Outdoor programs have shown holistic health benefits for participants, with recent evidence indicating that these benefits can extend long after the conclusion of the program. The methods employed in retrospective studies exploring these outcomes are diverse, leading to many different approaches. Furthermore, only a few studies reference a theoretical framework guiding the authors' approach. The primary objectives of this review were to (1) identify the purposes and outcomes from retrospective studies related to outdoor experiences, (2) summarize the methodological characteristics, and (3) compile reported methodological limitations. A Peer Reviewed Electronic Search Strategy (PRESS) was employed to search four prominent databases; Yielding 5206 candidate studies, from which 31 met the inclusion criteria. Data analysis revealed that there were four main study purposes and 22 unique outcomes. Retrospective, longitudinal, and follow-up were the three main methodological designs, with methods exhibiting significant variation and diversity. This review concludes with five suggestions for future research.

IntroductionThe purpose of this study was to investigate the psychometric properties of the remote first aid self-efficacy scale (RFA SES). The RFA SES is a 30-item self-report scale developed in response to emerging evidence showing that self-efficacy is predictive of performance. MethodsTrained alumni from Wilderness Medical Associates (WMA) training courses and less trained students from Laurentian University (LU) were recruited via email to complete an online questionnaire at 2 different periods (T1 and T2). The questionnaire included demographic questions, the 30-item RFA SES, the 10-item Connor-Davidson resilience scale (CD-RISC), and the 10-item generalized self-efficacy scale (GSES). Data analysis included assessment of the dimensionality, reliability, and validity of the scale. ResultsThere were 448 alumni from WMA and 1106 students from LU who participated in the study. The RFA SES demonstrated a clear unidimensional structure. The mean interitem correlation was 0.75 at T1. Test-retest reliability (T1 to T2) was high for both the LU group (intraclass correlation [ICC]=0.90) and the WMA group (ICC=0.92). Moderate correlations were found between RFA SES and CD-RISC (r=0.42, P<0.001), a general measure of resilience, and the GSES (r=0.48, P<0.001), a general measure of self-efficacy. Wilderness Medical Associates participants showed higher mean scores than LU students at T1 (t [569]=16.2, P<0.001). ConclusionsThe RFA SES is a unidimensional, reliable, and potentially valid scale. Further research should focus on item reduction followed by additional tests of reliability and validity.

This study examined student experiences participating in a peer-led three-day wilderness canoe excursion in Northern Ontario, Canada. This program is a mandatory outdoor experience program (MOEP) for third-year students and is the final course in a progressive series of outdoor experiences offered at the beginning of the first, second, and third year. Guided by principles of realist evaluation, the written reflections from consenting students in the 2015 MOEP cohort were analyzed to identify the contexts and mechanisms associated with enjoyment or lack of enjoyment of their trip. These findings will help improve the MOEP program and have implications for similar intentionally led outdoor programs offered at other higher education institutions.

Heart rate variability (HRV) is a psychophysiological variable that is often used in applied analysis techniques to indicate health status because it provides a window into the intrinsic regulation of the autonomic nervous system. However, HRV data analysis methods are varied and complex, which has led to different approaches to data collection, analysis, and interpretation of results. Our scoping review aimed to explore the diverse use of HRV methods in studies designed to assess health outcomes in outdoor free-living contexts. Four database indexes were searched, which resulted in the identification of 17,505 candidate studies. There were 34 studies and eight systematic reviews that met the inclusion criteria. Just over half of the papers referenced the 1996 task force paper that outlined the standards of measurement and physiological interpretation of HRV data, with even fewer adhering to recommended HRV recording and analysis procedures. Most authors reported an increase in parasympathetic (n = 23) and a decrease in systematic nervous system activity (n = 20). Few studies mentioned methods-related limitations and challenges, despite a wide diversity of recording devices and analysis software used. We conclude our review with five recommendations for future research using HRV methods in outdoor and health-related contexts.

The study of mindfulness proceeds from a number of perspectives. Two of the best-known academic conceptualizations of mindfulness are those identified with Kabat-Zinn and Langer. These conceptions, meditative and sociocognitive, have been built from different foundations and have been argued to be quite distinct. However, it has been suggested that they may be related through a shared component of self-regulation of attention. To put this hypothesis to a test, a convenience sample of participants (n = 208) were asked to complete the Five-Facet Mindfulness Questionnaire (FFMQ), Langer Mindfulness Scale (LMS), and the Self-Regulation Scale (SRS), a measure of the self-regulation of attention. These three dispositional measures were shown to be correlated, suggesting that reliance on the capacity to regulate attention in pursuit of a goal is shared by these two approaches to mindfulness. On further analysis, the correlation between FFMQ and the LMS was found to be higher for those participants with the highest SRS scores. The implications of this somewhat counter-intuitive finding are discussed.

Introduction: International service-learning (ISL) excursions involve service work with international communities, coupled with academic learning and reflection for the students involved. There are anecdotal descriptions that this can result in cultural dissonance as part of the learning and service provision process. The Health Promotion Without Borders (HPWB) program at Laurentian University in northern Ontario, Canada, provides undergraduate students with an opportunity to engage in ISL. However, no formal research has investigated HPWB participants' experiences of cultural dissonance. Thus, we used the HPWB excursion in 2017 to answer the research question: "To what extent was cultural dissonance experienced by HPWB participants during their excursion to Mongolia?" Approach: We used a case study approach to investigate HPWB program participants' experiences of cultural dissonance during an ISL excursion to Mongolia from May 21st – June 19th, 2017. During the excursion, participants were engaged in teaching health promotion lessons to women and children in the local communities. The students were required to keep daily journals of their experiences as part of the ISL component. Those journals were then made available for research under informed consent. The lead author then analyzed the transcribed excursion journals and identified and categorized examples of cultural dissonance within the HPWB participants' journals. These categories were reviewed and endorsed by the co-authors. Findings: We identified three categories related to the nature of cultural dissonance that were common for the HPWB participants: (1) Disruption to Personal Values, Routines, and Behaviours; (2) Application of Knowledge and Scope Limitations; and (3) The Role of Existing Relationships and Group Dynamics. Conclusion: Experiences of cultural dissonance were a central characteristic of the ISL excursion to Mongolia. This result extends the emerging literature on cultural dissonance in other ISL contexts. Future research should consider longitudinal and retrospective study designs to identify longer-term impacts and how these relate to the learning process. This could lead to developing an evidence-based theory on how cultural dissonance may enhance or diminish the educational process for ISL participants.

Introduction: The Remote First Aid Self-Efficacy Scale was originally developed as a 30-item self-report instrument designed as an evaluation tool for training providers and a reflection tool for course participants. Remote first aid training courses and programs are designed for remote communities, worksites, and other wilderness contexts involving activities such as recreation, education, and therapy. Self-efficacy refers to the strength of the beliefs a person has in their capacity to organize and take the necessary actions towards any given attainment. The purpose of our study was to measure the reliability and validity of the 15-Item Remote First Aid Self-Efficacy Scale (RFA SES) in French and English populations. Methods: Alumni from SIRIUSMEDx wilderness first aid courses were invited via email to complete either a French or English online questionnaire at two different time periods (T1 & T2). Data collection involved using online questionnaires containing demographic questions, the 15-Item RFA SES, and the 10-Item Generalized Self-Efficacy Scale (GSES). Data analysis involved assessing the scale for internal consistency, test re-test reliability, and concurrent validity. Results: There were 58 French and 47 English alumni respondents from SIRIUSMEDx courses for a total of 105 respondents. Internal consistency was high amongst the French group (alpha = .95) and the English group (alpha = .92). Test re-test reliability was high amongst the French group, (r = 0.78, p < .01), and the English group (r = .92, p < .01). The correlations between the RFS SES and GSES were positive and moderate in the French group (r = 0.53, p < .01), as well as in the English group (r = 0.32, p = .03). Conclusions: Results from this study suggest that both the French and English 15-Item RFA SES are reliable and valid. This shorter 15-item version is now available for use, along with the original validated 30-Item version of the RFA SES. Future research should focus on validation of the scale in other contexts and populations, using the scale as a participant reflection tool, and using it for evaluation of training programs and courses.

A mandatory outdoor experience program (MOEP), involving a three- to four-day outdoor canoe excursion, has been a compulsory university course for undergraduate students for nearly five decades at a post-secondary institution in Northern Ontario, Canada. However, the experiences and perspectives of students who participated in these excursions have not been fully investigated. The aim of this study was to harness the power of storytelling by alumni to improve our understanding of the long-term impact of MOEPs. Using an innovative methodology combining computer-assisted qualitative data analysis (Leximancer) and framing theory, the links between alumni stories became evident through three main interconnected frames: people, activity, and environment. Although there are unique components of the MOEP program described by our participants, the results contribute to the retrospective literature on the critical and memorable features that students recall years after completing an outdoor adventure experience.

As the popularity of International Service-Learning (ISL) excursions continues to grow, there is an increasing need for research that explores these types of experiences. This manuscript focuses on the experiences of the lead author (S.L.D.) while participating in an ISL excursion offered by the Health Promotion Without Borders (HPWB) Program as part of their graduate research. The HPWB Program has facilitated ISL excursions for students in the School of Kinesiology and Health Sciences (SKHS) at Laurentian University (LU) in Canada for over two decades. However, there is limited formal research about the experiences of HPWB participants while completing their ISL excursions. This research addresses this need by using an autoethnographic approach to explore the lead author's HPWB experience. During the lead author's excursion, they confronted many moments of cultural dissonance, which challenged their usual way of thinking. Through critical reflection after their excursion, the lead author realized the defining role those moments of cultural dissonance had on the nature of their ISL experience. The lead author wrote six stories to share their understanding of those cultural dissonance encounters and provide a snapshot of their excursion for the reader to make sense of in their own way. Overall, this research may benefit future ISL participants and coordinators and adds to the sparse literature available on the nature of ISL experiences from the participant perspective using an autoethnographic method.

Real-world food label reading is examined in two laboratory tasks to evaluate the role of cognitive factors in peoples’ willingness and ability to follow therapeutic diets. Participants were asked to repeatedly make decisions about the safety of foods that did or did not contain specified allergen targets; each of 30 foods were presented 15 times in randomized and intermixed orders. At each presentation the safety judgement could be made with or without consulting the food ingredient label. The results imply limitations to reading accuracy, learning, and judgements about that learning. Most participants became less likely to read ingredient lists over time, suggesting that decisions to read is driven by cost-benefit. The findings suggest that despite the improvements to food label formats, people probably choose not to read them as often as they should and will miss seeing target ingredients when they do.

Objective This cross-sectional study examined the self-perceived impact of the COVID-19 pandemic on 2,378 education workers in Ontario, Canada, during the second wave. Methods We examined six domains of functioning as per the short version of the World Health Organization Disability Assessment Schedule-2.0. Participants selected if their functioning had improved, remained unchanged or worsened during the pandemic for each item. Results Educational workers described a general worsening of functional activities since the beginning of the pandemic. Moderate-to-extreme challenges were reported for all six functional domains. These challenges appeared to aggravate functional challenges for workers with disability, as indicated by pre-existing work accommodations. Older participants reported worse mobility than younger participants; however, they appeared to have better coping skills in learning new tasks and maintaining friendships. Women were more likely to report difficulties in maintaining household responsibilities. Conclusions We consider the role of mental health challenges and pre-existing inequality as predictors of pandemic-related difficulties. Recommendations include more longitudinal research in this population and policymakers to incorporate a health promotion lens to support their education workers more proactively.

Objective: Patients who are fully recovered from a concussion may still be more vulnerable in the face of subsequent concussions. This study examines symptoms associated with repeated concussions in young and otherwise healthy adults. Design: Cross sectional. Setting: Institutional study at a university setting. Participants: University students with a history of concussion. Independent Variables: Participants were grouped based on numbers of concussions. Main Outcome Measures: The impact of incremental concussion on symptom clusters in Sport Concussion Assessment Tools 5 and Spearman ranking correlation coefficients between symptom clusters. Results: One hundred thirty-five participants reported having had 1 concussion, 63 reported 2 concussions, 50 reported 3 concussions, and 43 reported 4 to 6 concussions. Total severity scores over the range of concussion number (1, 2, 3, and greater than 3) did not show a clear incremental effect. However, average scores of cognitive symptoms rose with each subsequent concussion (P ≤ 0.05). The largest incremental effect observed was that of second concussions on emotional symptom scores (t = 5.85, P < 0.01). Symptoms in the emotional and cognitive clusters were the most correlated regardless of the number of reported concussions; the correlations were lowest with symptoms associated with sensitivity to light or noise. Conclusions: The incremental rise of cognitive symptom scores with each concussion affirms the importance of cognitive impairment in concussion assessment and implies a cumulative brain vulnerability that persists even after symptom resolution. The cognitive-emotional symptom clusters may reflect underlying concussion-induced impairments in the corticostriatothalamocortical (CSTC) networks, although sensitivity symptoms are potentially attributable to different neural correlates.

In the Sternberg item recognition task and its variants, an individual's mean reaction time increases with the number of items to be retained in the memory set. An increase in reaction time has also been seen when a secondary task was added. The usual interpretation for this increased reaction time is that adding cognitive load makes tasks more difficult. In a series of three experiments, we manipulated cognitive load through increases in the memory set or through a second task. In each experiment, high cognitive load was associated with higher mean response times but a reduced slope, based on the target position in a series of probes. Thus, in a Sternberg task with multiple word targets and multiple word probes, participants searched more efficiently per probe under high load than under low load. This pattern was replicated with the addition of a working memory task requiring participants to calculate a cumulative price based on the price per target word item. By considering both initial response times and reaction time slopes in large memory sets, this study provides a challenge to the traditional interpretation of cognitive load effects on search performance.

In this paper, I (S. L. Deibert) share my story of discovering the relationship between reflexivity, autoethnography, and yoga through a meaningful experience. Yoga has been an important influence on my physical and mental well-being for over a decade, but I did not consider its implications in my academic life until I was asked to write a reflexive assignment for a course. The task was exploring who I am in connection to my master's thesis project; the challenge was finding a starting point for my reflexive journey of self-discovery. Frustrated by the latter, I turned to yoga for refuge; instead of escaping the assignment, I found that my quest for self-exploration was intertwined with my yoga practice. The purpose of this paper is to delve further into my experience with yoga as a medium for developing reflexivity. Using autoethnography, I share my journey of developing critical thinking through a narrative related to my yoga class experience. Linking my research to my yoga practice allowed me to better understand myself as a person and researcher, become mindful of how my own views shape my experiences, and develop a deeper level of critical reflection. Overall, this work demonstrates the experience of a connection between yoga, reflexivity, and autoethnography, and adds to the sparse literature exploring the intersection of these three.

Foot-transmitted vibration (FTV) is an occupational hazard in construction, forestry and mining which places workers at risk of vibration-induced white-foot. A universally accepted measurement protocol (MP) for evaluating FTV exposure does not exist. As such, the purpose of this study was to determine the inter-rater and intra-rater reliability of the selected FTV-MP using different research assistants (RA) to take the FTV measurements. Preliminary tests evaluating changes in measured FTV using different accelerometer mounting locations and orientations, participant standing postures, time of day of measurements and trial duration. The results of this testing, combined with results from literature using a laser Doppler vibrometer at 24 anatomical locations on the foot, developed an FTV-MP requiring the use of two accelerometers secured to the platform and two to the right foot (first metatarsal head and medial malleolus), to capture anatomical locations with the highest and lowest transmissibility. RA repeatedly attached the accelerometers to the platform and participants as previously described. Inter- and intra-rater reliability was assessed for all vibration measures using intraclass correlation (ICC) tests and three raters. ICCs revealed reliability coefficients in the range of ‘good’ reliability for 3 of the 4 measurement locations and moderate reliability at the ankle (r.m.s. acceleration).

To facilitate research and safety studies, it is desirable to identify the minimum number of measurement points needed to characterize the biodynamic response of the foot to vibration exposure. In previous experiments, transmissibility measurements were taken at 24 anatomical locations on the foot when 21 participants were standing with their centre of pressure (COP) in a natural, forward and backward location. Multiple correspondence analysis was performed using the peak transmissibility magnitudes from these data in order to identify clusters of behaviour that might be used to reduce the total number of measurement locations. Peak transmissibility was analysed based on two magnitude thresholds: at 2.0 (100% amplification of the input signal), and at 2.5 (150% amplification). Results indicate that transmissibility measurements at the nail bed of the first phalange (T1P1), the head of first metatarsal (T1P3), the head of second metatarsal (M1), and the lateral malleolus (L4) may be sufficient to effectively measure foot-transmitted vibration across the range of COP locations analysed (natural, forward and backward). A reduced measurement set for capturing the biodynamic response to foot-transmitted vibration exposure will allow for more practical laboratory and field measurements, reducing equipment set-up and exposure times for participants/workers.

Outdoor adventure education programs often feature common elements, such as backcountry settings, small group sizes, and different levels of challenges. A mandatory outdoor experience program (MOEP), offered at a Canadian university for nearly 50 years, involved a three- to four-day wilderness canoe excursion. Research related to outdoor orientation programs offered at universities has identified a number of positive outcomes related to personal growth, sense of belonging, and improved academic performance. However, little is known about longer-term impacts, and how alumni perceive the experience years later. The purpose of this study was to address this gap by providing insight into alumnis' perspectives of the importance of their participation in a MOEP. This mixed methods study comprised data collection using an online self-report questionnaire with a combination of closed- and open-ended questions to explore the importance of the MOEP as a student, and in life after graduation. Data analysis involved: (1) two thematic analyses of the reasons for importance of the MOEP; and (2) two regression analyses using visual analogue scales of MOEP importance. There were 167 respondents, and the majority provided positive reflections of the importance of their experiences that occurred from 1969 to 2016. Group bonding, learning, lifestyle, nature, challenge, memories, enjoyment, leadership, growth, confidence, and career were identified as themes in participant responses. Logistic regression analysis revealed group bonding (p =0.003) to be significantly important during life as a student, while being francophone (p =0.033) and lifestyle (p =0.000) were significantly important in life after graduation.

This study looks at the experiences of organizations that have fallen victim to ransomware attacks. Using quantitative and qualitative data of 55 ransomware cases drawn from 50 organizations in the UK and North America, we assessed the severity of the crypto-ransomware attacks experienced and looked at various factors to test if they had an influence on the degree of severity. An organization’s size was found to have no effect on the degree of severity of the attack, but the sector was found to be relevant, with private sector organizations feeling the pain much more severely than those in the public sector. Moreover, an organization’s security posture influences the degree of severity of a ransomware attack. We did not find that the attack target (i.e. human or machine) or the crypto-ransomware propagation class had any significant bearing on the severity of the outcome, but attacks that were purposefully directed at specific victims wreaked more damage than opportunistic ones.

The study of mindfulness proceeds from a number of perspectives. Two of the best-known academic conceptualizations of mindfulness are those identified with Kabat-Zinn and Langer. These conceptions, meditative and socio-cognitive, have been built from different foundations and have been argued to be quite distinct. However, Hart, Ivtzan and Hart [1][1] suggested that self-regulation of attention is a mediator between the two. To put this hypothesis to a test, a convenience sample of participants (n = 208) were asked to complete the Five Facet Mindfulness Questionnaire (FFMQ), Langer Mindfulness Scale (LMS), and the Self-Regulation Scale (SRS), a measure of the self-regulation of attention. These three dispositional measures were shown to be correlated. Self-regulation passes a statistical test for partial mediation of the relationship between the two measures of mindfulness. This suggests that reliance on the capacity to regulate attention in pursuit of a goal is shared by these two approaches to mindfulness. However, there is no clear conceptual basis for mediation in either particular direction. Further, the correlation between the LMS and FFMQ is highest for those with the highest SRS scores; we discuss the implications for conceptual distinctions within mindfulness. [1]: #ref-1

The present study was conducted to evaluate the reliability of the FOCUS© (Focus on the Outcomes of Communication Under Six). The FOCUS© is intended to measure the functional change in real-world communication associated with speech-language therapy. Clinicians administer this test by interviewing parents before and after treatment. The inter-rater reliability of detected change was high when evaluating preschool children (n = 13). Results indicate that this measure is reliable for both practical and research purposes. The necessity of establishing reliability is discussed, as are limitations of the FOCUS©.