Psychological effects of forest environments on healthy adults: Shinrin-yoku (forest-air bathing, walking) as a possible method of stress reduction

Enhancing Adolescent Girls' Well-Being in the Arctic-Finding What Motivates Spending Time in Nature

Background: According to previous studies, the natural environment positively influences well-being, including that of adolescent girls. However, knowledge is lacking on what motivates adolescent girls to spend time in nature. A secondary analysis of qualitative data was conducted employing three preexisting sets of interview data that had formed the basis of previously published research reports. A novel perspective on what motivates adolescent girls in the Arctic to spend time in nature was uncovered—a finding that previous articles have not reported. Aim: The aim was to describe what motivates adolescent girls in the Arctic to spend time in nature. Methods: The participants were adolescent girls aged 13 to 16 living in the province of Finnish Lapland. The girls wrote about well-being (n = 117) and were interviewed (n = 19) about the meaning of seasonal changes, nature and animals’ influence on well-being. Also, five focus group interviews (n = 17) were held. The materials were analyzed by inductive content analysis. Results: After the secondary analysis, three generic categories were found: (1) wanting to have pleasant emotions, (2) the possibility of participating in activities and (3) a desire to feel better. The main category of “need to experience positive sensations” was formed. Conclusion: Based on these results, through personalized guidance and advice, it is possible to strengthen adolescent girls’ willingness to spend time in nature.

Effects of exposure to immersive videos and photo slideshows of forest and urban environments

A large number of studies have demonstrated the benefits of natural environments on people's health and well-being. For people who have limited access to nature (e.g., elderly in nursing homes, hospital patients, or jail inmates), virtual representations may provide an alternative to benefit from the illusion of a natural environment. For this purpose and in most previous studies, conventional photos of nature have been used. Immersive virtual reality (VR) environments, however, can induce a higher sense of presence compared to conventional photos. Whether this higher sense of presence leads to increased positive impacts of virtual nature exposure is the main research question of this study. Therefore, we compared exposure to a forest and an urban virtual environment in terms of their respective impact on mood, stress, physiological reactions, and cognition. The environments were presented via a head-mounted display as (1) conventional photo slideshows or (2) 360[Formula: see text] videos. The results show that the forest environment had a positive effect on cognition and the urban environment disturbed mood regardless of the mode of presentation. In addition, photos of either urban or forest environment were both more effective in reducing physiological arousal compared to immersive 360[Formula: see text] videos.

A Pragmatic Controlled Trial of Forest Bathing Compared with Compassionate Mind Training in the UK: Impacts on Self-Reported Wellbeing and Heart Rate Variability

Forest Bathing, where individuals use mindfulness to engage with nature, has been reported to increase heart rate variability and benefit wellbeing. To date, most Forest Bathing studies have been conducted in Asia. Accordingly, this paper reports the first pragmatic controlled trial of Forest Bathing in the United Kingdom, comparing Forest Bathing with a control comprising an established wellbeing intervention also known to increase heart rate variability called Compassionate Mind Training. Sixty-one university staff and students (50 females, 11 males) were allocated to (i) Forest Bathing, (ii) Compassionate Mind Training or (iii) Forest Bathing combined with Compassionate Mind Training. Wellbeing and heart rate variability were measured at baseline, post-intervention and three-months follow-up. There were improvements in positive emotions, mood disturbance, rumination, nature connection and compassion and 57% of participants showed an increase in heart rate variability. There were no significant differences between conditions, showing that Forest Bathing had equivalence with an established wellbeing intervention. The findings will help healthcare providers and policy makers to understand the effects of Forest Bathing and implement it as a feasible social prescription to improve wellbeing. Future research needs to involve clinical populations and to assess the effects of Forest Bathing in a fully powered randomised controlled trial.

The effects of viewing a winter forest landscape with the ground and trees covered in snow on the psychological relaxation of young Finnish adults: A pilot study

Forest bathing is an outdoor activity, and it might be a promising preventive treatment for social problems involving stress. A vast number of studies confirm the positive effects of this activity on people's health. Nevertheless, little is known about the influence of winter forest bathing when conducted in an environment with snow cover on the ground and trees. Thus, a crossover experiment was designed in this study, with the participation of twenty-two healthy university students from Finland. During the experiment, a short exposition by a forest environment or landscape with buildings (as a control) was applied. Participants self-reported their psychological relaxation before and after the exposition, and the results were analyzed and compared. The mood, emotions, restorativeness, and subjective vitality were recorded as indices reflecting the psychological relaxation effect. The negative mood indices decreased significantly after exposition by the snow-covered environment, but the positive 'vigor' indices did not increase or decrease significantly. The level of negative emotions increased after the exposition with the control environment. Likewise, positive emotions decreased after the interaction with the control. Restorativeness was significantly increased after the exposition by the experimental forest but decreased after the viewing of the control buildings. The size of the effect in terms of restorativeness was the highest in this experiment. The subjective vitality was lowered as affected by the control, but it did not increase or decrease after the exposition with the experimental forest. There is probably an effect from the slight interruption in the process from the influence of the forest greens on participants because their vigor and vitality did not increase after the exposition with this environment in the study. However, snow might influence the participants as a calming and emotion-lowering component of the environment, but this idea needs to be further explored with the involvement of participants from other countries who would be viewing forest environments with snow cover and whose psychological relaxation could be measured.

Can Viewing Nature Through Windows Improve Isolated Living? A Pathway Analysis on Chinese Male Prisoners During the COVID-19 Epidemic

Nature exposure is known to promote life satisfaction and well-being, and indirect exposure through windows is likely to benefit isolated populations. However, whether such type of exposure can benefit prisoners, the extremely isolated population, is unknown. In the current study, we investigated 326 male prisoners from three prisons in southwest China. Psychological variables including depression, anxiety, loneliness, distress tolerance, life satisfaction, and well-being were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), short-form UCLA Loneliness Scale (ULS-6), Distress Tolerance Scale (DTS), Satisfaction with Life Scale (SWLS), and 5-item World Health Organization Well-Being Index (WHO-5), respectively. Structural equation modeling was employed to identify the pathways from the visibility of nature through windows to prisoners' life satisfaction and well-being. Our results demonstrated that visibility of nature promoted the frequency and duration of viewing nature through windows. The frequency directly affected well-being, but the duration did not effectively affect any measured variables. The visibility of nature enhanced life satisfaction mainly via direct effects but enhanced well-being mainly via indirect effects. Regarding the indirect pathways, the visibility of nature increased distress tolerance and thus reduced loneliness and mental health problems. The reduced mental health problem, in turn, promoted life satisfaction and well-being. Our findings suggest that nature exposure through windows is effective in enhancing prisoners' life satisfaction and well-being. The policymaker may need to consider nature-based solutions such as indirect nature exposure in prions to benefit isolated populations.

Possibilities for Harmonisation between Recreation Services and Their Production within the Forest Sector—A Case Study of Municipal Forest Enterprise Hradec Králové (CZ)

This paper deals with the possibility of harmonising the needs of society and the possibilities of the forest property manager. The Municipal forest enterprise of the city of Hradec Králové (MLHK) in the Czech Republic (CZ) is an example of this principle, which proves that the intensive development of a recreational service is possible without limiting this principle. The forest enterprise manages 3707 ha of forest in the immediate vicinity of the city with 92,000 inhabitants. The forest enterprise pays the city rent and makes a profit. The data were obtained by analysing the economic data of the surveyed company, the annual observation of the forest attendance, the surveys of the characteristics of the forest visitors and the surveys of selected 16 companies (from seven countries) managing the forests of some European cities. The main results concerning MLHK are as follows: the share of recreational service costs in the total costs of the forestry activities is 19.7%. The recreational services of the forest are financed from 71.5% from revenues from the sale of raw wood, 17.5% from revenues from the sale of sand from its own quarry, 3.9% from revenues from the recreational services and 7.1% from subsidies. The operation of the gravel quarry contributes to the economic result of the forest enterprise roughly by an amount corresponding to the costs of the recreational services. An average annual forest attendance is 243 people/ha. The inhabitants of the city account for 61.5% of the visitors, 20.4% of the visitors live within a distance of up to 30 km, and 18.1% of the visitors live at a distance of more than 30 km. The main results of the survey among the forest enterprises managing the forests of the selected European cities are as follows: the share of costs for the recreational services in the total costs of the forestry activities is 21–72% for cities with a population of over 100,000, and 3–14% for cities with less than 100,000 inhabitants. As a source of financing recreational services, the forest enterprises from mentioned cities with over 100,000 inhabitants, the money especially came from the city budget (70–100%). Forest enterprises from cities under 100,000 inhabitants stated that they fund a recreational service with 95–100% of the revenues from the sale of raw wood. Data on the MLHK show that it is possible to finance a recreational forest service from its own resources if this is the owner’s priority. However, this only applies under certain conditions, such as that, in addition to the income from forest management, there are other sources of income (in this case, sand mining or subsidies from public programmes). If the forest owner did not have these resources, they would have to pay for the recreational service from their own other resources (e.g., from the city budget).

The Effects of Green and Urban Walking in Different Time Frames on Physio-Psychological Responses of Middle-Aged and Older People in Chengdu, China

Nighttime walking is becoming a popular exercise for many middle-aged and older people in Asian countries. However, the health benefits of nighttime walking in urban areas and green spaces are still unclear. This study evaluated the physiological and psychological responses of 48 middle-aged and older people who walked 1.6 km through a green space and an urban area during daytime and nighttime. The Positive and Negative Affect Schedule (PANAS), Profile of Mood States (POMS), Perceived Restorativeness Scale (PRS), and Restorative Outcome Scale (ROS) were employed to measure the psychological responses, and pulse rate and blood pressure (SBP, DBP and MAP) were measured to evaluate the physiological responses. The results showed that the daytime green walking induced psychological improvements and lowered blood pressure (p < 0.05), while the daytime urban walking resulted in slight deterioration of all the measured parameters (p > 0.05). On the other hand, the nighttime green walking induced lowered blood pressure (p < 0.05), whilst the nighttime urban walking resulted in psychological improvements and lowered blood pressure (p < 0.05), and no significant difference was found in any measured parameter between the two nighttime walking groups. In conclusion, urban areas are noisy and irritating in the daytime, and not suitable for walking, but may become pleasurable and attractive at night. The psychological benefits of green walking may decrease at night, and nighttime walking in either an urban area or a green space may achieve similar health benefits. Therefore, we recommend that urban citizens start nighttime walking in a green space or an urban area to keep fit when the air is less polluted.

The phantom chorus: birdsong boosts human well-being in protected areas

Spending time in nature is known to benefit human health and well-being, but evidence is mixed as to whether biodiversity or perceptions of biodiversity contribute to these benefits. Perhaps more importantly, little is known about the sensory modalities by which humans perceive biodiversity and obtain benefits from their interactions with nature. Here, we used a 'phantom birdsong chorus' consisting of hidden speakers to experimentally increase audible birdsong biodiversity during 'on' and 'off' (i.e. ambient conditions) blocks on two trails to study the role of audition in biodiversity perception and self-reported well-being among hikers. Hikers exposed to the phantom chorus reported higher levels of restorative effects compared to those that experienced ambient conditions on both trails; however, increased restorative effects were directly linked to the phantom chorus on one trail and indirectly linked to the phantom chorus on the other trail through perceptions of avian biodiversity. Our findings add to a growing body of evidence linking mental health to nature experiences and suggest that audition is an important modality by which natural environments confer restorative effects. Finally, our results suggest that maintaining or improving natural soundscapes within protected areas may be an important component to maximizing human experiences.

What Types of Greenspaces Are Associated with Depression in Urban and Rural Older Adults? A Multilevel Cross-Sectional Study from JAGES

Depression in older adults is a public health challenge. We aimed to clarify the relationship between depression in older adults and three types of neighborhood greenspaces: trees, grasslands, and fields. We utilized data from the Japan Gerontological Evaluation Study (JAGES) performed in 2016. Multilevel logistic regression analysis was used for non-stratified and stratified analyses for the urban–rural regions. The target population comprised 126,878 older adults (age ≥ 65 years) who responded to the depression questions and were living in 881 neighborhoods in Japan. Depression was diagnosed based on a Geriatric Depression Scale score ≥5, and 20.4% of the study population had depression. In the pre-stratification analysis, areas with more greenspaces revealed lower odds of depression (odds ratio (OR) 0.95, 95% confidence interval (CI) 0.85–0.95). In urban areas, more trees correlated with lower odds of depression (OR 0.94, 95% CI 0.89–1.00). In rural areas, moderate amounts of grassland were associated with lower odds of depression compared to areas with fewer grasslands (OR 0.91, 95% CI 0.83–1.00). We found that urban areas with higher tree density and rural areas with moderate amounts of grassland were associated with lower odds of depression.

Perceived Loudness Sensitivity Influenced by Brightness in Urban Forests: A Comparison When Eyes Were Opened and Closed

Soundscape plays a positive, health-related role in urban forests, and there is a competitive allocation of cognitive resources between soundscapes and lightscapes. This study aimed to explore the relationship between perceived loudness sensitivity and brightness in urban forests through eye opening and closure. Questionnaires and measuring equipment were used to gather soundscape and lightscape information at 44 observation sites in urban forested areas. Diurnal variations, Pearson’s correlations, and formula derivations were then used to analyze the relationship between perception sensitivity and how perceived loudness sensitivity was influenced by lightscape. Our results suggested that soundscape variation plays a role in audio–visual perception in urban forests. Our findings also showed a gap in perception sensitivity between loudness and brightness, which conducted two opposite conditions bounded by 1.24 dBA. Furthermore, we found that the effect of brightness on perceived loudness sensitivity was limited if variations of brightness were sequential and weak. This can facilitate the understanding of individual perception to soundscape and lightscape in urban forests when proposing suitable design plans.

Mental health rescue effects of women's outdoor tourism: A role in COVID-19 recovery

Mental and social health outcomes from a portfolio of women's outdoor tourism products, with ~100,000 clients, are analysed using a catalysed netnography of >1000 social media posts. Entirely novel outcomes include: psychological rescue; recognition of a previously missing life component, and flow-on effects to family members. Outcomes reported previously for extreme sports, but not previously for hiking in nature, include psychological transformation. Outcomes also identified previously include: happiness, gratitude, relaxation, clarity and insights, nature appreciation, challenge and capability, and companionship and community effects. Commercial outdoor tourism enterprises can contribute powerfully to the wellbeing of women and families. This will be especially valuable for mental health recovery, following deterioration during COVID-19 coronavirus lockdowns worldwide.

A Guide to Nature Immersion: Psychological and Physiological Benefits

Nature exposure has been renowned for its positive physiological and psychological benefits. Recent years have seen a rise in nature immersion programs that make use of Guided Forest Therapy walks in a standard sequence of sensory awareness activities to expose participants to natural environments in a safe but effective manner. The study aimed to compare the efficacy of guided versus unguided nature immersion, upon three dependent variables of mood, nature connectedness and heartrate. 51 participants were assigned to either guided or unguided nature immersion. Nature connectedness (Connectedness to Nature Scale, CNS), Environmental Identity Scale, EID short form) and mood (Positive and Negative Affect Scale, PANAS) were assessed before and after nature immersion, while heart rate was tracked continuously by a wristwatch heart rate tracker throughout the 2-h experience. Demographics and general health practice (GHP) information were also collected. A mixed model ANOVA revealed that nature connectedness and mood (but not heart rate) improved post-immersion for all participants. Comparing the guided/unguided conditions, there were no significant differences in the change in nature connectedness, mood or heart rate. Comparing within the five segments within the standard sequence in the guided condition, the third and fifth segments revealed a significantly lower heart rate compared to the baseline heart rate.

Effects of Shinrin-Yoku (Forest Bathing) and Nature Therapy on Mental Health: a Systematic Review and Meta-analysis

Shinrin-yoku, immersing oneself in nature using one’s senses, has been receiving increased attention internationally. While most of the existing studies have focused on physical health, this systematic review and meta-analysis examined the mental health impacts of shinrin-yoku, using the PRISMA guidelines (PROSPERO registry: BLINDED). Of 497 articles retrieved on databases including PubMed/MEDLINE, PsycINFO, Science Direct and Google Scholar, twenty met the inclusion criteria. All studies were conducted in Asia and Europe, and used a variety of different bathing approaches (e.g. breathing, walking, yoga). While noting a need for more rigorous research and extensive follow-up assessments, the findings indicate that shinrin-yoku can be effective in reducing mental health symptoms in the short term, particularly anxiety. More careful examination of shinrin-yoku practices is needed; longer follow-up with participants from a range of countries along with greater examination of potential mechanisms is needed for shinrin-yoku to be accepted into mainstream interventions.

Forest and Wellbeing: Bridging Medical and Forest Research for Effective Forest-Based Initiatives

Research Highlights: This review gives an overview of existing literature on the emerging topic of human wellbeing-forest contact nexus and provides a preliminary framework linking forests to wellbeing by highlighting key variables affecting this relationship. Background and Objectives: Existing literature reveals the psychological, physiological and social wellbeing benefits of contact with forest ecosystems; however, the role of forests in this relationship remains largely unexplored. The objectives of this review are twofold: (i) to provide an overview of the contributions of forest experiences to human wellbeing and the related interplay with forest ecosystems and (ii) to identify knowledge gaps to inform future research and systematize information available for forest managers and planners to support the development of effective forest-based initiatives. Materials and Methods: A scoping review was performed with a five-phase method integrating a systematic approach on Scopus, Web of Science and PubMed databases and snowball search. Studies were analyzed using a descriptive-analytical method. Results: Overall, 93 papers were included in the review. These are mainly from health-related sciences providing limited information for forest managers, planners and practitioners. Four main underlying variables of the forest-wellbeing relationship are identified: interaction, forest features, sensorial dimension of the forest and individual traits and reactions. Conclusions: Forest-based initiatives provide good opportunities for supporting public health and time spent in contact with forests seems to have a “health-bonus”. Whether and to what extent forest management can contribute to this is still poorly investigated. There is the need to better study causal relationships between specific forest features, type of interactions, frequency and “dose” of experiences, individual reactions and needs and wellbeing effects to maximize benefits from forest-based initiatives.

Urban Trees and Human Health: A Scoping Review

The urban forest is a green infrastructure system that delivers multiple environmental, economic, social and health services, and functions in cities. Environmental benefits of urban trees are well understood, but no review to date has examined how urban trees affect human health. This review provides a comprehensive summary of existing literature on the health impacts of urban trees that can inform future research, policy, and nature-based public health interventions. A systematic search used keywords representing human health, environmental health, and urban forestry. Following screening and appraisal of several thousand articles, 201 studies were conceptually sorted into a three-part framework. Reducing Harm, representing 41% of studies, includes topics such as air pollution, ultraviolet radiation, heat exposure, and pollen. Restoring Capacities, at 31%, includes attention restoration, mental health, stress reduction, and clinical outcomes. Building Capacities, at 28%, includes topics such as birth outcomes, active living, and weight status. The studies that were reviewed show substantial heterogeneity in purpose and method yet indicate important health outcomes associated with people’s exposure to trees. This review will help inform future research and practice, and demonstrates why urban forest planning and management should strategically promote trees as a social determinant of public health.

The effect of green walking on heart rate variability: A pilot crossover study

We investigated the effects of regular walking in green and suburban environments on heart rate variability (HRV) and blood pressure (BP) in middle-aged adults. Twenty-three adults participated in a non-randomized crossover experiment comprised of once-weekly 50-min moderate-intensity walking sessions. Separated by a two-week washout period, participants walked for three weeks in each of two treatment conditions (green and suburban) in a local arboretum and suburban sidewalks of Chaska, MN. Eleven participants completed green walking first and 12 suburban walking first. Walks were split into 15-min intra-walk phases, with phases representing each walk's beginning, middle, and final 15-min. Repeated measures linear mixed models evaluated (1) HRV phase differences between treatments and HRV change within treatments, and (2) pre- and post-walk BP differences between treatments and pre-to post-walk BP changes. Intra-walk phase analyses revealed higher HRV during green walking vs. suburban walking during phase 2 (p < 0.0001) and phase 3 (p = 0.02). Less HRV reduction was seen between intra-walk phases 1 and 2 during green vs. suburban walking (p = 0.02). Pre-to post-walk changes revealed decreased mean systolic BP for both green (p = 0.0002) and suburban (p = 0.003) walking conditions, but not for diastolic BP. Post-walk BP results were similar after both green walking and suburban walking. In summary, walking sessions in a green environment elicited greater beneficial HRV responses compared to a suburban environment. Additionally, walking in either environment, green or suburban, promoted reductions in systolic BP.

Physiological and Psychological Effects of Watching Videos of Different Durations Showing Urban Bamboo Forests with Varied Structures

This study illustrated the physiological and psychological effects of watching videos of different durations showing bamboo forests with varied structures. Physiological indicators, including EEG (electroencephalogram), blood pressure, skin conductance, and pulse, were monitored in 180 Chinese university students (mean age: 20.72 ± 2.56 years) while they were watching bamboo videos. Before and after watching the videos, their psychological indicators, including positive and negative moods, were measured using the Profile of Mood States questionnaire. After watching the bamboo videos of different durations, all of the physiological indicators responded to the stimulation after only 1 min. The indicators showed different trends at 1, 3 and 5 min. EEG decreased and then was maintained at a stable level after 1 min, and the high β, low β, and α waves had no significant differences between 1, 3 and 5 min. Blood pressure dropped to a stable state after 3 min, and the decline was significantly different greater after 3 min than after 1 min. Skin conductance increased for 1 to 5 min, and it did not stabilize after a long time (5 min). Pulse decreased after 1 min but increased after 5 min. After watching the videos with bamboo of varying structures, the physiological and psychological indicators showed significantly different changes. Skin conductance significantly increased (mean value: 6.78%), and the amount of sweat was more effectively reduced, thereby reducing tension, when the students viewed videos of sympodial bamboo forests compared with monopodial bamboo forests. Bamboo forests with a higher canopy density (0.83–0.85) could significantly decrease α waves (mean value: 1.50 Hz), relaxing the human body. High β and low β waves showed greater decreases, with tension reduced more effectively, when bamboo forests with a low tilt ratio (< 1.5%) were viewed. Bamboo forests with neat undergrowth could have more beneficial physiological and psychological effects on the human body.

The Restorative Effect of the Natural Environment on University Students' Psychological Health

The present study evaluated the effect of a three-week intervention aimed at improving psychological health in university students. Participants included 200 Australian students randomly assigned to an experimental or waitlist control group, with 42 adhering to intervention instructions. Participants in the experimental group read a story about someone who used the natural environment to decrease stress and burnout levels and to increase their perceived satisfaction with life. They were then instructed to spend 20 minutes each week, for three weeks, in any chosen natural environment. Waitlist control participants received intervention instructions three weeks later. Restorativeness was positively associated with life satisfaction and negatively related to stress and burnout. Experimental participants, compared to waitlist control participants, experienced a significant decrease in stress; however, the intervention had no effect on life satisfaction or burnout. More research is still needed to determine the practical significance of nature exposure on university students' psychological health.

Benefits of a Three-Day Bamboo Forest Therapy Session on the Physiological Responses of University Students

Studies have indicated that natural environments have the potential to improve the relationship between a stressful life and psychological well-being and physical health. Forest therapy has recently received widespread attention as a novel solution for stress recovery and health promotion. Bamboo is an important forest type in many countries, especially in East and Southeast Asia and in African countries. Bamboo is widespread throughout southwestern China. Empirical field research on the physiological effects of bamboo forest therapy is currently lacking. To explore the benefits of bamboo forest therapy on the physiological responses of university students, 120 university volunteers between the ages of 19 and 24 participated in this study (60 males and 60 females) and were randomly divided into four groups of equal size (15 males and 15 females in each). Four sites were selected for the experiment, including two natural bamboo forests (YA and YB), a bamboo forest park (DJY), and an urban environment (CS). During the testing period, all participants were asked to view the landscape for 15 min in the morning and then walk in the testing area for 15 min in the afternoon. Blood pressure (BP), heart rate (HR), and peripheral oxygen saturation (SpO2) were measured as the physiological indexes, and the semantic differential method (SDM) questionnaire was completed for the environmental satisfaction evaluation. The SDM for the subjective environmental evaluation differed significantly among the university students; they obtained a better environmental experience, in terms of sensory perception, atmosphere, climate, place, and space, in the bamboo forest sites. The three-day bamboo forest therapy session improved the physiological well-being of university students. First, the blood pressure and heart rate of the university students decreased, and the SpO2 increased, after the three-day viewing and walking activities of the three-day bamboo forest therapy session. The viewing activities had a more pronounced effect on decreased heart rate in university students. Additionally, three-day bamboo forest therapy had a positive impact on decreased systolic blood pressure and heart rate in the university students, and it was significantly decreased in females, while peripheral oxygen saturation (SpO2) remained relatively low. Finally, compared with the urban site (CS), the bamboo forest sites effectively improved the university students’ physiological state of health, decreased their physical pressure, and stabilized their physiological indicators. These findings provide scientific evidence that a three-day bamboo forest therapy session can increase positive physiological responses. The potential for a longer-term effect on human physiological health requires further investigation.

Today's protected areas: supporting a more sustainable future for humanity

Nature provides significant benefits to people, especially those living in and around protected areas. Ecosystem services from protected areas include producing wild food, supporting biodiversity and water cycles, regulating climate, and providing cultural services like better health, tourism, and legacy for future generations. In economic terms, the flows of ecosystem services provided by protected areas are worth hundreds of billions of dollars each year, well justifying the costs of managing these sites, but protected areas are suffering from environmental problems such as impacts from human population growth, rural poverty, growing demands for natural resources, land use change that degrades ecosystem productivity, invasive non-native species that harm natural ecosystems, and climate change that is affecting all ecosystems. Addressing these linked challenges will require mobilizing all parts of the economy, including the protected area estate. For example, protected areas can take a leadership role in rural development, expand the conservation estate to half of the planet through connectivity and improved management of more of the non-agricultural land, enhance the prominent role of protected areas in contributing to climate change mitigation and adaptation, encourage productive research on applying modern technology to protected areas management, seek broader private sector participation in conserving biodiversity and ecosystem services, and include protected areas as relevant parties in relevant trade and other international negotiations. When protected area managers embrace this broader role, they will find enthusiastic public support for this contribution to a sustainable human society.

Relationship Between Mental Health and the Education Level in Elderly People: Mediation of Leisure Attitude

Purpose

The present study intends to explore the influence of education on the mental health of retired people and the mediating role of a leisure attitude in this relationship.

Design/Methodology

The sample was simple random, and a confidentiality agreement was established. The sample was composed of 403 Portuguese participants (37.2% male; 62.8% female). The participants completed the MHI and the LAS.

Findings

The hypothesized mediation model showed that a leisure attitude mediated the association between education and well-being. In addition, higher levels of distress were found in participants with higher levels of education.

Scientific Contribution

Our results suggest that old-aged people with high education and a more positive leisure attitude have a better psychological adjustment concerning well-being. Also, a higher level of education can lead to a better perception of aging changes (physical, life, profession).

Frequency of forest walking is not associated with prevalence of hypertension based on cross-sectional studies of a general Japanese population: a reconfirmation by the J-MICC Daiko Study

Forest walking or Shinrin-yoku is a health promotion activity in Japan. Although some studies have reported the acute effects of walking a few hours in forested areas in reducing blood pressure level compared to other environments, studies investigating whether successive walking has long-term effects in lowering blood pressure levels or lowering prevalence of hypertension are rare. This study aimed to reconfirm the presence or absence of an association between the frequency of forest walking and prevalence of hypertension in a Japanese population. This J-MICC Daiko Study was conducted targeting residents in Nagoya City. A total of 5,109 participants (1,452 men and 3,657 women; age, mean ± standard deviation: 52.5 ± 10.3 years) were included in the analysis. Age-adjusted blood pressure level by frequency of forest walking was not significant. After adjusting for age and lifestyle, the adjusted odds ratios (aORs) of the most frequent group (n=88, 1.7%; once a week or more group) relative to the less than once a month group (n=4,558, 89.2%) for prevalence of hypertension were not also significant [0.80 (95% CI: 0.40–1.62) for men and 1.48 (95% CI: 0.73–3.00) for women]. This study reconfirmed that either lowering blood pressure level or lowering the prevalence of hypertension is not associated with frequency of forest walking, similar to the results of our previous J-MICC Shizuoka Study. Given that these two studies were cross-sectional studies, cohort studies investigating the causal relationship are required to evaluate the effect of frequent forest walking on the prevention of hypertension.

'Into the Wild': A meta-synthesis of talking therapy in natural outdoor spaces

Time spent in natural outdoor spaces has physiological and psychological benefits, such as reduced stress responses and improved mood. Mental health practitioners have begun to harness nature's restorative capacity by challenging convention and taking talking therapies outdoors. This review synthesises the experiences of these practitioners and their clients, with the aim of establishing a framework for best practice. A thematic synthesis was used to provide a systematic and integrative exploration of multiple therapy professions. Articles (N = 38, published from 1994 to 2019) comprised 322 practitioners and 163 clients. A mixed-method meta-synthesis resulted in a framework of higher and lower level themes. The outdoor context for therapy ranged in intensity from sitting or walking in urban parks and woodland to remote wilderness expeditions. The outdoors provided either a passive backdrop to therapy or was more actively incorporated through behavioural analysis, relationship building, metaphor, narrative therapy, role play, modelling, and stabilisation. Practical, therapeutic, and organisational issues were mitigated through assessment and formulation, informed consent, process contracting, enhancing predictability where possible, and awareness of professional competency. Therapy was subsequently enriched by added mutuality, freedom of expression, mind-body holism, interconnectedness with the natural world, and practitioner well-being. The question of whether therapy in natural spaces should become a more mainstream option for clients and practitioners is discussed.

How Should Forests Be Characterized in Regard to Human Health? Evidence from Existing Literature

The potential of forests as a source of health has been addressed by the scientific community and is now being considered in national forest strategies, management plans and policies. Studies identifying the mechanisms by which forest characteristics may induce these effects on human health are nevertheless scarce. This systematic review of literature on forests and human health with real-life human exposure was conducted to assess the extent to which forests have been studied and described in detail and the extent to which relationships between forest variables and health effects have been reported. The analysis underlines the lack of forest descriptions in 19.35% of the 62 studies selected for review as well as the high heterogeneity of forest variables’ description. Patterns among the articles could not be identified correlating the broader forest variable (forest type) and the most studied health variables identified (blood pressure, pulse rate or/and cortisol levels). These findings, together with previous ex situ researches, suggest the need to ameliorate and incorporate more accurate descriptions of forest variables within human health studies to provide data for forest management and the potential use of these habitats for preventive medicine and clinical practice guidelines.

Six-Step Model of Nature-Based Therapy Process

Several studies have confirmed that the natural environment has psychophysiological healing effects. However, few studies have investigated the healing process involved in the effect of the natural environment. To date, no theoretical model on the nature-based therapy process has been clearly established. Thus, the aim of this study was to develop a theoretical model of the nature-based therapy process by analyzing individual empirical data. Research materials were 180 self-reported essays on “Forest Therapy Experiences” submitted to the Korea Forest Service. This study was conducted based on grounded theory. Data were analyzed through open coding. A total of 82 concepts, 21 subcategories, and six categories were derived. Results revealed that the nature-based therapy process contained six categories: Stimulation, acceptance, purification, insight, recharging, and change. When in the natural environment, participants first experienced positive emotional change, followed by cognitive and behavioral changes. Based on these results, a nature-based therapy process model was derived. This study revealed that the nature-based therapy process did not consist of just a single element or step, but involved an integrated way of healing with emotional and cognitive changes. This study is significant in that it derives a theoretical model of the nature-based therapy process with comprehensive mechanisms. Further research is needed to establish more systematic theoretical model.

[Effects of strolling on the mind and autonomic activities of elderly people in the 2018 Yamaguchi Yume Flower Expo Well-being Garden based on the heart rate, blood pressure, low frequency/high frequency and mood]

AIM

In recent years in Japan, forest therapies have been implemented in various places. While the effects of such therapies have been reported in previous research papers, those of artificial gardens have not been clarified. At the 2018 Yamaguchi Yume Flower Expo, the Yamaguchi University Faculty of Medicine had the opportunity to provide a "Well-being Garden" in collaboration with the Japan Landscape Contractors Association Yamaguchi Prefecture Branch. We examined the physical and mental responses of older people who strolled in the Well-being Garden.

METHODS

Participants were 158 people ≥ 65 years old. Pre-and post-stroll interviews were conducted, and the heart rate, blood pressure, and autonomic nervous activities were measured.

RESULTS

After strolling in the garden, the heart rate significantly decreased from 76.1±12.9 to 73.9±11.8/min (p<0.01), and both the systolic and diastolic blood pressure significantly decreased from 142.5±24.4 to 139.4±24.1 mmHg and from 83.7±12.0 to 81.5±11.9 mmHg, respectively (p<0.01). The ralue of low frequency/high frequency (LF/HF) after strolling in the garden came closer to the standard one than before, both in the participants with much tension and with less tension. In the post-stroll interview, 74 reported feeling very good, and 84 felt good.

CONCLUSIONS

These results suggested that strolling in the Well-being Garden positively influenced the physical and mental condition of the participants.

Is greenery associated with mental health among residents of aged care facilities? A systematic search and narrative review

Objectives: Older adults living in residential aged care facilities (RACFs) may be vulnerable to mental health issues. Evidence suggests greenery is beneficial for adults' mental health in community settings. This review aims to summarise evidence of associations between greenery in RACFs and residents' mental health.Method: Six databases were searched with three sets of terms related to: (1) exposure (e.g. garden, green); (2) outcome (e.g. mental health, well-being); and (3) setting (e.g. aged care, nursing home). The inclusion criteria were peer-reviewed journal articles published in English up to 2017, reporting quantitative/qualitative associations between greenery and mental health in RACFs.Results: Of the nine articles identified, seven reported positive associations between greenery (in particular, garden use) at RACFs and some aspect of residents' mental well-being (e.g. quality of life); however, four out of seven studies used observations and perceptions of staff and relatives. One study examined depression and reported reduction in depression following garden use, while one examined physiological indicators of stress (blood pressure, heart rate) and found no association with garden use. Seven studies examined garden use and four examined the presence of greenery (two examined both exposures).Conclusion: Exposure to greenery and use of greenspace in RACFs show promise for promoting mental health. However, the findings relied mainly on non-validated measures of mental health. More robust evidence based on valid and reliable mental health measures is needed. Future studies also need to examine the effect of visual exposure to greenery and the effect of greenery on stress reduction.

The Effects of a Forest Therapy Programme on Mental Hospital Patients with Affective and Psychotic Disorders

The positive effect of forest bathing on the mental health and wellbeing of those suffering from post-traumatic stress disorder or experiencing stress has been proven. It is not known, however, how 'forest therapy' affects the mental health of people who are treated in a psychiatric hospital for affective or psychotic disorders. Potentially, forest therapy could bring many benefits to these people. To test the potential effectiveness of this therapy, a quasi-experiment was carried out in a psychiatric hospital in Olsztyn (north Poland). In the summer and autumn of 2018, the patients of the psychiatric hospital in Olsztyn participated in forest therapy interventions. The proposed forest therapy consisted of participating in one hour and forty-five minutes walks under the supervision of a therapist. Subjects filled out the Profile of Mood States Questionnaire (POMS) and the State Trait Anxiety Inventory (STAI-S) before and after the study. In the case of a group of patients with affective disorders, forest therapy had a positive effect on nearly all POMS scale subscales, with the exception of the 'anger-hostility' subscale, which did not change its values significantly after the intervention. In these patients, the greatest impacts were noted in the subscales 'confusion' and 'depression-dejection'; the level of anxiety measured with the STAI-S scale also significantly decreased. In the case of patients with psychotic disorders, the values of the 'confusion' and 'vigour' subscales and the STAI-S scale exhibited the greatest changes. These changes were positive for the health of patients. Regarding the 'fatigue' subscale, no significant changes were observed in patients with psychotic disorders. The observed changes in psychological indicators in psychiatric hospital patients with both kinds of disorders indicate that the intervention of forest therapy can positively affect their mental health. The changes observed in psychological indicators were related to the characteristics of the given disorder.

Benefits of A Three-Day Bamboo Forest Therapy Session on the Psychophysiology and Immune System Responses of Male College Students

Forest therapy is a fast-growing treatment approach, as it has the potential to alleviate stressful life events and to improve psychological well-being and physical health. Bamboo forests are widespread in southwestern China. Nevertheless, a knowledge gap on the specific health benefits of bamboo forest (BF) therapy still exists. To explore the psycho-physiologic responses of participants to the effects of BF therapy, 60 male adults aged between 19 and 24, with similar healthy conditions, were selected to participate in this study. A one-group pretest–posttest design was used for the BF sites and the city site (CS) to compare the difference in the psycho-physiologic responses of participants before and after the test. Participants at the BF sites participated in a three-day bamboo forest therapy session, and those at the CS participated in a three-day urban program. Blood pressure, heart rate, and peripheral oxygen saturation were measured as the physical signs, and the profile of mood state (POMS) questionnaire was completed by the participants for the psychological evaluation. Blood was sampled, and natural killer (NK) activity, the number of NK cells, and the levels of corticosterone, granulysin, perforin, and granzyme A/B in peripheral blood lymphocytes (PBLs) were measured. All the measurements mentioned above were performed at 08:00 on the first and fourth days within the test. Results indicated that the three-day BF therapy was capable of enhancing positive mood states and also reducing negative mood states in the male participants. The blood pressure and heart rates of the male participants decreased, while the peripheral oxygen saturation increased after the three-day BF therapy session. Furthermore, BF therapy significantly increased NK activity and the number of NK cells and perforin-, granulysin-, and granzyme A/B-expressing cells and significantly decreased the corticosterone level in PBLs in the male participants. The three-day BF therapy session improved the psychological and physiological well-being and enhanced the immune functions of the male college students.

Temporal and Spatial Variability of Volatile Organic Compounds in the Forest Atmosphere

The healing effects of the forest are increasingly being valued for their contribution to human psychological and physiological health, motivating further advances aimed at improving knowledge of relevant forest resources. Biogenic volatile organic compounds, emitted by the plants and accumulating in the forest atmosphere, are essential contributors to the healing effects of the forest, and represent the focus of this study. Using a photoionization detector, we investigated the high frequency variability, in time and space, of the concentration of total volatile organic compounds on a hilly site as well as along forest paths and long hiking trails in the Italian northern Apennines. The scale of concentration variability was found to be comparable to absolute concentration levels within time scales of less than one hour and spatial scales of several hundred meters. During daylight hours, on clear and calm days, the concentration peaked from noon to early afternoon, followed by early morning, with the lowest levels in the late afternoon. These results were related to meteorological variables including the atmospheric vertical stability profile. Moreover, preliminary evidence pointed to higher concentrations of volatile organic compounds in forests dominated by conifer trees in comparison to pure beech forests.

Comparison of surf and hike therapy for active duty service members with major depressive disorder: Study protocol for a randomized controlled trial of novel interventions in a naturalistic setting

Many active duty service members suffer from major depressive disorder (MDD). Although traditional treatments exist, alternative approaches may also be effective in treating depressive symptoms. Previous research has shown that physical activity has significant positive effects on depression symptoms in individuals with MDD, and that these benefits may be enhanced when physical activity occurs in a natural environment. Even though physical activity (i.e., hiking, walking) in natural environments has been shown to reduce depressive symptoms, water-based activity occurring in a natural environment (e.g., surfing) may produce even greater improvements in depressive symptoms. We detail an ongoing randomized controlled trial (RCT) comparing the efficacy of surf therapy and hike therapy with respect to immediate and longer-term psychological, physical, and functional outcomes in active duty service members with MDD. We describe the methodological development of this RCT evaluating novel treatment approaches and discuss considerations for evaluating physical activity interventions in a naturalistic setting.

Facial Expressions of Visitors in Forests along the Urbanization Gradient: What Can We Learn from Selfies on Social Networking Services?

People’s satisfaction towards the experience in forests is one of most important feedbacks that forest park managers need to meet positive visitors’ experiences. Although the drawbacks of questionnaire methodology are obvious for data collection from self-reported scores at the landscape scale, few alternative methods have been proposed. In this study, nine urban forest parks along the urbanization gradients in three capital cities of Northeast China were targeted to investigate their visitors’ selfies from social networking services (SNS) by assessing facial expressions. A total of 935 photos with location records were obtained from the SNS platform of Sina Micro-Blog in a social hot-event of ‘Golden Week Holidays of National Day of China’ of 2017. Images were recognized by FireFace software to assess scores of neutral, happy, sad, angry, surprised, scared, disgusted, and contempt expressions. Data were ranked in descending order and analyzed by Friedman’s test, correlation analysis, and Poisson regression. Visitors in downtown-forests showed fewer negative expressions at the most northern city than at the southern most one. The negative expressions tended to be alleviated with the increasing distance of forest parks from downtown. However, when the distance reached over 10 km no geographical effect was found. Female visitors showed positive emotional expressions to urban forests while male visitors showed no response. In conclusion, using data from SNS, this study found an experience in forest park less than 10 km from the downtown of a northern city resulted in female visitors showing the most positive expressions.

Subtypes of Park Use and Self-Reported Psychological Benefits Among Older Adults: A Multilevel Latent Class Analysis Approach

Healthy aging is a global health priority. Urban parks and green space have been demonstrated to provide mental health benefits to older adults. Despite growing interest in prescribing nature and park visits by physicians, we do not know what type of park visit is most effective for the psychological benefits. This lack of knowledge prevents planners and designers from making informed decisions to promote mental health. We collected field data from 200 visitors from 15 different parks in Shanghai, China. The participants completed pre-visit and post-visit surveys, wearing a GPS and a pedometer while visiting the park. A multilevel latent class analysis (LCA) yielded a three-class structure of park use patterns: the active park lingerer, the active walker, and the passive scanner. Paired-sample t-test and ANCOVA tests showed that affective states (i.e., anxiety, depression, relaxation, contention) were enhanced after park visits for all subtypes. However, the active park lingerer displayed significantly higher levels of relaxation and contention, compared to the active walker and the passive scanner. The findings offer insights into park design characteristics that could promote the mental health of older adults.

The Effect of Recreation in a Snow-Covered Forest Environment on the Psychological Wellbeing of Young Adults: Randomized Controlled Study

Forest recreation can be successfully conducted for the purpose of psychological relaxation, as has been proven in previous scientific studies. During the winter in many countries, when snow cover occurs frequently, forest recreation (walking, relaxation, photography, etc.) is common. Nevertheless, whether forest therapy conducted in a forest environment with a snow cover will also have a positive effect on psychological indicators remains unknown. Furthermore, male subjects frequently participate in forest therapy experiments, whereas females are rarely involved. Thus, in this study, the effectuality of forest recreation during winter and with snow cover was tested on 32 young females. For these reasons, the experiment involved 15 min periods of relaxation in a forest environment or in an urban street environment, in addition to a pre-test under indoor conditions (randomized controlled study). Four psychological questionnaires Profile of Mood States (POMS), Positive and Negative Affect Schedule (PANAS), Restorative Outcome Scale (ROS), Subjective Vitality Scale (SVS)) were administered to participants before and after interventions. Results showed that participants’ levels of negative mood, as measured by different aspects of the POMS questionnaire (tension/anxiety, anger/hostility, depression/dejection, confusion, and fatigue), decreased after exposure to the forest environment. In contrast, both tension/anxiety and anger/hostility increased in the urban street environment. The indicator of negative affect from the PANAS questionnaire also increased after exposure to the urban street environment, whereas the indicator of positive affect based on PANAS was higher in the forest environment than in the urban street environment. Restorativeness and subjective vitality exhibited higher values after exposure to the forest environment in comparison to those from the control and pre-test. The changes in these indicators demonstrate that forest recreation in the snow during winter can significantly increase psychological relaxation in females, as well as show that recreation can be successfully conducted under these winter conditions.

The Influence of Forest Resting Environments on Stress Using Virtual Reality

To explore the effects of different types of forest environments for forest therapy, this study focused on forest resting environments. Seven representative forest resting environments found in field research in Beijing were used as independent variables and were shown to subjects by a virtual reality (VR) video. Stress level was used as the dependent variable, and blood pressure, heart rate, salivary amylase, and the Brief Profile of Mood States (BPOMS) were used as physiological and psychological indicators. A between-subjects design was used in the experiment. A total of 96 subjects were randomly assigned to each environment type, and only one type of forest resting environment was observed. Through the relevant sample t-test and one-way analysis of variance, the pre- and post-test data of the indicators were analyzed. This study found that all the seven different types of forest resting environments can produce stress relief effects to some extent. Different types of forest resting environments have different effects on relieving stress. The most natural environment does not have the most significant effect on stress relief. A water landscape has a positive effect on the relief of stress. The conclusions of this study are conducive to the better use of the forest environment for forest therapy services.

Exploring Psychophysiological Restoration and Individual Preference in the Different Environments Based on Virtual Reality

Accumulated evidence claims that urban green spaces (UGS) have a positive impact on the physical and mental health of humans. However, little information is available to clearly reveal what the most important driving factors are for human psychophysiological restoration. In order to unveil this uncertainty, this study employed virtual reality (VR) technology to investigate the physiological (electroencephalogram, EEG), and psychological (attention, positive mood, negative mood) responses and individual preferences for different urban environments. Participants (120) were recruited and randomly assigned to experience six different types of environments varying in land use and vegetation structures, which were: Grey space, blue space, open green space, partly open green space, partly closed green space, and closed green space. The results showed that the experience of the six environmental types through VR devices had positive restorative effects on the individuals' attentional fatigue and negative mood; however, all the participants obtained the highest levels of physiological stress restoration when asked to close their eyes for relaxation. The physiological measurements of the EEG showed no significant differences among the selected types of environments. Meanwhile, the results of the psychological measures suggested that only negative mood showed significant differences of change among the six types of environments, and while the partly open green space had the most positive effect on negative mood, the closed green space had the worst. The blue space and partly closed green space received higher recreational preference ratings than the other four environments, while the closed green space received the lowest recreational preference rating. Moreover, the findings showed that there was a strong positive correlation between people's preferences and the improvement of their positive mood. This indicated that as the popularity of a natural environment increased, so did the benefits of human health and well-being. In addition, this study shows that VR technology may be utilized as a possible surrogate measure to real scenes in evaluating human physiological and psychological restoration in the future. The present findings can provide the theoretical basis and practical guidance for future optimal planning of urban restorative environments.

Effects of forest bathing (shinrin-yoku) on levels of cortisol as a stress biomarker: a systematic review and meta-analysis

Forest bathing is a traditional practice characterized by visiting a forest and breathing its air. This review aims to investigate the effects of forest bathing on levels of salivary or serum cortisol as a stress biomarker in order to understand whether forest bathing can reduce stress. Medline/PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar were systematically searched for relevant articles. The quality of included trials was assessed following the criteria of the NIH dedicated tools. Afterwards, a qualitative and quantitative synthesis of retrieved evidence was performed. A total of 971 articles were screened; 22 of them were included in the systematic review and 8 in the meta-analysis. In all but two included studies, cortisol levels were significantly lower after intervention in forest groups if compared with control/comparison groups, or a significant pre-post reduction of cortisol levels was reported in the forest groups. The main results of the meta-analysis showed that salivary cortisol levels were significantly lower in the forest groups compared with the urban groups both before (MD = - 0.08 μg/dl [95% CI - 0.11 to - 0.05 μg/dl]; p < 0.01; I² = 46%) and after intervention (MD = - 0.05 μg/dl [95% CI - 0.06 to - 0.04 μg/dl]; p < 0.01; I² = 88%). Overall, forest bathing can significantly influence cortisol levels on a short term in such a way as to reduce stress, and anticipated placebo effects can play an important role in it. Further research is advised because of the limited available data.

Physiological and Psychological Effects of Viewing Forests on Young Women

Research Highlights: This study demonstrated that viewing forest landscapes induced physical and mental health benefits on young women. Background and Objectives: The health-promoting effects of spending time in forests have received increasing attention; however, there is a lack of evidence-based research investigating the effects of spending time in forests on women. This study aimed to evaluate the physiological and psychological effects of viewing forest landscapes on young women. Materials and Methods: The experiments were conducted in six forests and six city areas and included 65 women (mean age, 21.0 ± 1.3 years). Participants viewed a forest and a city area for 15 min, during which their heart rate variability and heart rate were measured continuously. Blood pressure and pulse rate were measured before and after the viewing. After the viewing, participants’ psychological responses were assessed using the modified semantic differential method, Profile of Mood States (POMS), and the State–Trait Anxiety Inventory (STAI). Results: Compared with viewing city areas, viewing forest landscapes was associated with significantly higher parasympathetic nervous activity and lower sympathetic nervous activity and heart rate. Moreover, scores of the comfortable, relaxed, and natural parameters and vigor subscales of POMS were significantly higher with forest viewing. The scores of negative feelings, such as tension–anxiety, depression–dejection, anger–hostility, fatigue, and confusion, were significantly lower, as were scores for the total mood disturbance observed using POMS and the anxiety dimension observed using STAI. Conclusions: Viewing forest landscapes resulted in physiological and psychological relaxations in young women.

[Reviewing the psychological and physical health effects of forests]

Civilization illnesses today impact, and will impact in the future, everyday life of people, particularly in high-income countries. Consequences are loss in life expectancy, reduction of quality of life as well as rising economic loads. The positive effects of stays and visits in natural environments on human well-being are known for a long time. Particularly, there are many indications that forest stays have health-promoting effects. This narrative review of the literature presents the current state of the research on health-promoting effects of forest exposure. Forest exposure has positive health effects on the cardiovascular system, the immune system and on mood. Especially in the context of stress reduction, forest exposure seems to have positive influences. However, little can be concluded about the extent of these positive effects, as most studies work without control environment or control groups. Moreover forest exposure is often associated with physical activity which is also known to have health benefits. Against the background of the positive health promoting trend further research should be carried out.

A comparative study of the physiological and psychological effects of forest bathing (Shinrin-yoku) on working age people with and without depressive tendencies

BACKGROUND

In recent years, many of Japanese workers have complained of fatigue and stress, considering them as risk factors for depression. Studies have found that "forest bathing" (Shinrin-yoku) has positive physiological effects, such as blood pressure reduction, improvement of autonomic and immune functions, as well as psychological effects of alleviating depression and improving mental health. In this study, we investigate the physiological and psychological effects of "forest bathing" on people of a working age with and without depressive tendencies.

METHODS

We conducted physiological measurements and psychological surveys before and after forest bathing with subjects who participated in day-long sessions of forest bathing, at a forest therapy base located in Hiroshima Prefecture. After excluding severely depressed individuals, the participants were classified into two groups: those with depressive tendencies (5 ≤ K6 ≤ 12) and those without depressive tendencies (K6 < 5) for comparative study. The evaluation indices measured were systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), autonomic functions, and profile of mood states (POMS).

RESULTS

Of the 155 participants, 37% had depressive tendencies, without any differences observed between males and females. All participants showed significant decrease in SBP, DBP, and in negative POMS items after a forest bathing session. Before the session, those with depressive tendencies scored significantly higher on the POMS negative items than those without depressive tendencies. After forest bathing, those with depressive tendencies demonstrated significantly greater improvement in many of POMS items than those without depressive tendencies, and many of them no longer differed between those with and without depressive tendencies.

CONCLUSIONS

Examining the physiological and psychological effects of a day-long session of forest bathing on a working age group demonstrated significant positive effects on mental health, especially in those with depressive tendencies. Not applicable; this is not a report of intervention trial.

Green environments and cardiovascular health

Several large epidemiological studies have found robust associations between greenness and the risk of cardiovascular disease (CVD). These studies report that close residential proximity to greenness is associated with a decrease in cardiovascular mortality as well as major adverse cardiovascular events. Although mechanisms underlying this link are not well understood, the beneficial health effects of greenness have been linked to its ability to relieve stress, decrease air pollution, and encourage physical activity. Greenness in residential neighborhoods could also increase access to healthy goods and services, as well as social interactions. Research into the health effects of greenness could provide new insights into the environmental determinants of CVD risk and could inform the development of actionable greenness-based strategies to prevent CVD and its clinical manifestations.

A Scoping Review Mapping Research on Green Space and Associated Mental Health Benefits

BACKGROUND

There is a growing interest in research investigating the association between green space (GS) and mental health and wellbeing (HWB), in order to understand the underlying mechanisms. Accordingly, there is a need to map the literature and create an overview of the research.

METHODS

A scoping review approach was used to map literature on GS, including context and co-exposures (the GS exposome), and their associations with mental HWB. The review considers mental HWB definitions and measurements and how GS is characterized. Furthermore, the review aims to identify knowledge gaps and make recommendations for future research.

RESULTS

We identified a great diversity in study designs, definitions, outcome measures, consideration of the totality of the GS exposome, and reporting of results. Around 70% of the 263 reviewed studies reported a positive association between some aspect of GS and HWB. However, there is a limited amount of research using randomized controlled crossover trails (RCTs) and mixed methods and an abundance of qualitative subjective research.

CONCLUSIONS

The discords between study designs, definitions, and the reporting of results makes it difficult to aggregate the evidence and identify any potential causal mechanisms. We propose key points to consider when defining and quantifying GS and make recommendations for reporting on research investigating GS and mental HWB. This review highlights a need for large well-designed RCTs that reliably measure the GS exposome in relation to mental HWB.

Vital spaces and mental health

The impact of social and material conditions on mental health is well established but lacking in a coherent approach. We offer the concept of 'vitality' as means of describing how environments facilitate 'feelings of being alive' that cut across existing diagnostic categories. Drawing on the work of Stern, Fuchs, Worms and Duff, we argue that vitality is not solely a quality of an individual body, but rather emerges from attunements and resonances between bodies and materials. We use vitality as a lens to explore how movements within and between assembled sets of relations can facilitate or disable feelings and expressions of being alive. Building on extended discussions of both inpatient and community-based mental healthcare, we sketch out a research agenda for analysing 'vital spaces'.

The Influence of Audio-Visual Interactions on Psychological Responses of Young People in Urban Green Areas: A Case Study in Two Parks in China

Audio-visual interactions in green spaces are important for mental health and wellbeing. However, the influence of audio-visual interactions on psychological responses is still less clear. This study introduced a new method, namely the audio-visual walk (AV-walk), to obtain data on the audio-visual context, audio-visual experiences, and psychological responses in two typical parks, namely Cloves Park and Music Park in Harbin, China. Some interesting results are as follows: First, based on Pearson’s correlation analysis, sound pressure level and roughness were significantly correlated with psychological responses in Cloves Park (p < 0.05). Second, the results of stepwise regression models showed the impact intensity of acoustic comfort was 1.64–1.68 times higher than that of visual comfort on psychological responses of emotion dimension, while visual comfort was 1.35–1.37 times higher than acoustic comfort on psychological responses of cognition dimension in Music Park. In addition, an orthogonal analysis diagram explained the influence of audio-visual interactions on psychological responses of young people. The audio-visual context located beside the waterscape with a relatively higher level of acoustic and visual comfort was the most cheerful (2.60), relaxed (2.45), and energetic (2.05), while the audio-visual context close to an urban built environment tended to be both acoustically and visually uncomfortable, and the psychological state was decreased to the most depressed (−0.25), anxious (−0.75), fatigued (−1.13) and distracted (−1.13).

Immersive Nature-Experiences as Health Promotion Interventions for Healthy, Vulnerable, and Sick Populations? A Systematic Review and Appraisal of Controlled Studies

In this systematic review, we summarized and evaluated the evidence for effects of, and associations between, immersive nature-experience on mental, physical, and social health promotion outcomes. Immersive nature-experience was operationalized as non-competitive activities, both sedentary and active, occurring in natural environments removed from everyday environments. We defined health according to the World Health Organization's holistic and positive definition of health and included steady-state, intermediate, and health promotion outcomes. An electronic search was performed for Danish, English, German, Norwegian, and Swedish articles published between January 2004 and May 2017. Manual approaches, e.g., bibliographies from experts, supplemented the literature search. Data were extracted from 461 publications that met the inclusion criteria. To assess the status and quality of the evidence for health promotion effects of immersive nature-experience, we focused on the subset of studies based on controlled designs (n = 133). Outcome level quality of the evidence was assessed narratively. Interventions most often involved adventure-based activities, short-termed walking, and seated relaxation in natural environments. We found positive effects on a range of health promotion outcomes grouped under psychological wellbeing (n = 97; ≈55% positive; ≈13% mixed; ≈29% non-significant; 2% negative); psychosocial function (n = 67; ≈61% positive; ≈9% mixed; ≈30% non-significant); psychophysiological stress response (n = 50; ≈58% positive; ≈18% mixed; ≈24% non-significant), and cognitive performance (n = 36; ≈58% positive; ≈6% mixed; ≈33% non-significant; 3% negative); and social skills and relationships (n = 34; ≈70% positive; ≈7% mixed; ≈22% non-significant). Findings related to outcomes categorized under physical health, e.g., risk of cardiovascular disease, were less consistent (n = 51; ≈37% positive; ≈28% mixed; ≈35% non-significant). Across the types of interventions and outcomes, the quality of the evidence was deemed low and occasionally moderate. In the review, we identify, discuss, and present possible solutions to four core methodological challenges associated with investigating immersive nature-experience and health outcomes: (1) intervention and program complexity; (2) feasibility and desirability of randomization; (3) blinding of participants and researchers; and (4) transferability and generalizability. The results of the review have been published as a popular-scientific report and a scientific research overview, both in Danish language.

Relation between Psychological Restorativeness and Lifestyle, Quality of Life, Resilience, and Stress-Coping in Forest Settings

Previous research has mainly dealt with the physiological and psychological restorative effects of the forest environment. However, comparatively few studies have focused on how the traits and attributes of individuals (individual traits) affect the restorative effects of the forest environment. In this study, we examined the relationships between the psychological restorative effects offered by perceived restorativeness of outdoor settings and the individual traits. Then, we investigated the relationships between the restorative indicators that are useful in examining the restorative properties (i.e., the Perceived Restorativeness Scale (PRS); seven indicators in total), the psychological restorative effect (Profile of Mood States (POMS), Restorative Outcome Scale (ROS), positive and negative affect schedule (PANAS), and Subjective Vitality Scale (SVS); 10 indicators in total), and the individual trait indicators that could be used to investigate individual traits (Development of Health and Life Habit Inventory for lifestyle, Lazarus-type Stress Coping Inventory for stress coping, World Health Organization Quality of Life Assessment 26 for quality of life (QOL), and Sukemune-Hiew Resilience test for resilience; 28 indicators in total) in forest and urban settings. Respondents consisted of 46 male students in their twenties. A short-term experiment was conducted using the same method in both environmental settings. We then analyzed the intrinsic restorative properties and the restorative effects of the settings and referred to prior research to determine the restorative effects. Furthermore, we analyzed the relationship between the restorative indicators and the individual trait indicators by correlation analysis and multiple regression (step-wise) analysis. These new findings were obtained: (1) the forest setting was a restorative environment with a higher restorative effect than the urban setting; (2) although the forest setting had a higher restorative effect than the urban setting, and the influence of individual traits was small; (3) in the forest setting, the relationship between the restorative indicators and individual traits indicators were arranged; (4) distancing (Stress coping), psychological health (QOL), and satisfaction with living environment (QOL) were likely important indicators that are related to the restorative effects in the forest setting.

Is it Really Nature That Restores People? A Comparison With Historical Sites With High Restorative Potential

Research on restorative environments has showed the healthy outcomes of nature experience, though often by comparing attractive natural to unattractive built environments. Some studies indeed showed the restorative value of artistic/historical settings. In a quasi-experimental study involving 125 participants in Rome, Italy, a natural and a built/historical environment, both scoring high in restorative properties, were evaluated in a natural, built/historical, or neutral setting. In accordance with the Biophilia hypothesis and the Attention Restoration Theory (ART), we hypothesized: a higher restorative potential of nature also when compared to built/historical environments; a moderation effect of on-site experience on perceived restorative potential (PRP) of both environmental typologies; higher levels of restorative properties of the environment for on-site vs. not on-site respondents; and a mediation effect of the restorative properties of the environment in the relationship between time spent on-site and PRP. Results supported the hypotheses. In addition, different psychological processes leading to restoration emerged for the natural and the built/historical environment. Theoretical implications for ART and practical applications for an integrative urban design with natural and historical elements are discussed.