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Hood M, Baumann O. Could Nature Contribute to the Management of ADHD in Children? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:736. [PMID: 38928982 PMCID: PMC11203786 DOI: 10.3390/ijerph21060736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/04/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that is typically managed with pharmacological and psychotherapeutic interventions. In the general population, exposure to nature has been found to have robust beneficial effects on cognitive performance, including attention. With inattention being a factor of the symptomatology of individuals with ADHD, this provides a rationale to investigate the potential benefits of exposure to nature for this population. Four electronic databases (PubMED, PsycINFO, Embase, and Web of Science) were searched for empirical studies investigating the effects of nature on ADHD prevalence and/or symptom severity in populations of school-aged children. Key characteristics, methodologies, and outcomes of included studies were extracted and evaluated. Out of the 458 studies identified, 7 met the inclusion criteria. Despite the large heterogeneity in methodological approaches, the included articles consistently reported that exposure to nature is associated with reduced ADHD diagnoses and symptom severity. Furthermore, when several covariates, such as age, gender, annual household income, parental income, and education level, as well as several pre-natal factors, were controlled for, the relationship between nature and ADHD remained significant. The reviewed literature provides strong support for the benefits of exposure to nature on ADHD in school-aged children.
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Affiliation(s)
| | - Oliver Baumann
- School of Psychology, Bond University, Robina, QLD 4226, Australia;
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2
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Benedetti V, Giganti F, Cotugno M, Noferini C, Gavazzi G, Gronchi G, Righi S, Meneguzzo F, Becheri FR, Li Q, Viggiano MP. Interplay among Anxiety, Digital Environmental Exposure, and Cognitive Control: Implications of Natural Settings. Behav Sci (Basel) 2024; 14:323. [PMID: 38667119 PMCID: PMC11047410 DOI: 10.3390/bs14040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
Inhibitory control performance may differ greatly as a function of individual differences such as anxiety. Nonetheless, how cognitive control proficiency might be influenced by exposure to various environments and how anxiety traits might impact these effects remain unexplored. A cohort of thirty healthy volunteers participated in the study. Participants performed a Go/No-Go task before exposure to a 'forest' and 'urban' virtual environment, in a counterbalanced design, before repeating the GNG task. The State-Trait Anxiety Inventory (STAI) was finally filled-in. Our findings unveiled an initial negative correlation between anxiety trait levels and GNG task performance, consistent with the established literature attributing difficulties in inhibitory functionality to anxiety. Additionally, different environmental exposures reported opposite trends. Exposure to the 'forest' environment distinctly improved the GNG performance in relation to anxiety traits, while the 'urban' setting demonstrated adverse effects on task performance. These results underscore the intricate relationship among cognitive control, environmental exposure, and trait anxiety. In particular, our findings highlight the potential of natural settings, such as forests, to mitigate the impact of anxiety on inhibition. This might have implications for interventions aimed at improving cognitive control.
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Affiliation(s)
- Viola Benedetti
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
| | - Fiorenza Giganti
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
| | - Maria Cotugno
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
| | - Chiara Noferini
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
- European Laboratory for Non-Linear Spectroscopy, University of Florence, Sesto Fiorentino, 50019 Florence, Italy
| | - Gioele Gavazzi
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
| | - Giorgio Gronchi
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
| | - Stefania Righi
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
| | - Francesco Meneguzzo
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, Sesto Fiorentino, 50019 Florence, Italy;
- Central Scientific Committee, Italian Alpine Club, 19 Via E. Petrella, 20124 Milano, Italy
| | | | - Qing Li
- Department of Rehabilitation and Physical Medicine, Graduate School of Medicine—Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan;
| | - Maria Pia Viggiano
- Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 50135 Florence, Italy; (V.B.); (F.G.); (M.C.); (C.N.); (G.G.); (G.G.); (S.R.)
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Mattenklodt P, Ingenhorst A, Flatau B, Becker K, Grießinger N. [Interdisciplinary pain therapy in the elderly]. Schmerz 2024; 38:89-98. [PMID: 37266908 DOI: 10.1007/s00482-023-00721-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 06/03/2023]
Abstract
Chronic pain in the elderly is becoming increasingly important and is associated with serious health impacts. Therefore, international guidelines demand that pain therapy for the elderly preferably be a multimodal therapy based on a bio-psycho-social pain model. Specific psychometric tests and interview guidelines are available for the interdisciplinary pain assessment. Evidence for the effectiveness of multimodal pain therapy in the elderly remains limited. However, controlled clinical trials have shown that these patients benefit-especially if the intervention is adapted to their specific needs. The focus of movement therapy is not only muscle strengthening but also coordination exercises. In individual physical therapy and occupational therapy, everyday solutions can be developed for individual physical limitations that are more frequent in old age. In psychological training, pain acceptance, balancing rest and activity, social integration and dealing with aging are particularly important topics. Relaxation and mindfulness techniques can also favorably affect pain and function. Thus, these are popular with patients and are often adopted in everyday pain management. Pain education is considered useful as an adjunctive measure and can also be increasingly supported by digital media in the elderly. Complementary therapy components include confrontational treatment of fear-avoidance beliefs (the German AMIKA scale, Ältere Menschen in körperlicher Aktion, "older people in physical action") and naturopathic applications as an active self-help strategy. Since it is unclear how long the achieved therapeutic effects last, follow-up care is of particular importance in therapy for older patients.
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Affiliation(s)
- Peter Mattenklodt
- Schmerzzentrum, Uniklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
| | - Anne Ingenhorst
- Schmerzzentrum, Uniklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland
| | - Brigitta Flatau
- medi train - Bewegungstherapie Physiotherapie, Erlangen, Deutschland
| | - Kristina Becker
- medi train - Bewegungstherapie Physiotherapie, Erlangen, Deutschland
| | - Norbert Grießinger
- Schmerzzentrum, Uniklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland
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Robinson JM, Breed AC, Camargo A, Redvers N, Breed MF. Biodiversity and human health: A scoping review and examples of underrepresented linkages. ENVIRONMENTAL RESEARCH 2024; 246:118115. [PMID: 38199470 DOI: 10.1016/j.envres.2024.118115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/09/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
Mounting evidence supports the connections between exposure to environmental typologies(such as green and blue spaces)and human health. However, the mechanistic links that connect biodiversity (the variety of life) and human health, and the extent of supporting evidence remain less clear. Here, we undertook a scoping review to map the links between biodiversity and human health and summarise the levels of associated evidence using an established weight of evidence framework. Distinct from other reviews, we provide additional context regarding the environment-microbiome-health axis, evaluate the environmental buffering pathway (e.g., biodiversity impacts on air pollution), and provide examples of three under- or minimally-represented linkages. The examples are (1) biodiversity and Indigenous Peoples' health, (2) biodiversity and urban social equity, and (3) biodiversity and COVID-19. We observed a moderate level of evidence to support the environmental microbiota-human health pathway and a moderate-high level of evidence to support broader nature pathways (e.g., greenspace) to various health outcomes, from stress reduction to enhanced wellbeing and improved social cohesion. However, studies of broader nature pathways did not typically include specific biodiversity metrics, indicating clear research gaps. Further research is required to understand the connections and causative pathways between biodiversity (e.g., using metrics such as taxonomy, diversity/richness, structure, and function) and health outcomes. There are well-established frameworks to assess the effects of broad classifications of nature on human health. These can assist future research in linking biodiversity metrics to human health outcomes. Our examples of underrepresented linkages highlight the roles of biodiversity and its loss on urban lived experiences, infectious diseases, and Indigenous Peoples' sovereignty and livelihoods. More research and awareness of these socioecological interconnections are needed.
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Affiliation(s)
- Jake M Robinson
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia.
| | - Andrew C Breed
- Epidemiology and One Health Section, Department of Agriculture, Water, and the Environment, Canberra, ACT, Australia; School of Veterinary Science, University of Queensland, Gatton, Qld, Australia
| | | | - Nicole Redvers
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Martin F Breed
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
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5
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Morita E, Kadotani H, Yamada N, Sasakabe T, Kawai S, Naito M, Tamura T, Wakai K. The Inverse Association between the Frequency of Forest Walking (Shinrin-yoku) and the Prevalence of Insomnia Symptoms in the General Japanese Population: A Japan Multi-Institutional Collaborative Cohort Daiko Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:350. [PMID: 38541349 PMCID: PMC10970638 DOI: 10.3390/ijerph21030350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 04/07/2024]
Abstract
Since a single forest walk (Shinrin-yoku or forest bathing) session is reported to improve sleep temporarily, occasional forest walks may have a positive effect on daily sleep. Therefore, this study aimed to examine whether more frequent forest walking is associated with better daily sleep conditions. Data from the second survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Daiko Study conducted among residents of Nagoya City, Japan, were used. The study design was a cross-sectional study. In total, 2044 participants (529 men and 1515 women; age, mean ± standard deviation: 58.8 ± 9.9 years) were included in the analysis. Frequent forest walks were associated with a low percentage of insomnia symptoms (Insomnia Severity Index ≥10) in women, but not in men. The adjusted odds ratio for the group that rarely took forest walks with reference to the group that engaged in the activity once a month or more often was 2.04 (95% confidence interval: 1.29-3.23) in women. Forest walk frequency was not significantly associated with sleep duration or sleep efficiency as measured by actigraphy in either men or women. In conclusion, the results suggested that increasing the frequency of forest walks or Shinrin-yoku may be effective in preventing insomnia in women.
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Grants
- Priority Areas of Cancer (No. 17015018) Ministry of Education, Culture, Sports, Science and Technology, Japan.
- Innovative Areas (No. 221S0001) Ministry of Education, Culture, Sports, Science and Technology, Japan.
- JSPS KAKENHI Grant (No. 16H06277, 18K11065, 21H02246, 22H04923 and No. 26507005) Ministry of Education, Culture, Sports, Science and Technology, Japan.
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Affiliation(s)
- Emi Morita
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
- Forestry and Forest Products Research Institute, Forest Research and Management Organization, 1 Matsunosato, Tsukuba 305-8687, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu 520-2192, Japan; (H.K.); (N.Y.)
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu 520-2192, Japan; (H.K.); (N.Y.)
- Kanbayashi Memorial Hospital, 89-1 Orikuchinishi, Okucho, Ichinomiya 491-0201, Japan
| | - Tae Sasakabe
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan
| | - Sayo Kawai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan;
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
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6
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Mattenklodt P, Ingenhorst A, Flatau B, Becker K, Grießinger N. [Interdisciplinary pain therapy in the elderly]. DIE ANAESTHESIOLOGIE 2024; 73:147-155. [PMID: 38376754 DOI: 10.1007/s00101-024-01392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Chronic pain in the elderly is becoming increasingly important and is associated with serious health impacts. Therefore, international guidelines demand that pain therapy for the elderly preferably be a multimodal therapy based on a bio-psycho-social pain model. Specific psychometric tests and interview guidelines are available for the interdisciplinary pain assessment. Evidence for the effectiveness of multimodal pain therapy in the elderly remains limited. However, controlled clinical trials have shown that these patients benefit-especially if the intervention is adapted to their specific needs. The focus of movement therapy is not only muscle strengthening but also coordination exercises. In individual physical therapy and occupational therapy, everyday solutions can be developed for individual physical limitations that are more frequent in old age. In psychological training, pain acceptance, balancing rest and activity, social integration and dealing with aging are particularly important topics. Relaxation and mindfulness techniques can also favorably affect pain and function. Thus, these are popular with patients and are often adopted in everyday pain management. Pain education is considered useful as an adjunctive measure and can also be increasingly supported by digital media in the elderly. Complementary therapy components include confrontational treatment of fear-avoidance beliefs (the German AMIKA scale, Ältere Menschen in körperlicher Aktion, "older people in physical action") and naturopathic applications as an active self-help strategy. Since it is unclear how long the achieved therapeutic effects last, follow-up care is of particular importance in therapy for older patients.
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Affiliation(s)
- Peter Mattenklodt
- Schmerzzentrum, Uniklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
| | - Anne Ingenhorst
- Schmerzzentrum, Uniklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland
| | - Brigitta Flatau
- medi train - Bewegungstherapie Physiotherapie, Erlangen, Deutschland
| | - Kristina Becker
- medi train - Bewegungstherapie Physiotherapie, Erlangen, Deutschland
| | - Norbert Grießinger
- Schmerzzentrum, Uniklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland
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Li H, Zhang G. How can plant-enriched natural environments benefit human health: a narrative review of relevant theories. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1241-1254. [PMID: 36697394 DOI: 10.1080/09603123.2023.2170990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/17/2023] [Indexed: 06/17/2023]
Abstract
Plant-enriched environments, the most common terrestrial landscapes, are usually coded as "green space" in urban studies. To understand how these natural environments can benefit human health, many theories have been developed, such as the well-known Attention Restoration Theory. Nowadays, more theories are emerging with regard to various and complex health dimensions. In this context, we searched online databases (from 2000 to 2022) and conducted a narrative review aiming to introduce relevant theories concerning psychological (e.g. Perceptual Fluency Account and Conditioned Restoration Theory), physiological (e.g. volatile organic compounds and environmental microbiomes), and behavioural (e.g. physical activity and social contact) perspectives. We also slightly mentioned some limitations and directions to be considered when using these theories. These results may offer general readers insights into the value of nature exposure and also help relevant researchers with study design and result interpretation.
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Affiliation(s)
- Hansen Li
- Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
| | - Guodong Zhang
- Key Laboratory of Physical Fitness Evaluation and Motor Function Monitoring, Institute of Sports Science, College of Physical Education, Southwest University, Chongqing, China
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Gungormus DB, Fernández-Martín M, Ortigosa-Luque ME, Pérez-Mármol JM. Effects of Nature-Based Multisensory Stimulation on Pain Mechanisms in Women with Fibromyalgia Syndrome: A Randomized Double-Blind Placebo-Controlled Trial. Pain Manag Nurs 2024; 25:46-55. [PMID: 37495473 DOI: 10.1016/j.pmn.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND The term "nature-based sensory stimuli" refers to the sensory information produced by biotic and abiotic agents from natural environments. The literature has reported the beneficial effects of these agents on various pain dimensions in non-clinical populations. AIMS To evaluate the potential analgesic effects of nature-based multisensory stimulation in women with fibromyalgia syndrome. METHODS A randomized, double-blind, placebo-controlled, parallel-group trial with a 1:1 allocation ratio was conducted. Forty-two women with fibromyalgia syndrome interacted with either different plant species with flowers, stones, and soil organic matter or their synthetic imitations for 30 minutes. Outcome measurements were performed before and after the intervention, including clinical pain intensity using the Numeric Rating Scale, cold pain thresholds using the Cold Pressor Test, mechanical hyperalgesia and wind-up using a monofilament, and pressure pain thresholds using a pressure algometer. RESULTS Analyses revealed group × time interactions for clinical pain intensity (F = 7.915, p = .008), cold-water immersion time (F = 7.271, p = .010), mechanical hyperalgesia (F = 4.701, p = .036), and pressure pain threshold (p ≤ .017). Between-group differences were found in clinical pain intensity (p = .012), cold pain thresholds (p = .002), and pressure pain thresholds (p < .05). The experimental group exhibited reduced clinical pain intensity (p = .001) and increased pressure pain thresholds (p ≤ .034). CONCLUSIONS Women with fibromyalgia syndrome may benefit from multisensory stimulation using biotic and abiotic agents from natural environments for 30 minutes. Interacting with flowering plants and soil components appears to induce analgesic effects.
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Affiliation(s)
- Dogukan Baran Gungormus
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Mónica Fernández-Martín
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.
| | | | - José Manuel Pérez-Mármol
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
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Catissi G, Gouveia G, Savieto RM, Silva CPR, de Almeida RS, Borba GB, Rosario KA, Leão ER. Nature-Based Interventions Targeting Elderly People's Health and Well-Being: An Evidence Map. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:112. [PMID: 38276806 PMCID: PMC10815627 DOI: 10.3390/ijerph21010112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Healthy aging encompasses more than the absence of disease, emphasizing the preservation of functional abilities for enhanced well-being and quality of life. Nature-based interventions are scientifically proven contributors to healthy aging. OBJECTIVE To develop an evidence map showcasing nature-based interventions targeting older individuals' health and well-being. METHODS The evidence map was developed through critical analysis of systematic reviews and clinical trials utilizing the tools AMSTAR2 and CONSORT. A systematic search spanning the past decade was conducted across databases: Cochrane, SCOPUS, PubMed, Web of Science, Embase, and LILACS. RESULTS Twelve articles met the eligibility criteria. Nature-based interventions such as forest bathing, hiking, therapeutic gardens, virtual reality, and forest sounds were identified. Outcomes were categorized into physical aspects (cardiovascular and pulmonary; neuro-immuno-endocrinological) and mental/behavioral aspects. The final map integrated interventions, outcomes, and quality assessments. CONCLUSIONS The survey highlights the positive impact of nature-based interventions on the health of the elderly. This study provides insights across various domains, fostering the development of programs and policies in management to promote healthy aging. Regarding healthcare, it encourages discourse among professionals regarding the integration of nature-based practices for equitable care in both individual and group settings. Furthermore, it underscores the need for research in the Southern Hemisphere, particularly in Brazil, where the study was conducted.
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Affiliation(s)
- Giulia Catissi
- Albert Einstein Israeli Faculty of Health Sciences, Hospital Israelita Albert Einstein, São Paulo 05651-901, Brazil;
| | - Gabriela Gouveia
- A Beneficência Portuguesa de São Paulo, São Paulo 01323-001, Brazil;
| | - Roberta Maria Savieto
- Hospital Israelita Albert Einstein, Education and Research Center, São Paulo 05651-901, Brazil;
| | | | - Raquel Simões de Almeida
- Psychosocial Rehabilitation Laboratory (LabRP-CIR, ESS), Polytechnic of Porto, 4200-072 Porto, Portugal;
| | - Gustavo Benvenutti Borba
- Department of Electronics-DAELN, Graduate School on Biomedical Engineering—PPGEB, Federal University of Technology-Paraná—UTFPR, Curitiba 80230-901, Brazil; (G.B.B.); (K.A.R.)
| | - Kaue Alves Rosario
- Department of Electronics-DAELN, Graduate School on Biomedical Engineering—PPGEB, Federal University of Technology-Paraná—UTFPR, Curitiba 80230-901, Brazil; (G.B.B.); (K.A.R.)
| | - Eliseth Ribeiro Leão
- Hospital Israelita Albert Einstein, Education and Research Center, São Paulo 05651-901, Brazil;
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10
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Abookire SA, Ayala SG, Shadick NA. Supporting Wellness, Resilience, and Community With Forest Therapy. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241246503. [PMID: 38601344 PMCID: PMC11005489 DOI: 10.1177/27536130241246503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 04/12/2024]
Abstract
Background Physician burnout has reached epidemic proportions. Although burnout is rooted in systems, practices for physician wellbeing and community can address exhaustion, burnout, and isolation. Inspired by the Japanese practice shinrin-yoku, forest therapy/bathing (FT) is a nature immersion practice that improves wellbeing in a group setting. Objective This program offered guided FT experiences to frontline faculty physicians in the Department of Medicine and evaluated potential for impact on burnout, resilience, and community. Methods Faculty physicians were recruited via email invitations to a free Forest Therapy group experience in the Arnold Arboretum in Boston, MA. Participants completed pre-and post-course surveys and evaluated its value as a community experience. Surveys measured burnout, resilience, and qualitative feedback on the experience. Results Twenty-seven faculty completed the baseline survey, twenty-three faculty participated, with 19 survey respondents. At baseline, 85% reported feeling burned out at least once a month. 46% reported feeling burned out more than a few times a month. 83% of participants responded that forest therapy could help them with the feeling of being burned out from work. Post-intervention, 100% of participants rated the experience as very or extremely valuable. 96% of participants reported they were interested in more frequent forest therapy sessions. 100% of participants would recommend this practice to other faculty. 70% of respondents reported the program could help them with burnout. Despite high baseline resilience, 94% of participants reported that forest therapy could help with stressful events and setbacks. Post-intervention, participants reported feeling relaxed, at peace, and calm. Conclusion This pilot demonstrates feasibility and acceptability for physicians of FT. Participants would consider recommending FT to their colleagues, and agreed that FT can help with wellbeing, and expressed enthusiasm for the community experience. This program may also be successfully incorporated into programs for leadership, teambuilding, and support after adverse events.
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Affiliation(s)
- Susan A Abookire
- Harvard Medical School, Boston, MA, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Nancy A Shadick
- Harvard Medical School, Boston, MA, USA
- Brigham and Women’s Hospital, Boston, MA, USA
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11
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Trudel SM, Winter EL, Guerrera MP. Nature as Medicine and Classroom: Evaluating an Innovative, Outdoor Course for Medical and Dental Students. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241246788. [PMID: 38629109 PMCID: PMC11020736 DOI: 10.1177/27536130241246788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/14/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024]
Abstract
Background There is a growing, global awareness and recognition of the important, interdependent relationships between our natural world and human health. Several contemporary health organizations have placed calls to action and emphasize an urgent need for collaboration and interdisciplinary research, education, and clinical work to address the increasing degradation of our planetary and human health. With more research dedicated to nature's health impacts, health professions schools would benefit by including such training in their programs while also cultivating a comprehensive mind-body health perspective to support both the health of student practitioners and their future patients. Objective The present program evaluation investigates a five-day outdoor mini-course covering nature-based health techniques at a medical and dental school in the American Northeast. This unique outdoor course combines nature, creativity, and reflection within the context of modern medicine. Methods A concurrent mixed-method design using descriptive statistics, quantitative and qualitative data from students' anonymous final course evaluations and final reflection projects are evaluated. Results Data suggests that students benefitted from their experience during this five-day course. Students provided feedback reinforcing the enjoyment and transformative outcomes gleaned from the course experiences. Students entered the course describing feeling stressed, overwhelmed, and overextended, not uncommon for learners in medical and dental school, and completed the course describing the acquisition of applicable skills, increased attention and mindfulness, creativity, and connection to the natural world. Conclusions Students described a positive experience of the course. Several areas of personal and professional development were also described, such as improvements within cognitive domains, enhanced connection with nature, others, and themselves, increased mindfulness, and overall improved well-being. Findings have implications for medical and dental programs on how such innovative training may lean into the work of nature-based care to provide for the whole person.
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Affiliation(s)
- Sierra M. Trudel
- University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - Mary P. Guerrera
- University of Connecticut School of Medicine, Farmington, CT, USA
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12
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Gu X, Zheng H, Tse CS. Contact with nature for emotion regulation: the roles of nature connectedness and beauty engagement in urban young adults. Sci Rep 2023; 13:21377. [PMID: 38049530 PMCID: PMC10695948 DOI: 10.1038/s41598-023-48756-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/29/2023] [Indexed: 12/06/2023] Open
Abstract
Contact with nature has emotional benefits, but the psychological mechanism and potential moderator underlying the association between nature contact and emotion regulation remain unclear. The present study investigated how self-reported frequency of nature contact is associated with the use of emotion regulation strategies and explored the mediating role of nature connectedness (i.e., psychological connection to nature) and the moderating role of engagement with natural beauty. Employing mediation and moderated mediation analyses, in a cross-sectional sample of 2097 young adults aged 18-35 years old (M = 24.01, SD = 4.80) residing in urban China, we obtained three major findings. First, nature connectedness mediated the associations between direct/indirect nature contact and cognitive reappraisal as well as expressive suppression. Second, engagement with natural beauty moderated the path from direct/indirect nature contact to cognitive reappraisal in the mediation models. Third, engagement with natural beauty moderated the path from indirect nature contact to nature connectedness in the mediation models. Our study is the first to reveal mediating and moderating factors in the relationships among direct/indirect contact with nature, nature connectedness, engagement with natural beauty, and emotion regulation strategies. These findings provide support for the emotional health of nature contact and have implications for nature-based education and urban planning.
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Affiliation(s)
- Xuan Gu
- Department of Social Work, Shandong University, Jinan, China.
- Center for Animal Protection Studies, Shandong University, Jinan, China.
- Department of Applied Psychology, Guangdong University of Finance and Economics, Guangzhou, China.
| | - Hailin Zheng
- Department of Applied Psychology, Guangdong University of Finance and Economics, Guangzhou, China
| | - Chi-Shing Tse
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
- Centre for Learning Sciences and Technology, The Chinese University of Hong Kong, Hong Kong, China
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13
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Morelli V, Heizelman RJ. Monitoring Social Determinants of Health Assessing Patients and Communities. Prim Care 2023; 50:527-547. [PMID: 37866829 DOI: 10.1016/j.pop.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Because of the devastating health effects of social determinants of health (SDoH), it is important for the primary care provider to assess and monitor these types of stressors. This can be done via surveys, geomapping, or various biomarkers. To date, however, each of these methods is fraught with obstacles. There are currently are no validated "best" SDoH screening tools for use in clinical practice. Nor is geomapping, a perfect solution. Although mapping can collect location specific factors, it does not account for the fact that patients may live in one area, work in another and travel frequently to a third.
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Affiliation(s)
- Vincent Morelli
- Department of Family and Community Medicine, Meharry Medical College, 3rd Floor, Old Hospital Building, 1005 Dr. D. B. Todd, Jr., Boulevard, Nashville, TN 37208-3599, USA.
| | - Robert Joseph Heizelman
- Department of Family Medicine, Medical Informatics, University of Michigan, 3rd Floor, Old Hospital Building, 1005 Dr. D. B. Todd, Jr., Boulevard, Nashville, TN 37208-3599, USA
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14
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Williams MT, Holmes S, Zare M, Haeny A, Faber S. An Evidence-Based Approach for Treating Stress and Trauma due to Racism. COGNITIVE AND BEHAVIORAL PRACTICE 2023; 30:565-588. [PMID: 38037647 PMCID: PMC10686550 DOI: 10.1016/j.cbpra.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Racism can be stressful or even traumatizing. Psychological unwellness emerges out of the confluence of historical, cultural, and individual experiences, and resulting syndromes may or may not fit into a DSM-5 PTSD diagnostic framework. Although racial stress and trauma are common presentations in therapy, few therapists have the resources or training to treat these issues. Based on the empirical evidence to date, this article describes the essential components of treatment for racial stress and trauma from a cognitive-behavioral perspective, called the Healing Racial Trauma protocol. Each technique is described with reference to the literature supporting its use for racial stress and trauma, along with guidance for how therapists might implement the method with clients. Also provided is information about sequencing techniques for optimal outcomes. Critical therapist prerequisites for engaging in this work are also discussed, with an emphasis on an anti-racist, empathy-centered approach throughout.
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15
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White MP, Hartig T, Martin L, Pahl S, van den Berg AE, Wells NM, Costongs C, Dzhambov AM, Elliott LR, Godfrey A, Hartl A, Konijnendijk C, Litt JS, Lovell R, Lymeus F, O'Driscoll C, Pichler C, Pouso S, Razani N, Secco L, Steininger MO, Stigsdotter UK, Uyarra M, van den Bosch M. Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health. ENVIRONMENT INTERNATIONAL 2023; 181:108234. [PMID: 37832260 DOI: 10.1016/j.envint.2023.108234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/09/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.
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Affiliation(s)
- Mathew P White
- Cognitive Science HUB, University of Vienna, Austria; European Centre for Environment & Human Health, University of Exeter, UK.
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | - Leanne Martin
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Sabine Pahl
- Urban and Environmental Psychology Group, University of Vienna, Austria
| | | | - Nancy M Wells
- Department of Human Centered Design, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | | | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, UK
| | | | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Jill S Litt
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebecca Lovell
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Freddie Lymeus
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | | | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Sarai Pouso
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Nooshin Razani
- University of California San Francisco, San Francisco, CA, United States
| | - Laura Secco
- Department of Territorio e Sistemi Agro-Forestali (TESAF), University of Padua, Padua, Italy
| | | | - Ulrika K Stigsdotter
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Denmark
| | - Maria Uyarra
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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16
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Donelli D, Lazzeroni D, Rizzato M, Antonelli M. Silence and its effects on the autonomic nervous system: A systematic review. PROGRESS IN BRAIN RESEARCH 2023; 280:103-144. [PMID: 37714570 DOI: 10.1016/bs.pbr.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
This systematic review explores the influence of silence on the autonomic nervous system. The Polyvagal Theory has been used as a reference model to describe the autonomic nervous system by explaining its role in emotional regulation, social engagement, and adaptive physiological responses. PubMed, Scopus, PsycInfo, EMBASE, and Google Scholar were systematically searched up until July 2023 for relevant studies. The literature search yielded 511 results, and 37 studies were eventually included in this review. Silence affects the autonomic nervous system differently based on whether it is inner or outer silence. Inner silence enhances activity of the ventral vagus, favoring social engagement, and reducing sympathetic nervous system activity and physiological stress. Outer silence, conversely, can induce a heightened state of alertness, potentially triggering vagal brake removal and sympathetic nervous system activation, though with training, it can foster inner silence, preventing such activation. The autonomic nervous system response to silence can also be influenced by other factors such as context, familiarity with silence, presence and quality of outer noise, and empathy.
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Affiliation(s)
- Davide Donelli
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
| | - Davide Lazzeroni
- Prevention and Rehabilitation Unit, IRCCS Fondazione Don Gnocchi, Parma, Italy
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Sundermann M, Chielli D, Spell S. Nature As Medicine: The 7th (Unofficial) Pillar of Lifestyle Medicine. Am J Lifestyle Med 2023; 17:717-729. [PMID: 37711353 PMCID: PMC10498981 DOI: 10.1177/15598276231174863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
There are 6 Official Pillars of Lifestyle Medicine, and now mounting evidence supports daily exposure to nature and fresh air as vital to optimizing overall physical and mental health. Time spent in nature has been shown to help lower blood pressure, reduce nervous system arousal, enhance immune system function, reduce anxiety and increase self-esteem. The positive effects of time spent in nature span different occupations, ethnic groups, financial status and individuals with a variety of chronic illnesses and disabilities. "Forest Bathing" is the term coined by Japanese researchers for walking in the woods. It is suspected that aerosols from trees, when inhaled during a forest walk, are one factor responsible for elevated immune system Natural Killer (NK) cells, which help fight off infections and tumor growth. In a culture of ever-increasing technology and screen time, now more than ever it is crucial to educate and empower individuals to incorporate nature into therapeutic treatment regimens. This article will demonstrate the potential benefits of nature, share evidence supporting nature as medicine and provide tools to help engage individuals to spend more time outdoors.
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18
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Barsotti TJ, Jain S, Guarneri M, King RP, Vicario D, Mills PJ. An exploratory investigation of human biofield responses to encountering a sacred object. Explore (NY) 2023; 19:689-694. [PMID: 36710104 DOI: 10.1016/j.explore.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023]
Abstract
CONTEXT While advances in the Western sciences have increased our understanding of the human biofield, few studies have examined the potential effects of sacred objects on its functioning. DESIGN AND STUDY PARTICIPANTS This exploratory study examined the effects of a sacred object called the Sri Yantra / Durga Stone on the human biofield. Twelve women and five men were studied on three separate occasions using the Bio-Well device, which purportedly measures aspects of the biofield: baseline (the day before exposure to the sacred object), pre-exposure (immediately prior to exposure to the sacred object), and post-exposure (immediately following exposure to the sacred object). A set of a priori hypotheses examined outcome effects on a set of variables, including multiple physiological systems. RESULTS The overall Bio-Well energy state (Bio-Well variables are in units of joules) was significantly changed following exposure to the sacred object (p = 0.001). In addition, the cardiovascular, endocrine, musculoskeletal, digestive, urinogenital, and immune system readings showed significant changes (p's<0.003) while the nervous and respiratory system assessments were unchanged. Chakra (defined as a center of vital prana) energy was changed following exposure to the stone (p = 0.001), while chakra alignment was not (p = 0.145). CONCLUSIONS The findings from this exploratory study suggest that short-term human exposure to this particular sacred object had significant effects on aspects of the human biofield.
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Affiliation(s)
- Tiffany J Barsotti
- Center of Excellence for Research and Training in Integrative Health, University of California at San Diego, La Jolla, CA, USA; Heal and Thrive, Weaverville, NC, USA.
| | - Shamini Jain
- Center of Excellence for Research and Training in Integrative Health, University of California at San Diego, La Jolla, CA, USA; Consciousness and Healing Initiative, La Jolla, CA, USA
| | - Mimi Guarneri
- Pacific Pearl La Jolla, Integrative Health Center, La Jolla, CA, USA
| | | | | | - Paul J Mills
- Center of Excellence for Research and Training in Integrative Health, University of California at San Diego, La Jolla, CA, USA
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Jöhr J, Martinez T, Marquis R, Bruce S, Binz PA, Rey S, Hafner G, Attwell C, Diserens K. Measuring Salivary Cortisol to Assess the Effect of Natural Environments on Stress Level in Acute Patients With Severe Brain Injuries: An Exploratory Study. Cureus 2023; 15:e44878. [PMID: 37814730 PMCID: PMC10560321 DOI: 10.7759/cureus.44878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Salivary cortisol is a safe and non-invasive measure of hypothalamic-pituitary-adrenal axis function and is used as a biomarker of the human stress response. Natural environments are recognized to contribute to help reduce the effect of stress. OBJECTIVE To determine the feasibility of a salivary cortisol collection protocol for acute severely brain-injured patients, and to explore the influence of exposure to natural settings on salivary cortisol concentration as an index of stress level. METHODS An exploratory study on 17 acute patients with severe brain injury was performed. We collected salivary samples in a closed hospital ward and a therapeutic garden at the start of the session and after 30 minutes of rest time. Physiological parameters, level of communication, and subjective well-being were also assessed. RESULTS The primary objectives regarding the feasibility of the protocol were met overall. We found no significant differences in cortisol values when including the whole population. However, cortisol values were significantly higher in the indoor environment in patients with communication attempts. CONCLUSIONS A salivary collection protocol with brain-injured patients in the acute phase is feasible and safe, and this type of measurement could pave the way for future research supporting the benefits of nature as an additional resource in their neurorehabilitation.
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Affiliation(s)
- Jane Jöhr
- Department of Clinical Neurosciences/Neurology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Tania Martinez
- Department of Clinical Neurosciences/Neurology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Renaud Marquis
- Department of Clinical Neurosciences/Neurology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Stephen Bruce
- Laboratory of Clinical Chemistry/Biomedicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Pierre-Alain Binz
- Laboratory of Clinical Chemistry/Biomedicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Sabine Rey
- Department of Clinical Neurosciences/Neurology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Gaël Hafner
- Department of Clinical Neurosciences/Neurology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Caroline Attwell
- Department of Clinical Neurosciences/Neurology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
| | - Karin Diserens
- Department of Clinical Neurosciences/Neurology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, CHE
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Meixner C, Baumann H, Wollesen B. [Health-Related Goals of Digital Prevention and Health Promotion in Families]. DAS GESUNDHEITSWESEN 2023; 85:371-379. [PMID: 35948045 PMCID: PMC11248612 DOI: 10.1055/a-1860-0911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
STUDY AIM There is an increase in digital technologies to support health promotion. The majority of offerings is aimed at the individual but are less adapted to social life constellations such as families. The goal of this is study was to highlight the need and the requirements for an addressee-oriented app development. This was to be achieved by determining the initial situation and health goals of the surveyed families in the fields of exercise, nutrition and relaxation, and identifying points of intersection of the family members for a health app. METHODS The online survey was conducted with n=1008 parents (Ø 48 years, 59% female, 39.3% male, 1.7% diverse) on health status as well as exercise, nutrition and relaxation, smartphone use, app features and gamification. Quantitative data analysis (frequency analyses, Chi2 test, factor analysis, and single-factor analysis of variance) was performed using IBM SPSS Analytics (25; Armonk, NewYork). RESULTS The majority of those surveyed considered their state of health to be good. The minority met the WHO reference values for physical activity and nutrition. In addition, the respondents were exposed to a high level of stress with simultaneously low coping skills. The identified target areas were active relaxation measures, nutrition, general competence, physical activity, nature activities and sports-recreation opportunities. Significant differences were found in age, in the active relaxation measures [F(2)=3.367; p=0.035] and sports-recreation opportunities [F(2)=7.480; p=0.001]. CONCLUSION The study reveals intersections of families' content for a behavior change process with digital support. The interest in individual offers differs between the age groups of the children surveyed. Further research should identify health app usage preferences in families and in different family constellations as well as a family-friendly approach.
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Affiliation(s)
- Charlotte Meixner
- Institut für Bewegungswissenschaft, Universität Hamburg, Hamburg, Germany
| | - Hannes Baumann
- Institut für Bewegungswissenschaft, Universität Hamburg, Hamburg, Germany
- Technische Universität Berlin, Institut für Psychologie und Arbeitswissenschaft, Berlin, Germany
- Medical School Hamburg, Institute of Interdisciplinary Exercise Science and Sports Medicine, Hamburg, Germany
| | - Bettina Wollesen
- Institut für Bewegungswissenschaft, Universität Hamburg, Hamburg, Germany
- Technische Universität Berlin, Institut für Psychologie und Arbeitswissenschaft, Berlin, Germany
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Siah CJR, Goh YS, Lee J, Poon SN, Ow Yong JQY, Tam WSW. The effects of forest bathing on psychological well-being: A systematic review and meta-analysis. Int J Ment Health Nurs 2023. [PMID: 36864583 DOI: 10.1111/inm.13131] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/19/2023] [Accepted: 02/09/2023] [Indexed: 03/04/2023]
Abstract
Globally, around half (55%) of the population live in fast-paced urban settings where many people find it challenging to manage their stress and respond to crises with a positive mindset. This resulted in prolonged distress where anxiety and fatigue caused physical and mental health concerns. Nature walks involving immersive exposure in the forest, and green spaces have been posited to offer physiological and psychological benefits. Therefore, in this systematic review, we evaluated the effects of forest bathing on psychological and physiological outcomes. We searched four English and five non-English databases (Chinese and Korean) for peer-reviewed studies published between January 2000 and March 2021. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement 2020. The primary outcomes explored in this review were mainly psychological, including anxiety, depression, mood and quality of life. The secondary outcomes were physiological outcomes such as blood pressure and heart rate. We conducted a meta-analysis on each outcome using the random-effects model. Heterogeneity was assessed by the I2 statistic. Thirty-six articles (21 in English, 3 in Chinese and 12 in Korean) with 3554 participants were included in this review. Our meta-analysis suggested that forest bathing can significantly reduce symptoms of depression and anxiety. However, we did not observe as many benefits in physiological outcomes. Against the background of the negative effects of urbanization on mental well-being, this review highlighted the potential therapeutic role of forests in the contemporary world, lending further evidence-based support for forest conservation.
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Affiliation(s)
- Chiew Jiat Rosalind Siah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jungup Lee
- Department of Social Work, Faculty of Arts and Social Science, National University of Singapore, Singapore, Singapore
| | - Sum Nok Poon
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jenna Qing Yun Ow Yong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wai-San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Tung YH, Hung SH, Chang CY, Tang HF. Onsite restorative effect of a rural ecological farm versus an urban public greenery space. LANDSCAPE AND ECOLOGICAL ENGINEERING 2023. [PMCID: PMC9923656 DOI: 10.1007/s11355-023-00546-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Accessible urban greenery allows short breaks and leisure activities while experiencing nature. Studies have shown that contact with nature elicits psychological and physical health benefits. However, the immediate impact and influence of exposure to artificial versus rural ecological nature have yet to be examined. This study investigates their psychophysiological restorative effects onsite, specifically when individuals view a ubiquitous urban public greenery space or a more indigenous ecological forest-like nature area, to compare levels of restorativeness and relaxation. Participants were asked to sit and view a scene onsite for 6 min while their facial muscle tension was recorded. The data were used to evaluate the degree of facial relaxation for both scenes. In addition, participant self-reports measured perceived restorativeness after the 6-min period. The self-reported data showed that the ecological farm scene was rated significantly higher for perceived restorativeness (t [49.136] = 9.094, p < .001) after 6 min of viewing. The muscle tension analysis showed that facial tension significantly declined when participants viewed the farm scene compared to the urban greenery space. These results, especially those on the farm, show that nature with more forest-like and rural elements elicited more powerful restorative effects and significantly lowered facial muscle tension (t [65] = − 2.785, p < .05), thus verifying that a more ecological nature landscape provides immediate, significant health benefits through attention recovery and reduced facial muscle stress.
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Affiliation(s)
- Yu-Hsin Tung
- grid.19188.390000 0004 0546 0241Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei City, Taiwan
| | - Shih-Han Hung
- grid.265231.10000 0004 0532 1428Department of Landscape Architecture, Tunghai University, Taichung, Taiwan
| | - Chun-Yen Chang
- grid.19188.390000 0004 0546 0241Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei City, Taiwan
| | - Hsing-Fen Tang
- grid.412146.40000 0004 0573 0416Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
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23
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Muro A, Mateo C, Parrado E, Subirana-Malaret M, Moya M, Garriga A, Canals J, Chamarro A, Sanz A. Forest bathing and hiking benefits for mental health during the COVID-19 pandemic in Mediterranean regions. EUROPEAN JOURNAL OF FOREST RESEARCH 2023; 142:415-426. [PMID: 36779181 PMCID: PMC9896453 DOI: 10.1007/s10342-023-01531-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/07/2022] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
Forest bathing (FB) has evidenced positive effects on individuals' mental health and well-being, but its benefits have mainly been studied in Asian biomes. The present study aimed to evaluate whether its benefits are also generalisable to other forests and biomes of the world, such as the Mediterranean. Eighty-six healthy adults of the general population were assessed before and after a FB near Barcelona (Spain) during the COVID-19 pandemic. A control-hiking group of participants was also analysed to contrast the FB effects on anxiety, affect, mood states and mindfulness. Results show that the guided practice of FB in Mediterranean-Catalan forests increases mindfulness states and positive affect and reduces anxiety and negative affect, with effect sizes being large to very large. Hiking also induced significant changes in all variables tested, but FB showed higher effect sizes. An exploratory analysis also revealed a different profile of the FB participants compared to the hiking practitioners, being highly educated women living in urban areas and with lower basal levels of psychological well-being. Accordingly, it is concluded that both Mediterranean FB and hiking (to a lesser degree) might be cost-effective strategies to promote and restore psychological well-being after the COVID-19 pandemic and to promote sustainable tourism in Mediterranean biomes of the European forested and protected areas.
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Affiliation(s)
- Anna Muro
- Departament of Basic, Developmental and Health Psychology, Autonomous University of Barcelona, Office B5-111, Campus UAB, Bellaterra, 08193 Barcelona, Spain
- Serra Húnter Programme, Generalitat de Catalunya, Barcelona, Spain
| | - Corel Mateo
- Departament of Basic, Developmental and Health Psychology, Autonomous University of Barcelona, Office B5-111, Campus UAB, Bellaterra, 08193 Barcelona, Spain
| | - Eva Parrado
- Departament of Basic, Developmental and Health Psychology, Autonomous University of Barcelona, Office B5-111, Campus UAB, Bellaterra, 08193 Barcelona, Spain
- Sport Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Adrià Garriga
- School of Nature La Muntada, Sant Llorenç Savall, Barcelona, Spain
| | - Josep Canals
- Natural Park of Sant Llorenç, Catalan Net of Natural Parks, Barcelona Provincial Council, Barcelona, Spain
| | - Andrés Chamarro
- Departament of Basic, Developmental and Health Psychology, Autonomous University of Barcelona, Office B5-111, Campus UAB, Bellaterra, 08193 Barcelona, Spain
- Serra Húnter Programme, Generalitat de Catalunya, Barcelona, Spain
- Sport Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Sanz
- Departament of Basic, Developmental and Health Psychology, Autonomous University of Barcelona, Office B5-111, Campus UAB, Bellaterra, 08193 Barcelona, Spain
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Gao J, Mancus GC, Yuen HK, Watson JH, Lake ML, Jenkins GR. Changes in cortisol and dehydroepiandrosterone levels immediately after urban park visits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:206-218. [PMID: 34879780 DOI: 10.1080/09603123.2021.2013454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/29/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study is to explore physiological and psychological changes immediately after a short-term visit to urban parks in an uncontrolled condition. Sixty park visitors completed a short questionnaire evaluating their subjective well-being (SWB) and donated a saliva sample immediately before and after their park visit. In addition, participants wore a pedometer to track their physical activity level during the park visit. Results indicated the levels of all biomarkers (cortisol, dehydroepiandrosterone [DHEA], and cortisol/DHEA ratio) decreased while SWB scores increased after the park visit. The duration of park visit was identified as a key variable significantly associated with cortisol reduction, and changes in SWB scores after the park visit were significantly associated with changes in cortisol level. A park visit duration of 21.8 min has the predictive ability to discriminate park visitors who exhibit reductions in cortisol levels after the park visit from those who do not.
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Affiliation(s)
- Jie Gao
- Clinical Laboratory Sciences Program/Department of Clinical and Diagnostic Science, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gibran C Mancus
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Hon K Yuen
- Department of Occupational Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James H Watson
- Clinical Laboratory Sciences Program/Department of Clinical and Diagnostic Science, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Menesha L Lake
- Clinical Laboratory Sciences Program/Department of Clinical and Diagnostic Science, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gavin R Jenkins
- Department of Occupational Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Park EY, Song MK, Baek SY. Analysis of Perceptions, Preferences, and Participation Intention of Urban Forest Healing Program among Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1604. [PMID: 36674361 PMCID: PMC9865761 DOI: 10.3390/ijerph20021604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
It is important to manage the health of cancer survivors who have returned to their daily lives. An increasing number of cancer survivors are undertaking health care in forests near their residences. This cross-sectional study aimed to determine the perceptions of forest healing and the program preferences of adult cancer survivors. Data were collected from 388 female cancer survivors through an online survey. Breast cancer survivors comprised 66.2%, and 63.6% of the study participants were diagnosed with cancer within 2 to 5 years prior to the study. The subjective health status was 2.68 ± 0.61 out of 4 points. Of the participants, 62.1% had heard of forest healing and 65.7% intended to participate in the forest healing program. Participants who frequently visited the forest were more likely to participate in the forest healing program in the future than those who rarely visited the forest. A survey among 255 people on specific preferences for the program found that the regular visit type was preferred over the one-time visit type. These results are meaningful because they can be used as a basis for the development of a forest treatment program that reflects the needs of cancer survivors.
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Affiliation(s)
- Eun Young Park
- College of Nursing, Gachon University, Incheon 21936, Republic of Korea
| | - Min Kyung Song
- Department of Nursing, College of Medicine, University of Ulsan, Ulsan 44610, Republic of Korea
| | - Sang Yi Baek
- College of Nursing, Gachon University, Incheon 21936, Republic of Korea
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Su X, Lei T, Yu H, Zhang L, Feng Z, Shuai T, Guo H, Liu J. NT-proBNP in Different Patient Groups of COPD: A Systematic Review and Meta-Analysis. Int J Chron Obstruct Pulmon Dis 2023; 18:811-825. [PMID: 37197601 PMCID: PMC10183357 DOI: 10.2147/copd.s396663] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/29/2023] [Indexed: 05/19/2023] Open
Abstract
Purpose NT-proBNP, a peptide biomarker synthesized and secreted by cardiomyocytes in response to cardiac load, has gained attention in recent years for its potential role in respiratory diseases. Chronic Obstructive Pulmonary Disease (COPD), a chronic and progressive inflammatory condition affecting the respiratory system, is frequently associated with comorbidities involving the cardiovascular system. Consequently, the aim of this systematic review and meta-analysis was to evaluate the variations in NT-proBNP levels across distinct patient groups with COPD and establish a foundation for future investigations into the precise clinical significance of NT-proBNP in COPD. Methods The search databases for this study were conducted in PubMed, Excerpt Medica database (Embase), Web of Science (WOS), and Cochrane Library databases. Databases were searched for studies on the predictive value of NT-proBNP in adult COPD patients. Results A total of 29 studies (8534 participants) were included. Patients with stable COPD exhibit elevated levels of NT-proBNP [standardized mean difference(SMD) [95CI%]=0.51 [0.13,0.89]; p=0.0092]. COPD patients with predicted forced expiratory volume in 1 s (FEV1) < 50% exhibit significantly elevated levels of NT-proBNP compared to those with FEV1 ⩾50%[SMD [95CI%]=0.17 [0.05,0.29]; p=0.0058]. NT-proBNP levels were significantly higher in acute exacerbations (AECOPD) compared to patients with stable COPD [SMD [95CI%]=1.18 [0.07,2.29]; p=0.037]. NT-proBNP levels was significantly higher in non-survivors than in survivors of hospitalised AECOPD patients [SMD [95CI%]=1.67 [0.47,2.88]; p=0.0063]. Both COPD patients with pulmonary hypertension(PH) [SMD [95CI%]=0.82 [0.69,0.96]; p<0.0001] and chronic heart failure(CHF) [SMD [95CI%]=1.49 [0.96,2.01]; p<0.0001] showed higher NT-proBNP level. Conclusion NT-proBNP, a biomarker commonly used in clinical practice to evaluate cardiovascular disease, demonstrates significant variations in different stages of COPD and during the progression of the disease. The fluctuations in NT-proBNP levels could be indicative of the severity of pulmonary hypoxia and inflammation and cardiovascular stress among COPD patients. Therefore, assessing NT-proBNP levels in COPD patients can aid in making informed clinical decisions.
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Affiliation(s)
- Xiaojie Su
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
| | - Ting Lei
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
| | - Haichuan Yu
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
| | - Lu Zhang
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
| | - Zhouzhou Feng
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
| | - Tiankui Shuai
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
| | - Hong Guo
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
| | - Jian Liu
- The First Clinical Medical College of Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Lanzhou University, Lanzhou City, Gansu Province, People’s Republic of China
- Correspondence: Jian Liu, Department of Clinical Medicine, the First Clinical Medical College of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, People’s Republic of China, Tel +86 136 0935 4197, Email
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Qiu Q, Yang L, He M, Gao W, Mar H, Li J, Wang G. The Effects of Forest Therapy on the Blood Pressure and Salivary Cortisol Levels of Urban Residents: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:458. [PMID: 36612777 PMCID: PMC9819785 DOI: 10.3390/ijerph20010458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Urban residents have a higher risk of hypertension and psychological stress than rural residents. Aside from medical interventions, understanding how to control hypertension and alleviate the stress of urban populations has become a public concern. As an alternative medical measure, forest therapy has shown the effects of normalizing blood pressure (BP) and reducing stress increasingly in recent literature, but this is still inconclusive. In order to systematically verify forest therapy’s effects on the BP and mental stress of urban residents, we conducted meta-analyses to assess the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and salivary cortisol concentration (SCC; a stress biomarker) between the forest therapy group and urban control group. We searched 4 online databases, and 21 studies on BP involving 2270 participants and 13 studies on SCC involving 1786 participants were included. Through the meta-analysis, the mean difference and confidence interval (CI) estimates indicated that forest therapy significantly reduced participants’ SBP −3.44 (95% CI −5.74, −1.14), DBP −3.07 (95% CI −5.59, −0.54), and SCC −0.07 (95% CI −0.10, −0.04), as compared with urban control. Yet, there was substantial heterogeneity (I2 = 72.87−88.59%) among these studies. We also found that each prediction interval (PI) for SBP (95% PI −13.30, 6.42), DBP (95% PI −15.54, 9.41), and SCC (95% PI −0.18, 0.05) were all much wider than the CIs and contained values above 0. This means that forest therapy may reduce SBP, DBP, and SCC on average, but may not exclude adverse results. Meta-regression analyses showed that participants’ age and baseline SBP levels determined the heterogeneity among SBP studies. After forest therapy, older participants and those with higher baseline SBP levels had greater SBP-lowering effects. Among DBP studies, the primary source of heterogeneity was participants’ baseline DBP levels; participants with higher baseline DBP levels had greater DBP reduction. In subgroup analyses, we discovered that longer-term forest therapy programs (≥20 min) resulted in a greater reduction in BP and SCC than shorter-term forest therapy programs (<20 min). Additionally, seated viewing, walking, or multi-session programs in forests were observed to have similar effects on reducing BP and SCC. Despite extensive analyses, the study did not identify any sources of heterogeneity among forest therapy programs for lowering SCC levels. Overall, we conclude that forest therapy programs have beneficial therapeutic effects on urban residents’ physio-psychological health through lowering BP and relieving stress (reducing SCC). This finding provides solid evidence of the contribution of forest therapy to urban residents’ health and wellbeing.
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Affiliation(s)
- Quan Qiu
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ling Yang
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
| | - Mei He
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Jiangxi Academy of Forestry, Nanchang 330013, China
| | - Wen Gao
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Co-Innovation Center for Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China
| | - Harrison Mar
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jiyue Li
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
| | - Guangyu Wang
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Nejade RM, Grace D, Bowman LR. What is the impact of nature on human health? A scoping review of the literature. J Glob Health 2022; 12:04099. [PMID: 36520498 PMCID: PMC9754067 DOI: 10.7189/jogh.12.04099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background The burden of non-communicable diseases (including poor mental health) is increasing, and some practitioners are turning to nature to provide the solution. Nature-based interventions (NBIs) could offer cost-effective solutions by reconnecting individuals with nature, but the success of these interventions depends partially on the way in which people engage with blue and green spaces. Methods We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Cochrane guidelines to establish the evidence base for treating poor mental and physical health with NBIs. We searched five databases and the grey literature. Exposure was the active engagement with natural environments. The primary outcome was mental health and the secondary outcome was physical health defined using established metrics. All data were extracted to a charting table and reported as a narrative synthesis. Results 952 studies were identified, of which 39 met the inclusion criteria. 92% demonstrated consistent improvements across any health outcome where individuals engaged with natural outdoor environments. Mental health outcomes improved across 98% of studies while physical and cognitive health outcomes showed improvement across 83% and 75% of studies respectively. Additionally, we identified 153 factors affecting engagement with nature, 78% of which facilitated engagement compared with 22% that reduced engagement. Aspects such as the sense of wilderness, accessibility, opportunities for physical activity and the absence of noise/ air pollution all increased engagement. Conclusions Further research (accompanied by a global improvement in study design) is needed to establish the magnitude and relative effect of nature-based interventions, and to quantify the compounding effect of factors that improve engagement with green and blue spaces. Nevertheless, this review has documented the increasing body of evidence in support of NBIs as effective tools to improve mental, physical, and cognitive health outcomes, and highlighted key factors that improve engagement with the natural world. Registration Open Science Framework: https://doi.org/10.17605/OSF.IO/8J5Q3.
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Affiliation(s)
- Rachel M Nejade
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Daniel Grace
- Abertawe Bro Morgannwg University Health Board, NHS Wales, Swansea, UK
| | - Leigh R Bowman
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
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Liu S, Li C, Chu M, Zhang W, Wang W, Wang Y, Guo X, Deng F. Associations of forest negative air ions exposure with cardiac autonomic nervous function and the related metabolic linkages: A repeated-measure panel study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 850:158019. [PMID: 35973547 DOI: 10.1016/j.scitotenv.2022.158019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Forest environment has many health benefits, and negative air ions (NAI) is one of the major forest environmental factors. Many studies have explored the effect of forest environment on cardiac autonomic nervous function, while forest NAI in the among function and the underlying mechanism still remain unclear. To explore the associations and molecular linkages between short-term exposure to forest NAI and heart rate variability (HRV), a repeated-measure panel study was conducted among 31 healthy adults. Participants were randomly selected to stay in a forest park for 3 days and 2 nights. Individual exposures including NAI were monitored simultaneously and HRV indices were measured repeatedly at the follow-up period. Urine samples were collected for non-targeted metabolomics analysis. Mixed-effect models were adopted to evaluate associations among NAI, HRV indices and metabolites. The median of NAI concentration was 68.11 (138.20) cm-3 during the study period. Short-term exposure to forest NAI was associated with the ameliorative HRV indices, especially the excitatory parasympathetic nerve. For instance, per interquartile range increase of 5-min moving average of NAI was associated with 9.99 % (95%CI: 8.95 %, 11.03 %) increase of power in high frequency. Eight metabolites were associated with NAI exposure. The down-regulated tyrosine metabolism was firstly observed, followed by other amino acid metabolic alterations. The NAI-related metabolic changes reflect the reduction of inflammation and oxidative stress. HRV indices were associated with 25 metabolites, mainly including arginine, proline and histidine metabolism. Short-term exposure to forest NAI is beneficial to HRV, especially to the parasympathetic nerve activity, by successively disturbing different metabolic pathways which mainly reflect the increased anti-inflammation and the reduced inflammation. The results will provide epidemiological evidences for developing forest therapy and improving cardiac autonomic nervous function.
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Affiliation(s)
- Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Chen Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Mengtian Chu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yazheng Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
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Oomen-Welke K, Schlachter E, Hilbich T, Naumann J, Müller A, Hinterberger T, Huber R. Spending Time in the Forest or the Field: Investigations on Stress Perception and Psychological Well-Being-A Randomized Cross-Over Trial in Highly Sensitive Persons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15322. [PMID: 36430041 PMCID: PMC9690301 DOI: 10.3390/ijerph192215322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Research suggests that stays in a forest promote relaxation and reduce stress compared to spending time in a city. The aim of this study was to compare stays in a forest with another natural environment, a cultivated field. Healthy, highly sensitive persons (HSP, SV12 score > 18) aged between 18 and 70 years spent one hour in the forest and in the field at intervals of one week. The primary outcome was measured using the Change in Subjective Self-Perception (CSP-14) questionnaire. Secondary outcomes were measured using the Profile Of Mood States (POMS) questionnaire and by analyzing salivary cortisol. We randomized 43 participants. Thirty-nine were allocated and included in the intention-to-treat analysis (90% female, mean age 45 years). CSP-14 in part showed significant differences-total score (p = 0.054, Cohen's d = 0.319), item "integration" (p = 0.028, Cohen's d = 0.365)-favoring the effects of the forest. These effects were more pronounced in summer (August). In October, during rainfall, we detected no relevant differences. POMS only showed a significant difference in the subcategory "depression/anxiety" in favor of the field. The amount of cortisol in saliva was not different between the groups. A short-term stay in a forest in summer caused a greater improvement in mood and well-being in HSP than in a field. This effect was not detectable during bad weather in the fall.
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Affiliation(s)
- Katja Oomen-Welke
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Evelyn Schlachter
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Tina Hilbich
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Johannes Naumann
- Interdisciplinary Center for Treatment and Research in Balneology, European Institute for Physical Therapy and Balneology (EIPB), Sonnenbergstr. 35, 79117 Freiburg im Breisgau, Germany
| | - Alexander Müller
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Thilo Hinterberger
- Forschungsbereich Angewandte Bewusstseinswissenschaften, Abteilung für Psychosomatische Medizin, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Roman Huber
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
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McEwan K, Collett H, Nairn J, Bird J, Faghy MA, Pfeifer E, Jackson JE, Cook C, Bond A. The Feasibility and Impact of Practising Online Forest Bathing to Improve Anxiety, Rumination, Social Connection and Long-COVID Symptoms: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14905. [PMID: 36429623 PMCID: PMC9691063 DOI: 10.3390/ijerph192214905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Long-COVID affects over 144 million people globally. In the absence of treatments, there is a need to establish the efficacy of therapies that improve patient outcomes. Forest bathing has been demonstrated to improve physical and mental outcomes but there is no evidence in Long-COVID patients. Accordingly, this pilot study sought to determine the feasibility and effectiveness of online forest bathing in adults with Long-COVID. METHODS Feasibility was assessed by monitoring retention rates and participant feedback. In a waitlist controlled, repeated measures design, 22 Long-COVID patients completed weekly online surveys during a four-week waitlist control period, before engaging in four weekly online forest bathing sessions, completing post-intervention surveys following each session. RESULTS In terms of retention, 27% did not provide post-intervention data, reasons for non-adherence were: feeling too ill, having medical appointments, or having career responsibilities. Compared with the waitlist control period, there were statistically significant improvements in Anxiety (49% decrease), Rumination (48% decrease), Social Connection (78% increase), and Long-COVID symptoms (22% decrease). Written qualitative comments indicated that participants experienced feelings of calm and joy, felt more connected socially and with nature, and experienced a break from the pain and rumination surrounding their illness. CONCLUSIONS Online Forest bathing resulted in significant improvements in well-being and symptom severity and could be considered an accessible and inexpensive adjunct therapy for Long-COVID patients. Where people have limited access to in-person nature, virtual nature may offer an alternative to improve health and well-being outcomes.
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Affiliation(s)
- Kirsten McEwan
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | | | - Jean Nairn
- Woodlands Breathing, Edinburgh EH27 8BW, UK
| | - Jamie Bird
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Mark A. Faghy
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby DE22 1GB, UK
- Healthy Living for Pandemic Event Protection (HL–PIVOT) Network, Chicago, IL 60612, USA
| | - Eric Pfeifer
- Catholic University of Applied Sciences, Karlstr. 63, 79104 Freiburg, Germany
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Jessica E. Jackson
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | | | - Amanda Bond
- Wild Edgewalker Forest Therapy, Jersey JE3 8AF, UK
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Büssing A, Recchia DR, Baumann K. Experience of nature and times of silence as a resource to cope with the COVID-19 pandemic and their effects on psychological wellbeing-Findings from a continuous cross-sectional survey in Germany. Front Public Health 2022; 10:1020053. [PMID: 36420008 PMCID: PMC9678082 DOI: 10.3389/fpubh.2022.1020053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/28/2022] [Indexed: 11/09/2022] Open
Abstract
Background The COVID-19 pandemic with its lockdowns affected social relations and mental health conditions of people worldwide. We aimed to analyze the relevance of nature and times of silence as resources to cope with the pandemic. Of interest were how experiences of nature and times of silence are related to the perception of wondering awe and gratitude and psychological wellbeing and how these have changed during the different phases of the pandemic. Finally, we asked whether Nature/Silence would mediate the link between Awe/Gratitude and wellbeing. Methods A cross-sectional survey with standardized questionnaires (i.e., PCQ, GrAw-7, BMLSS-10, WHO-5) enrolling participants during the different phases of the COVID-19 pandemic was conducted. The total sample of 5,155 participants from Germany consisted of 65% women and 34% men, with a mean age of 45.0 ± 14.0 years. Results Directly after the first lockdown, Nature/Silence and Awe/Gratitude scores were high and decreased along with wellbeing with the onset of the second lockdown in winter 2020, while perceived burden constantly increased. Nature/Silence was rated lowest by people with reduced wellbeing (eta2 = 0.058) and feeling lonely or socially isolated (eta2 = 0.042). Predictor analyses revealed that wellbeing as a dependent variable was predicted best by corona-related perception of burden, Awe/Gratitude, reflection of life, and Nature/Silence and further by perceived changes in terms of relationships and spirituality (R2 = 0.55). In mediation analyses, Awe/Gratitude proved to be a significant predictor for Nature/Silence (β = 0.55, p< 0.0001) and wellbeing (β = 0.05, p < 0.0001). The mediation analysis explained 37% of the variability in the data. The direct influence of Awe/Gratitude on wellbeing was estimated as β = 0.09 (p < 0.0001), and the mediation effect of Nature/Silence on the link between Awe/Gratitude and wellbeing was significant, too (β = 0.03, p < 0.0001), explaining 25% of the total effect. Conclusion Nature/Silence and Awe/Gratitude were used as relevant resources during the pandemic, although they cannot fully buffer the negative effects of the social restrictions that resulted in decreases in wellbeing and increases in perceived burden. Perception of nature as a sensitizer of positive experiences particularly during difficult phases of life could be trained to stabilize wellbeing and thus to contribute to public health.
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Affiliation(s)
- Arndt Büssing
- Professorship Quality of Life, Spirituality and Coping, Faculty of Health, Witten/Herdecke University, Herdecke, Germany
- IUNCTUS - Competence Center for Christian Spirituality, Philosophical-Theological Academy, Münster, Germany
| | - Daniela Rodrigues Recchia
- Department of Research Methods and Statistics in Psychology, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, Freiburg, Germany
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Rantala MJ, Luoto S, Borráz-León JI, Krams I. Schizophrenia: the new etiological synthesis. Neurosci Biobehav Rev 2022; 142:104894. [PMID: 36181926 DOI: 10.1016/j.neubiorev.2022.104894] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 08/25/2022] [Accepted: 09/25/2022] [Indexed: 10/31/2022]
Abstract
Schizophrenia has been an evolutionary paradox: it has high heritability, but it is associated with decreased reproductive success. The causal genetic variants underlying schizophrenia are thought to be under weak negative selection. To unravel this paradox, many evolutionary explanations have been suggested for schizophrenia. We critically discuss the constellation of evolutionary hypotheses for schizophrenia, highlighting the lack of empirical support for most existing evolutionary hypotheses-with the exception of the relatively well supported evolutionary mismatch hypothesis. It posits that evolutionarily novel features of contemporary environments, such as chronic stress, low-grade systemic inflammation, and gut dysbiosis, increase susceptibility to schizophrenia. Environmental factors such as microbial infections (e.g., Toxoplasma gondii) can better predict the onset of schizophrenia than polygenic risk scores. However, researchers have not been able to explain why only a small minority of infected people develop schizophrenia. The new etiological synthesis of schizophrenia indicates that an interaction between host genotype, microbe infection, and chronic stress causes schizophrenia, with neuroinflammation and gut dysbiosis mediating this etiological pathway. Instead of just alleviating symptoms with drugs, the parasite x genotype x stress model emphasizes that schizophrenia treatment should focus on detecting and treating possible underlying microbial infection(s), neuroinflammation, gut dysbiosis, and chronic stress.
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Affiliation(s)
- Markus J Rantala
- Department of Biology, University of Turku, FIN-20014 Turku, Finland.
| | - Severi Luoto
- School of Population Health, University of Auckland, 1023 Auckland, New Zealand
| | | | - Indrikis Krams
- Institute of Ecology and Earth Sciences, University of Tartu, 51014 Tartu, Estonia; Department of Zoology and Animal Ecology, Faculty of Biology, University of Latvia, 1004, Rīga, Latvia
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Park EY, An MY, Sung JH. A present from the forest: Focus group interviews on cancer survivors’ forest experiences. Asia Pac J Oncol Nurs 2022; 9:100105. [PMID: 36060272 PMCID: PMC9428799 DOI: 10.1016/j.apjon.2022.100105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/01/2022] [Indexed: 01/05/2023] Open
Abstract
Objective To explore cancer survivors' forest experiences and to understand the relevance of these experiences from their perspectives in the context of the growing interest in nature's impact on health and quality of life. Methods From July 29 to August 12, 2021, four focus group interviews were conducted with cancer survivors who visited forests in South Korea. The data were analyzed using qualitative content and thematic analysis. Results The participants were 21 female cancer survivors with a mean age of 58.4 (age range 44–69) years. The focus group interviews revealed three themes and 10 sub-themes regarding subjective perceptions and experiences related to forests. The overarching themes were as follows: (1) awakened bodily senses and fascination with the forest; (2) remedial effect; and (3) a source of inspiration. These three themes capture the impact of forest experiences on participants’ lives and the value they derived from these experiences. The participants considered these experiences a gift from forests. In particular, they experienced aesthetic enrichment and restorative effects such as boosted energy levels, reduced fatigue, and a buffer against mood swings. Finally, forests were a source of inspiration that led the participants toward personal growth. Conclusions By gaining a better understanding of survivors' forest experiences, we identified that forest-based interventions for supportive cancer care can align with patients’ values and preferences and serve as a secure space where they can feel cared for. This study can contribute to the development of forest-based interventions for cancer survivorship care. Cancer survivors experienced awakened bodily senses and fascination with the forest. Cancer survivors realized the remedial effects of forests. Forests also became sources of inspiration for cancer survivors. These results can contribute to the development of forest-based interventions.
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Affiliation(s)
- Eun Young Park
- College of Nursing, Gachon University, Incheon, Republic of Korea
| | - Mi Young An
- College of Nursing, Gachon University, Incheon, Republic of Korea
| | - Ji Hyun Sung
- College of Nursing, Kosin University, Busan, Republic of Korea
- Corresponding author.
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Antonelli M, Donelli D, Carlone L, Maggini V, Firenzuoli F, Bedeschi E. Effects of forest bathing (shinrin-yoku) on individual well-being: an umbrella review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1842-1867. [PMID: 33910423 DOI: 10.1080/09603123.2021.1919293] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/15/2021] [Indexed: 06/12/2023]
Abstract
The aim of this review was to outline the most relevant benefits of forest bathing for well-being promotion. This study was designed as an umbrella literature review. Medline (via PubMed), EMBASE, Web of Science, Cochrane Library, Google Scholar, Scopus, PsycINFO, CINAHL and the DOAJ were systematically searched for relevant reviews up to February 2021. After article selection, 16 systematic reviews met inclusion criteria. Overall, the best available evidence supports the use of forest bathing as a complementary practice for the promotion of psychophysical well-being, whereas evidence for its use as a therapeutic practice for the improvement of organic diseases needs to grow before clear and specific clinical indications can be formulated. The positive impact of forest bathing on individual quality of life, along with its favorable cost-effectiveness profile, may justify its possible adoption for public health strategies of well-being promotion. Further investigations on the topic are advised.
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Affiliation(s)
| | - Davide Donelli
- Local Public Health Authority, AUSL-IRCCS, Reggio Emilia, Italy
| | - Lucrezia Carlone
- Department of Medicine and Surgery, University of Parma , Parma, Italy
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Owens M, Bunce HLI. Nature-Based Meditation, Rumination and Mental Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9118. [PMID: 35897493 PMCID: PMC9332585 DOI: 10.3390/ijerph19159118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
Novel approaches for children and young people (CYP) in the prevention and intervention of mental illness are needed and nature-based interventions (NBI) may be clinically useful. This proof-of-principle study tested the effects of a novel brief nature-based meditation on rumination, depressive symptoms and wellbeing in young people. Sixty-eight university students were randomised to one of three conditions: active control (n = 23), indoor meditation (n = 22) or nature-based meditation (n = 23). Participants completed self-report measures on state and trait rumination post intervention and depression and wellbeing at a 2-week follow-up. Depressive rumination significantly decreased post intervention in the nature condition and depressive symptoms improved for both intervention groups. Wellbeing only significantly improved at follow-up in the nature condition. Nature condition participants demonstrated one minimal clinically important difference (MCID) for wellbeing at follow-up. Depressive symptoms for this condition were below the clinically significant threshold for depression. The number needed to treat (NNT) analysis suggested that two to five young people would need to complete the intervention. Preliminary evidence suggests NBIs, such as the one in the present study, can reduce depressive rumination and symptoms and improve wellbeing. Replication with larger clinical samples is required to substantiate findings.
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Affiliation(s)
- Matthew Owens
- Department of Psychology, The Mood Disorders Centre, University of Exeter, Exeter EX4 4QQ, UK
- The ROWAN Group, Exeter EX4 4QQ, UK;
| | - Hannah L. I. Bunce
- The ROWAN Group, Exeter EX4 4QQ, UK;
- CEDAR, University of Exeter, Exeter EX4 4QQ, UK
- Somerset Foundation Trust NHS, Taunton TA1 5DA, UK
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Rakow DA, Ibes DC. Campus Nature Rx: How investing in nature interventions benefits college students. Front Psychol 2022; 13:960370. [PMID: 35959044 PMCID: PMC9358038 DOI: 10.3389/fpsyg.2022.960370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Donald A. Rakow
- Cornell University, Ithaca, NY, United States
- College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, United States
- Section of Horticulture, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, United States
- *Correspondence: Donald A. Rakow
| | - Dorothy C. Ibes
- Environmental Science and Policy, Center for Geospatial Analysis, William & Mary, Williamsburg, VA, United States
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Loebach J, Rakow DA, Meredith G, Shepley MM. Time Outdoors in Nature to Improve Staff Well-Being: Examining Changes in Behaviors and Motivations Among University Staff in the Use of Natural Outdoor Environments Since the Emergence of the COVID-19 Pandemic. Front Psychol 2022; 13:869122. [PMID: 35936287 PMCID: PMC9354818 DOI: 10.3389/fpsyg.2022.869122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Work-related stress is of growing concern to employers because of its significant implications for employee dissatisfaction, reduced productivity, and lowered emotional and physical health. Job-related stress is particularly acute among staff members in higher education, negatively impacting the professional work and personal welfare of staff. During the COVID-19 pandemic, stress levels increased, due to work- and non-work-related factors. Work expectations and environments shifted, as did new non-work responsibilities, such as care of dependents. As a result, many people were forced to spend much more time at home. Given the anticipated levels of stress (higher) and the change in time spent at home (increased), we sought to explore if adults were spending more time outdoors, as compared to pre-pandemic times, and if so, for what purposes. We hypothesized that people would be spending more time outdoors in nature during the pandemic, and that they would be doing so to achieve some of the well-documented benefits including managing stress, and bolstering mental health and wellbeing. We further hypothesized that some staff would experience barriers to spending time outdoors in natural outdoor environments (NOEs), potentially limiting their ability to experience these beneficial effects. Materials and Methods This study surveyed 507 staff from a large United States university to examine the degree to which staff were spending time in natural outdoor environments (NOEs) during the pandemic (two time-points, compared to pre-pandemic), and whether and how nature-based routines changed as a result of its emergence. The study also examined whether staff were motivated to spend time in nature to improve their mental health and/or wellbeing. Results The majority of respondents reported spending more time in NOEs since COVID-19 emerged, particularly early in the pandemic. Respondents reported doing so for restorative purposes, including stress relief, improved mental health, and improved physical health. Relative accessibility of NOEs, both in terms of proximity and number of barriers to access, significantly impacted both time outdoors and the number of NOEs used. Access to safe, high-quality NOEs was not experienced equally across staff respondents; barriers to access tended to be higher among staff living with dependents or others in their household, and for staff who identify as non-White. Conclusion Spending time outdoors may have served as a protective factor for many university staff against some of the potentially detrimental effects of the pandemic, particularly reduced mental health and well-being. Universities can contribute to the ongoing well-being of their staff by supporting access to safe, high-quality NOEs on or adjacent to campus. This may also serve to reduce disparities in access to nature and experience of its benefits. Universities may also consider alternative work arrangements for staff to allow for more time for health and wellness self-care during the work day, including spending time outdoors in nature.
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Affiliation(s)
- Janet Loebach
- Department of Human Centered Design, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Donald A. Rakow
- Section of Horticulture, School of Integrative Plant Science, Cornell University, Ithaca, NY, United States
| | - Genevieve Meredith
- Master of Public Health Program, Cornell University, Ithaca, NY, United States
| | - Mardelle McCuskey Shepley
- Department of Human Centered Design, College of Human Ecology, Cornell University, Ithaca, NY, United States
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The Role of Personalization in the User Experience, Preferences and Engagement with Virtual Reality Environments for Relaxation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127237. [PMID: 35742483 PMCID: PMC9223778 DOI: 10.3390/ijerph19127237] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 12/10/2022]
Abstract
Virtual Reality Environments (VREs) are widely deployed in mental health treatments, often associated with relaxation techniques. The personalization of natural VR-based scenarios is a key element that can further facilitate users’ sense of presence and relaxation. This study explored the role of VREs’ personalization in the user experience with an environment supporting relaxation, by deploying mixed methods. Methods: A non-clinical sample of 20 individuals participated in exposure to a supportive body-scan-guided relaxation VRE. In the personalized conditions, the participants had the option of choosing the context (e.g., sea, mountain, or countryside) and including in the scenario different types of sounds, visual elements, and changing the time of day and weather. In the standard conditions, individuals were exposed to a relaxing VRE, but they could choose neither the context nor the auditory and visual elements. The order of presentation of the personalized vs non-personalized environments was randomized. Measures regarding relaxation, state-anxiety perceived levels, VRE-related symptoms, the usability of the Virtual Reality (VR) setting, sense of presence, pleasure, activation, engagement, and level of immersion experienced were collected before and after exposure to the VR environments. Results: Findings showed that personalized VREs were preferred by users. Participants generally preferred to experience a greater immersivity, pleasure, engagement, and relaxation in the personalized virtual settings. Conclusion: The study further confirms the role of personalization as a component positively contributing to relaxation and engagement. Future research may further assess this effect in the context of large-scale controlled studies involving clinical and non-clinical populations.
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Balanzá-Martínez V, Cervera-Martínez J. Lifestyle Prescription for Depression with a Focus on Nature Exposure and Screen Time: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5094. [PMID: 35564489 PMCID: PMC9104582 DOI: 10.3390/ijerph19095094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 12/10/2022]
Abstract
Recent lifestyles changes have favored increased time in contact with screens and a parallel reduction in contact with natural environments. There is growing awareness that nature exposure and screen time are related to depression. So far, the roles of how these environmental lifestyles affect depressive symptoms and disorders have not been reviewed simultaneously. The aim of this review was to gather the literature regarding the role of nature exposure and screen time in depression. An emphasis was made on clinical samples of patients with well-defined depression and the different methodological approaches used in the field. A second goal was to suggest an agenda for clinical practice and research. Studies were included if they assessed depressive symptoms in patients with a clinical diagnosis of depression. An overview of the published literature was conducted using three scientific databases up to December 2021. Several interventions involving nature exposure have shown positive effects on depressive symptoms and mood-related measures. The most consistent finding suggests that walks in natural environments may decrease depressive symptoms in patients with clinical depression. Less researched interventions, such as psychotherapy delivered in a forest or access to natural environments via virtual reality, may also be effective. In contrast, fewer observational studies and no experimental research on screen time have been conducted in patients with clinical depression. Thus, recommendations for practice and research are also discussed. Scarce research, diverse interventions, and several methodological shortcomings prevent us from drawing conclusions in this area. More high-quality experimental research is needed to establish interventions with proven efficacy in clinical depression. At this stage, it is too early to formulate practice guidelines and advise the prescription of these lifestyles to individuals with depression. The present findings may serve as a basis to develop strategies based on nature exposure and screen time targeting clinical depression.
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Affiliation(s)
- Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Jose Cervera-Martínez
- Department of Medicine, University of Valencia, 46010 Valencia, Spain;
- Hospital de Denia-Marina Salud, 03700 Denia, Spain
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Kang MJ, Kim HS, Kim JY. Effects of Forest-Based Interventions on Mental Health: A Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4884. [PMID: 35457755 PMCID: PMC9031621 DOI: 10.3390/ijerph19084884] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023]
Abstract
Forest-based interventions are a promising alternative therapy for enhancing mental health. The current study investigated the effects of forest therapy on anxiety, depression, and negative and positive mental condition through a meta-analysis of recent randomized controlled trials, using the PRISMA guideline. Of 825 articles retrieved from databases including PubMed, EMBASE, CINAHL, Cochrane, and PsycINFO, 6 met the inclusion criteria. The results of this study showed that forest-based interventions improved the mental health of participants in the intervention groups when compared to those in the control groups. Thirty-four outcome variables were analyzed from six studies. The overall effect size of the forest therapy programs was 1.25 (95% CI = 0.93−1.57, p < 0.001), which was large and statistically significant. These findings imply that forest-based interventions can improve mental health as a nonpharmacological intervention. This study is significant in that it is a meta-analysis of mental health that included only high-quality domestic and international RCTs. In future studies, more RCTs related to various forest interventions and studies involving many participants should be undertaken, which will complement heterogeneity in future meta-analysis studies.
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Affiliation(s)
| | - Hyun-Sun Kim
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Korea;
| | - Ji-Yeon Kim
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Korea;
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Moyers SI, Abildso CG, Kelley GA. Context, classification and study methodologies in research into nature-based therapies: protocol for a scoping review. BMJ Open 2022; 12:e060734. [PMID: 35393333 PMCID: PMC8991050 DOI: 10.1136/bmjopen-2021-060734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nature provides an array of health benefits, and recent decades have seen a resurgence in nature-based interventions (NBI). While NBI have shown promise in addressing health needs, the wide variety of intervention approaches create difficulty in understanding the efficacy of NBI as a whole. This scoping review will (1) identify the different nomenclature used to define NBI, (2) describe the interventions used and the contexts in which they occurred and (3) describe the methodologies and measurement tools used in NBI studies. METHODS AND ANALYSIS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews, four databases will be searched (PubMed, Web of Science, Scopus, ProQuest Dissertations and Theses Global) as well as cross-referencing for published and unpublished (masters theses and dissertations) studies on NBI in humans. Eligible studies must employ intervention or observational designs, and an English-language abstract will be required. Database searches will occur from inception up to the date of the search. Animal-based therapies and virtual-reality therapies involving simulated nature will be excluded. Independent dual screening and data abstraction will be conducted. Results will be analysed qualitatively as well as with simple descriptive statistics (frequencies and percentages). ETHICS AND DISSEMINATION Since this is a scoping review of previously published summary data, ethical approval for this study is not needed. Findings will be published in a peer-reviewed journal. This protocol has been registered with Open Science Framework (https://osf.io/mtzc8).
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Affiliation(s)
- Samantha I Moyers
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - Christiaan G Abildso
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
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Owens M, Bunce HLI. The Potential for Outdoor Nature-Based Interventions in the Treatment and Prevention of Depression. Front Psychol 2022; 13:740210. [PMID: 35401311 PMCID: PMC8984301 DOI: 10.3389/fpsyg.2022.740210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/15/2022] [Indexed: 01/05/2023] Open
Abstract
There is growing interest in nature-based interventions (NBI) to improve human health and wellbeing. An important nascent area is exploring the potential of outdoor therapies to treat and prevent common mental health problems like depression. In this conceptual analysis on the nature-depression nexus, we distil some of the main issues for consideration when NBIs for depression are being developed. We argue that understanding the mechanisms, or 'active ingredients' in NBIs is crucial to understand what works and for whom. Successfully identifying modifiable mediating intervention targets will pave the way for interventions with increased efficacy. We highlight a non-exhaustive list of five clinically relevant putative, candidate mechanisms which may underly the beneficial effects of NBIs on depression: stress, rumination, mindfulness, sleep and exercise. We also make the case that when developing NBIs it is important to not neglect young people, explore personalised approaches and focus on both treatment and prevention approaches. To achieve these aims methodologically rigorous programmes of clinical research are needed that include well-powered and controlled experimental designs including randomised controlled trials, qualitative research, longitudinal studies and large prospective cohorts.
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Affiliation(s)
- Matthew Owens
- Department of Psychology, The Mood Disorders Centre, University of Exeter, Exeter, United Kingdom
| | - Hannah L. I. Bunce
- CEDAR, University of Exeter and Somerset Foundation Trust NHS, Taunton, United Kingdom
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Levhar M, Schonblum A, Arnon L, Michael Y, Sheelo LS, Eisner M, Hadar E, Meizner I, Wiznitzer A, Weller A, Koren L, Agay-Shay K. Residential greenness and hair cortisol levels during the first trimester of pregnancy. ENVIRONMENTAL RESEARCH 2022; 204:112378. [PMID: 34780787 DOI: 10.1016/j.envres.2021.112378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/24/2021] [Accepted: 11/10/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND AIM Studies have shown that increased maternal cortisol level is associated with child adverse health outcomes. Hair cortisol (HC) is suitable for assessing long-term circulating cortisol concentration. Only two previous studies reported beneficial associations between cortisol and residential greenness during pregnancy and no study focused on the first trimester. Our aim was to evaluate the association between residential greenness and first trimester HC levels among pregnant women in Israel. METHODS Women were recruited during second and third trimesters. Hair samples were collected from the scalp and retrospective HC levels during the first trimester were quantified for 217 women. HC levels were natural log transformed and outliers were excluded. Based on geocoded birth address, small area sociodemographic status (SES) and mean residential surrounding greenness were calculated using high-resolution satellite-based Normalised Difference Vegetation Index (NDVI) data at 100, 300 and 500-m buffers in a cross-sectional approach. In addition, longitudinal exposure to mean greenness during a week preconception and during the first trimester were calculated. Missing covariates were imputed and linearity of the associations were evaluated. Generalized linear models were used to estimate the crude and adjusted associations controlled for the relevant covariates. RESULTS After exclusion of outliers, for 211 women, crude and adjusted beneficial associations between exposure to higher mean NDVI and HC levels were observed for all the exposure measures. An increase in 1 interquartile range of greenness (100 m buffer) was associated with a statistically significant lower estimated natural log mean HC level (-0.27 95% CI: -0.44; -0.11). The associations were robust to adjustment for covariates. The findings were consistent for different buffers, for the longitudinal approach, when all observations were included in the analysis and slightly stronger associations were observed for women with addresses geocoded at the home or street level. For most of the exposure measures, stronger associations were observed among those of lower sociodemographic status. CONCLUSION Our findings that more greenness associated with reduced maternal cortisol levels measured in the hair during the first trimester, could have substantial implications for urban planners and public health professional. If our observations will be replicated, it may present a useful avenue for public-health intervention to promote health through the provision of greenness exposure during early pregnancy, specifically to disadvantage populations.
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Affiliation(s)
- Maya Levhar
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel; Health and Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Anat Schonblum
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel; Health and Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Liat Arnon
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Yaron Michael
- Department of Geography and Environment, Bar-Ilan University, Ramat-Gan, Israel
| | - Liat Salzer Sheelo
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Eisner
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Israel Meizner
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Wiznitzer
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aron Weller
- Department of Psychology & Gonda Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Lee Koren
- Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Keren Agay-Shay
- Health and Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
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Park S, Kim E, Kim G, Kim S, Choi Y, Paek D. What Activities in Forests Are Beneficial for Human Health? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2692. [PMID: 35270397 PMCID: PMC8909949 DOI: 10.3390/ijerph19052692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/14/2022]
Abstract
Over the past decade, clinical trials of forest-based interventions have increased, leading to their recognition as preventive medicine. However, little is known about the differences in health effects according to the activity characteristics of interventions. This study aimed to understand the types of activities and their associated health effects to identify differences in health effects between activities. PubMed, PsycINFO, Web of Science, and Scopus databases were searched, and methodological quality was assessed using Cochrane ROB2. A total of 32 randomized controlled trials (RCTs) met the eligibility criteria. Health outcomes were collected from 6264 participants aged 6-98 years, and the sample size was 12-585. The Interventions were walking (n = 21), staying (n = 7), exercise (n = 4), indirect exposure (n = 4), and the activity time was between 10 and 240 min. Overall, walking showed consistent positive health effects, and there were differences in effects on anxiety and depression, cognitive function, stress hormone, and inflammation according to the activity. However, most of the included studies had a high risk of bias, and interventions were limited to specific activities, durations, and frequencies. Although a few limitations remain, the findings in this study are of great significance in providing the basis for the design of forest-based interventions.
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Affiliation(s)
- Sujin Park
- Forest Human Service Division, Future Forest Strategy Department, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (E.K.); (G.K.); (S.K.); (Y.C.)
| | - Eunsoo Kim
- Forest Human Service Division, Future Forest Strategy Department, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (E.K.); (G.K.); (S.K.); (Y.C.)
| | - Geonwoo Kim
- Forest Human Service Division, Future Forest Strategy Department, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (E.K.); (G.K.); (S.K.); (Y.C.)
| | - Soojin Kim
- Forest Human Service Division, Future Forest Strategy Department, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (E.K.); (G.K.); (S.K.); (Y.C.)
| | - Yeji Choi
- Forest Human Service Division, Future Forest Strategy Department, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (E.K.); (G.K.); (S.K.); (Y.C.)
| | - Domyung Paek
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea
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Bikomeye JC, Beyer AM, Kwarteng JL, Beyer KMM. Greenspace, Inflammation, Cardiovascular Health, and Cancer: A Review and Conceptual Framework for Greenspace in Cardio-Oncology Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2426. [PMID: 35206610 PMCID: PMC8872601 DOI: 10.3390/ijerph19042426] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of global morbidity and mortality. Cancer survivors have significantly elevated risk of poor cardiovascular (CV) health outcomes due to close co-morbid linkages and shared risk factors between CVD and cancer, as well as adverse effects of cancer treatment-related cardiotoxicity. CVD and cancer-related outcomes are exacerbated by increased risk of inflammation. Results from different pharmacological interventions aimed at reducing inflammation and risk of major adverse cardiovascular events (MACEs) have been largely mixed to date. Greenspaces have been shown to reduce inflammation and have been associated with CV health benefits, including reduced CVD behavioral risk factors and overall improvement in CV outcomes. Greenspace may, thus, serve to alleviate the CVD burden among cancer survivors. To understand pathways through which greenspace can prevent or reduce adverse CV outcomes among cancer survivors, we review the state of knowledge on associations among inflammation, CVD, cancer, and existing pharmacological interventions. We then discuss greenspace benefits for CV health from ecological to multilevel studies and a few existing experimental studies. Furthermore, we review the relationship between greenspace and inflammation, and we highlight forest bathing in Asian-based studies while presenting existing research gaps in the US literature. Then, we use the socioecological model of health to present an expanded conceptual framework to help fill this US literature gap. Lastly, we present a way forward, including implications for translational science and a brief discussion on necessities for virtual nature and/or exposure to nature images due to the increasing human-nature disconnect; we also offer guidance for greenspace research in cardio-oncology to improve CV health outcomes among cancer survivors.
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Affiliation(s)
- Jean C. Bikomeye
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Andreas M. Beyer
- Department of Medicine, Division of Cardiology, Cardiovascular and Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Jamila L. Kwarteng
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- MCW Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - Kirsten M. M. Beyer
- Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (J.L.K.)
- PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
- MCW Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
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Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042248. [PMID: 35206441 PMCID: PMC8871637 DOI: 10.3390/ijerph19042248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/22/2022]
Abstract
The benefits of biophilic interior design have been recognized by healthcare facilities, but residential environments receive relatively less attention with respect to improving the health of people living with chronic diseases. Recent “stay-at-home” restrictions due to the COVID-19 pandemic further emphasized the importance of creating interior spaces that directly and indirectly support physical and mental health. In this viewpoint article, we discuss opportunities for combining biophilic interventions with interior design, fostering disease-specific self-care. We provide examples of designing residential spaces integrating biophilic interventions, light therapy, relaxation opportunities, mindfulness meditation, listening to music, physical activities, aromatherapy, and quality sleep. These modalities can provide the clinical benefits of reducing migraine headaches and chronic pain, as well as improving depressive symptoms. The disease-specific interior environment can be incorporated into residential homes, workplaces, assisted-living residences, hospitals and hospital at home programs. This work aims to promote a cross-disciplinary dialogue towards combining biophilic design and advances in lifestyle medicine to create therapeutic interior environments and to improve healthcare outcomes.
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Exploring the Physiological and Psychological Effects of Digital Shinrin-Yoku and Its Characteristics as a Restorative Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031202. [PMID: 35162221 PMCID: PMC8834905 DOI: 10.3390/ijerph19031202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/09/2021] [Accepted: 01/05/2022] [Indexed: 02/01/2023]
Abstract
This study investigated the physiological and psychological therapeutic effects of a digital Shinrin-yoku environment constructed indoors in an urban facility as well as the characteristics of the environment that contribute to restorativeness (restorative traits). We measured the fluctuations in the physical and mental states of 25 subjects by obtaining both before–after measurements and continuous measurements while exposed to a digital Shinrin-yoku environment that reproduced visual, auditory, and olfactory elements. The results demonstrated that the parasympathetic nerve activity was significantly increased and that the heart rate was significantly decreased during the exposure compared with that during the resting state. As for mood, five of the six Profile of Mood States (POMS) scales (“Tension–Anxiety,” “Depression,” “Anger–Hostility,” “Fatigue,” and “Confusion”) were significantly decreased after the experience. In addition, psychological restorative effects were also confirmed, with a significant decrease in “negative affect” (measured using the Positive and Negative Affect Schedule (PANAS)) and a significant increase in the sense of restorativeness (Restorative Outcome Scale (ROS)) after the experience. In contrast, comparing the digital Shinrin-yoku environment with the actual forest environment and the urban environment using POMS, PANAS, ROS, and Perceived Restorativeness Scale (PRS), the psychological effects and environmental traits of the digital Shinrin-yoku were found to be considerably similar to those of the actual forest environment.
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DeLauer V, McGill-O'Rourke A, Hayes T, Haluch A, Gordon C, Crane J, Kossakowski D, Dillon C, Thibeault N, Schofield D. The Impact of Natural Environments and Biophilic Design as Supportive and Nurturing Spaces on a Residential College Campus. COGENT SOCIAL SCIENCES 2022; 8:2000570. [PMID: 35785135 PMCID: PMC9248534 DOI: 10.1080/23311886.2021.2000570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
With so many college students experiencing disengagement, the physical design of a college and the connection to its natural surroundings has the potential for profound change. Natural environments, even viewing pictures of them, have the potential to positively impact parasympathetic nervous systems, increase cognitive functioning, and improve attention. This study investigated college student perceptions of their personal well-being with attention to coping, self-esteem, and physical health in a residential academic setting in the northeastern United States. Female students reported less resiliency, lower self-esteem, and a decreased ability to choose positive health behaviors than male students. Findings point to the potential for the built environment on a college campus to be designed with biophilic elements to support and nurture students all year long.
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Rossi S, Santini SJ, Di Genova D, Maggi G, Verrotti A, Farello G, Romualdi R, Alisi A, Tozzi AE, Balsano C. Using social robot NAO for emotional support to children at a paediatric emergency department: a randomised clinical trial. J Med Internet Res 2021; 24:e29656. [PMID: 34854814 PMCID: PMC8796042 DOI: 10.2196/29656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/11/2021] [Accepted: 11/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background Social robots (SRs) have been used for improving anxiety in children in stressful clinical situations, such as during painful procedures. However, no studies have yet been performed to assess their effect in children while waiting for emergency room consultations. Objective This study aims to assess the impact of SRs on managing stress in children waiting for an emergency room procedure through the assessment of salivary cortisol levels. Methods This was an open randomized clinical trial in children attending a pediatric emergency department. Children accessing the emergency room were randomized to 1 of 3 groups: (1) playing with a NAO SR, (2) playing with a study nurse, or (3) waiting with parents. The salivary cortisol levels of all children were measured through a swab. Salivary cortisol levels before and after the intervention were compared in the 3 groups. We calculated the effect size of our interventions through the Cohen d-based effect size correlation (r). Results A total of 109 children aged 3-10 years were enrolled in the study, and 94 (86.2%) had complete data for the analyses. Salivary cortisol levels significantly decreased more in the group exposed to robot interaction than in the other two groups (r=0.75). Cortisol levels decreased more in girls (r=0.92) than in boys (r=0.57). Conclusions SRs are efficacious in decreasing stress in children accessing the emergency room and may be considered a tool for improving emotional perceptions of children and their families in such a critical setting. Trial Registration ClinicalTrials.gov NCT04627909; https://clinicaltrials.gov/ct2/show/study/NCT04627909
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Affiliation(s)
- Silvia Rossi
- Department of Electrical Engineering and Information Technology, University Federico II-Naples, Naples, IT
| | - Silvano Junior Santini
- Department of life, health & Environmental sciences- MESVA-School of Emergency and Urgency Medicine, University of L'Aquila, via spennati L'aquila 67100, L'Aquila, IT
| | - Daniela Di Genova
- Department of life, health & Environmental sciences- MESVA-School of Emergency and Urgency Medicine, University of L'Aquila, via spennati L'aquila 67100, L'Aquila, IT
| | - Gianpaolo Maggi
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, IT
| | | | | | - Roberta Romualdi
- Department of life, health & Environmental sciences- MESVA-School of Emergency and Urgency, University of L'Aquila, L'Aquila, IT
| | - Anna Alisi
- Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Rome, IT
| | | | - Clara Balsano
- Department of life, health & Environmental sciences- MESVA-School of Emergency and Urgency Medicine, University of L'Aquila, via spennati L'aquila 67100, L'Aquila, IT
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