From therapeutic landscapes to healthy spaces, places and practices: A scoping review

Digital geographies of care: Telehealth landscapes of addiction treatment during the COVID-19 pandemic

The COVID-19 pandemic has created new digital health care landscapes for the management of substance use and misuse. While telehealth was prohibited for addiction treatment prior to the pandemic, the severity of COVID-19 precipitated telehealth expansion for the delivery of individual and group-based treatment. Research has highlighted benefits and challenges of telehealth; however, little is known about the impacts of telehealth on the quality, use, and effectiveness of treatment. Fewer studies examine how these emerging digital geographies of care transform the spaces and landscapes of substance misuse. This article examines how telehealth affects landscapes of opioid use disorder care in Pennsylvania, West Virginia, and Kentucky during the COVID-19 pandemic. Our findings reveal that while telehealth extends access to treatment for opioid use disorder (OUD), it also creates new care inequities within and between providers and clientele that can undermine effective care and recovery.

Public nature and health for homeless populations: Professionals' perceptions of contingent human benefits and harms

This article investigates relationships between public nature and health for unsheltered homeless populations. It examines perceptions of health benefits and harms for people living in public natural areas including local, state, and national forests and parks in the Seattle metropolitan area (USA). Interviews with environmental, social service, and law enforcement professionals who regularly interact with this vulnerable population were conducted and thematically analyzed to understand perceptions of physical and mental health outcomes. Results show professionals' perspectives on the health benefits and detriments of time spent in natural environments and the contextual factors perceived to influence health. Interviewees' observations about the variability of personal circumstances and biophysical, social, and weather conditions encourage the nuanced consideration of how contingent therapeutic landscapes provide deeply needed benefits, but for a population with a diminished capacity to adapt when conditions change. We conclude with insights for future research that directly assesses homeless populations' exposures and health outcomes of living in public natural areas.

The varied restorative values of campus landscapes to students' well-being: evidence from a Chinese University

BACKGROUND

The literature on therapeutic landscapes highlights that the university campus landscape has restorative effects on students. This deserves more scholarly attention since mental health has become an important issue among university students. However, existing empirical studies have revealed mixed evidence with little attention to the heterogeneity across the design and, therefore, the potential therapeutic effects across different landscapes.

METHOD

This research examined how 13 landscape sites on a university campus might be differentially related to student well-being. These sites were identified from a variety of sources (campus design documents, photos used in the university's social media posts, and interviews with a small group of students) to represent a comprehensive list of places that students might visit. The data was collected in a large online survey of a Chinese university (n = 2,528). We asked about students' use of individual landscape sites and the associated motivations for visits, and measured well-being using a perceived stress scale and overall evaluation of the happiness level. Bivariate analysis was used to explore the zero-order associations between landscape use and well-being. OLS (for stress) and logistic regressions (for happiness) were conducted to further evaluate the associations after controlling the student background variables and potential correlations of uses across different landscapes.

RESULTS

Among 13 landscape sites, four sites had significant positive associations with either or both measures of well-being after controlling for the student characteristics and use of the other landscape sites. There was also an additive benefit of visiting more landscapes. Compared to those who did not frequently visit any of the sites, well-being had a significant stepwise increase among those who frequently visited one or two and more sites. One site that was significantly related to both measures of well-being only offered distant views of landscapes, but it was right next to the study areas.

CONCLUSIONS

This study demonstrates the heterogeneity of restorative effects across different landscapes on campus. The findings suggest that effective landscape design that aims to promote student well-being should be placed close to stressors (i.e., where they study), and between where they study and live to offer students opportunities to break from the common routines and to relax. The findings hold greater relevance for universities in China and institutions with similar student campus lifestyles, occupancies, and behavior patterns worldwide.

Sponge city construction and population health

Introduction

This paper focuses on the construction of sponge cities and their effects on population health. Sponge cities in China both solve stormwater problems and are a systemic transformation in the urban construction paradigm, addressing related issues arising from high-speed urbanization. Whether sponge city construction in China can promote population health has received scant attention. Most previous studies have focused on urban environments and population health, with few exploring the potential effects on population health caused by urban environment changes due to urban policies. This study hypothesizes that sponge city construction improves the urban environment, and thus, population health.

Methods

Using panel data from 119 prefecture-level cities between 2011 and 2019 and the China Labor-force Dynamics Survey (CLDS), based on China's sponge city pilot policy, a quasi-natural experiment is conducted using Difference-in-Differences (DID) model to identify the health effects of the sponge city policy.

Results

The findings show that sponge city pilot policy not only reduced ecological environment pollution and promoted the quality of built environment, but also significantly improved population health by 10.4%. This mechanism is mainly due to the restorative effects of the built environment.

Discussion

The health effects vary across city administrative levels, and especially among non-older adults and local populations. Compared with the cities at higher administrative level, the health effect in lower administrative level is significantly positive, indicating that there is a diminishing marginal effect of sponge city construction. This study extends the causal identification chain of the impact of urban environment on population health to urban policies and provide insights into policy objectives for sponge city construction.

"It is like post-traumatic stress disorder, but in a positive sense!": New territories of the self as inner therapeutic landscapes for youth experiencing mental ill-health

The manuscript reports on a study conducted on a youth mental health intervention, proposing a novel framework to look at the therapeutic potential of viticultural landscapes. Drawing on care studies applied to agricultural contexts, the work explores how the attention-based practice of manual grape harvest in a specific natural and social environment can produce a "therapeutic landscape of the mind". Through ethnographic research, we investigate how the spatial and social context of the viticultural environment influences the experience of a group of young people with mental-ill health, eventually supporting their process of recovery. Findings describe how the lived experience of caring for the vines while interacting with professional winegrowers in a one-to-one relationship allows participants to explore new territories of the self. It is argued that this powerful experience is not only beneficial as it unfolds, but also at a later time. Its therapeutic potential resides in the fact that the "landscape of the mind" can be recalled by the person, while positive identities associated with it and newly discovered "ways of being" can be re-enacted. The paper furthers the reflection on place-making practices of public health services and the way they can support the identification and cultivation of enabling places, particularly for vulnerable populations (e.g. young people) that can benefit from interventions conducted in non-medical, non-stigmatizing environments. The work is the result of an interdisciplinary collaboration between a psychiatrist (designing and coordinating the intervention) and a sociologist (designing and conducting the ethnographic study).

The impact of outdoor blue spaces on the health of the elderly: A systematic review

Research on natural health has identified the potential benefit of outdoor blue spaces for human health and wellbeing. However, the existing evidence has relatively limited attention to the elderly. This study aims to review the available evidence on outdoor blue spaces and health outcomes among older individuals and identify knowledge gaps. In accordance with the PRISMA guidelines, specific keywords were used to search for articles published in English from inception to October 2023. Five databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO) were searched, and 22 studies were identified in this review. We classified articles based on elderly health as general health (e.g., self-reported, perceived health and wellbeing), physical health (e.g., physical activity, physical function index), and mental health and wellbeing (e.g., depression). The findings indicated a positive correlation between outdoor blue space and the health of the elderly. In terms of the characteristics of exposure to outdoor blue spaces, direct contact (e.g., sensory-based) has not been well documented compared to indirect contact (e.g., distance, percentage, region-based). Although encouraging, the available body of evidence is limited and lacks consistency. Future research is needed to provide complementary evidence between outdoor blue spaces and elderly health.

Caring through things at a distance: Intimacy and presence in teletherapy assemblages

The COVID-19 crisis in the UK precipitated a sharp rise in the use of remote technologies to provide therapy during the lockdown. With mental health care services migrating to devices and video-conferencing platforms, nearly all forms of therapy had become 'teletherapy'. Drawing on interviews with UK-based practitioners, this paper explores how existing ideas of intimacy and presence are challenged when care is practiced at a distance. Against the background of concerns that remote technologies erode intimacy and degrade physical presence, the argument is made that presence, distance, intimacy and control are reconfigured within mediated therapy. Analysis of practitioners' experiences of teletherapy examines the material and expressive components of 'assemblages' characterised by their stable and fluid properties. Two assemblages are identified and discussed: emergency care assemblages and assemblages of intimacy, both of which are aligned with specific sectors of mental health care. Evidence that therapeutic encounters are constrained by technologies are considered alongside the material conditions and inequalities of vulnerable groups, while assemblages with relatively stable properties are generative of new ways of relating to clients online. These findings highlight the material and expressive components of human and nonhuman assemblages that create new kinds of affective relations in distanced care.

Current evidence and opportunities in child and adolescent public mental health: a research review

BACKGROUND

A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents.

METHODS

This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions.

RESULTS

In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements.

CONCLUSIONS

There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

A health data led approach for assessing potential health benefits of green and blue spaces: Lessons from an Irish case study

Research producing evidence-based information on the health benefits of green and blue spaces often has within its design, the potential for inherent or implicit bias which can unconsciously orient the outcomes of such studies towards preconceived hypothesis. Many studies are situated in proximity to specific or generic green and blue spaces (hence, constituting a green or blue space led approach), others are conducted due to availability of green and blue space data (hence, applying a green or blue space data led approach), while other studies are shaped by particular interests in the association of particular health conditions with presence of, or engagements with green or blue spaces (hence, adopting a health or health status led approach). In order to tackle this bias and develop a more objective research design for studying associations between human health outcomes and green and blue spaces, this paper discussed the features of a methodological framework suitable for that purpose after an initial, year-long, exploratory Irish study. The innovative approach explored by this study (i.e., the health-data led approach) first identifies sample sites with good and poor health outcomes from available health data (using data clustering techniques) before examining the potential role of the presence of, or engagement with green and blue spaces in creating such health outcomes. By doing so, we argue that some of the bias associated with the other three listed methods can be reduced and even eliminated. Finally, we infer that the principles and paradigm adopted by the health data led approach can be applicable and effective in analyzing other sustainability problems beyond associations between human health outcomes and green and blue spaces (e.g., health, energy, food, income, environment and climate inequality and justice etc.). The possibility of this is also discussed within this paper.

"This family and the Games are my world": Conceptualizing the British and European Transplant Games as therapeutic landscapes

The first Transplant Games took place in 1978 in Portsmouth, England. Since then, numerous Olympic-style sporting 'Games' have been established, each aiming to increase public awareness of organ donation, demonstrate the benefits of transplantation, and encourage patient fitness. Despite this, there is limited research exploring the psycho-social and health impacts of the Games. Drawing on qualitative research conducted at the 2022 British Transplant Games and the 2022 European Transplant and Dialysis Games, this paper explores the Games through a therapeutic landscapes framework, a concept that examines the ways in which environments contribute to health and wellbeing. Building upon work that acknowledges the relational and contingent nature of health-in-place, I argue that the Games are a therapeutic landscape of social relations for transplant recipients in three ways: providing a landscape of belonging, a landscape of hope, and a landscape of motivation. Through this therapeutic landscapes perspective, the Transplant Games are presented as a peer-to-peer clinic - a care space where individuals are more actively involved in their health on a reciprocal level than in the traditional hospital clinic. In turn, this paper emphasises the crucial role of affective peer support in producing health-promoting environments. This research seeks to make a practical contribution to the wider transplant community by promoting the Games as an environment which may positively contribute to both physical and mental wellbeing.

What makes a space safe? Consumers' perspectives on a mental health safe space

The provision of community-based space for people experiencing a mental health crisis is regarded as a favourable alternative to the emergency department. However, the only non-emergency department safe spaces in Western Australia are located within hospitals or hospital grounds. This qualitative study asked mental health consumers in Western Australia with experience of presentation at the emergency department during a mental health crisis to describe what a safe space would look and feel like. Data were collected through focus groups and thematically analysed. The findings present the voices of mental health consumers through the framework of health geography and the therapeutic landscape. These participants articulated important physical and social features of a therapeutic safe space and their symbolism as inclusive, accessible places where they would experience a sense of agency and belonging. Participants also expressed a need for trained peer support within the space to complement the skilled professional mental health team. Participants' experiences of the emergency department during mental health crises were described as contrary to their recovery needs. The research reinforces the need for an alternative to the emergency department for adults who experience mental health crises and provides consumer-led evidence to inform the design and development of a recovery-focused safe space.

Cognition and Interaction: From the Perspective of Daily Therapeutic Landscape of the Coastal Zone

This study explored the relationship between mental and physical therapeutic effects through three dimensions: man-environment relationships, a sense of place, and symbolic landscapes. The study used a combination of qualitative and quantitative research methods. Local residents living in the coastal area of Xinglin Bay were the research objects. Quantitative data analysis revealed that the frequency of residents' visits was an important variable affecting their physical and treatment perceptions. For those who visit frequently, these visits can evoke memories, which can better express their sensory experience. The text analysis showed that residents picked up two major landscape elements to form the sense of place and symbolic landscape: one is the water body in the coastal zone, and the other is the cultural symbol of the peninsula. Based on untoward event experience, the residents assembled the elements into a new spatial relationship with therapeutic affordance.

The Impact of Health Geography on Public Health Research, Policy, and Practice in Canada

The link between geography and health means that the places we occupy-where we are born, where we live, where we work, and where we play-have a direct impact on our health, including our experiences of health. A subdiscipline of human geography, health geography studies the relationships between our environments and the impact of factors that operate within those environments on human health. Researchers have focused on the social and physical environments, including spatial location, patterns, causes of disease and related outcomes, and health service delivery. The work of health geographers has adopted various theories and philosophies (i.e., positivism, social interactionism, structuralism) and methods to collect and analyze data (i.e., quantitative, qualitative, spatial analysis) to examine our environments and their relationship to health. The field of public health is an organized effort to promote the health of its population and prevent disease, injury, and premature death. Public health agencies and practitioners develop programs, services, and policies to promote healthy environments to support and enable health. This commentary provides an overview of the recent landscape of health geography and makes a case for how health geography is critically important to the field of public health, including examples from the field to highlight these links in practice.

Designing environments that contribute to a reduction in the progression of Parkinson's disease; a literature review

Parkinson's Disease (PD), a prevalent neurological disorder, causes physical difficulties like stiffness and impaired walking and affects patients' emotional well-being. Regular exercise and exposure to enriched environments are crucial to managing these symptoms. This review aims to extract evidence from studies regarding built environments' impact on reducing the progression of PD. Keywords from 2005 to 2022 were used in five databases, including PubMed, Clarivate Web of Science, UGA Library, and Google Scholar. Many studies emphasized physiotherapy and training for physical enhancement, often utilizing virtual games and smart devices. Others highlighted the advantages of non-slip flooring and accessible outdoor spaces, with some based on universal design principles. Few studies considered the emotional impact of built environments, showing a considerable gap in the studies simultaneously evaluating psychological and physical perspectives of Parkinson-friendly environments. There needs to be more consistency when considering these aspects of planning. Our findings suggest future research modeling enriched environments and tracking their impact on patients via Virtual Reality to find a comprehensive guideline for the most effective PD management environments.

"And if my goal is never to leave Casey House?": The significance of place attachment for patients at a specialty HIV hospital in Toronto, Canada

The current healthcare context prioritizes shorter hospital stays and fewer readmissions. However, these measures may not fully capture care experiences for people living with HIV, especially those experiencing medical, psychosocial, and economic complexity. As part of a larger study, we conducted seven focus groups with people living with HIV (n = 52), who were current/former patients at a Toronto-based specialty hospital, examining their desires/needs for hospital programs. Using a novel place attachment lens, we conducted a thematic analysis focusing on the emotional bond between person (patient) and place (hospital). Our findings show that participants wanted an ongoing connection to hospital to fulfill their need(s) for control, security, restoration and belonging. Indeed, continual attachment to hospital may be beneficial for patients with complex care needs. Our research has implications for care engagement and retention frameworks.

Migrant gardeners, health and wellbeing: exploring complexity and ambivalence from a UK perspective

There has been increasing interest in how green spaces and gardening contribute to people's physical, mental and social wellbeing, and this interest has increased due to COVID-19. This article explores the particular experiences of migrant gardeners and the implications for their health and wellbeing. It draws on a qualitative research project that involved conducting semi-structured interviews with participants with migration heritage in and around a city in the north of England. The participants were recruited through purposive and snowball sampling; of the 25 participants, some were allotment holders, whilst the rest cultivated crops in their gardens or even on their balcony. Thematic analysis of the interview transcripts generated themes that reflect current definitions of health, encompassing physical, mental and social wellbeing. However, whilst the findings confirm many positive effects of gardening, they also point to some ambivalence in relation to cultivation, outdoor practices and health, with evidence of neutral or even negative effects at times. The article explores the implications of these findings for initiatives to encourage gardening, such as social prescribing, and to address 'green poverty'. An additional finding is that for gardeners with migration heritage, gardening can be understood in terms of cultural wellbeing. Consequently, there is a need to broaden the concept of wellbeing to include this cultural dimension.

Supporting student learning and development through trauma-informed campuses

Many students come to higher education with a history of trauma. College life may also expose students to traumatizing events. While the past decade has witnessed greater discussion of trauma-informed frameworks, it has not regularly been applied to the college environment. We advance the concept of a trauma-informed campus, where administrators, faculty, staff, and students from diverse disciplines create an environment that recognizes the widespread nature of trauma, integrates knowledge about trauma into practices and procedures, and minimizes further re-traumatization for all community members. A trauma-informed campus is prepared for students' past or future traumatic experiences, while also recognizing and responding to structural and historical harms. In addition, it recognizes the role of the surrounding community challenges, particularly how violence, substance use, hunger, poverty, and housing insecurity may contribute to further trauma or negatively impact healing. We use an ecological model to frame and shape the construct of trauma-informed campuses.

Place, health and dis/advantage: A sociomaterial analysis

The substantial literature on interactions between places/spaces and well-being/health often differentiate between physical and social aspects of geographical location. This paper sidesteps this dualism, instead considering places as sociomaterial assemblages of human and non-human materialities. It uses this posthuman and 'new materialist' perspective to explore how place-assemblages affect human capacities, in terms of both health and social dis/advantage. Based on secondary analysis of interview data on human/place interactions, it analyses the physical, sociocultural, psychological and emotional effects of place-assemblages, assessing how these produce opportunities for, and constraints upon human bodies. It than assesses how these emergent capacities affect both social dis/advantage and well-being. This analysis of how place-assemblages contribute positively or negatively to health and dis/advantage offers possibilities for further research and for social and public health policy.

What is attractive rural landscape? Differences in the social and expert assessment of the changes in the rural landscape of the Carpathian region in Poland with regard to the need of its protection

Contemporary villages of the mountain region are subject to uncontrolled structural and spatial transformations, which cause deformation of centuries-old spatial systems of high cultural and natural value. The aim of the study is to confront the opinions of the inhabitants and experts regarding the condition of the cultural landscape of the villages in south-eastern Poland. This area belongs to the Carpathian region of Central Europe. The historical and economic conditions of the studied region, related to the functioning in the post-war period, and then its breakdown and the development of the free market economy, constitute an interesting background for the proposed research. Local communities still remembering the period of difficulties related to the period of systemic transformations, are currently experiencing a relative prosperity, many difficulties related to the period of systemic transformations, are currently experiencing a relative prosperity, which is also expressed in a completely new, previously unknown way of managing the landscape. Investments implemented in villages are associated by the inhabitants with the improvement of the standards and quality of life. They assess them rather positively. An expert assessment of these landscape transformations indicates their negative dimension and the risk of losing timeless values. The discrepancy in the assessment of experts and local residents creates difficulties in the protection of the rural landscape. Therefore, high-quality visual landscape features among rural residents is necessary from the point of view of its multi-faceted and effective protection. Local initiatives and actions in the field of industry policy should play a significant role in this respect by consolidating the images of a harmonious landscape in the public awareness.

Beyond "bluespace" and "greenspace": A narrative review of possible health benefits from exposure to other natural landscapes

Numerous studies have highlighted the physical and mental health benefits of contact with nature, typically in landscapes characterized by plants (i.e., "greenspace") and water (i.e., "bluespace"). However, natural landscapes are not always green or blue, and the effects of other landscapes are worth attention. This narrative review attempts to overcome this limitation of past research. Rather than focusing on colors, we propose that natural landscapes are composed of at least one of three components: (1) plants (e.g., trees, flowering plants, grasses, sedges, mosses, ferns, and algae), (2) water (e.g., rivers, canals, lakes, and oceans), and/or (3) rocks and minerals, including soil. Landscapes not dominated by plants or liquid-state water include those with abundant solid-state water (e.g., polar spaces) and rocks or minerals (e.g., deserts and caves). Possible health benefits of solid-state water or rock/mineral dominated landscapes include both shorter-term (e.g., viewing images) and longer-term (e.g., living in these landscapes) exposure durations. Reported benefits span improved emotional and mental states and medical treatment resources for respiratory conditions and allergies. Mechanisms underlying the health benefits of exposure consist of commonly discussed theories in the "greenspace" and "bluespace" literature (i.e., instoration and restoration) as well as less discussed pathways in that literature (i.e., post-traumatic growth, self-determination, supportive environment theory, and place attachment). This is the first review to draw attention to the potential salutogenic value of natural landscapes beyond "greenspace" and "bluespace." It is also among the first to highlight the limitations and confusion that result from classifying natural landscapes using color. Since the extant literature on natural landscapes - beyond those with abundant plants or liquid-state water - is limited in regard to quantity and quality, additional research is needed to understand their restorative potential and therapeutic possibilities.

Dimensions of the health benefits of wellness tourism: A review

The benefits of wellness tourism have been recently noted by researchers and industry representatives. This study examined the health dimensions of these benefits posited by a large array of interdisciplinary studies from 2002 up to the present. Open coding was used to conduct an inductive evaluation to classify these health benefits. Results showed four main dimensions, namely, physical fitness, psychological fitness, quality of life (QOL), and environmental health; however, these dimensions need further investigation. Physiological health benefits can also be demonstrated through future experiments, which can further focus on empirical research on the psychological benefits and its overall effect on the QOL. This study contributes to the current literature by providing novel theoretical foundations and subsequently aids practitioners to understand customers better and convey their marketing messages to tourists more effectively.

Nature-based tourism as therapeutic landscape in a COVID era: autoethnographic learnings from a visitor's experience in Iceland

One of the few silver linings in the COVID pandemic has been a new appreciation for, interest in, and engagement with nature. As countries open, and travel becomes accessible again, there is an opportunity to reimagine sustainable nature-based tourism from a therapeutic landscape lens. Framed within the therapeutic landscape concept, this paper provides an autoethnographic account of a visitor's experience of three different natural landscapes in Iceland shortly after the country's fourth wave of the pandemic. It adds to the understanding of the healing effects of the multi-colored natural landscapes of Iceland. The natural landscapes of interest herein include: the southern part of the Westfjörd peninsula, Jökulsárlón glacial lagoon, and the Central Highlands. In totality, the natural, built and symbolic environments worked in synchronicity to produce three thematic results: restoration, awe and concern, all which provided reduced stress, renewed attention, as well as enhanced physical and psycho-social benefits for the autoethnographic visiting researcher. Implications of these restorative outcomes for sustainable nature-based tourism in a post-COVID era are discussed. This paper highlights how health and tourism geographers can work collaboratively to recognize, protect, and sustain the therapeutic elements of natural landscapes, recognized as a cultural ecosystem service. In so doing, such collaborations can positively influence sustainable nature-based tourism development and consumption through proper and appropriate planning and development of such tourism destinations.

The ends of an assemblage of health

This paper identifies and responds to three key challenges that have emerged in discussions of the assemblage across health geography. These challenges concern the problem of identifying the borders or limits of an assemblage of health; the problem of clarifying how such assemblages change over time; and the more general problem of identifying the affective and material character of the assemblage such that one may distinguish 'therapeutic' from 'oppressive' arrangements. The paper argues that each challenge calls for a novel analytics of power grounded in assessments of the generative forces of stratification and selection expressed within an assemblage. Assemblages of health are composed in relations of power, affect and desire that stratify the assemblage in ongoing processes of selection, acting upon heterogeneous entities (material and immaterial, intensive and extensive, human and nonhuman), bringing them into contact, causing them to affect one another, transforming their activity. Analysis of these processes provides potent tools for rethinking how relations, events, spaces and encounters mediate experiences of health and illness, and novel grounds for intervening in the formation of an assemblage of health.

Employee well-being and innovativeness: A multi-level conceptual framework based on citation network analysis and data mining techniques

This study proposes a multilevel conceptual framework for a deeper understanding of the relationship between employee well-being and innovativeness. We overview 49 years of well-being research [1972-2021] and 54 years of research on innovativeness [1967-2021] to uncover 24 dominant themes in well-being and ten primary topics in innovativeness research. Citation network analysis and text semantic similarity were used to develop a conceptual framework featuring 21 components and three levels: individual, organizational, and market. These components consist of constructs, domains, and factors that can influence or be influenced by employee well-being and innovativeness either directly or indirectly. This is the first study to use citation network analysis and data mining techniques to investigate the relationship between employee well-being and innovativeness. This novel framework can aid organizations in identifying more holistic and efficient strategies for fostering innovativeness and enhancing the well-being of their workforce. It can also assist in developing new theories and serve as a roadmap for future research. We discuss the research limitations and theoretical and practical implications and propose three research themes that future studies may address.

What types of green space disrupt a lonelygenic environment? A cohort study

INTRODUCTION

Associations between green space type and social loneliness (a scarcity of people one feels they can depend on) were investigated in city-living participants in the Sax Institute's 45 and Up Study.

METHODS

Availability of green space, tree canopy and open grass were measured as a percentage of land-use within 1.6 km road-network distance buffers using high-resolution data. Multilevel logistic regressions adjusted for confounding tested associations between each green space indicator with the odds of social loneliness at baseline (prevalence) and follow-up (incidence), adjusted for demographic and socioeconomic confounders.

RESULTS

The prevalence of social loneliness at baseline was 5.3% (n = 5627 /105,498). Incidence of social loneliness at follow-up was 3.4% (n = 1772/51,365). Adjusted regressions indicated reduced odds of prevalent (OR = 0.95, 95%CI = 0.92-0.98) and incident social loneliness with 10% more green space (OR = 0.92, 95%CI = 0.90- 0.96). Similar associations were found with a 10% increase in tree canopy for both prevalent (OR = 0.92, 95%CI = 0.88-0.95) and incident social loneliness (OR = 0.92, 95%CI = 0.88-0.97). Two-way interaction terms indicated effect modification by sex but not couple status. Among women, a 10% increase in total green space was associated with lower odds of prevalent (OR = 0.95, 0.91-0.95) and incident (OR = 0.89, 0.85-0.95) social loneliness. A 10% increase in tree canopy among women was associated with lower odds of prevalent (OR = 0.89, 085-0.92) and incident (OR = 0.85, 0.80-0.92) social loneliness. Meanwhile, a 10% increase in open grass among women was associated with higher odds of prevalent (OR = 1.08, 1.01-1.15) and incident (OR = 1.19, 1.03-1.35) social loneliness. Associations for men were statistically significant for a 10% increase in total green space (OR = 0.96, 0.92-0.99) and tree canopy (OR = 0.93, 0.90-0.97) for prevalent social loneliness only.

CONCLUSION

Urban greening and tree canopy restoration may reduce risks of social loneliness, perhaps especially in women.

Can imaginary mobilities be conducive to mental health?

Despite the growing interest in the relationship between physical mobility and mental health in health geography, there has been less attention to mobility in the non-physical imaginary realm and its effects on health. This study attempts to explore whether and how 'imaginary mobilities' can be conducive to mental health. It conceptualised imaginary mobilities and designed 'Imaginary Travels' as a type of imaginary mobility. To verify the research questions, 50 young unemployed people living in Seoul, South Korea, were examined (experimental group: n = 25; control group: n = 25). The results demonstrate the immediate and long-term therapeutic effects of Imaginary Travels as imaginary mobility using three psychological questionnaires in the quantitative analysis and data derived from interviews and diary entries in the qualitative analysis. The quantitative statistical analysis revealed significant effects in the experimental group in contrast to the control group. The qualitative analysis indicated that imaginary mobilities are conducive to mental health through immersing, exploring, and practising inner geographies. These findings have implications for understanding mobilities and their associated therapeutic qualities in the imaginary realm beyond the physical realm.

Urban Blue Spaces as Therapeutic Landscapes: "A Slice of Nature in the City"

Urban blue spaces are defined as all natural and manmade surface water in urban environments. This paper draws on how the concepts of experienced, symbolic, social, and activity space combine to position urban blue spaces as therapeutic landscapes. We conducted 203 intercept interviews between 12 October 2019 and 10 November 2019. Although safety concerns had health-limiting impacts, interacting with the Glasgow Canal and surrounding landscape was predominantly perceived as health-enhancing. Our findings build on current evidence, which has suggested that urban blue spaces, particularly canals, may foster therapeutic properties, contributing to healthier city environments. Further research is required to understand better the interconnectedness of urban blue spaces and health and how such spaces can be best developed and managed to improve the health outcomes of local populations.

Green space and loneliness: A systematic review with theoretical and methodological guidance for future research

Persistent loneliness troubles people across the life span, with prevalence as high as 61 % in some groups. Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain how green space would work as a structural intervention. Both are needed to guide decision making and further research. We conducted a systematic review of quantitative studies testing associations between green space and loneliness, searching seven databases. Twenty two studies were identified by 25/01/2022. Most of the studies were conducted in high-income countries and fifteen (68 %) had cross-sectional designs. Green space was measured inconsistently using either objective or subjective indicators. Few studies examined specific green space types or qualities. The majority of studies measured general loneliness (e.g. using the UCLA loneliness scale). Different types of loneliness (social, emotional, existential) were not analysed. Of 132 associations, 88 (66.6 %) indicated potential protection from green space against loneliness, with 44 (33.3 %) reaching statistical significance (p < 0.05). We integrated these findings with evidence from qualitative studies to elaborate and extend the existing pathway domain model linking green space and health. These elaborations and extensions acknowledge the following: (a) different types of green space have implications for different types of loneliness; (b) multilevel circumstances influence the likelihood a person will benefit or suffer harm from green space; (c) personal, relational, and collective processes operate within different domains of pathways linking green space with loneliness and its concomitants; (d) loneliness and its concomitants are explicitly positioned as mediators within the broader causal system that links green space with health and wellbeing. This review and model provide guidance for decision making and further epidemiological research on green space and loneliness.

Enabling care: Maggie's centres and the affordance of hope

This study explores the role of architecture in the affordance of hope for people with cancer. Specifically, it revisits 'enabling places' debates to understand the influence of spatial design in the experience of cancer care. Combining interviews and focus group data from two separate studies of visitors, volunteers, and staff members of Maggie's Centres, an organisation providing cancer support in the UK and internationally, the study investigates the emotional power of their buildings. In particular, we explore how Maggie's Centre buildings provide material, social, and affective resources for their users. We argue that Maggie's Centres help its visitors to orient themselves to their changing lives and uncertain futures in thoughtful ways and, thus, their buildings offer examples of the 'taking place' of hope.

The experience of individuals affected by Australia's international border closure during the COVID-19 pandemic

This study explored the experiences of individuals who reported being negatively affected by Australia's international border closure during the COVID-19 pandemic. Qualitative data from 1930 adults who responded to a cross-sectional online survey exploring the mental health and wellbeing of individuals affected by border closure were analysed using theoretical thematic analysis, drawing on understandings of the relationship between place and wellbeing. Four themes were identified: 'Disconnection from family and social connections', 'Disconnection from a sense of home and belonging', 'Disconnection and sense of self', and 'A desire for reconnection'. Results provide a rich illustration of the relationship between disconnection from place and wellbeing during COVID-19 and highlight the need to support those affected and consider these adverse effects in future public health planning.

From scary places to therapeutic landscapes: Voices from the community of people living with schizophrenia

This article discusses how people living with schizophrenia experience, understand, and respond to their urban environment. Our study relies on experiential photo-voice data gathered with a sample of six people diagnosed with schizophrenia and living in non-institutional settings in Montréal, Canada, to identify how individuals in this community perceive the urban landscape. We adopt a therapeutic landscapes' framework that explores the urban fabric at three levels: physical, social, and symbolic. Research participants identified both health-denying and health-enhancing places within ordinary urban landscapes. Landscapes identified as health-denying are characterized by environmental stressors and loss of control, with construction sites an example highlighted by participants. Healing and restorative landscapes, as identified by participants, were physically attractive or quiet, socially safe and welcoming, and symbolically affirmative of one's identity, all factors worthy of further study. The findings are also policy-relevant: they suggest that people living with schizophrenia and their clinicians can develop strategies to make health-enhancing uses of urban landscapes; and that urban policies and practices can foster urban environments conducive to enhanced health and well-being, both for the community of people living with schizophrenia and the wider population of urban dwellers.

The significance of the social and material environment to place attachment and quality of life: findings from a large population-based health survey

Background

There is an international public health interest in sustainable environments that promote human wellbeing. An individual’s bond to places, understood as place attachment (PA), is an important factor for quality of life (QoL). The material environment, such as access to nature (AtN), access to amenities (AtA), or noise, and the social environment, such as social support or loneliness, has the potential to influence PA. The aim of the present study was to explore the relationship between these factors and QoL.

Methods

The study relied on data from 28,047 adults from 30 municipalities in Southern Norway obtained from the Norwegian Counties Public Health Surveys in 2019. Latent regression analyses were used to examine the relationship between the material and social environmental factors and QoL, mediated by PA.

Results

We found a relationship between social and material environmental factors and PA. Higher AtN and AtA scores were related to an increase in PA, whereas higher perception of noise problems was related to decreased PA scores. When social environment factors were added to the model, they were even stronger predictors of PA and, in turn, QoL through mediated effects. We also found a strong positive association between PA and QoL (unstandardized β = 0.88, 95% CI = 0.87–0.90, p < 0.001). The whole model explained 83% of the variance in PA and 65% of the variance in QoL.

Conclusions

Taken together, the findings suggest the relevance of material and social environmental factors for PA and QoL. Therefore, research on public health and QoL should include place-sensitive variables.

Residential open space and the perception of health benefits: How much is the public willing to pay?

Emerging evidence suggests that residential open space (ROS) is beneficial for multiple health outcomes for urban residents. However, the general public's understanding of and demand for the health benefits related to ROS have not been widely explored. This study aims to examine the impact of residents' socioeconomic status and perceptions of landscape health benefits on their willingness to pay (WTP) for ROS and to evaluate the perceived monetary value of different residential landscape elements. An online survey with 1348 respondents was conducted between August 2020 and October 2021 in China using a contingent valuation (CV) method. Respondents perceived the landscape benefits related to mental health to be higher than those related to physical and social health. The perception of landscape health benefits positively affected WTP and the WTP value of ROS. Residents' monthly income was a significant influencing factor for WTP and the latter's value. For individuals with positive WTP, the average annual WTP for ROS was CNY 68.98 (USD 10.81), while for all the respondents, the estimated mean annual WTP for ROS was CNY 91.75 (USD 14.38). Moreover, the estimated WTP for plants was the highest, whereas the WTP for activity spaces was estimated as the lowest. These findings may improve city planners' and community managers' understanding of the perceived value of residential landscapes among the public and help them make effective decisions to build healthy communities.

Mental health and well-being in times of COVID-19: A mixed-methods study of the role of neighborhood parks, outdoor spaces, and nature among US older adults

The role of parks and nature to support well-being during the COVID-19 pandemic is uncertain. To examine this topic, we used mixed-methods data collected in April-May 2020 from US adults aged ≥55 in the COVID-19 Coping Study. We quantitatively evaluated the associations between number of neighborhood parks and depression, anxiety, and loneliness; and conducted qualitative thematic analysis of participants' outdoor experiences. Among urban residents, depression and anxiety were inversely associated with the number of neighborhood parks. Thematic analysis identified diverse engagement in greenspaces that boosted physical, mental, and social well-being. The therapeutic potential of outdoor and greenspaces should be considered for interventions during future epidemics.

Processes underpinning survival in gay men living with HIV and a history of suicidality

Gay men living with HIV represent a particularly high risk group for suicide; however, little is known about suicidality, specifically, resiliencies in the context of suicidality among this particular group of men. The current study draws on photovoice and grounded theory methods to examine the processes that underpin survival for gay men living with HIV who have experienced suicidality. Twenty-two Canadian-based gay men participated, taking photographs to depict and discuss their perspectives on resiliencies. Analyses revealed three processes that supported men's survival: (1) connecting to key supports, (2) finding sanctity in the outdoors, and (3) giving help as purposeful value-adding. Connecting to key supports highlighted the utility of connection and therapeutic communication, listening and support provided by friends, family and professionals. Finding sanctity in the outdoors emphasised the healing capacity of outdoor green spaces, and giving help as purposeful value-adding illustrated the meaning and purpose men derived from supporting others. These findings can inform public health and primary care interventions to foster gay men's resilience and coping, and ultimately suicide prevention efforts.

The Intersection of Neighborhood Environment and Adverse Childhood Experiences: Methods for Creation of a Neighborhood ACEs Index

This study evaluated methods for creating a neighborhood adverse childhood experiences (ACEs) index, a composite measure that captures the association between neighborhood environment characteristics (e.g., crime, healthcare access) and individual-level ACEs exposure, for a particular population. A neighborhood ACEs index can help understand and address neighborhood-level influences on health among individuals affected by ACEs. Methods entailed cross-sectional secondary analysis connecting individual-level ACEs data from the Philadelphia ACE Survey (n = 1677) with 25 spatial datasets capturing neighborhood characteristics. Four methods were tested for index creation (three methods of principal components analysis, Bayesian index regression). Resulting indexes were compared using Akaike Information Criteria for accuracy in explaining ACEs exposure. Exploratory linear regression analyses were conducted to examine associations between ACEs, the neighborhood ACEs index, and a health outcome—in this case body mass index (BMI). Results demonstrated that Bayesian index regression was the best method for index creation. The neighborhood ACEs index was associated with higher BMI, both independently and after controlling for ACEs exposure. The neighborhood ACEs index attenuated the association between BMI and ACEs. Future research can employ a neighborhood ACEs index to inform upstream, place-based interventions and policies to promote health among individuals affected by ACEs.

Seating in Doctors' Waiting Rooms: Has COVID-19 Changed Our Choices?

OBJECTIVE

This study investigates preference for five different seating arrangements (e.g., rows, clusters) in a doctor's office waiting room, whether these reduce stress and improve judgments of medical care, and how such choices may have changed over the pandemic (2013 vs. 2021).

BACKGROUND

What is called the doctor's office layout, with chairs lining the perimeter of the waiting room, is criticized by designers, yet little empirical evidence exists to support that assessment.

METHOD

Data collected in 2013 and 2021 used sketches of five different seating arrangements; people saw just one of these. The study examined the effect of time and seating arrangement on anxiety, need for privacy, situational awareness, evaluation of the environment, and perception of the doctor.

RESULTS

There was no significant impact of the seating arrangement on any of the dependent variables, but ratings were higher for situational awareness, need for privacy, evaluation of the environment, and aspects related to the physician in 2021. In addition, seating preferences favored end, not middle seats, and chair selections with the chair back to a wall.

CONCLUSION

In this study, no evidence exists that the doctor's office layout is less preferred than four other seating arrangements, but seat choice shows people prefer end seats (not middle seats) across arrangements. The doctor's office layout may offer a supportive familiarity to people; also, given the percentage of people who visit the doctor unaccompanied, layouts designed to encourage social interaction may not always be appropriate.

Contemplative practices: The body as therapeutic site linking health and place

During times of upheaval, supporting stability, health and wellbeing on all levels is essential. While literature regarding 'therapeutic landscapes' has burgeoned over the last 30 years, to date no studies have considered the therapeutic potential of embodied contemplative practices (CP), such as yoga and meditation, within the most accessible, ordinary environment - the body at home. Equally, the field of mobilities appears to have overlooked the spiritual and political nature of these deliberately immobilising acts of resistance. Our paper draws on narrative data collected over the course of three months of daily CP. We interpret the resulting autoethnography through thematic analysis. We conclude that within a fast-paced, hyper-connected world, CPs can be a therapeutic counterpoint, connecting health and place by nurturing an appreciation for the immaterial, interdependent aspects of life.

Pleistocene Hypothesis - Moving Savanna Perceptual Preference Hypothesis Beyond Savanna

We provide an extension of the Savanna perceptual preference hypothesis ("Savanna Hypothesis"), supposing that interaction with landscapes offering survival advantage for human groups during evolution might have gradually evolved to permanent landscape preferences. This additional support is based on the palaeoenvironmental analysis of the spread of modern humans into Europe in the late Pleistocene and their living environments there. Our hypothesis is that the preference for park-like landscapes after African savannas experienced a kind of "refreshment" in the Pleistocene. Thus, preferences for certain types of natural settings and scenes may have a more continuous evolutionary history than previously thought. The extended Savanna Hypothesis termed "Pleistocene Hypothesis" might stimulate further work on this important topic linking human evolution and human environmental preferences.

The Reorganization of a Psychiatric Unit During COVID-19: A Reflection for Psychiatric Hospital Design

OBJECTIVE

The COVID-19 pandemic has impacted healthcare systems worldwide. Although this disease has primarily impacted general medicine intensive care units, other areas of healthcare including psychiatry were modified in response to corona measures to decrease the transmission of the disease. Reflecting on the modifications to the environment provides an opportunity to design psychiatric environments for future pandemics or other demands for healthcare.

BACKGROUND

The therapeutic environment of psychiatric wards was modified in Friesland, the Netherlands, in response to COVID-19. During this time, an interdisciplinary team met consistently to contribute to the preliminary design of a new psychiatric hospital.

METHODS

During the first 18 months of the pandemic, clinical reflections were made to describe the impact of COVID-19 on the psychiatric care environment. Architects have created a preliminary design of a new psychiatric hospital based on these reflections, monthly collaborative design discussions based on virtual mock-ups and evidence-based design based on theoretical concepts and research.

RESULTS AND CONCLUSIONS

This theoretical and reflective study describes how an inpatient psychiatric environment was restructured to manage infection during COVID-19. The therapeutic environment of the psychiatric ward and patient care changed drastically during COVID-19. The number of patients accessing care decreased, patient autonomy was restricted, and the function of designated behavioral support spaces changed to manage the risk of infection. However, these challenging times have provided an opportunity to reflect on theories and consider the design of new hospital environments that can be adapted in response to future pandemics or be restructured for different care functions.

Community gardening and wellbeing: The understandings of organisers and their implications for gardening for health

Community gardening is increasingly framed and promoted as a way to foster healthful behaviours, as a wellbeing practice, and as a public health tool. This paper draws on semi-structured interviews with community gardening organisers (n = 9) in the North East of England, who were engaged in translating and transforming discourses and ideas about community gardening into places and practices that people can draw benefit from. Here, community gardening can be understood as a bricolage of ideas, resources, and skills at the nexus of several influences and movements, assembled to produce a localised, everyday sort of social change. We conclude that framing community gardening as a simple solution to be harnessed in the promotion of health and wellbeing undermines the richness that sustains it and may lead to disenchantment within health services and community gardening organisations that could threaten the future of 'green social prescribing'.

Therapeutic Garden With Contemplative Features Induces Desirable Changes in Mood and Brain Activity in Depressed Adults

The therapeutic values of contact with nature have been increasingly recognized. A growing body of evidence suggests that a unique subcategory of "contemplative landscapes" is particularly therapeutic. Previous studies predominantly focused on observational designs in non-clinical populations. It is not known if these effects can be extrapolated to populations suffering from depression, and experimental designs need to be utilized to establish causality. We examined the effects of in-situ passive exposure to three urban spaces on brain activity, namely a Therapeutic Garden with high Contemplative Landscape scores (TG), Residential Green (RG) and Busy Downtown (BD), and self-reported momentary mood in adults aged 21-74 (n = 92), including 24 clinically depressed and 68 healthy participants. Portable, multimodal electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) systems were used to record brain activity, and a Profile of Mood States (POMS) questionnaire was used to record mood before and after exposure. We tested the interactions between the site, time and group for the mood, and between site and group for the neuroelectric oscillations and brain hemodynamics. Self-reported pre- post-mood was significant only at the TG (p = 0.032) in both groups. The lowest Total Mood Disturbance (TMD) was reported at TG and the highest in BD (p = 0.026). Results from fNIRS indicated marginally significant lower oxy-Hb in the frontal region at TG as compared to BD (p = 0.054) across both groups. The marginally significant effect of site and group was also observed (p = 0.062), with the Clinical group showing much lower oxy-Hb at TG than Healthy. The opposite pattern was observed at BD. EEG results showed differences between Healthy and Clinical groups in the Frontal Alpha Asymmetry (FAA) pattern across the sites (p = 0.04), with more frontal alpha right in the Clinical sample and more left lateralization in the Healthy sample at TG. Temporal Beta Asymmetry (TBA) analyses suggested that patients displayed lower bottom-up attention than Healthy participants across all sites (p = 0.039). The results suggest that both healthy and depressed adults benefitted from exposure to TG, with possibly different pathways of mood improvement. Visiting therapeutic nature with contemplative features may provide valuable support for the treatment of depression in clinical populations and a self-care intervention in non-clinical populations.

‘It Was Magical’: Intersections of Pilgrimage, Nature, Gender and Enchantment as a Potential Bridge to Environmental Action in the Anthropocene

Centring on embodiment, gendered eco-spiritual responses to nature, enchantment and environmental crises in the Anthropocene, this paper explores engagement with nature as a spiritual experience and resource through ‘Celtic’ Christian prayer walks in the Isle of Man. Web-based and printed materials for the walks are analysed for references to nature and environmental responsibility, and the complexities of personal, gendered and theological relation to nature and the environment are explored through participants’ accounts. The analysis is attentive to participants professing Christian faith and institutional affiliation as well as those without affiliation or faith and to their gendered experience. Themes identified include nature-inspired ‘Celtic’ spirituality; personal relation to the non-human (the divine, nature and nature-as-divine); the landscape as a liminal ‘thin place’; and social and environmental responsibility. The paper concludes by signalling the potential for bridging between pilgrimage-centred enchantment and eco-spirituality in order to mobilise engagement with and for the environment in the Anthropocene, including environmental conservation activities, lobbying or protest. Whilst eschewing gendered stereotypes, empirical findings evidence gendered patterns of engagement and responses to different expressions of spirituality. Attention to these differences could facilitate the engaging and mobilising of different cohorts of pilgrims with environmental agendas, inspiring personal and collective environmental action.

Relationships between Recreation and Pollution When Striving for Wellbeing in Blue Spaces

Our aim for this research was to identify and examine how recreation enthusiasts cope with and mitigate the violence of pollution as they strive for wellbeing in polluted “blue spaces” (e.g., seas, oceans). Our methodology to undertake the research was ethnography (online and offline), including autoethnography and informal interviews (40). The study proceeded from a constructivist epistemology which emphasizes that knowledge is situated and perspectival. The study site was a post-industrial area of northeast England where a long-standing but also rapidly growing surfing culture has to live with pollution (legacy and ongoing). We found evidence of what have become quotidian tactics that attach to themes of familiarity, embodiment, resignation, denial, and affect/emotion used by enthusiasts to cope with and mitigate the violence of pollution. We argue that by necessity some surfers are persisting in striving for wellbeing not simply in spite of pollution but rather with pollution. We assert surfers enact a “resigned activism” that influences their persistence. We extend critical scholarship concerning relationships between recreation, blue spaces, and wellbeing by moving beyond a restrictive binary of focusing on either threats and risks or opportunities and benefits of blue space to health and wellbeing, instead showing how striving for wellbeing through recreation in the presence of pollution provides evidence of how such efforts are more negotiated, fluid, situated, uncertain, dissonant, and even political than any such binary structure allows for.

Understanding the Role of Nature Engagement in Supporting Health and Wellbeing during COVID-19

The importance of natural environments in supporting health and wellbeing has been well evidenced in supporting positive mental and physical health outcomes, including during periods of crisis and stress. Given the disproportionate impacts of the COVID-19 pandemic have been greatest for those who are most vulnerable, understanding the role of natural environment and alternative forms of nature engagement in supporting health and wellbeing for vulnerable groups is important. This study explored how nature engagement supported health and wellbeing in those with a pre-existing health condition during the first UK lockdown. Semi-structured interviews were conducted with 17 adults with a pre-existing health condition and analysed using Interpretative Phenomenological Analysis (IPA). Four themes were identified: COVID-19 versus nature; Nature as an extension and replacement; Nature connectedness; and Therapeutic nature. The findings show the importance of nature in supporting health and wellbeing in those with a pre-existing health condition through engagement with private and public natural environments, micro-restorative opportunities, nature connection as an important pathway, and the therapeutic benefits of nature engagement. The present research extends the evidence-base beyond patterns of nature engagement to a deeper understanding of how those with existing health conditions perceived and interacted with nature in relation to their health and wellbeing during the first UK lockdown. Findings are discussed in relation to health supporting environments, micro-restorative opportunities, and policy implications.

Therapeutic Landscapes and Psychiatric Care Facilities: A Qualitative Meta-Analysis

The environment in healthcare facilities can influence health and recovery of service users and furthermore contribute to healthy workplaces for staff. The concept of therapeutic landscapes seems to be a promising approach in this context. The aim of this qualitative meta-analysis is to review the effects of therapeutic landscapes for different stakeholders in psychiatric care facilities. A systematic literature search was conducted in the four data bases PubMed, PsycInfo, CINAHL, and Web of Science. Thirteen predominately qualitative studies were included in this qualitative meta-analysis. The methodological quality of these qualitative studies was assessed, using an adapted version of the Journal Article Reporting Standards for Qualitative Research, and a thematic analysis was conducted. The results were categorised into the three main themes of the physical (built and natural), social, and symbolic dimensions of the therapeutic landscape. Given the heterogeneity of the summarised data and an overall methodological quality of the included studies that can be rated as medium, the results should be interpreted with caution. Current findings are based almost exclusively on qualitative studies. Therefore, there is a need for quantitative study designs that investigate the relationship between specific environmental elements and mental health outcomes for different stakeholders in psychiatric facilities.

Healing Architecture in Healthcare: A Scoping Review

OBJECTIVES

The purpose of this scoping review is to identify evidence on how characteristics of healing architecture in clinical contexts impact clinical practice and patient experiences. Based on these insights, we advance a more practice-based approach to the study of how healing architectures work.

BACKGROUND

The notion of "healing architecture" has recently emerged in discussions of the spatial organization of healthcare settings, particularly in the Nordic countries. This scoping review summarizes findings from seven articles which specifically describe how patients and staff experience characteristics of healing architecture.

METHODS

This scoping review was conducted using the framework developed by Arksey and O'Malley. We referred to the decision tool developed by Pollock et al. to confirm that this approach was the most appropriate evidence synthesis type to identify characteristics related to healing architecture and practice. To ensure the rigor of this review, we referred to the methodological guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews.

RESULTS

There are two main findings of the review. First, there is no common or operative definition of healing architecture used in the selected articles. Secondly, there is limited knowledge of how healing architecture shapes clinical and patient outcomes.

CONCLUSIONS

We conclude that further research is needed into how healing architectures make a difference in everyday clinical practices, both to better inform the development of evidence-based designs in the future and to further elaborate criteria to guide postoccupancy evaluations of purpose-built sites.

Conserve My Village—Finnish, Norwegian and Swedish Students’ Valued Landscapes and Well-Being

In the context of landscape, both the natural environment and the built environment can be linked with human health and well-being. This connection has been studied among adults, but no research has been conducted on young people. To fill this gap, this case study aimed to elucidate students’ views on landscapes worth conserving and the landscapes that affect and support their well-being. The participants (n = 538) were Finnish, Norwegian and Swedish students from grades 3–6. The students drew the landscapes they wanted to conserve. The drawn landscapes and the welfare-supporting features they contained were analysed using inductive and abductive content analyses. The students from all three countries preferred water, forest and yard landscapes. In the drawings of natural landscapes, the most recurring themes were sunrise or sunset, forest, beach and mountain landscapes. Physical well-being was manifested in the opportunity to jog and walk. Social well-being was reflected in the presence of friends, relatives and animals. Therapeutically important well-being-related spaces—the so-called green (natural areas), blue (aquatic environments) and white (e.g., snow) areas—were also depicted in the participants’ drawings. It can be concluded that the drawn landscapes reflect several values that promote students’ well-being.