outdoor settings include: increased student engagement and ownership of their learning, some evidence of academic improvement, development of social and collaborative skills, and improved self-concept factors. Conclusions: Nature-specific outdoor learning has measurable socio-emotional, academic and wellbeing benefits, and should be incorporated into every child's school experience with reference to their local context. Teacher pre-service and in-service education needs to include a focus on how natural settings can be used effectively for learning. Further research is needed to clarify the conditions under which specific forms of outdoor learning are most efficacious for various target outcomes. It is recommended that future studies measuring outdoor learning adopt established methodologies to improve the quality of research in this field. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=153171.

The Power of a Profound Experience With Nature: Living With Meaning.

Nature based experiences have been linked to significant positive outcomes for people and the planet. Significant life experience research investigates the associations between formative experiences in nature and resulting environmental concern and action, including both singular events and repeated experiences. However, little is known about the long-term impacts of singular profound experiences with nature. This research sought to better understand how a singular, meaningful experience defines an individual's self-awareness of his or her relationship with nature, changes social relationships, and directs environmental decisions and behaviors. Twenty-one adults who had a profound experience with nature participated in a semi-structured interview exploring how they make sense of their experience, the meaning they attribute to it, and the role it served in their lives. Three themes resulted from the thematic analysis process: (1) Living in relation with nature, (2) Living authentically, and (3) Living a meaningful life. The findings demonstrate that a single profound experience with nature can have long-lasting and significant effects on an individual. Understanding these long-term influences of a profound experience with nature have implications for intervention designers such as health practitioners and environmental educators, as well as policy-makers.

The Relationship Between Climate Change Issue Engagement, Connection to Nature and Mental Wellbeing.

As the threat of climate change becomes increasingly prevalent for people in both the developed and developing world, the impact of climate change on mental wellbeing has become a crucial area of research. In addition to the direct, indirect, and psychosocial impacts of climate change on mental wellbeing, there is also a question of how climate change driven changes to the environment will influence the well-established positive relationship between connection to nature and mental wellbeing. The aim of this study was to investigate the relationship between climate change issue engagement, connection to nature, and mental wellbeing in English speaking adults over 18 years of age. This study examined the average levels of connection to nature and mental wellbeing in people with different levels of climate change issue engagement, and evaluated whether a person's level of climate change issue engagement uniquely predicted mental wellbeing. The study corroborated positive relationships between wellbeing and various aspects of relatedness to nature in the overall sample. The strength of these relationships, however, depended on the level of climate change issue engagement. More specifically, the level of engagement is inversely linked to mental wellbeing, such that the lower the level of engagement, generally the higher is wellbeing.

An Ecological Dynamics Approach to Understanding Human-Environment Interactions in the Adventure Sport Context-Implications for Research and Practice.

The last few decades have witnessed a surge of interest in adventure sports, and has led to an emerging research focus on these activities. However, recent conceptual analyses and scientific reviews have highlighted a major, fundamental question that remains unresolved: what constitutes an adventure sport. Despite several proposals for definitions, the field still seems to lack a shared conceptualization. This deficit may be a serious limitation for research and practice, restricting the development of a more nuanced theoretical explanation of participation and practical implications within and across adventure sports. In this article, we address another crucial question, how can adventure sports be better understood for research and practice? We briefly summarize previous definitions to address evident confusion and a lack of conceptual clarity in the discourse. Alternatively, we propose how an ecological perspective of human behaviors, such as interactions with the environment, may provide an appropriate conceptualization to guide and enhance future research and practice, using examples from activities such as freeride skiing/snowboarding, white-water kayaking, climbing, mountaineering and the fields of sport science, psychology and avalanche research and education. We draw on ecological dynamics as a transdisciplinary approach to discuss how this holistic framework presents a more detailed, nuanced, and precise understanding of adventure sports.

What Is So Special about Wingsuit BASE Jumpers? A Comparative Study of Their Psychological Characteristics.

For the general public, BASE jumping is considered the ultimate extreme activity. Among BASE jumpers, those using wingsuits are generally perceived as the most experienced but also as the most risk-taking. Starting from this observation, we wanted to know whether wingsuit users differed in their psychological characteristics from other BASE jumpers. More specifically, we hypothesized that wingsuit users would be characterized by higher levels of mental toughness and by lower levels of harm avoidance. We also expected them to use more mental training techniques than the other jumpers. To this end, we conducted a vast survey on a sample of 183 BASE jumpers. Contrary to our hypotheses, the results did not reveal any significant difference in psychological characteristics between wingsuit users and other BASE jumpers. This absence of significant differences is discussed and recommendations for the use of mixed or multi-methods in the study of extreme sports are proposed.

Injuries and illnesses related to dinghy-sailing on hydrofoiling boats.

BACKGROUND: Hydrofoil technology has changed sailing, significantly increasing its speed and resulting in spectacularity and mass media interest. Although high speed can expose participants to a risk of high-energy trauma, there are no scientific studies related to trauma in dinghies that exploit this technology. Therefore, this study aims primarily to measure the injury rate, and identify the kind and anatomical distribution of most common injuries and secondarily identify the traumatic dynamics most often involved and the main risk factors. METHODS: This descriptive epidemiology study examined data relative to injuries and illnesses suffered by 77 sailors (91% males) from 13 nationalities during three international, gathered through a specifically designed questionnaire. RESULTS: The prevalence of illnesses and overuse injuries during the regatta week were 6.5% and 18.2%, respectively, while the incidence of acute injuries was 16/1000 sailor-hours. Upper limbs, lower limbs and lumbar spine were involved in 34.6%, 26.9% and 15.4% of cases of musculoskeletal injuries, respectively. None of the acute injuries reached the maximal score of severity, while the higher score value was 63/100. Most of the reported illnesses (80%; n = 4) were upper respiratory tract infections with a prevalence in the week of the regatta of 5.2% and an incidence of 0.51/1000 sailor-hours. Environmental factors played a role in 77% of the incidents resulting in acute injuries. CONCLUSIONS: This study provides valuable information for regatta organizers, boat builders, athletes, coaches, and doctors. In addition, it fosters the importance of ergonomics of boats, adequate clothing and specific physical training for injuries and illnesses prevention.

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.

Time Spent in Nature Is Associated with Increased Pro-Environmental Attitudes and Behaviors.

Urbanization, screen dependency, and the changing nature of childhood and parenting have led to increased time indoors, creating physical and emotional distancing from nature and time spent in natural environments. Substantial evidence from observational and intervention studies indicates that overall time spent in nature leads to increased perceived value for connectedness to nature and, subsequently, greater pro-environmental attitudes and behaviors (PEAB). This narrative review of the recent literature evaluates associations between time spent in nature with values ascribed to nature and nature connectedness, as well as PEAB. We discuss the influence of nature exposure and education in childhood on subsequent development of PEAB in adulthood. We analyze theoretical frameworks applied to this research as well as metrics employed, populations studied, and individual and societal values before presenting limitations of this research. We conclude with suggestions for future research directions based on current knowledge, underscoring the importance of promoting time spent in nature and PEAB in the face of growing challenges to planetary health. Research indicates that overall time spent in nature, regardless of the quality of environmental conditions, leads to increased perceived values ascribed to nature, which is associated with PEAB; however, this literature is predominantly cross-sectional. Furthermore, personal and social factors may influence PEAB. Thus, more longitudinal studies that consider these factors are needed to assess the duration and frequency of time spent in nature in childhood and its impact on PEAB throughout the life course. Identifying contexts which cultivate PEAB and reverse alienation from nature beginning in childhood may better sensitize adults to the urgency of environmental issues such as climate change, which adversely impact individual and environmental health.

Conceptualizing the Human Health Outcomes of Acting in Natural Environments: An Ecological Perspective.

Human-nature interactions have been presented as important for promoting and sustaining wellbeing and health benefits. Research has shown that pictures of nature, interacting with nature, physical activity in nature, immersion in nature and even feeling connected to nature can improve health. While considerable research supports this notion that nature can have positive health impact, theoretical and conceptual frameworks that help explain how the natural environment provides benefits to human health and wellbeing have proved limited. In extreme cases, theoretical approaches reinforce a problematic notion where nature is viewed as a separate entity, as a treatment to be taken as prescribed to remediate health problems that arise. Such approaches are limited as they fail to address how beneficial person-nature relations may be captured in interventions. There is a need for a deeper understanding of the processes underlying the observed benefits of the person-nature link in order to design effective research and interventions. It is especially important to consider the implications of research on person-nature relations for people living in urban contexts. In this paper, we present an ecological perspective building on James Gibson's conceptualization of human behavior. Specifically, we outline a framework that emphasizes the person-environment system as the most appropriate scale of analysis. We present three relevant concepts from the ecological approach: form of life, affordances and niche construction, as helpful for appreciating how acting in natural environments might benefit human health and wellbeing. This approach urges policy makers and urban designers to rethink environmental designs to provide and support a landscape of affordances that makes use of the richness of natural environments.

Health and Wellbeing in an Outdoor and Adventure Sports Context.

Outdoor and adventure sports (OAS) have been linked to positive health and wellbeing outcomes. This Special Edition brings together cutting-edge research and thought on the implications of this link. An analysis of the papers in this Special Edition reveals important insights into (i) the diverse and powerful outcomes derived from adventure experiences, (ii) how adventure experiences facilitate these outcomes, (iii) how best to design outdoor and adventure experiences. The evidence in this edition indicates a need for a more systematic approach to the inclusion of OAS as important to good health and wellbeing. OAS should be included as part of education, health, policy and planning.

Reconsidering McKenzie's Six Adventure Education Programming Elements Using an Ecological Dynamics Lens and Its Implications for Health and Wellbeing.

Two decades ago, McKenzie's meta-analysis of literature provided six fundamental elements of adventure education programme design still used to guide research and practice today. While the value of McKenzie's early work should not be underestimated, adventure education has undergone considerable changes. Adventurous activities are now available in urban and indoor contexts and used to facilitate a growing health and wellbeing agenda. The use of risk as part of adventure education programming has also been critiqued. This paper reflects on contemporary notions of adventure, risk and the emergent narratives emphasising the associated psychological benefits. The Ecological Dynamics framework, along with representative design delivery, are presented as a viable way of building on McKenzie's work. Both consider how effective outcomes in adventure education programmes are achieved through designs that focus on the unique relationship between the individual and their environment. While McKenzie's six elements recognise the importance of human relationships, Ecological Dynamics forefronts relational elements, not just between participants but, importantly, the task and the environment. Individual participant needs in relation to their everyday life therefore become the focus of adventure education expanding beyond the traditional long-standing narratives of risk and danger. Through these two important concepts, this paper advocates an approach to the design of adventure representative of a participant's everyday environment. In this way, adventure education outcomes translate beyond the adventure-specific context and align more holistically with the needs of individual participants while also assuring emphasis on individual health and wellbeing.

BASE Jumping Fatalities Between 2007 and 2017: Main Causes of Fatal Events and Recommendations for Safety.

INTRODUCTION: BASE (buildings, antennae, span, earth) jumping involves jumping from fixed objects with a parachute. This practice is associated with fatal events. Despite considerable evolution in BASE jump practice over the past years, fatalities have increased. Identifying the main causes of fatal events and recommending processes to reduce fatalities is vital for safe BASE jumping practice. METHODS: In an effort to capture worldwide cases between 2007 and 2017, we identified and classified on a Haddon matrix each fatal event from the BASE jumping fatality list. Although not devoid of limitations, this is the most comprehensive list of BASE jumping fatal events and the main source of information on BASE-related fatalities for BASE jump participants. RESULTS: The report noted 223 fatalities, 197 of them being cliff jumps. In addition, 137 fatal jumps were wingsuit jumps. Impact and object strike were the main cause of fatal event (96%). Human factors leading to fatality were mostly low pull/no pull (64%) and bad exits (15%). Equipment factors included off-heading openings, twists, and pilot chute entanglement. Environmental factors included strong wind, poor visibility, and water. CONCLUSIONS: BASE jump practice has undergone radical transformations in the last 10 y, especially linked to the mountain environment and the use of wingsuits. These factors were linked to most fatal events. Key recommendations are basic practical measures, such as ground preparation and equipment checks, and deep technical and personal knowledge that involves regular engagement and significant introspection.