Ecological Bodies and Relational Anatomies: Toward a Transversal Foundation for Planetary Health Education

As planetary health education enters medical and health professional training, transversal implementation across curricula is critical in developing its full potential and enabling future health professionals to meet the social, environmental, and health challenges of current and future generations in an integrated manner. To advance the transversal implementation of planetary health education, our study proceeded through: (1) a sequence analysis of documents framing physiotherapy education to identify relevant nexus points; (2) an explorative implementation of planetary health into foundational anatomy and physiology modules identified as critical nexus points; (3) practical implementation during the 2021 autumn semester. Implementation in the operative foundations of healthcare education—anatomy and physiology—enables the emphasis of the ecological nature of human bodies and interconnection with our planetary environment. Musculoskeletal joints accentuate the relational nature of bodies highlighted across current research and traditional knowledges, as dynamically pervaded and in interaction with culture, technology, objects, ideas, plants, planets, etc. Teaching relational anatomies thus highlights planetary health as the transversal foundation of medical and healthcare education. Making this foundation more explicit will be critical for the transversal implementation of planetary health education and subsequent practice, as well as the fundamental shifts in our understanding of human lives and health they require

Physiopunk Vol 1

Physiopunk emerged out of an introductory public health module for first-year students in the Bachelor program in physiotherapy at UiT The Arctic University of Norway. Throughout the module, students gradually expanded their view of physiotherapy, from its past and present individual and physical health focus toward the integration of social and ecological issues as fundamental determinants of health. Because considering and addressing social and ecological issues is still a novelty in physiotherapy that will require considerable innovation and transformation, students were finally invited to conclude their learning by writing fictional stories about diverse futures for physiotherapy

South African Healthcare Professionals’ Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study

Climate change, biodiversity loss and large-scale environmental degradation are widely recognized as the biggest health threats of the 21st century, with the African continent already amongst the most severely affected and vulnerable to their further progression. The healthcare system’s contribution to climate change and environmental degradation requires healthcare professionals to address environmental issues urgently. However, the foundation for context-relevant interventions across research, practice, and education is not readily available. Therefore, we conducted a convergent mixed-methods study to investigate South African healthcare professionals’ knowledge, attitudes, practices, and barriers to environmental sustainability. Healthcare professionals participated in a cross-sectional questionnaire (n = 100) and in-depth semi-structured focus group discussions (n = 18). Data were analyzed using descriptive statistics and thematic analysis, respectively, and integrated to provide holistic findings. Our results confirm overwhelmingly positive attitudes and a high degree of interest in education, implementation, and taking on more corresponding responsibility, but a lack of substantial knowledge of the subject matter, and only tentative implementation of practices. Identified barriers include a lack of knowledge, resources, and policies. Further research, education, and policy development on overcoming these barriers is required. This will facilitate harnessing the extant enthusiasm and advance environmental sustainability in South Africa’s healthcare practice

Mitigating the environmental impact of NSAIDs - physiotherapy as a contribution to one health and the SDGs

Non-steroidal anti-inflammatory drugs (NSAIDs) continue to be amongst the most frequently used pharmaceutical treatments for mild to moderate musculoskeletal pain globally. In this short communication, we continue to expand the growing field of environmental physiotherapy by tracing NSAIDs journey through aquatic ecosystems, and the potential of physiotherapy to mitigate these negative environmental impacts and so contribute to achieving a range of UN Agenda 2030 Sustainable Development Goals and the aspirations of One Health. Through metabolic excretion into waterways, NSAIDs negatively impact the health and survival of various aquatic lifeforms, which, in turn, has consequences for human health. By reducing and delaying the need for pharmacotherapy for mild to moderate musculoskeletal pain, physiotherapy presents an important sustainable healthcare solution. Beyond this, however, the ecological persistence of NSAIDs also underscores the need for transformative change in healthcare and physiotherapy, towards the full recognition of the interconnected nature of human, animal, and ecosystems health and the complex questions and responsibilities this raises. For this, we need to increase our understanding of the entangled nature of health and its negotiation with human and non-human others and develop approaches to include them in our thinking, pursuit, and practice of health and care

Physiopunk Vol. 1 Speculative fiction for future physiotherapies

In light of today’s deeply connected social and environmental crises, environmental and sustainability education is increasingly being integrated into public health and healthcare professional education around the world (Barna, Maric, Simons, Kumar & Blankestijn, 2020). The Norwegian ‘regulations on national guidelines for physiotherapist education’ clearly support the integration of these topics by stating that ‘in addition to individually oriented work, physiotherapists should contribute to improving public health and the sustainability of society on the group and system-levels…with competencies in interdisciplinary and goal-oriented collaborations within the health- and care-sector and other sectors…to meet societies existing and future needs’ (Forskrift om nasjonal retningslinje for fysioterapeututdanning, 2019, our translation). In a new introductory public health module for our 1st year physiotherapy students at UiT Norges arktiske universitet we therefore integrated education about the social and environmental problems of our time and how they interact with health at many levels to inspire students to imagine novel futures for physiotherapy and the role of healthcare professionals in the future

Physiopunk Vol 1 Spekulativ fiksjon for fremtidige fysioterapier

Dagens sosiale og miljømessige kriser er dypt forbundet med hverandre. Miljø- og bærekraftsutdanning blir derfor stadig mer integrert i internasjonale folkehelse- og helsepersonellutdanninger (Barna, Maric, Simons, Kumar & Blankestijn, 2020). Den norske «Forskrift om nasjonal retningslinje for fysioterapeututdanning» støtter integrering av disse temaene og sier at fysioterapeuter «skal […] bidra på gruppe- og systemnivå for å fremme folkehelsen og samfunnets bærekraft […] med kompetanse i tverrfaglige og målrettede samarbeidsprosesser innenfor helse- og omsorgssektoren og i andre sektorer […] for å møte samfunnets eksisterende og fremtidige behov» (Forskrift om nasjonal retningslinje for fysioterapeututdanning, 2019). Ved Bachelorprogrammet i fysioterapi ved UiT Norges arktiske universitet har vi i år utviklet et nytt emne i folkehelse for våre førsteårsstudenter. I tråd med signalene i de nye retningslinjene for fysioterapeututdanning har vi integrert undervisning om sosiale, miljømessige og miljørelaterte helseproblemer for å inspirere studentene til å forestille seg nye roller og fremtider for helsepersonell

Physiotherapy and ecosystem services: improving the health of our patients, the population, and the environment

Introduction - The relevance of ecosystems to physiotherapy has traditionally been overlooked, despite its potential for health impacts relevant to conditions often managed by physiotherapists. Purpose - The purpose of this article is to introduce the concept of ecosystem services to physiotherapists, and to discuss how understanding ecosystem services may improve patient care, and population and planetary health. Discussion and Conclusion - Physiotherapists with an understanding of ecosystem services may improve patient care by value-adding to management through patient education, empathy, advocacy, and broader population health approaches. Physiotherapists are also well placed to promote the conservation and restoration of ecosystem through participation, advocacy, and the development of public health measures, to the benefit of global sustainability and population health. Further research is required into how physiotherapists currently use nature-based interventions, and the barriers and enablers to their use. To be adequately prepared to meet the challenges that climate change and environmental degradation pose to patient care, population health and health systems, both current and future physiotherapists need to take a broader view of their practice. By including consideration of the potential role of the environment and green space exposure in particular on their patient’s health, physiotherapists can ultimately contribute more to population and planetary health