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The therapeutic landscapes literature has evolved considerably since the concept was first proposed to under stand how experiences of health and wellbeing unfold and develop through physical, social and symbolic di mensions of landscape encounter. Informed by a critical scoping review, this paper charts how the senses have been attended to across the therapeutic landscapes literature published since 2007 (the publication date of the previous edited volume on Therapeutic Landscapes). We focus specifically on literature pertaining to ‘nature based’ therapeutic encounters, responding to calls to re-situate the body in wider interdisciplinary scholarship around nature, health and wellbeing. We attend to imagined and embodied visual, sonic, olfactory, haptic and gustatory sensations, and the varied ways in which these are interpreted and made sense of individually and collectively. In line with prominent visual landscape preoccupations, this body of literature largely privileges and focuses on the visual sense. While there is increasing interest in auditory, haptic and olfactory qualities of encounter, taste remains largely overlooked. This uneven focus neglects the potential richness and diversity of therapeutic sensescape encounters, as well as the cultural and social sensory histories that shape how contem porary encounters may be experienced and interpreted. Suggestions for future research are outlined, including methodological and empirical directions across the social sciences, arts and humanities. yes

Sensing Nature was a two-year in-depth qualitative research project, based at the University of Exeter, from 2016-2018, to explore opportunities to promote more inclusive nature experiences for wellbeing amongst people with sight impairment in the UK. In the initial phase of the research the lead researcher has volunteered with a range of activity groups across England, including those involving participants with visual impairment. This opportunity was used to build an awareness of people’s diverse sensory worlds and to explore how people might like to share their experiences and stories. In the project's second phase, both narrative and go-along interviews were conducted with people of different ages and backgrounds, and with varying forms of visual impairment. These interviews offered a much deeper understanding of people’s diverse sensory experiences in nature, alongside the conditions that can both enhance and undermine these experiences.

Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprised a Mental Health First Aid (MHFA) training package to at least 16 percent of staff, a short mental health awareness session to all teachers, and development of a staff peer-support service. Twenty-five schools were randomised to intervention or control arms. This paper reports findings regarding the extent of uptake and fidelity of the intervention. Methods: Mixed methods data collection comprised researcher observations of training delivery, training participant evaluation forms, trainer and peer supporter interviews, peer supporter feedback meetings, logs of support provided, and teacher questionnaires. Quantitative data were summarised descriptively, while thematic analysis was applied to the qualitative data. Results: In the 12 schools assigned to the intervention arm, 113 (8.6%) staff completed the two-day standard MHFA training course, and a further 146 (11.1%) staff completed the one-day MHFA for Schools and Colleges training. In seven (58.3%) schools the required eight percent of staff completed the MHFA training packages. A one-hour mental health awareness raising session was attended by 666 (54.5%) staff. Delivery of the MHFA training package was achieved with high levels of fidelity and quality across schools. All schools set up the peer-support service following training, with a majority adhering to most of the operational guidelines developed from the pilot study at the outset. Teachers reported limited use of the peer support service during follow-up. At the one year follow up, only three (25.0%) schools indicated they had readvertised the service and there was evidence of a reduction in support from senior leadership. Conclusion: The MHFA training package was delivered with reasonably high fidelity, and a staff peer support service was established with general, but not complete, adherence to guidelines. In some schools insufficient staff received MHFA training and levels of delivery of the peer support service compromised intervention dose and reach.

We have seen longstanding research interest in diverse nature-society relations, including contentious debates regarding what nature is, the role of humans within or apart from it, and how varied types of non-human nature shape different societies and individuals within society. Within this work, relatively little attention has been paid to an important aspect of nature experienced everyday; people’s “weather-worlds”. These encompass the qualities of sensory experience that are shaped by fluxes in the 2 medium – the air – in which we routinely live and breathe. Such currents, forces and pressure gradients underwrite our capacities to act and interact with both the animate and inanimate materials and beings we encounter as we negotiate our everyday lives. We focus on these weather worlds here, drawing on the findings of an in-depth qualitative study exploring how people with varying forms and severities of sight impairment describe their nature experiences; with the weather emerging as an immediate and often highly visceral form of everyday nature encounter amongst all participants. We reflect on the ephemeral qualities of people’s weather-worlds, highlighting their potential to comfort, invigorate and connect, but also to disorientate, threaten and isolate, at times supporting moments of wellbeing, at others exacerbating experiences of impairment and disability. In doing so, we highlight how attending to the weather is essential if we are to fully understand people’s emplaced experiences of wellbeing, impairment and disability with(in) diverse forms of multi-elemental, assembled ‘nature’.

BACKGROUND: Swallowing dysfunction after radiation treatment for head and neck cancer can be devastating. A randomized control trial compared swallow exercises versus exercise plus neuromuscular electrical stimulation therapy and found no overall difference in outcomes. METHODS: Quality of life, diet, and swallowing variables collected at discrete intervals on 117 patients were re-analyzed to test the hypothesis that shorter time between completion of radiation therapy and beginning the swallowing therapy program yielded improved outcomes. RESULTS: At baseline, subjects less than 1 year post radiation had significantly better function than subjects more than 2 years post RT in several measures. Over the therapy program, the early group showed significant improvement in diet and QOL. Swallowing physiology variables showed no difference between groups. CONCLUSIONS: Beginning a swallowing therapy program within one year of completion of radiation therapy demonstrates more consistent improvement in quality of life and diet performance compared to later time periods.

Growing cross‐disciplinary interest in understanding if, how, and why time spent with nature can contribute to human health and well‐being has recently prompted efforts to identify an ideal healthy dose of nature; exposure to a specific type of nature at a specified frequency and duration. These efforts build on longstanding attempts to prescribe nature in some way, most recently in the form of so‐called “green prescriptions.” In this critical discussion paper, we draw on key examples from within the fields of health and cultural geography to encourage deeper and more critical reflection on the value of such reductionist dose‐response frameworks. By foregrounding the relationally emergent qualities of people's dynamic nature encounters, we suggest such efforts may be both illusory and potentially exclusionary for the many individuals and groups whose healthy nature interactions diverge from the statistical average or “normal” way of being. We suggest value in working towards alternative more‐than‐human approaches to health and well‐being, drawing on posthumanist theories of social practice. We present two practice examples—beach‐going and citizen science—to demonstrate how a focus on social practices can better cater for the diverse and dynamic ways in which people come to conceptualise, embody, and interpret nature in their everyday lives. We close by reflecting on the wider societal transformations required to foster greater respect for embodied difference and diversity.

Platelet clumping is a common occurrence during peripheral blood hematopoietic stem cell (HSC) collection using the Spectra Optia mononuclear cell (MNC) protocol. If clumping persists, it may prevent continuation of the collection and interfere with proper MNC separation. This study is the first to report the incidence of clumping, identify precollection factors associated with platelet clumping, and describe the degree to which platelet clumping interferes with HSC product yield.In total, 258 HSC collections performed on 116 patients using the Optia MNC protocol were reviewed. Collections utilized heparin in anticoagulant citrate dextrose to facilitate large-volume leukapheresis. Linear and logistic regression models were utilized to determine which precollection factors were predictive of platelet clumping and whether clumping was associated with product yield or collection efficiency.Platelet clumping was observed in 63% of collections. Multivariable analysis revealed that a lower white blood cell count was an independent predictor of clumping occurrence. Chemotherapy mobilization and a lower peripheral blood CD34+ cell count were predictors of the degree of clumping. Procedures with clumping had higher collection efficiency but lower blood volume processed on average, resulting in no difference in collection yields. Citrate toxicity did not correlate with clumping.Although platelet clumping is a common technical problem seen during HSC collection, the total CD34+ cell-collection yields were not affected by clumping. WBC count, mobilization approach, and peripheral blood CD34+ cell count can help predict clumping and potentially drive interventions to proactively manage clumping.