In Denmark, there are increasing problems with school refusal and marginalization of vulnerable youth. At thesame time, joint gaming activities may have a positive influence on young people's social relationships and experience ofbeing part of communities. In this article, we focus on how esports education with games such as Counter-Strike and Leagueof Legends can contribute to engaging vulnerable and isolated young people (age 16-25) at Specially Planned Youth Education(STU). Specifically, we look at how esport teachers and municipal educational guidance counsellors experience the isolatedyoung people's participation in gaming activities as a process of social inclusion that helps young people to cross boundariesbetween different domains - e.g. leisure, education and/or internship. Our analyses are based on interviews with teachersand guidance counsellors affiliated with three STUs, who are participating in the research project "Esports as a learning spaceand bridge builder for vulnerable young people at STU". We understand the young people's participation in esports educationas a process of social inclusion, which involves bridging of experiences across different domains that have specific knowledgepractices and social norms for what counts and does not count as legitimate participation. More precisely, we understandesports education at STU as social inclusion through an interplay of four domains: 1) the young people's gaming domain intheir leisure time, 2) the STU as an educational domain, 3) the young people's adult domain, as well as a 4) guidance domain.Based on thematic analysis of the interview data, we identify three themes: 1. Esports education as an introduction to STU,2. Esports education as a safe and structured framework, and 3. Esports education as a springboard to participation in newcommunities. Lastly, we discuss the potentials and challenges of social inclusion of vulnerable youth through esportseducation.

The impact of social media on young people's body perception, eating behaviours and diet literacy has become an increasingly important public health issue. In this cross-sectional study, the interactions between social media addiction, e-healthy diet literacy, weight-related self-stigma and orthorexia nervosa were examined in depth The study was conducted between January and March 2025 with 651 young people at a state university in Turkey. Participants were administered a general information form, the e-Healthy Eating Literacy Scale, the Bergen Social Media Addiction Scale, the Orthorexia Nervosa Inventory, and the Weight Self-Stigma Scale. Participants' level of social media addiction was positively correlated with e-healthy eating literacy (r = 0.121, p = 0.002), total orthorexia nervosa score (r = 0.150, p < 0.001), and weight-related self-stigma (r = 0.229, p < 0.001). According to multiple regression analysis, weight self-stigma score (β = 0.385, p < 0.001) and e-healthy diet literacy score (β = 0.176, p < 0.001) were found to be significant predictors of orthorexia nervosa and explained 22.6% of the model variance (R²=0.226, F = 48.556, p < 0.001). On the other hand, social media addiction (β = 0.166, p < 0.001), orthorexia nervosa (β = 0.358, p < 0.001) and BMI (β = 0.257, p < 0.001) were significant variables predicting weight self-stigma and the model explained 28.6% of the variance (R²=0.286, F = 64.663, p < 0.001). In conclusion, it has been observed that young people's knowledge and experiences in the digital environment can influence their eating behaviour not only at the cognitive level but also at the psychosocial level, and the need for comprehensive interventions targeting body image, weight stigmatisation and digital media policies has been emphasised.

BackgroundEnd-of-life communication as part of advance care planning (ACP) aims to support older people to reflect on their values, needs, and wishes regarding the end of life. Previous studies have provided an understanding of the important aspects (“fundamentals”) of end-of-life conversations with older people from the perspective of nursing staff. Developing further understanding of the experiences and needs of older people and their family caregivers will help identify gaps in communication, guide nursing staff in providing successful ACP, and ultimately enhance person-centered care. We aimed to explore the experiences of older people and their family caregivers in home, nursing home and hospital settings regarding the fundamentals of end-of-life communication as part of ACP by nursing staff.MethodsSemi-structured interviews were performed with older people and their family caregivers about their experiences, opinions, and preferences before, during, and after recent formal end-of-life conversations. Data were analyzed thematically.ResultsEight older people and four of their family caregivers participated in three dyadic and six individual interviews between June 2023 and May 2024. Overall, participants felt it was difficult to describe and evaluate their experiences with the end-of-life conversations because they initially had no specific expectations about end-of-life conversations and approached them with an open mind. Three overall themes were composed comprising 11 fundamentals of end-of-life communication: “Navigating conversational phases: probing and reflecting” (e.g., readiness), “Fostering recognition and relational safety: acknowledging the older person” (e.g., feeling at ease, feeling seen while nursing staff attune to the older person, feeling a human connection), and “Engaging with family caregivers: valuing their role and well-being” (e.g., considering their well-being).ConclusionOlder people and their family caregivers prioritize feeling comfortable in natural and humane end-of-life conversations. They want to be seen, heard, and acknowledged as individuals with backgrounds, values, and needs, not just as patients with a disease. Nursing staff should be aware of the expectations of an older person and family caregiver in end-of-life communication and adjust their approach accordingly. The results of this study can help in developing effective strategies to ensure that end-of-life communication is tailored to the unique needs of older people and their family caregivers, fostering an informed approach.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12912-025-03882-4.

People with disabilities, who make up 1.3 billion globally, frequently face systemic exclusion from healthcare due to a range of barriers. This qualitative study explored the healthcare access experiences of 30 adults with disabilities in Bahir Dar City, Ethiopia, aiming to identify barriers, facilitators, and context-driven solutions. Both purposive and snowball sampling was conducted to identify participants. In-depth interviews were conducted in the local language. Data were analysed using reflexive thematic analysis in NVivo 14, guided by the Missing Billion Health System Framework service delivery components. The study identified five key themes each for barriers, facilitators, and coping strategies. Major barriers included low health literacy, unaffordable care, negative provider attitudes, inaccessible infrastructure, and lack of assistive technologies and rehabilitation services. Facilitators included family support, community-based health insurance, disability-sensitive training of healthcare workers, presence of a rehabilitation centre, and initiation of renovation infrastructure in model facilities. Participants proposed actionable strategies such as increasing awareness, insurance coverage, local production of assistive technologies, assigning personal assistants in health facilities, improving accessibility, and establishing disability units within governance structures. People with disabilities experienced persistent, intersecting barriers to healthcare access in Ethiopia. However, scaling disability-inclusive training, infrastructure improvemnts, and governance reforms—rooted in lived experience and aligned with human rights of people with disabilities—can help drive progress toward Universal Health Coverage.

ABSTRACT Research on sexuality and gender diverse people has focused largely on experiences of people from a single minority group. According to the minority stress theory, people who belong to multiple minority groups may experience accumulated stress from multiple microaggressions and systemic discrimination, which may lead to different experiences of key milestones, such as “coming out.” These experiences may be intensified for those who also have non-normative relationship structures, such as open relationships. This qualitative study explored how a sample of five Latino and South-east Asian gay men living in Australia navigated the disclosure of their open relationships. Using thematic analysis of verbatim transcripts, four superordinate themes were identified: concern with others’ judgment, self-stigma, open relationship concealment, and social support. Open relationships were revealed to limited audiences, while intimate support for a decision believed outside normative and socially acceptable boundaries was still sought. Disclosure decisions were associated with distal stressors (others’ judgments) and proximal stressors (self-stigma), influenced by religious and cultural considerations and the dominance of mononormativity in shaping relational expectations. Findings support the continued utility of minority stress theory and may raise awareness about alternative relationship structures, challenge misconceptions related to them and encourage cultural literacy and cultural competence in clinical psychologists.

Trans* new materialism (TNM) is a relatively recent trend in trans studies which attempts to conjoin analyses of transness with insights from posthumanism and animal studies. As of yet, it represents the most substantial corpus of literature engaged with fostering connections between trans people and animals. TNM has, however, come under criticism from within trans studies. Andrea Long Chu provocatively called it “the worst possible direction for trans studies to go in” and authors like Kadji Amin and Josch Hoenes warn that TNM runs the risk of decentring actual lived experiences of trans people and neglecting the specific historical situatedness of power structures. Rather than dismissing TNM’s project of fostering trans-animal connections, I am interested in addressing the concerns of TNM’s critics by linking the struggles of trans people and animals in a historical materialist way. In this paper, I create such an analysis by drawing on Gabriel Rosenberg’s work on the US agricultural youth organisation 4-H and the heteronormative family farm. Extending the purview of Rosenberg’s account to include cisnormativity, this case study reveals that: firstly, the elimination of transness from the bodies of rural youth via 4-H and the family farm was inextricably tied to the capital-intensification of agriculture in the early twentieth century, which aggravated animal domination both qualitatively and quantitatively; and, secondly, the normalisation of children’s bodies according to a eugenic ideal of healthy, white, hetero, and cis bodies was informed by the biopolitical governance of animals and vice versa. Reproduction signified a vital link between the two.

Apartheid is clearly defined as a crime against humanity under international law, involving inhuman(e) acts committed in the context of systematic oppression and domination by one racial group over any other. The term apartheid has long been used to describe the experience of the Palestinian people. Despite its increased use in recent years, the term "medical apartheid" has not been as formally defined by public health bodies. In this article, we use a settler colonial lens to track the formation and expansion of health care services in Palestine/Israel that has mirrored the current reality of systematic oppression and domination, where Jewish Israelis and Palestinians across fragmented geographies enjoy differential access to the full enjoyment of their right to health. We examine the development of the health care services accessible to Palestinians to explore larger notions of statehood/statelessness, (denial of) sovereignty, citizenship, de-development, dependency, humanitarianism, and aid as they shape the life, health, illness, and death of Palestinians. By exploring the historical events that led to the formation of separate and unequal health care systems, built by and for different populations in Palestine/Israel, we identify the contours of Israel's medical apartheid system.

Research capturing the experiences of disabled people in physical education (PE) is on the rise. However, the available literature has given less consideration to disabled people representing various racial and ethnic groups. As such, the purpose of this study was to examine the intersubjective experiences of inclusion of Latina and Latino blind and visually impaired students in PE and the meanings ascribed to those experiences. The research approach was interpretative phenomenological analysis. Seven adults (two females and five males; 18–29 years of age) who identified as Latina or Latino, blind or visually impaired, and had previous experiences in integrated PE in the United States or its territories participated in this study. The analytical thematic development followed a four-step approach informed by the research design. Based on the analysis, the following three interrelated themes were constructed: (a) “They didn’t know what to do with me”: Teachers as barriers to feelings of inclusion, (b) “I wanted to be part of the group”: Social interactions, peer relationships, and sense of belonging, and (c) “Making my life easier is the best option”: Self-agency and empowerment to experience inclusion. The findings reported in this retrospective study are consistent with those in other geographical regions. Nonetheless, one key aspect is that some participants demonstrated resistance toward their experiences of exclusion, leading to a self-agency to demonstrate their presence in PE.

To examine how people perceive and experience humiliation, we analysed 2635 narratives from 1048 participants, capturing definitions of humiliation and accounts of humiliating situations. The findings reveal that humiliation is perceived as both an interactive event and an emotional resolution process, that the impact on the self (whether individual or collective) depends on whether humiliation is experienced personally or vicariously; and that agency-related devaluations were more prevalent than communion-related devaluations in both defining humiliation and recalling personally humiliating situations. In an attempt to capture the variety of definitions of humiliation and recollections of humiliating situations as interactive experiences involving emotional and behavioural resolution processes, we propose (drawing on self-discrepancy theory) that humiliation can be conceptualised as the experience of a discrepancy between a person’s actual/other self-concept (i.e. how they believe significant others perceive them) and their actual/own self-concept (i.e. how they perceive themselves). We argue that this conceptualisation holds significant potential not only to capture the diverse nature of humiliation experiences but also to contribute to ongoing efforts to deepen our understanding of the underlying psychological processes.

Disability remains a largely invisible component of diversity within the nursing profession due to a lack of comprehensive data collection and ongoing systemic ableism. This article explores the multifaceted experiences of nurses with disabilities through an intersectional lens, illustrating how disability intersects with other marginalized identities to create unique and compounded barriers. Drawing on the authors' personal narratives, one with an apparent physical disability and the other with a nonapparent, dynamic disability, the paper highlights how disabled nurses navigate intersectional discrimination, exclusion, and invisibility in both educational and professional settings. Emphasizing that disability is a natural part of human diversity, this article calls for nurses and professional nursing organizations to reimagine equity, diversity, inclusivity, and belonging to include the experiences of people with disabilities and to ensure access in nursing.

Borderland identities transcend conventional conceptualizations of their identity category and challenge prevalent social theories underlying a given identity domain. The experiences of people with borderland identities differ from the experiences of people with conventional dominant or marginalized identities. Since Anzaldúa advanced her original 1980s theory of borderland identities focusing on the Chicano experience in the U.S., humanities and social sciences scholars have applied borderland theory to understanding experiences of gender, race, and sexuality. However, to date, no review has been conducted to integrate findings across the field of social psychology and highlight potential areas of growth. This paper aims to do so by mapping the literature on four borderland identities: asexual, bisexual, gender non-binary, and Multiracial. We discuss previous findings around three common themes: categorization, discrimination, and identity development. Common findings, remaining questions, and future directions are highlighted. Finally, we consider both theoretical and practical implications of a borderland identity perspective for the field of social psychology.

ABSTRACTBackgroundFacilitated telemedicine is highly effective for hepatitis C virus (HCV) treatment among people with opioid use disorder (OUD). However, the long‐term impact of sustained virological response (SVR) through this model of treatment remains unexplored. We examined how people with OUD perceive SVR achieved through facilitated telemedicine.MethodsWe conducted two focus group discussions (FGDs) with nine participants at least 5 years post‐SVR through a randomised controlled trial of facilitated telemedicine in opioid treatment programmes (OTPs) (New York State, 2018–2020). Eligibility required active OTP enrolment at the time of FGDs. We used a semi‐structured interview guide and performed thematic analysis of FGD transcripts.ResultsParticipants had a mean age of 52.6 years (SD = 13.7), 66.6% were male, and 88.8% identified as White. We identified three FGD themes, each corresponding to pre‐, during and post‐intervention phases (see Figure 1): (1) Attitudes towards HCV and barriers to treatment among people with OUD, (2) Embracing facilitated telemedicine for HCV care integrated into OTPs, and (3) Experiencing long‐term benefits from facilitated telemedicine across all aspects of HCV care and overall well‐being. Barriers included competing priorities, perceiving HCV treatment as a low priority, and insurance restrictions (Theme 1). Participants valued facilitated telemedicine for its convenience, empathetic clinicians, and one‐stop shop approach (Theme 2). At least 5 years post‐SVR, participants reported benefits in HCV knowledge, improved OUD recovery, and improvement in whole health (Theme 3).ConclusionAt least 5 years post‐SVR, people with OUD reported improvements in OUD recovery, overall well‐being and sustained satisfaction with telemedicine‐based HCV care. These findings highlight the lasting impact of both an SVR and care delivery through facilitated telemedicine.Patient and Public ContributionIn this study of patient involvement, we conducted focus groups with patient‐participants to examine the long‐term impact of receiving HCV care through facilitated telemedicine integrated into OTPs. Participants had previously taken part in a randomised controlled trial of facilitated telemedicine (New York State, 2018–2020). At least 5 years after achieving an SVR, we sought participant feedback to evaluate the long‐term impact and sustainability of facilitated telemedicine as an approach to achieve an HCV cure with the objective of informing future policy development. Participants had also contributed critical input at various stages of the original study's design and implementation. During the pilot phase, participants advocated for facilitated telemedicine in a testimonial video. Participants provided feedback on design and implementation by participating in planning and site initiation meetings. A Patient Advisory Committee ensured participant voices were integrated into the research process by representing their feedback on study conduct. Additionally, a Sustainability Committee supported public involvement by promoting educational opportunities, providing input on implementation, and addressing long‐term sustainability considerations.

Children and young people are facing increasing mental health challenges. Access to emergency mental health care for young people is under-researched and poorly understood. Police data indicates a rise in youth mental health emergency calls, but officers often feel unprepared to support young people in crisis. Mental health practitioners have the experience and training to provide helpful support to young people in crisis, although the availability of mental health services for young people can be limited during evenings and weekends, especially in rural areas. We know that children and young people can benefit when police and mental health services work together. However, we need to better understand the full range of impacts of joint responses for young people and their families and how these impacts are generated. Joint emergency response is a complex intervention, and a realist synthesis was chosen as it can make sense of such interventions. Therefore, this realist synthesis aims to develop a programme theory of the underlying generative mechanisms by which, and contexts within which, emergency responders collaborate and co-respond to support young people experiencing a mental health crisis. We will follow five steps to undertake the realist review: (1) Define the review scope, (2) develop initial programme theories, (3) conduct an evidence search, (4) select and appraise evidence, and (5) extract and synthesise data. Embase, CINAHL, Social Policy and Practice, MEDLINE, PsycINFO, and AMED databases will be searched up to June 2024, supplementing searches with citation tracking, grey literature, relevant NHS England guidance, and practitioner interpretation workshops. Data selection will be based on relevance and richness. Data will be extracted and synthesised iteratively, and causal links between contexts, mechanisms, and outcomes will be illuminated in the process. The results will be conducted and reported according to the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards. Findings will be disseminated to the research community through conference presentations and a peer-reviewed journal article. We will work with healthcare and police organisations, as well as professional and expert-by-experience stakeholder groups, including commissioners, to develop a strategy for far-reaching dissemination with impact to share findings across a range of audiences. This study will develop a programme theory regarding how emergency responders collaborate to support young people experiencing mental health crises. Findings will inform future practices, aiming to improve collaborative responses and outcomes across youth contexts. PROSPERO CRD42024542081.

Obesity is a chronic, multifactorial, and relapsing disease. This condition is the result of a complex interplay of biological, psychological, social, environmental, and genetic factors. Management in primary care requires a comprehensive, individualized, and interdisciplinary approach centered on the lived experiences of people living with obesity. Therapeutic patient education, early screening for complications, and addressing weight stigma are essential pillars. Pharmacological and surgical options can be valuable, but only as part of a structured, long-term care plan. The primary care physician plays a key role in rebuilding trust, supporting motivation for long-term behavioral changes, and coordinating care within an interdisciplinary network.

Background A disproportionate number of transgender and nonbinary people are autistic, and research suggests that trans autistic people experience significant barriers and challenges to accessing gender-affirming care. Much of the existing research in this area focuses on determining why trans people are more likely to be autistic, and less research has attended to trans autistic people’s lived experiences of accessing gender-affirming care. Methods To better understand these barriers and their impacts, I conducted qualitative interviews with 12 trans autistic people who had recently accessed gender-affirming medical care in the province of Ontario, Canada. Interviews were analyzed using reflexive thematic analysis. Results Participants reported being frequently not believed, listened to, or taken seriously by healthcare providers, which I conceptualize as instances of epistemic injustice. I identify how medical discourses, ideologies, and clinical guidelines create conditions for gender-affirming care in which trans autistic people experience pervasive epistemic injustice. For example, participants felt pressure to conform to a transnormative and neuronormative narrative in order to be taken seriously by gender-affirming care providers. Some providers misinterpreted autistic communication styles and unfairly discredited their client’s knowledge, eroding their trust in health care. While participants used creative self-advocacy strategies to access care, some providers felt threatened by this challenge to their epistemic power and medical authority. Conversely, participants also had positive experiences of epistemic justice when providers took their knowledge and lived experience seriously. Conclusion I argue that gender-affirming care providers must practice epistemic humility by listening deeply and acknowledging the limits of their knowledge to deliver patient-centered care for trans autistic people. Systemic changes to the healthcare system and disrupting transnormativity and neuronormativity are necessary to improve trans autistic people’s experiences of gender-affirming care and enable epistemic justice.

This study, co-produced by a team of academics, lived experience researchers and clinicians, explores the views and experiences of people who have been compulsorily detained in hospital under the Mental Health Act (1983) (MHA) in England, to understand how and why, from their perspective, compulsory detentions occur, and what might help prevent them. Semi-structured qualitative interviews were conducted with 20 people (55% male, 40% Black/Black British, 30% White British) who had been compulsory detained in hospital within the past 5 years. Lived experience researchers with relevant personal experience carried out interviews via telephone or videoconference and participated in analysis of data via a template approach. We derived three over-arching themes from interviews. The first theme “Individual factors increasing or reducing likelihood of being detained” encompassed factors related to people’s own lives and attitudes, including life stressors, not taking medication as prescribed, the risk individuals may pose to themselves or others, and their attitude to and management of their mental health. The second theme “Family and Social Network” reflects how attitudes and quality of support from family, friends and social network may contribute to compulsory detentions or help people to stay well. The third theme “Need for improvement in Service Responses” identified limitations of services that contribute to detention, including lack of collaborative care and choice, poor quality of professional support, and discriminatory attitudes from staff. Each theme also included potential approaches to addressing these limitations and reducing compulsory detentions. Findings suggest multiple interacting factors may lead to people being detained in hospital under the MHA, and that improvements to services, such as increasing collaborative care and service user-led family involvement, could prevent further detentions.

Mental disorders, especially depression, are becoming increasingly common in society, but are often underestimated because they are not physically visible. Depression is characterized by deep sadness, loss of hope, helplessness, difficulty concentrating, and even thoughts of suicide. This phenomenon inspired the creation of Kecil?, an experimental fiction work based on 360⁰ Virtual Reality (VR), which aims to convey the emotional experiences of people with depression in an immersive way. The film tells the story of an individual who personifies his internal conflicts through imaginary characters, depicting an inner struggle related to existential questions about birth, life, and death. The film creation process was carried out systematically through the stages of development, preproduction, production, and post-production, including idea development, visual observation, concept design, location selection, casting, controlled improvisation staging, lighting arrangements, and shooting using the point of view (POV) technique with an Insta360 X3 camera. The post-production stage involves editing long takes and using visual effects such as Content-Aware Fill and Masking to maintain visual continuity and enhance the film's aesthetics. The results of the study show that Kecil? successfully represents the emotional experiences of people with depression in depth. The careful use of mise-en-scène, cinematography, lighting, sound, and staging allows the audience to feel the main character's cathartic process and understand the complexity of the feelings of individuals with depression. The 360⁰ VR approach increases audience engagement directly, opens up space for dialogue, reduces stigma, and emphasizes the importance of community support for mental health. This film proves that film media can be an effective educational tool and mental health campaign, highlighting that mental health issues, though seemingly minor, have a significant impact if ignored.

Visual depictions of designed/proposed spaces communicate their intended qualities, use, and users, but visualizations that fail to include a fair representation of the people for whom the spaces are designed can create barriers, both real and imagined. A lack of diversity and inclusivity within visuals reflects a disregard for marginalized individuals and a lack of understanding of their needs. Here, we investigated whether an initial focus on the representation of people within design visualizations could be an effective pedagogical tool to introduce and aid further development in student understanding of Diversity and Inclusion more broadly, and how these can impact the practice of Interior Architecture and Design to create more truly inclusive spaces. Our workshops focused on the effects of visual representation, unconscious bias, and inclusion/exclusion; the range of individual characteristics to consider when developing designs; and how to engage with potential users via co-creation. We also used writing activities to enhance reflection and empathy, providing guidance on developing diverse and inclusive human representations. Collection of quantitative and qualitative data from two cohorts of undergraduate Interior Architecture &amp; Design students who took part in our interactive workshops via a hybrid setup allowed us to observe three main outcomes from workshop participation: improved understanding of the importance of visuals in communicating social and political aspects of designed spaces; increased consideration of the characteristics of inhabitants for whom spaces are designed; and improved confidence in engaging with marginalized communities. Our workshops also led to a deeper understanding of ways in which different group characteristics and identities intersect to influence how people experience and use designed spaces, and to the successful application of this knowledge to subsequent student projects. We conclude that an initial focus on diverse and inclusive visual representations of people appears to be an effective approach to facilitating the use of more inclusive practices throughout the entire design process.

Abstract Globally, wetland conservation is impeded by a lack of public awareness, appreciation and advocacy for these conservation‐dependant environments. To address this issue, the global policy response has increasingly focused on provisioning meaningful experiences for people in wetlands. However, this relies on an understanding of how people actually experience wetlands and how these experiences relate to their awareness and appreciation (or lack thereof) of these environments. Human–nature connection theory has emerged as a framework through which to explore peoples' experiences of and appreciation for nature. The human–nature connection framework is used here to study peoples' experiences in wetlands of Tasmania, Australia, with a focus on understanding how these experiences can inform policy and practice. On‐site semi‐structured interviews were conducted with 62 participants in 14 wetlands of diverse types and settings across Tasmania. Qualitative analysis of interviews revealed five themes and 12 subthemes which were structured into three levels based on how themes related to each other. Results revealed insights into visitors' immediate direct experiences with nature in wetlands, both positive ( Muddy Marvels ) and negative ( Dismal Swamps ). There was also a clear indication of how visitors responded towards other visitors ( Paradise for the Recluse ), as well as their views towards potential development of the wetland ( Nature for Nature ). Prevailing lack of ecological consciousness was also apparent with wetlands being Hidden Landscapes . These findings reveal important insights into these diverse and conflicting experiences and perceptions that need to be considered for policy and practice in providing visitors with meaningful experiences. Recommendations are made towards (1) provisioning information on wetlands that are accessible; (2) provisioning information on experiences that suit visitor preferences; (3) creating experiences that are targeted, immersive, contemplative and transformative; (4) cultivating an ecological consciousness that can define and distinguish wetlands. Synthesis and applications . policymakers, wetland managers and stakeholders should foster human–nature connections in wetlands by providing meaningful experiences that address diverse and conflicting needs. This involves engaging visitors across experiential, cognitive and philosophical dimensions. Read the free Plain Language Summary for this article on the Journal blog.

Objective:To investigate the experience of people experiencing unsheltered homelessness (PEUH) in meeting their basic needs for food, drinking water, toilet, hygiene, and healthcare in Los Angeles County.Methods:Cross-sectional, in-person health assessment survey (modified HOUSED BEDS instrument) from 2022 to 2023 among PEUH age 18+ years and initiating care with street medicine (N = 665).Results:Few participants reported access to a toilet (23%), shower (44%), primary care (7%), and food (x̅ = 8.3 meals per week ±5.7). Geographical area was associated with statistically significant differences in participant demographic characteristics, access to, and source type of basic resources.Conclusions:Key gaps in access to basic resources for survival for PEUH continue to exist in an urban county where state and local government entities have prioritized addressing homelessness by heavily investing in housing solutions.Policy Implications:Pervasive unmet needs for basic resources among PEUH threatens wellbeing and holds important implications for public health, healthcare providers, and payers. Geographical differences in access to basic resources for PEUH suggests a need for heterogeneous services, resources, solutions, and policies to better support PEUH.