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Background and purpose: nature-based interventions (NBI) have been shown to have positiveeffects on physical, psychological, social, and spiritual health. The purpose of this scopingliterature review was to describe what is known regarding the cancer survivor experience inrelationship to their interaction with the natural environment. Description/methods: this reviewwas completed using the Preferred Reporting Items for Systematic reviews and Meta-Analysesextension for Scoping Reviews (PRISMA-ScR). The research strategy included a combination ofthese terms: cancer, neoplasms, nature, and forest therapy. The articles were blinded and screenedby four independent researchers. A total of twelve articles were selected. Outcome/results: a totalof 2786 cancer survivors participated in the twelve studies with multiple types and stages of cancerrepresented. The studies used multiple designs and measures. Results showed improvements inanxiety, depression, sleep, connectedness, stress, tension, confusion, fatigue, and pain. Participantsreported that nature was the most important resource in coping with their cancer. Conclusions andimplications: nature is beneficial for cancer survivors while they experience cancer diagnosis andtreatment. Nature opportunities can be feasibly delivered with this population and need to beexplored further and safely implemented to support the overall health and well-being of cancersurvivors.

The purpose of this paper is to put forward some evidence-based lessons that can be learned fromhow to respond to a Pandemic that relate to healthy living behaviours (HLB). A 4-stepmethodology was followed to conduct a narrative review of the literature and to present aprofessional practice vignette. The narrative review identified 8 lessons: 1) peer review; 2)historical perspectives; 3) investing in resilience and protection; 4) unintended consequences; 5)protecting physical activity; 6) school closures; 7) mental health; and 8) obesity. As in allprobability there will be another Pandemic, it is important that the lessons learned over the lastthree years in relation to HLB are acted upon. Whilst there will not always be a consensus on whatto emphasise, it is important that many evidence-based positions are presented. The authors of thispaper recognise that this work is a starting point and that the lessons presented here will need tobe revisited as new evidence becomes available.

The mental health crisis across college campuses is accelerating, with anxiety listed as the top mental health issue for undergraduate college students. Although evidence suggests the COVID-19 pandemic escalated the mental health crisis on college campuses, pre-COVID-19 anxiety among college students was on the rise. Research supports Mindfulness Based Interventions (MBIs) to reduce anxiety among college students. Additionally, exposure to natural environments, which are accessible to students on college campuses, is effective in reducing anxiety. While brief nature-based mindfulness interventions appear effective in reducing anxiety among college students, these interventions are often offered in isolation without social interaction among group members and lack intentional integration of mindfulness and nature-related theories. The purpose of this work is to describe a framework for integrating the use of Mindfulness and Attention Restoration Theory (ART) in an innovative psychoeducational group intervention, Nature-Based Mindfulness Training © (NBMT), for college students with anxiety. In conclusion, we argue for the need to intentionally integrate mindfulness and nature into nature-based mindfulness interventions as an effective and sustainable means to reduce anxiety. Limitations and areas for future research are described.

Introduction: In January 2020, a small, private school of nursing in a university in the pacificnorthwest, established the Initiative for Vital Practice (I4VP). The I4VP’s primary goal was tocreate a sustainable pathway for increasing vital practice through increasing resiliency and selfcarepractices. Objectives. The ensuing pathway’s objectives were to, (1) take previously identifiedfactors related to perceived stress related to workloads, impacts on professional quality of life andpsychosocial exposures during the COVID-19 pandemic; and (2) develop and pilot test a wellnessintervention (i.e., wellness pods) for faculty and staff to build community and find new ways toenhance well-being through peer support. Methods: Five focused Wellness Pods were developedon Microsoft Teams platform using the individual channels: (1) stress and mind–body explorationpod; (2) mindfulness in healthcare pod; (3) healing relationship pod; (4) environmental pod; and(5) physical activity pod. Faculty and staff self-selected into a Wellness Pod that interested them.The Wellness Pods met weekly in person over a period of two months. Quantitative and qualitativedata was collected via cross-sectional surveys including: four sociodemographic items, one itemon current stress level, one write-in item on current stress management at work, two write-in itemsfocused on the cognitive reasoning for participation, the 7-item subjective vitality scale focusedindividual difference, the 7-item subjective vitality scale focused on the state level, the 10-itemperceived stress scale, and one item ranking which wellness pod the individual wanted toparticipate in. There was one trained facilitator for the overall Wellness Pods operations andcommunication. Results. The average score on the perceived stress scale was 22.3 (SD = 3.5),indicating moderate levels of perceived stress. The average score on the individual differencevitality score was 26.5 (SD = 7.6), whereas the state level vitality score was 21.4 (

Burnout, compassion fatigue, and perceived stress among undergraduate nursing students aresignificant factors leading to a poorer quality of life, decreased job satisfaction, and adverselyimpact patient outcomes. Burnout among undergraduate nursing students is a critical individualand workforce issue with contributing factors including a relentless schedule, academicallychallenging and rigorous programs, pressure to perform, and the completion of clinical hourscaring for patients. This paper describes our feasibility study of a nature-based intervention (NBI)to reduce perceived stress and quality of life as it relates to burnout, and compassion fatigue.Quantitative data was collected through demographics, surveys, and electronic sensor data. Theproject’s aim was to determine the feasibility of NBI monitored by NatureDoseTM to decreaseperceived stress burnout and compassion fatigue among undergraduate nursing students.

The purpose of this Special Issue is to provide you, the reader, with an overview of newadvancements in wellness therapies using integrative health focusing on nature. Nature isinherently variable, and as such, we the editors do not ascribe to a single definition of nature.Experiencing the health benefits of nature is not limited to long immersions in remote naturepreserves. Ongoing research highlights the benefits of even short exposure to green and blue areas.Whether looking out an office window at a single tree or on a long mindfulness retreat in a remoteforest, there lies the potential to improve our mental and physical health. Depending on where youlive, your proximity to water, elevation, the equator, etc., will all change the objective appearanceand experience of nature. Moreover, how you perceive nature as an individual is subjective basedupon your own bio-psycho-social experience with and within nature—which is why you will findvariable definitions and applications of nature.

The unique health care needs of diverse individuals and communities are complex. To meet theseneeds, healthcare professionals are being called upon to alter traditional ways of thinking,perceiving, and acting in order to create more inclusive environments. Research shows that usingmindsight, a process that increases both insight and empathy, can enhance an individual’s mind–body-environment connection, increase self-awareness, and promote the development of culturalhumility. This paper will discuss the current perspectives on the mind/body/environmentconnection from a Western lens that may impact the enactment of cultural humility for healthcareproviders. Two evidence-based approaches, yoga and forest therapy, are recommended as effectiveintervention tools in fostering mindsight and cultural humility. Blending traditional cognitivelearning with techniques anchored in the physical body may hold promise in supporting thedevelopment of mindsight and cultural humility in healthcare education and practice.

We have been amid unhealthy living and related chronic disease pandemics for several decades.These longstanding crises have troublingly synergized with the coronavirus disease 2019 (COVID-19) pandemic. The need to establish research priorities in response to COVID-19 can be used toaddress broad health and wellbeing, social and economic impacts for the future is emerging.Accordingly, this paper sets out a series of research priorities that could inform interdisciplinarycollaboration between clinical sciences, public health, business, technology, economics, healthcareproviders, and the exercise science/sports medicine communities, among others. A five-stepmethodology was used to generate and evaluate the research priorities with a focus on broad healthand well-being impacts. The methodology was deployed by an international and interdisciplinaryteam from the Healthy Living for Pandemic Event Protection (HL- PIVOT) network. This teamwere all engaged in responding to the Pandemic either on the ‘front-line’ and/or in leadershippositions ensuring the currency and authenticity of the process. Eight research priorities wereidentified clustered into two groups: i) Societal & Environmental, and ii) Clinical. Our eightresearch priorities are presented with insight from previously published research priorities fromother groups.

This manuscript offers findings from a pilot project which prepares nursing students for embodiedprofessional practice through the lens of ethics. Four undergraduate nursing students werementored by two nursing faculty in the Dundon-Berchtold Institute Faculty Fellowship Programin the Application of Ethics through an exploration on the ethics of embodiment using an artspedagogy across one academic year. Inspired by the intersection of nature and health, this projectexplores the impact of an arts-integrated pedagogy on the human body. The findings from thisproject provide a natural first step for nursing students to consider multiple interpretations of thehuman body and to facilitate the students’ development of an embodied ethical practice that isperceptive, empathic, and attuned to themselves as natural beings as well as diverse individualsand populations. The findings from this pilot project presents a pivotal opportunity to guide futurenursing curricular development toward holistic, nature-inspired, and mindful-based interventionsin order to increase resilience, decrease risk factors of compassion fatigue and burnout, and supportnursing students to develop strength-based skills to use in their professional nursing practice.

Arts-based pedagogy (ABP) is an innovative teaching method combining art and learning in an existing curriculum. To understand the impact of students' perceptions of the effects of ABP on critical thinking, communication, and observational skills, 89 students completed an online survey. The results indicate that students enjoyed ABP and that it positively affected critical thinking, enhancing their future clinical practice and preparing them for increasingly complex health care environments.

People with spinal cord injury (SCI) face unique challenges during the COVID-19 pandemic, including greater risk of poor COVID-19-related outcomes, increased social isolation, and restricted access to important services. Furthermore, COVID-19 related restrictions have decreased already low levels of physical activity (PA) in this population. Therefore, the purpose of this commentary is to: 1) address the impact of COVID-19 on PA and sedentary behavior (SB) in people with SCI; 2) provide potential SB reduction strategies to guide future research; and 3) provide recommendations to increase PA and reduce SB on behalf of the American College of Sports Medicine Exercise is Medicine (ACSM-EIM) and Healthy Living for Pandemic Event Protection (HL-PIVOT) using a social-ecological model targeting the individual-, social environment-, physical environment-, and policy-level determinants of behavior in people with SCI.

Background: A private university nursing program established the Initiative for Vital Practice in response to increasing levels of compassion fatigue (CF) and burnout among faculty and staff during an undergraduate program revision and accompanying leadership transitions.Method: A pilot mixed-method project evaluated self-management practices meant to mitigate CF among faculty and staff.Results: Faculty and staff (N = 34) identified four primary risk factors for CF, including physical symptoms (14 of 34 = 41%); feeling trapped in work (14 of 34 = 41%); lacking time away from work (11 of 34 = 32%); and inability to work hard enough (10 of 34 = 29%). Individual and organizational stressors and alleviators were analyzed; aggregate scores for three Professional Quality of Life scales presented at a “moderate level.”Conclusion: Preliminary results establish a baseline to measure the effect of burnout and secondary stress and guide further development of our organizational framework and initiative.

Mindfulness and Shinrin-yoku (SY) translated as forest bathing, is potentially effective to alleviatemental health issues related to the COVID-19 pandemic and beyond. The purpose of this article isto provide a translational and pragmatic approach to understanding mindfulness in the context ofSY and psychological wellbeing through a rapid review of the literature. The background ofmindfulness and SY practice are discussed and the emotional, neuroendocrine, and neurobiologicalresponses are examined. Next, a rapid review of the literature examined six studies, publishedbetween 2010 and 2020 to determine what is known regarding the relationship between SY,mindfulness, and psychological wellbeing. The studies included 21–360 participants with a meanage of 20–55 years. The results demonstrated a significant positive correlation between nature,mindfulness, and measures of psychological wellbeing. During uncertain events, includingCOVID-19, weaving mindfulness with SY may be specifically important to at-risk groups, thoseexperiencing depression, loneliness, and social isolation, and at-risk populations such as collegestudents, veterans, and professionals with high levels of stress. The goal of this review is to providea thorough background and support of this cost-effective modality to promote overallpsychological wellbeing as a preventative measure to those at risk or experiencing psychologicalillnesses.

Nurses and other health care workers are often exposed to inappropriate patient sexual behavior (IPSB). Johnson and colleagues define IPSB as any “verbal or physical act of an explicit, or perceived sexual nature which is unacceptable within the social context in which it is carried out.” [1] IPSB encompasses a spectrum of behaviors including: gesturing, giving romantic gifts, making suggestive remarks, propositioning, exposing genitalia, unnecessary touching, with some of the more extreme cases resulting in sexual assault and rape. [2]. It is imperative to note that when a patient’s behavior creates a hostile or intimidating work environment for any health care worker, as in its extreme manifestations, IPSB falls under the legal classification of sexual harassment, a form of sex discrimination that violates Title VII of the Civil Rights Act of 1964 [3]. The definition of IPSB and how it relates to sexual harassment is not clear in existing literature. Not only are these terms unclear in and of themselves, but they are frequently used interchangeably. When IPSB is recognized as sexual harassment, it can imply patients as adversaries creating a difficult care environment. Sexual harassment by patients is a significant problem for general healthcare professionals; however, nurses consistently report sexual harassment by their patients more than any other healthcare sector [2]. This is particularly poignant given that nursing is predominantly female and that we are in the midst of several international campaigns increasing the awareness of sexual assault and harassment. Additionally, the Joint Commission has issued a Sentinel Event Alert on physical and verbal violence against healthcare workers, including sexual harassment, which calls to enforce workplace policies that keep nurses and other healthcare workers safe [4].

Background: Not meeting physical activity guidelines is a major public health concern. Studies show that Black and Latina women have general lower levels of physical activity (PA) than White women and are therefore at higher risk for chronic diseases including cardiovascular disease, diabetes, and obesity. The purpose of this study is to analyze National Health Interview Survey (NHIS) data to determine what factors, if any may contribute to Black and Latina women between the ages of 18 and 47, adhering to the federal PA guidelines. Identifying these factors will help in the development of PA promotion programs aimed at increasing adherence to the federal PA guidelines among minority women.Method: Secondary analysis of data from the National Health Interview Survey 2008–2014 was analyzed to determine factors which may be associated with PA adherence among Black (N = 23,162) and Latina (N = 37,103) women.Results: Logit modeling examined mean differences between groups and related variables. Blacks are more likely to meet muscle-strength guidelines with increased education and increased income. Latinas are more likely to meet muscle-strength as education and US acculturation increases.Conclusion: These findings highlight the importance of understanding and considering racial/ethnic differences when developing strategies for promotion of PA among minority women. Identifying strategies and factors for increasing PA is a major step toward reducing risk factors associated with inadequate PA. Practitioners should be aware of these results and trends when discussing PA recommendations with their patients.

Manifestations of stress have serious consequences for nursing professionals beginning withnursing students. [1, 2] One source of stress for baccalaureate nursing students is inappropriatepatient sexual behavior (IPSB). [3, 4] Baccalaureate nursing programs have limited responseframeworks to provide support to affected students. High levels of stress, regardless of duration orfrequency, can affect learning, performance, and retention in nursing programs. [1, 3] Manystressful incidents experienced by nursing students do not meet parameters of existing studentsupport policies, including Title IX or early alert programs since they occur in clinical sites offcampus. Repetitive high-stake stressors encountered by nursing students increase risks fordeleterious health outcomes. [1–4] Therefore, policy changes at university, state, and federal levelsto build resilience, health, and wellness for undergraduate nursing students must be developed andimplemented.