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Mindfulness and mind wandering may both enhance the psychological outcomes of nature experiences. Both states are multi-faceted, with mindfulness involving specific components such as decentering, body awareness, and nonjudgment, and mind wandering involving intentional and spontaneous mind wandering. These facets may differentially predict psychological outcomes of nature experiences, however these associations have not been tested. In this study we examined facets of mindfulness and mind wandering in nature and tested their associations with outcomes of psychological restoration and nature connection. We also tested the effects of situational factors on these engagement facets in nature. We conducted an experiment in which participants were instructed on how to engage with nature during a 20min experience in nearby nature and completed online surveys before and after the outdoor experience. Participants were allocated into one of four groups, each given different engagement instructions. We used measures of state mindfulness that assessed three facets – decentering, nonjudgment, and body awareness – and measures of mind wandering that assessed two facets – mindlessness, and deliberate mind wandering. Regression analyses revealed associations between these facets and outcomes of the nature experience; decentering and deliberate mind wandering were associated with positive outcomes, including stronger nature connection and positive affect, and nonjudgment was associated with higher negative affect. Further analyses revealed perceived restorativeness and other situational factors such as affective state influenced engagement during the nature experience. These results demonstrate the value of deconstructing mindfulness and mind wandering in nature to explore facets that have beneficial or adverse effects on psychological outcomes. We conclude with practical directions for nature-based engagement interventions that can target the beneficial components of these practic

Research indicates that heightened individual engagement in nature can improve psychological benefits of nature experiences, yet the current literature lacks robust consideration for how this occurs. Constrained nature experiences – such as busy, noisy urban environments – may undermine individual capacities to engage with nature, prompting the question of how engagement functions across different nature experiences. To address this gap, we draw on mindfulness as a framework to examine the pathways in which engagement in nature supports psychological restoration and connection with nature. We appraise existing literature and identify three key mechanisms underpinning mindful engagement in nature: perceptual sensitivity, decentering, and non-reactivity. This new framework provides a basis to examine mindful engagement in constrained nature experiences, where we find that the self-regulatory mechanisms of mindful engagement have a more direct role in supporting outcomes.

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.