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Objective: Emerging research supports the role of chronic stress in chronic disease development. This scoping review aimed to map the field of research exploring relationships between chronic stress and the development of arthritis in adult populations. Methods: Five electronic databases were systematically searched without publication limits based on three key concepts: stress, arthritis and adults. Eligible qualitative studies investigated individuals’ perceived causes of arthritis; quantitative studies investigated relationships between exposure to a chronic stressor and an arthritis presence outcome. Articles were screened by two independent reviewers and data were narratively synthesised. Results: Of 1819 unique records, 54 studies met inclusion criteria. Nine studies used qualitative methods and 45 used quantitative methods. Studies increased chronologically, with half (n = 27) published since 2010. Chronic stress exposures were heterogenous; most were categorised as adverse life events (n = 22) or adverse childhood experiences (n = 17). Self‐reported arthritis was the most frequent measure of arthritis outcome (n = 26) in quantitative studies. A majority of studies (n = 41) suggested a relationship between exposure to chronic stressors and arthritis development. Conclusion: Increasing study numbers in the past decade may reflect increasing awareness of the potential impact of chronic stress in arthritis development, consistent with a biopsychosocial approach to chronic disease aetiology and management. Further research, using precise arthritis definitions, conducted within a clearly articulated pathophysiological framework, is required to establish a causal relationship between exposure to chronic stressors and the development of specific arthritis conditions. Refereed/Peer-reviewed

Purpose-built nature play spaces are popular in schools around the globe; however, little is known about their distribution and use in South Australia. School staff representing 52 South Australian public primary schools participated in an online survey. Half (56%) of included schools were metropolitan. Half (52%) were economically advantaged. Purpose-built nature play spaces were present, planned or in construction in 88% of schools in the study. No significant associations were found between the presence of a purpose-built nature play or natural space and school characteristics. These findings show widespread uptake of purpose-built nature play spaces and suggest most South Australian schools have facilities to provide nature-based play and learning. Refereed/Peer-reviewed

Background Helicobacter pylori (H. pylori), a bacterium implicated in the development of peptic ulcer and gastric cancer, is estimated to infect around half the world’s population. Its prevalence in Australia is unclear. This scoping review aimed to evaluate all Australian literature providing estimates of the prevalence of H. pylori. Methods Australian studies examining H. pylori prevalence from 1982 onwards were eligible for inclusion. Medline, Embase and Scopus databases, and grey literature sources, were searched. Two independent reviewers undertook a two-stage screening process. Data were extracted by two independent reviewers using a pre-specified template. Results Of 444 identified studies, 75 were included in the review. H. pylori prevalence in Australian population-based studies (n = 8) ranged from 38.0% in 1991 to 15.1% in 2002; however, estimated prevalence across all non-clinical population studies in diverse sub-groups (n = 29) has varied dramatically. Decreased prevalence has been more marked in populations with gastrointestinal symptoms and conditions compared to non-clinical populations. Data on H. pyloriprevalence in vulnerable populations are lacking. Conclusions This is the first scoping review of Australian studies reporting H. pylori prevalence. A wide range of study designs, population groups, geographic regions, and diagnostic methods was included, involving data collected over a 50-year period (1969 to 2018). The summary of H. pylori prevalence estimates over time in this review points to a decrease in prevalence in Australia, particularly among populations with gastrointestinal symptoms and illnesses; however, it is unknown whether there is inequity in prevalence trends across vulnerable sub-groups of the Australian population. Future research and interventions supporting the health and wellbeing of vulnerable populations is required to ensure equitable health gains are made for all.

Refereed/Peer-reviewed 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.

Refereed/Peer-reviewed Introduction: This study aimed to systematically review and meta-analyze the relationship between resistance training and all-cause, cardiovascular disease, and cancer mortality. Methods: Systematic review and meta-analysis following PRISMA guidelines (International Prospective Register of Systematic Reviews Registration Number CRD42019136654) was conducted. MEDLINE (OVID), Embase, Emcare, SPORTDiscus, The Cochrane Library, and SCOPUS were searched from inception to June 6, 2021. Included studies reported resistance training as the exposure and all-cause mortality, cardiovascular disease‒specific mortality, and/or cancer-specific mortality as outcome/s. Only studies conducted among nonclinical adult populations (aged ≥18 years) and written in English were included. Results: A total of 10 studies were included in the meta-analyses. Compared with undertaking no resistance training, undertaking any amount of resistance training reduced the risk of all-cause mortality by 15% (RR of 6 studies=0.85; 95% CI=0.77, 0.93), cardiovascular disease mortality by 19% (RR of 4 studies=0.81; 95% CI=0.66, 1.00), and cancer mortality by 14% (RR of 5 studies=0.86; 95% CI=0.78, 0.95). A dose–response meta-analysis of 4 studies suggested a nonlinear relationship between resistance training and the risk of all-cause mortality. A maximum risk reduction of 27% was observed at around 60 minutes per week of resistance training (RR=0.74; 95% CI=0.64, 0.86). Mortality risk reductions diminished at higher volumes. Discussion: This systematic review and meta-analysis provides the strongest evidence to date that resistance training is associated with reduced risk of all-cause, cardiovascular disease, and cancer-specific mortality. More research is needed to determine whether any potential mortality benefits gained from resistance training diminish at higher volumes.

Nature-based play and learning is of increasing interest to primary schools and research suggests that it has many potential benefits for children’s health and development. However, little is known about educators’ perspectives and experiences of nature-based play and learning, particularly the barriers, benefits and enablers, despite their direct relevance to the uptake of nature-based play and learning in schools. A qualitative descriptive methodology was employed to uncover these. Individual, semi-structured interviews were conducted with 12 principals and educators from South Australian public primary schools, recruited via a participant contact list from a previous study. The participants were two principals, eight educators and two individuals with dual principal and educator positions. Metropolitan and rural schools were equally represented. Interviews were audio-taped, transcribed verbatim and analysed using thematic analysis. Analysis identified four overarching themes: the practice, perceived benefits, barriers and enablers of nature-based play and learning. Children’s learning, enjoyment, creativity, and a relaxed and flexible environment were clear benefits. Meanwhile educator knowledge and confidence and the crowded curriculum were barriers. Enablers were nature-based play and learning champions and support from school leadership. The findings suggest that schools can help engage students with nature-based play and learning activities by mitigating these barriers and promoting these enablers. Refereed/Peer-reviewed