Outdoor mental healthcare: What, who, why and where to?

Objective: Outdoor mental healthcare can increase the breadth of multidisciplinary interventions available to people with a therapeutic need. The aim of this article is to educate readers about the field of outdoor mental healthcare through the exploration of a series of basic questions.Conclusions: Outdoor mental healthcare spans a range of therapies that apply a variety of theoretical approaches and treatments across a multiplicity of settings, patient groups and desired outcomes unified by key evidence-informed practice elements. Through use of a predominantly non-mainstream workforce working in non-conventional clinical settings outdoor mental healthcare may contribute to treatment accessibility and acceptability.

Wildlife nidoviruses: biology, epidemiology, and disease associations of selected nidoviruses of mammals and reptiles.

Wildlife is the source of many emerging infectious diseases. Several viruses from the order Nidovirales have recently emerged in wildlife, sometimes with severe consequences for endangered species. The order Nidovirales is currently classified into eight suborders, three of which contain viruses of vertebrates. Vertebrate coronaviruses (suborder Cornidovirineae) have been extensively studied, yet the other major suborders have received less attention. The aim of this minireview was to summarize the key findings from the published literature on nidoviruses of vertebrate wildlife from two suborders: Arnidovirineae and Tornidovirineae. These viruses were identified either during investigations of disease outbreaks or through molecular surveys of wildlife viromes, and include pathogens of reptiles and mammals. The available data on key biological features, disease associations, and pathology are presented, in addition to data on the frequency of infections among various host populations, and putative routes of transmission. While nidoviruses discussed here appear to have a restricted in vivo host range, little is known about their natural life cycle. Observational field-based studies outside of the mortality events are needed to facilitate an understanding of the virus-host-environment interactions that lead to the outbreaks. Laboratory-based studies are needed to understand the pathogenesis of diseases caused by novel nidoviruses and their evolutionary histories. Barriers preventing research progress include limited funding and the unavailability of virus- and host-specific reagents. To reduce mortalities in wildlife and further population declines, proactive development of expertise, technologies, and networks should be developed. These steps would enable effective management of future outbreaks and support wildlife conservation.

Which soil microbiome? Bacteria, fungi, and protozoa communities show different relationships with urban green space type and use-intensity.

Exposure to diverse microbial communities early in life can help support healthy human immune function. Soil microbiomes in public and private urban green spaces are potentially important sources of contact with diverse microbiomes for much of the global population. However, we lack understanding of how soil microbial communities vary across and within urban green spaces, and whether these patterns vary across microbial kingdoms; closing this knowledge gap may help us optimise green spaces' capacities to provide this ecosystem service. Here we explore the diversity and community compositions of soil microbiomes across urban green space types in Tasmania, Australia. Specifically, we analysed soil bacterial, fungal, and protozoan diversity and composition across private backyards and public parks. Within parks, we conducted separate sampling for areas of high and low intensity use. We found that: (i) bacteria, fungi, and protozoa showed different patterns of variation, (ii) bacterial alpha-diversity was lowest in low-intensity use areas of parks, (iii) there was relatively little variation in the community composition across backyards, and high and low intensity-use park areas and (iv) neither human-associated bacteria, nor potential microbial community function of bacteria and fungi differed significantly across green space types. To our knowledge, this is the first urban soil microbiome analysis which analyses these three soil microbial kingdoms simultaneously across public and private green space types and within public spaces according to intensity of use. These findings demonstrate how green space type and use intensity may impact on soil microbial diversity and composition, and thus may influence our opportunity to gain healthy exposure to diverse environmental microbiomes.

Physical Activity and Food Environments in and around Schools: A Case Study in Regional North-West Tasmania.

A better understanding of the physical activity (PA) infrastructure in schools, the walkability of neighborhoods close to schools, and the food environments around schools, particularly in rural, socioeconomically challenged areas such as the North-West (NW) of Tasmania, could be important in the wider effort to improve the health of school-age children. Accordingly, this research aimed to assess PA resources, walkability, and food environments in and around schools in three socioeconomically disadvantaged, regional/rural Local Government Areas (LGAs) of Tasmania, Australia. A census of schools (including assessment of the PA infrastructure quality within school grounds), a walkability assessment, and a census of food outlets surrounding schools (through geospatial mapping) were executed. Most of the schools in the study region had access to an oval, basketball/volleyball/netball court, and free-standing exercise equipment. In all instances (i.e., regardless of school type), the quality of the available infrastructure was substantially higher than the number of incivilities observed. Most schools also had good (i.e., within the first four deciles) walkability. Numerous food outlets were within the walking zones of all schools in the study region, with an abundance of food outlets that predominantly sold processed unhealthy food.

Oceans and society: feedbacks between ocean and human health.

The concentration of human population along coastlines has far-reaching effects on ocean and societal health. The oceans provide benefits to humans such as food, coastal protection and improved mental well-being, but can also impact negatively via natural disasters. At the same time, humans influence ocean health, for example, via coastal development or through environmental stewardship. Given the strong feedbacks between ocean and human health there is a need to promote desirable interactions, while minimising undesirable interactions. To this end, we articulate two scenarios for 2030. First, Business-as-Usual, named 'Command and (out of) Control', focuses on the anticipated future based on our current trajectory. Second, a more sustainable scenario called 'Living and Connecting', emphasises the development of interactions between oceans and society consistent with achieving the Sustainable Development Goals. We describe a potential pathway to achieving the 'Living and Connecting' scenario, centred on improving marine citizenship, achieving a more equitable distribution of power among stakeholders, and more equitable access to resources and opportunities. The constituent actions of this pathway can be categorised into four groups: (i) improved approaches to science and health communication that account for society's diverse values, beliefs and worldviews, (ii) a shift towards more trusted relationships among stakeholders to enable two-way knowledge exchange, (iii) economic incentives that encourage behavioural changes necessary for achieving desired sustainability outcomes, and (iv) stronger regulations that simultaneously focus on ocean and human health. We contend that these changes will provide improved outcomes for both oceans and society over the United Nations Decade of Ocean Science. Supplementary Information: The online version contains supplementary material available at 10.1007/s11160-021-09669-5.

A Spatial Analysis of Access to Physical Activity Infrastructure and Healthy Food in Regional Tasmania.

Prevalence of physical inactivity and obesity continues to increase in regional areas such as North-West (NW) Tasmania and show no signs of abating. It is possible that limited access to physical activity infrastructure (PAI) and healthier food options are exacerbating the low levels of habitual physical activity and obesity prevalence in these communities. Despite a burgeoning research base, concomitant exploration of both physical activity and food environments in rural and regional areas remain scarce. This research evaluated access (i.e., coverage, variety, density, and proximity) to physical activity resources and food outlets in relation to socioeconomic status (SES) in three NW Tasmanian communities. In all three study areas, the PAI and food outlets were largely concentrated in the main urban areas with most recreational tracks and natural amenities located along the coastline or river areas. Circular Head had the lowest total number of PAI (n = 43) but a greater proportion (30%) of free-to-access outdoor amenities. There was marked variation in accessibility to infrastructure across different areas of disadvantage within and between sites. For a considerable proportion of the population, free-to-access natural amenities/green spaces and recreational tracks (73 and 57%, respectively) were beyond 800 m from their households. In relation to food accessibility, only a small proportion of the food outlets across the region sells predominantly healthy (i.e., Tier 1) foods (~6, 13, and 10% in Burnie, Circular Head and Devonport, respectively). Similarly, only a small proportion of the residents are within a reasonable walking distance (i.e., 5-10 min walk) from outlets. In contrast, a much larger proportion of residents lived close to food outlets selling predominantly energy-dense, highly processed food (i.e., Tier 2 outlets). Circular Head had at least twice as many Tier 1 food stores per capita than Devonport and Burnie (0.23 vs. 0.10 and 0.06; respectively) despite recording the highest average distance (4.35 and 5.66 km to Tier 2/Tier 1 stores) to a food outlet. As such, it is possible that both food and physical activity environment layouts in each site are contributing to the obesogenic nature of each community.

Nature-Based Citizen Science as a Mechanism to Improve Human Health in Urban Areas.

The world is becoming increasingly urbanised, impacting human interactions with natural environments (NEs). NEs take a number of forms, ranging from pristine, modified, to built NEs, which are common in many urban areas. NEs may include nature-based solutions, such as introducing nature elements and biological processes into cities that are used to solve problems created by urbanisation. Whilst urbanisation has negative impacts on human health, impacting mental and physical wellbeing through a number of mechanisms, exposure to NEs may improve human health and wellbeing. Here, we review the mechanisms by which health can be improved by exposure to NEs, as explained by Stress Reduction Theory, Attention Restoration Theory, and the 'Old Friends'/biodiversity hypothesis. Such exposures may have physiological and immunological benefits, mediated through endocrine pathways and altered microbiota. Citizen Science, which often causes exposure to NEs and social activity, is being increasingly used to not only collect scientific data but also to engage individuals and communities. Despite being a named component of scientific and environmental strategies of governments, to our knowledge, the intrinsic health benefits of Citizen Science in NEs do not form part of public health policy. We contend that Citizen Science programs that facilitate exposure to NEs in urban areas may represent an important public health policy advance.

Urbanisation reduces the abundance and diversity of airborne microbes - but what does that mean for our health? A systematic review.

Over half of people live in cities and while urban environments offer myriad social, cultural and economic benefits, they alter the microbial communities to which people are exposed: with potentially important but underexplored health impacts. In particular, higher rates of asthma and allergies in urban areas have been linked to urban-altered microbial communities - including aerial microbial communities. To date, however, there has been no synthesis of the disparate literature on the impacts of urbanisation on aerial microbial communities, making it difficult to ascertain potential health impacts. We fill this knowledge gap by systematically examining studies that compare the characteristics (e.g. microbial abundance/diversity) and/or health effects of airborne fungal and bacterial communities (hereafter referred to as 'aerobiomes') across urban and rural locations. We included 19 studies, with 31 distinct urban-rural comparisons, in our analysis. We found that rural aerobiomes more often have a greater abundance of microbes (57% of studies). Aerobiome diversity was under-reported but when comparisons were made, rural aerobiome diversity was often higher (67%). Only two studies experimentally examined the impact of urban and rural aerobiomes on human health outcomes; both found rural aerobiomes shifted immune function away from allergic (Th2-type) responses. Overall, we conclude that significant gaps remain in our understanding of how urbanisation impacts aerobiomes and the health implications of those changes. We highlight the need to standardise methods and make aerobiome data open access to facilitate cross-study comparisons. Further mechanistic studies are urgently needed to examine the impact of aerobiome composition on immune function to demonstrate how urban-driven changes to the aerobiome impact human health - ultimately facilitating the development of healthier cities.

An oral bait vaccination approach for the Tasmanian devil facial tumor diseases.

Introduction: The Tasmanian devil (Sarcophilus harrisii) is the largest extant carnivorous marsupial. Since 1996, its population has declined by 77% primarily due to a clonal transmissible tumor, known as devil facial tumor (DFT1) disease. In 2014, a second transmissible devil facial tumor (DFT2) was discovered. DFT1 and DFT2 are nearly 100% fatal.Areas covered: We review DFT control approaches and propose a rabies-style oral bait vaccine (OBV) platform for DFTs. This approach has an extensive safety record and was a primary tool in large-scale rabies virus elimination from wild carnivores across diverse landscapes. Like rabies virus, DFTs are transmitted by oral contact, so immunizing the oral cavity and stimulating resident memory cells could be advantageous. Additionally, exposing infected devils that already have tumors to OBVs could serve as an oncolytic virus immunotherapy. The primary challenges may be identifying appropriate DFT-specific antigens and optimization of field delivery methods.Expert opinion: DFT2 is currently found on a peninsula in southern Tasmania, so an OBV that could eliminate DFT2 should be the priority for this vaccine approach. Translation of an OBV approach to control DFTs will be challenging, but the approach is feasible for combatting ongoing and future disease threats.

Urban-associated diseases: Candidate diseases, environmental risk factors, and a path forward.

BACKGROUND: Cities are home to over half the global population; that proportion is expected to rise to 70% by mid-century. The urban environment differs greatly from that in which humans evolved, with potentially important consequences for health. Rates for allergic, inflammatory and auto-immune diseases appear to rise with urbanization and be higher in the more urbanized nations of the world which has led some to suggest that cities promote the occurrence of these diseases. However, there are no syntheses outlining what urban-associated diseases are and what characteristics of cities promote their occurrence. OBJECTIVES: To synthesize the current understanding of "urban-associated diseases", and discover the common, potentially modifiable features of cities that may be driving these associations. METHODS: We focus on any diseases that have been associated with cities or are particularly prominent in today's urban societies. We draw on expertise across diverse health fields to examine the evidence for urban connections and drivers. DISCUSSION: We found evidence for urban associations across allergic, auto-immune, inflammatory, lifestyle and infectious disease categories. Some conditions (e.g. obesity and diabetes) have complex relationships with cities that have been insufficiently explored. Other conditions (e.g. allergies and asthma) have more evidence demonstrating their relationship with cities and the mechanisms driving that association. Unsurprisingly, air pollution was the characteristic of cities most frequently associated with disease. Other identified urban risk factors are not as widely known: altered microbial exposure and a disconnect from environmental microbiomes, vitamin D deficiency, noise and light pollution, and a transient, over-crowded, impoverished population. However, many complexities and caveats to these relationships beg clarification; we highlight the current knowledge gaps and outline ways to fill those gaps. Identifying urban-associated diseases and their drivers will allow us to prepare for the urban-disease burden of the future and create healthy cities that mitigate that disease burden.

Astro-ecology? Shifting the interdisciplinary collaboration paradigm.

We present a case study whereby ecological research on fallen trees in forest plots was advanced by a collaboration with astronomers working on the vector fields of stars and gas, and we propose a framework by which such novel collaborations can progress.

Forecasting future global food demand: A systematic review and meta-analysis of model complexity.

Predicting future food demand is a critical step for formulating the agricultural, economic and conservation policies required to feed over 9 billion people by 2050 while doing minimal harm to the environment. However, published future food demand estimates range substantially, making it difficult to determine optimal policies. Here we present a systematic review of the food demand literature-including a meta-analysis of papers reporting average global food demand predictions-and test the effect of model complexity on predictions. We show that while estimates of future global kilocalorie demand have a broad range, they are not consistently dependent on model complexity or form. Indeed, time-series and simple income-based models often make similar predictions to integrated assessments (e.g., with expert opinions, future prices or climate influencing forecasts), despite having different underlying assumptions and mechanisms. However, reporting of model accuracy and uncertainty was uncommon, leading to difficulties in making evidence-based decisions about which forecasts to trust. We argue for improved model reporting and transparency to reduce this problem and improve the pace of development in this field.

Ross River Virus and the Necessity of Multiscale, Eco-epidemiological Analyses.

Background: Zoonotic vector-borne disease prevalence is affected by vector, human, and reservoir host factors, which are influenced by habitat and climate; these 5 components interact on microhabitat-to-landscape scales but are often analyzed at a single spatial scale. Methods: We present an information theoretic, multiscale, multiple regression analysis of the ecological drivers of Ross River virus. We analyze the spatial pattern of 20 years of Ross River virus infections from South Australia (1992-2012; n = 5261), using variables across these 5 components of disease ecology at 3 spatial scales. Results: We found that covariate importance depended on the spatial scale of the analysis; some biotic variables were more important at fine scales and some abiotic variables were more important at coarser spatial scales. The urban score of an area was most predictive of infections, and mosquito variables did not improve the explanatory power of these models. Conclusions: Through this multiscale analysis, we identified novel drivers of the spatial distribution of disease and recommend public health interventions. Our results underline that single-scale analyses may paint an incomplete picture of disease drivers, potentially creating a major flaw in epidemiological analyses. Multiscale, ecological analyses are needed to better understand infectious disease transmission.

Socioecological predictors of immune defences in wild spotted hyenas.

Social rank can profoundly affect many aspects of mammalian reproduction and stress physiology, but little is known about how immune function is affected by rank and other socio-ecological factors in free-living animals.In this study we examine the effects of sex, social rank, and reproductive status on immune function in long-lived carnivores that are routinely exposed to a plethora of pathogens, yet rarely show signs of disease.Here we show that two types of immune defenses, complement-mediated bacterial killing capacity (BKC) and total IgM, are positively correlated with social rank in wild hyenas, but that a third type, total IgG, does not vary with rank.Female spotted hyenas, which are socially dominant to males in this species, have higher BKC, and higher IgG and IgM concentrations, than do males.Immune defenses are lower in lactating than pregnant females, suggesting the immune defenses may be energetically costly.Serum cortisol and testosterone concentrations are not reliable predictors of basic immune defenses in wild female spotted hyenas.These results suggest that immune defenses are costly and multiple socioecological variables are important determinants of basic immune defenses among wild hyenas. Effects of these variables should be accounted for when attempting to understand disease ecology and immune function.

Regional Comparison of Mosquito Bloodmeals in South Australia: Implications for Ross River Virus Ecology.

Ross River virus (RRV) is responsible for the most notifications of human arboviral infection in Australia. Seroprevalence and experimental infection studies have implicated macropods (e.g., kangaroos) as the major reservoir hosts. However, transmission ecology varies spatially, and infections in urban areas have prompted the question of what animals serve as reservoirs in regions where macropods are scarce. In South Australia (SA), human infection rates for RRV vary greatly by region as do vector and reservoir abundance. We hypothesized that mosquito abundance and feeding patterns would vary among ecoregions of SA and could help explain divergent human case rates. To test our hypothesis, we amplified and sequenced a 457 base pair region of the cytochrome B segment of mitochondrial DNA from blood fed mosquitoes collected in three main ecoregions of SA and identified sequences using a BLAST search in NCBI. Domestic livestock made up the vast majority of bloodmeals from the region with the highest human infection rate. Livestock are generally not considered to be important reservoir hosts for RRV, but our results suggest they may have a role in transmission ecology in some places. Surprisingly, none of the 199 bloodmeal samples were identified as macropod in origin. In the context of these findings, we consider the possible RRV vectors and reservoir hosts in these regions and propose that diverse spatial and temporal transmission ecologies occur in SA, depending on vector and reservoir availability.

Converting Mosquito Surveillance to Arbovirus Surveillance with Honey-Baited Nucleic Acid Preservation Cards.

Spatially and temporally accurate information about infectious mosquito distribution allows for pre-emptive public health interventions that can reduce the burden of mosquito-borne infections on human populations. However, the labile nature of arboviruses, the low prevalence of infection in mosquitoes, the expensive labor costs for mosquito identification and sorting, and the specialized equipment required for arbovirus testing can obstruct arbovirus surveillance efforts. The recently developed techniques of testing mosquito expectorate using honey-baited nucleic acid preservation cards or sugar bait stations allows a sensitive method of testing for infectious, rather than infected, mosquito vectors. Here we report the results from the first large-scale incorporation of honey-baited cards into an existing mosquito surveillance program. During 4 months of the peak virus season (January-April, 2014) for a total of 577 trap nights, we set CO2-baited encephalitis vector survey (EVS) light traps at 88 locations in South Australia. The collection container for the EVS trap was modified to allow for the placement of a honey-baited nucleic acid preservation card (FTA™ card) inside. After collection, mosquitoes were maintained in a humid environment and allowed access to the cards for 1 week. Cards were then analyzed for common endemic Australian arboviruses using a nested RT-PCR. Eighteen virus detections, including 11 Ross River virus, four Barmah Forest virus, and three Stratford virus (not previously reported from South Australia) were obtained. Our findings suggest that adding FTA cards to an existing mosquito surveillance program is a rapid and efficient way of detecting infectious mosquitoes with high spatial resolution.