Towards a relational paradigm in sustainability research, practice, and education

Advancing the deliberate implementation of the concept of sustainability and its alternatives in physical therapy research, practice, and education

BACKGROUND

Sustainability has become a ubiquitous imperative across all sectors of society, including healthcare. Building on the broader discourse on sustainable development, sustainability is used in relation to social, ecological, and economic concerns with varying degrees of emphasis and often related to a sense of durability.

OBJECTIVE

To provide a detailed analysis of the concept of sustainability in current physical therapy literature and advance its deliberate future implementation.

METHODS

Setting out from a critical exposition of prevalent models of sustainability, we conducted a critical discourse analysis to (1) examine the implementation of the concept of sustainability in physical therapy academic literature and (2) critically evaluate its hitherto use in light of the broader discourse surrounding sustainability.

RESULTS

Our analysis identified a focus on the cost-effectiveness of healthcare interventions, and the use of so-called "weak" and "strong sustainability" models in the physical therapy literature. Other models and the broader critical discourse surrounding sustainability are only gradually finding their way into physical therapy literature.

CONCLUSION

Physical therapy lacks comprehensive exploration of both general and profession-specific understandings of sustainability. Nuanced engagement with sustainability and its alternatives is necessary to ensure its meaningful implementation in physical therapy research, education, and practice.

Nursing and medical students' views on their knowledge related to the Sustainable Development Goals - a mixed methods study at three Swedish universities

BACKGROUND

The challenges that the world faces to ensure good life for future generations are vast and complex. The United Nations Sustainable Development Goals (SDGs) aim to meet these challenges. A growing number of higher education institutions have integrated them within their curricula, but there are indications that health professional education has been lagging behind. Therefore, it is important to better understand the views of students in health professional education on the level and depth of their education on sustainable development.

METHODS

This sequential exploratory mixed methods study was based on survey responses from N = 294 nursing (N = 137) and medical (N = 157) students of first and last semesters from three Swedish universities. From the full group of survey responders, 21 students participated in 5 focus group discussions (FGDs) and 9 individual interviews. The survey findings were summarized through descriptive statistics and the interviews and FGDs were analyzed by qualitative content analysis.

RESULTS

The survey findings showed that most students (63%) perceived that they had not learned enough about the SDGs and Agenda 2030 during their education, or for the purposes of their future career. Most of the students (63%) also thought that Agenda 2030 and the SDGs should be a greater part of their education. The qualitative data gave a more in-depth understanding of the quantitative findings, forming two themes: The first theme revealed that the SDGs may be more relevant for health care practice than what the students initially thought, but that the education they had received was in most places superficial, or not tied to the SDGs. The second theme detailed what and how students wished to learn more about. Here, they called for a more in-depth understanding of how to promote equality, equity, inclusion and psychosocial aspects in health care. They also hoped for more knowledge about how to ensure a sustainable working life for themselves.

CONCLUSIONS

Nursing and medical students at three Swedish universities experience that they lack the knowledge necessary to face sustainability challenges they encounter in working life and give some suggestions about how this may be improved in future education.

Navigating causal reasoning in sustainability science

When reasoning about causes of sustainability problems and possible solutions, sustainability scientists rely on disciplinary-based understanding of cause-effect relations. These disciplinary assumptions enable and constrain how causal knowledge is generated, yet they are rarely made explicit. In a multidisciplinary field like sustainability science, lack of understanding differences in causal reasoning impedes our ability to address complex sustainability problems. To support navigating the diversity of causal reasoning, we articulate when and how during a research process researchers engage in causal reasoning and discuss four common ideas about causation that direct it. This articulation provides guidance for researchers to make their own assumptions and choices transparent and to interpret other researchers' approaches. Understanding how causal claims are made and justified enables sustainability researchers to evaluate the diversity of causal claims, to build collaborations across disciplines, and to assess whether proposed solutions are suitable for a given problem.

Consideration of Sustainability When Approving Human Medical Research-A Scoping Review

This article attempts to highlight the importance of including research sustainability as imperative when assessing human medical research in terms of ethical principles. Using a scoping review of recent literature, the complexity of research sustainability is highlighted with key themes and concepts surrounding this important topic being recognized and discussed. An overall paucity of guidance documents was identified and recommendations have been made to practically address this deficiency. An example of a research sustainability evaluation tool which is currently being piloted has been provided for possible adaptation and use by Ethics Committees and Institutional Review Boards to bolster the concept and inclusion of sustainability during the research approval process.

Fractal approaches to scaling transformations to sustainability

Responses to sustainability challenges are not delivering results at the scale and speed called for by science, international agreements, and concerned citizens. Yet there is a tendency to underestimate the large-scale impacts of small-scale, local, and contextualized actions, and particularly the role of individuals in scaling transformations. Here, we explore a fractal approach to scaling sustainability transformations based on "universal values." Universal values are proposed as intrinsic characteristics that connect humans and nature in a coherent, acausal way. Drawing on the Three Spheres of Transformation framework, we consider how enacting universal values can generate fractal-like patterns of sustainability that repeat recursively across scales. Fractal approaches shift the focus from scaling through "things" (e.g., technologies, behaviors, projects) to scaling through a quality of agency based on values that apply to all. We discuss practical steps involved in fractal approaches to scaling transformations to sustainability, provide examples, and conclude with questions for future research.

Exiting the Anthropocene: Achieving personal and planetary health in the 21st century

Planetary health provides a perspective of ecological interdependence that connects the health and vitality of individuals, communities, and Earth's natural systems. It includes the social, political, and economic ecosystems that influence both individuals and whole societies. In an era of interconnected grand challenges threatening health of all systems at all scales, planetary health provides a framework for cross-sectoral collaboration and unified systems approaches to solutions. The field of allergy is at the forefront of these efforts. Allergic conditions are a sentinel measure of environmental impact on human health in early life-illuminating how ecological changes affect immune development and predispose to a wider range of inflammatory noncommunicable diseases (NCDs). This shows how adverse macroscale ecology in the Anthropocene penetrates to the molecular level of personal and microscale ecology, including the microbial systems at the foundations of all ecosystems. It provides the basis for more integrated efforts to address widespread environmental degradation and adverse effects of maladaptive urbanization, food systems, lifestyle behaviors, and socioeconomic disadvantage. Nature-based solutions and efforts to improve nature-relatedness are crucial for restoring symbiosis, balance, and mutualism in every sense, recognizing that both personal lifestyle choices and collective structural actions are needed in tandem. Ultimately, meaningful ecological approaches will depend on placing greater emphasis on psychological and cultural dimensions such as mindfulness, values, and moral wisdom to ensure a sustainable and resilient future.

Re-Thinking Felid–Human Entanglements through the Lenses of Compassionate Conservation and Multispecies Studies

Simple Summary

Felids have long and complex historical associations with humans, ranging from fear and persecution to worship and care. With many felid species in widespread decline, re-thinking the messy entanglements of feline predators and human societies is a necessary step for fostering coexistence as current conservation frameworks that rely on the separation of people from nature are failing felids. Here, we explore two distinct but related interdisciplinary fields that, when put into dialogue with one another, offer novel perspectives and insights on felid–human relationships and conservation initiatives more broadly. We identified numerous similarities and emergent properties within compassionate conservation and multispecies studies, despite these fields arising from the sciences and social sciences and humanities respectively. Combined, reorientation of conservation values and practices to be morally inclusive of individual animals and their subjective experiences has the potential to support cohabitation and tolerance for felids, promoting multispecies flourishing.

Abstract

With many felid species in widespread decline, re-thinking the messy felid–human entanglements is a necessary step for fostering coexistence as current conservation frameworks centered on human exceptionalism and widespread violence toward wild animals are conspicuously failing felids. This paper argues for fostering a critical awareness of how we understand our relationships with nonhuman animals, particularly in the context of conservation. We bring two distinct but related interdisciplinary fields into a dialogue to critically question the values and conceptual assumptions that frame the practices of felid conservation today. Compassionate conservation and multispecies studies share many synergies and conceptual overlaps despite emerging from different academic domains. We identified four key areas for further exploration: (1) A shift in emphasis from practices of killing to the underlying assumptions that make forms of killing permissible and ethically unproblematic. (2) Re-engagement with individuals, not just species, in conservation settings. (3) Unsettling human exceptionalism through an emphasis on the agency of animals and an ethic involving compassion. (4) Acknowledging the ways in which humans co-become with other animals and cultivating relationships of multispecies cohabitation and flourishing.

Practises, Drivers and Barriers of an Emerging Regenerative Higher Education in The Netherlands—A Podcast-Based Inquiry

Universities have the potential, and the responsibility, to take on more ecological and relational approaches to facilitating learning-based change in times of interconnected socioecological crises. Signs for a transition towards these more regenerative approaches of higher education (RHE) that include more place-based, ecological, and relational, ways of educating can already be found in niches across Europe (see for example the proliferation of education-based living labs, field labs, challenge labs). In this paper, the results of a podcast-based inquiry into the design practises and barriers to enacting such forms of RHE are shown. This study revealed seven educational practises that occurred across the innovation niches. It is important to note that these practises are enacted in different ways, or are locally nested in unique expressions; for example, while the ‘practise’ of cultivating personal transformations was represented across the included cases, the way these transformations were cultivated were unique expressions of each context. These RHE-design practises are derived from twenty-seven narrative-based podcasts as interviews recorded in the April through June 2021 period. The resulting podcast (The Regenerative Education Podcast) was published on all major streaming platforms in October 2021 and included 21 participants active in Dutch universities, 1 in Sweden, 1 in Germany, 1 in France, and 3 primarily online. Each episode engages with a leading practitioner, professor, teacher, and/or activist that is trying to connect their educational practice to making the world a more equitable, sustainable, and regenerative place. The episodes ranged from 30 to 70 min in total length and included both English (14) and Dutch (12) interviews. These episodes were analysed through transition mapping a method based on story analysis and transition design. The results include seven design practises such as cultivating personal transformations, nurturing ecosystems of support, and tackling relevant and urgent transition challenges, as well as a preliminary design tool that educational teams can use together with students and local agents in (re)designing their own RHE to connect their educational praxis with transition challenges.

Characterizing the Relationship between Growth and Development in the Context of Strategic Management via Systems Thinking: A Systematic Literature Review

The consequence of the complexity of contemporary challenges has a significant impact on the management sphere. Growth and development are two critical stages in the lifecycle of any organization, enterprise, or corporation as a system. The purpose of this study is to conduct an overview of strategic management discourse to characterize the relationship between growth and development processes with the aim of alleviating complexity. In this regard, we conduct a bibliographic analysis in the Web of Science database using a systematic literature review along with a systems thinking approach as a method to synthesize the findings and finally propose a conceptual framework. According to the findings of this study, a lack of attention to the importance of the relationship between growth and development processes is identified. This implies a gap in this research area, emphasizing the importance of more focus on these processes regardless of their attributes. The implications of the findings in this article will provide a holistic perspective for strategic management practitioners, allowing a better understanding of the importance of growth and development convergence. Consequently, this study may provide a path for future research to explore the implications of growth and development process in other disciplines of management.

Stakeholder participation in sustainability assessment of non-wicked problems: The case of a future seaweed industry in Sweden

Acceptance by, and cooperation with relevant stakeholders in developing new sustainability initiatives when they are generally perceived as positive, is one of the keys for successful implementation of such new sustainability initiatives later on. It is remarkable, however, that ample literature exists about involving stakeholders in research projects focusing on problems with diverging views (controversy) around facts and values (wicked problems), but there is very little literature addressing whether and how to involve relevant stakeholders in case of initiatives where diverging norms and values do not play a (substantial) role, like in sustainability assessment for a future seaweed industry. This perspectives paper addresses that gap, and explores how to design such sustainability assessment, illustrated by how stakeholder interaction influenced the assessment and its results for a future seaweed industry in Sweden, followed by a discussion whether and how a similar approach may benefit sustainability assessment of other non-wicked sustainability initiatives.

A new approach to horse welfare based on systems thinking

Globally, calls for change in the horse industry to prioritise the health and well-being of domestic horses (Equus caballus) are reaching a critical threshold. Horse behaviour deemed undesirable or inconvenient by owners (henceforth referred to as undesirable behaviour) is reported across all aspects of a horse's life and may indicate a welfare issue. This study proposes a reconceptualisation of undesirable horse behaviour as a complex challenge based on systems thinking. Emerging from the natural sciences, systems thinking is an interdisciplinary approach to complex challenges (such as undesirable behaviour) as dynamic, highly interconnected networks of components and feedback relationships. This critical literature review examined the undesirable behaviours studied, the disciplines conducting research and their underpinning assumptions to identify opportunities for approaching research differently. Four themes emerged from the literature: undesirable behaviour is typically studied with unarticulated assumptions and in individual disciplines; behaviours are typically studied in isolation with the complexity of horse-human interactions generally not considered; management of behaviour typically has an anthropocentric linear 'cause and effect' focus; and solutions to undesirable behaviour are often short-term 'fixes' resulting in poor horse outcomes. From these, we outline the opportunities that each provide the next generation of horse research in terms of interdisciplinarity, systems thinking and management. Undesirable horse behaviour in a horse-human system is conceptually mapped in terms of factors associated with the behaviour (eg housing, stress, diet), and the relationships between them. Systems thinking offers a way to integrate multiple disciplines and identify and navigate new solutions to promote horse welfare.

A feminist ethos for caring knowledge production in transdisciplinary sustainability science

Transdisciplinary Sustainability Science has emerged as a viable answer to current sustainability crises with the aim to strengthen collaborative knowledge production. To expand its transformative potential, we argue that Transdisciplinary Sustainability Science needs to thoroughly engage with questions of unequal power relations and hierarchical scientific constructs. Drawing on the work of the feminist philosopher María Puig de la Bellacasa, we examine a feminist ethos of care which might provide useful guidance for sustainability researchers who are interested in generating critical-emancipatory knowledge. A feminist ethos of care is constituted by three interrelated modes of knowledge production: (1) thinking-with, (2) dissenting-within and (3) thinking-for. These modes of thinking and knowing enrich knowledge co-production in Transdisciplinary Sustainability Science by (i) embracing relational ontologies, (ii) relating to the 'other than human', (iii) cultivating caring academic cultures, (iv) taking care of non-academic research partners, (v) engaging with conflict and difference, (vi) interrogating positionalities and power relations through reflexivity, (vii) building upon marginalised knowledges via feminist standpoints and (viii) countering epistemic violence within and beyond academia. With our paper, we aim to make a specific feminist contribution to the field of Transdisciplinary Sustainability Science and emphasise its potentials to advance this field.

Towards an integral pedagogy in the age of ‘digital Gestell’: Moving between embodied co-presence and telepresence in learning and teaching practices

Digitalisation offers a wide array of opportunities, but also challenges, for universities and business schools alike, regarding the provision and delivery of their teaching and learning activities. The COVID-19 pandemic has highlighted some of these challenges, as it forced educational institutions to move their pedagogic activities online in line with new governmental regulations. In this article, we identify and discuss critically the following three interconnected challenges: (1) shifting from direct embodied co-presence to technologically mediated telepresence, (2) re-embodying teaching and learning activities and (3) rethinking the purpose and relevance of teachings in business schools. We explore these challenges through a phenomenological lens, informed by the Heideggerian concepts of enframing ( Gestell) and releasement ( Gelassenheit), with a focus on (re-)embodiment. Finally, we discuss the need, for teachers and learners, to be able to reflectively move between embodied and digital(ised) forms of learning and teaching and outline some implications and perspectives regarding the development of an integral pedagogy.

Enabling new mindsets and transformative skills for negotiating and activating climate action: Lessons from UNFCCC conferences of the parties

Technological and policy solutions for transitioning to a fossil-free society exist, many countries could afford the transition, and rational arguments for rapid climate action abound. Yet effective action is still lacking. Dominant policy approaches have failed to generate action at anywhere near the rate, scale or depth needed to avoid potentially catastrophic futures. This is despite 30 years of climate negotiations under the United Nations Framework Convention on Climate Change (UNFCCC), and wide-ranging actions at national, transnational and sub-national levels. Practitioners and scholars are, thus, increasingly arguing that also the root causes of the problem must be addressed - the mindset (or paradigm) out of which the climate emergency has arisen. Against this background, we investigate decision-makers' views of the need for a different mindset and inner qualities that can support negotiating and activating climate action, along with factors that could enable such a mindset shift. Data were collected during participatory workshops run at the 25th UNFCCC Conference of the Parties (COP25) in 2019, and comprise surveys, as well as social media communication and semi-structured interviews with COP attendees. Our results underline vast agreement among participants regarding the need for a mindset shift that can support new ways of communication and collaboration, based on more relational modes of knowing, being and acting. They also suggest the emergence of such a mindset shift across sectors and contexts, but not yet at the collective and systems levels. Finally, they highlight the importance of transformative skills and the need for experimental, safe spaces. The latter are seen as a visible manifestation and enabler that can support agency for change through shared self-reflection, experience and practice. We present a transformative skills framework, and conclude with further research needs and policy recommendations.