The Human-Nature Relationship and Its Impact on Health: A Critical Review

Fine-tuning the practical relevance of a quality framework for integrated nature-based interventions in healthcare facilities. A qualitative interview study

Introduction

Integrated nature-based interventions in healthcare facilities are gaining importance as promising health and biodiversity promotion strategies. This type of interventions combines the restoration of biodiversity in the vicinity of the healthcare facility with guiding patients in that natural environment for health outcomes. However, quality appraisal of these interventions is still poorly developed. Based on a recent scoping review, the authors developed a preliminary quality framework in support of healthcare facilities designing, implementing and evaluating integrated nature-based interventions. This present study aims to fine-tune the practical relevance of the quality framework within the emerging practice.

Methods

A qualitative interview study was conducted in seven healthcare facilities in Belgium. Using a combination of snowball and purposive sampling, 22 professionals, involved in the integrated nature-based intervention in their facility, participated in the study. The semi-structured interviews were transcribed and imported into NVivo. A deductive and inductive thematic analysis was used to explore the practical relevance of the quality framework. A stakeholders' assembly review and a member checking of the findings were also part of the study.

Findings

Twenty-two interviews with nature management coordinators, healthcare professionals, and healthcare managers were conducted by three principal investigators in seven healthcare facilities implementing integrated nature-based interventions. The contextualization and complexity of integrated nature-based interventions in the participating healthcare facilities demonstrated the need for an evidence-based quality framework describing nature-based interventions. The study led to nine quality criteria, confirming the eight quality criteria derived from a previous scoping review, and the identification of a new quality criterion 'Capacity building, leverage and continuity'. These quality criteria have been refined. Finally, a proposal for a quality framework was developed and operationalized in a checklist. Deployment of the quality framework should be embedded in a continuous cyclical, adaptive process of monitoring and adjusting based on evaluations at each phase of an integrated nature-based intervention.

Discussion

Bridging the domains of healthcare and nature management in the context of an integrated nature-based intervention in a healthcare facility requires a transdisciplinary approach. Scientific frameworks such as "complex interventions," Planetary Health and One Health can support the co-design, implementation and evaluation of integrated nature-based interventions within a cyclical, adaptive process. In addition, the importance of the quality of the interactions with nature could gain from more sophisticated attention. Finally, the implications for healthcare facilities, policymakers and education are discussed, as well as the strengths and limitations of the study.

Quality criteria of nature-based interventions in healthcare facilities: a scoping review

Introduction

Implementing integrated nature-based interventions that simultaneously serve human health and the restoration of biodiversity in healthcare facilities is considered a promising strategy. As an emerging field of research and practice in healthcare, identification of quality criteria is necessary to support desired outcomes related to biodiversity, human health and intervention processes. This study is part of a larger research project in collaboration with the Flemish Agency of Nature and Forest in Belgium.

Methods

A scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, in PubMed, Medline, Web of Science and Scopus. A step-by-step tabular screening process was conducted to identify relevant studies and reviews of nature-based interventions, published in English between January 2005 and April 2023. A qualitative content analysis was conducted and the results were then presented to the project steering group and a panel of stakeholders for refinement.

Results

After filtering on the eligibility criteria, and with focus on healthcare facilities, 14 articles were included in this study. A preliminary nature-based interventions quality framework with a set of quality indicators has been developed.

Discussion

When designing integrated nature-based interventions, a needs analysis of users and the outdoor environment should be conducted. Next, the integration of a One Health and biodiversity perspective and the application of a complex intervention framework, could support the quality of the design and implementation of nature-based interventions in healthcare facilities and facilitate their assessment. In future work, more rigorous research into the design and implementation of integrated nature-based interventions is needed to test and refine the quality criteria in practice.

Examining the Association between Medical Marijuana Legalization and Criminal Behaviors: Evidence from a U.S. Representative Sample

Background: Medical marijuana legalization (MML) has been widely implemented in the past decade. However, the debates regarding the consequences of MML persist, especially criminal behaviors. Objectives: We examined the association between MML and criminal behaviors among adults in the United States. The criminal behaviors measured three past-year offenses: whether the adult (1) have sold illegal drugs, (2) have stolen anything worth > $50 USD, or (3) have attacked someone. Methods: Using the 2015-2020 National Survey of Drug Use and Health, we included 214,505 adults in our primary analysis for 2015-2019 and 27,170 adults in 2020 for supplemental analysis (age > = 18). Weighted multivariable logistic regression models were used to examine the association between MML and three criminal behaviors. Results: In our primary analysis, we observed no statistically significant association between MML and the three outcomes of criminal behavior. Nevertheless, our supplemental analysis of the 2020 data showed MML was associated with increasing odds of the three criminal behaviors (have sold illegal drugs: AOR [adjusted odds ratio] = 1.7; have stolen anything worth > $50 USD: AOR = 1.9; have attacked someone: AOR = 1.8; all p < 0.05). Conclusion: Surveys from 2015 to 2019 did not suggest MML as a risk factor for higher incidence of criminal behaviors. However, 2020 data showed statistically significant association between MML and selected criminal behaviors. Issues related to the COVID-19 pandemic, such as the U.S. economic downturn, could potentially explain this discrepancy. Further research efforts may be warranted.

Psychological, social, and physical ecologies for child resilience: a South African perspective

Children live in a complex world surrounded by global concerns such as climate change, economic instability, threats of terrorism and war. However, in South Africa, one may note that children face several additional challenges including high unemployment rates in families, exposure to violence, living in conditions of poverty, exposure to HIV/AIDS, and high levels of orphanhood. Compounding these problems is the economic situation in the country where the government is unable to provide adequate support for children in various domains. Understanding the mechanisms through which children successfully adapt to their environments and transition into adulthood are important to understand. Resilience research seeks to understand these mechanisms and underlying processes that enable some individuals to recover from adversity against all odds. Therefore, there is an increased movement not only toward understanding resilience processes in children, which enable them to develop into fully functional and upstanding citizens of society despite the adversities they face, but also how resilience research can be translated into practice to be used by service professionals such as psychologists, school counselors, social workers, and teachers. Adopting a socioecological understanding of resilience, the author reviews literature on the psychological, social, and physical ecologies for child resilience globally. Special emphasis is placed on the ecologies of child resilience within the African context and South Africa in particular. A socioecological perspective positions child resilience within four important levels, namely individual, relationships, community, and society. The salient features of child resilience within a South African context are discussed within the four levels highlighting the implications for interventions to promote child resilience. The implications have global value because child resilience is a phenomenon that needs global attention.

Hepatoprotective and nephroprotective effects of Sedum adenotrichum in paracetamol-induced hepatotoxicity in rabbits

Sedum adenotrichum (SA) has been traditionally used against various ailments due to the presence of several important phenolic compounds. This study provides a scientific basis for the hepatoprotective and nephroprotective potentials of Sedum adenotrichum in paracetamol-induced toxicity in rabbits. Methanolic extract of Sedum adenotrichum along with paracetamol was administered orally to rabbits alone or in combination with paracetamol for 2 weeks. Results showed that paracetamol-induced toxicity was correlated with a significant change in biochemical, hematological parameters, and loss in body weight of rabbits, and the curative effect of SA methanolic extract was found. Liver and kidney histological studies showed significant induced toxicity of paracetamol and correspondence restoration power of SA methanolic extract. The levels of reduced glutathione, radical scavenging activity, and lipid peroxidation in the liver were restored to normal by the methanolic extract of SA. This study confirmed the protective effect of SA methanolic extract against hepatotoxicity and nephrotoxicity caused by paracetamol. Biochemical analysis of the methanolic extract of SA confirmed the presence of bioactive phenolic compounds which have hepatic and nephroprotective potentials.

MOCOVIDOA: a novel multi-objective coronavirus disease optimization algorithm for solving multi-objective optimization problems

A novel multi-objective Coronavirus disease optimization algorithm (MOCOVIDOA) is presented to solve global optimization problems with up to three objective functions. This algorithm used an archive to store non-dominated POSs during the optimization process. Then, a roulette wheel selection mechanism selects the effective archived solutions by simulating the frameshifting technique Coronavirus particles use for replication. We evaluated the efficiency by solving twenty-seven multi-objective (21 benchmarks & 6 real-world engineering design) problems, where the results are compared against five common multi-objective metaheuristics. The comparison uses six evaluation metrics, including IGD, GD, MS, SP, HV, and delta p (Δ P ). The obtained results and the Wilcoxon rank-sum test show the superiority of this novel algorithm over the existing algorithms and reveal its applicability in solving multi-objective problems.

Anthropause appreciation, biophilia, and ecophilosophical contemplations amidst a global pandemic

In 2020, COVID-19 mitigation measures, including lockdowns and travel bans to curtail disease transmission, inadvertently led to an "Anthropause" - a unique global pause to anthropogenic activities. While there was a spike in ecological studies measuring Anthropause effects on environmental indicators, people's experiences of the Anthropause or its potential to inspire change were hardly considered. Hence, we aimed to measure people's appreciation of the environmental outcomes of the Anthropause, ecophilosophical contemplations about the pandemic, and experiences of lockdown-triggered biophilia (human's innate love for and draw towards nature) and test the hypothesis that these experiences would be consistently more prominent among the already environmentally inclined. To that end, we developed and tested three measures on a representative sample of 993 New Zealanders. Anthropause Appreciation received the highest overall mean ratings, followed by Lockdown-Biophilia and Eco-Contemplation. Pre-existing pro-environmental dispositions and behaviours did not consistently influence our three measures as expected. Demographic variables had little influence, while experiences of financial and mental health impacts due to COVID-19 had no influence. We interpreted the limited influence of explanatory variables as indicative of a degree of uniformity in people's experiences. High appreciation of Anthropause benefits suggests that the public may be supportive of policies and ways of living that can lead to similar outcomes post-pandemic - offering environmental policymakers and communicators a basis for action. Ecophilosophical contemplations and biophilic draw among the public suggest an awareness of the significance of the human-nature relationship - offering a symbolic global keystone for communicating and advocating conservation and the many values of pauses in life to connect with nature. Building women's environmental leadership capabilities and the ongoing greening of Christianity may be essential steps for global post-pandemic environmental behaviour transformations.

"Dignity as a Small Candle Flame That Doesn't Go Out!": An Interpretative Phenomenological Study with Patients Living with Advanced Chronic Obstructive Pulmonary Disease

Long-term illness, such as chronic obstructive pulmonary disease (COPD), can expose people to existential suffering that threatens their dignity. This qualitative study explored the lived experiences of patients with advanced COPD in relation to dignity. An interpretative phenomenological approach based on lifeworld existentials was conducted to explore and understand the world of the lived experience. Twenty individuals with advanced COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stages III and IV) were selected using a purposive sampling strategy. In-depth interviews were used to collect data, which were then analysed using Van Manen's phenomenology of practice. The existential experience of dignity was understood, in essence, as "a small candle flame that doesn't go out!". Four intertwined constituents illuminated the phenomenon: "Lived body-balancing between sick body and willingness to continue"; "Lived relations-balancing between self-control and belongingness"; "Lived Time-balancing between past, present and a limited future"; and "Lived space-balancing between safe places and non-compassionate places". This study explains how existential life phenomena are experienced during the final phases of the COPD trajectory and provides ethical awareness of how dignity is lived. More research is needed to investigate innovative approaches to manage complex care in advanced COPD, in order to assist patients in discovering their inner resources to develop and promote dignity.

Does socioeconomic position and gender affect human-nature interactions?

Aim

The growing number of mental health problems worldwide is alarming. Encouraging human-nature interactions (HNIs) could help to tackle this issue. For this reason, the aim of the present research was to investigate certain components that promote HNI in two groups of students with different socioeconomic positions (SEPs) in Mexico. HNIs describe the direct relationship between humans and nature. HNIs are composed of elements such as connectedness to nature (CN) and commitment to the environment (CE), and are beneficial to both physical and mental health. However, the impact of CN and CE on people's lives seems to depend on their SEP, which has been investigated mainly in developed countries where SEP is less salient compared with developing countries.

Methods

A survey was sent to students from two universities representing each group. A total of 210 surveys was collected.

Results

The results showed no differences in CN (p = .480) and CE (p = .421) regarding SEP. However, gender differences were found with females from a low SEP showing higher levels of CN than men (p = .015) from the same SEP. For high SEP, no differences were found. In addition, men showed a higher CE than women, regardless of their SEP.

Conclusion

Given the high vulnerability of women to mental health problems, it is of major importance to conduct more research considering the relationship between gender, HNI, SEP, and health in developing countries.

The ‘Rippling’ Waves of Wellbeing: A Mixed Methods Evaluation of a Surf-Therapy Intervention on Patients with Acquired Brain Injury

Dominant psychological models of wellbeing neglect the role that nature connection and other key factors, such as positive health behaviours and behaviour change, play in determining wellbeing. The present mixed-methods evaluation explores the impact of ”Surf-Ability”, an adapted surf therapy intervention delivered in collaboration with a UK neurorehabilitation service, on individuals with acquired brain injury (ABI) as part of an effort to design interventions based on advances in wellbeing science. Following five surf-therapy sessions, within-subjects analysis (n= 15) revealed significant improvements on the Warwick–Edinburgh mental wellbeing scale (t (15) = −2.164, p = 0.048), as well as in anxiety and happiness as measured via a brief visual analogue. No significant changes occurred in the Hospital Anxiety and Depression Scale (HADS) or resting heart rate variability (HRV). A ripple effects mapping (REM) session at 6–10 months follow-up (n = 6) revealed that the physical and psychological experience of a nature-based challenge initiated a mindset shift in participants, which ultimately led to them adopting wellbeing-promoting long-term behaviour changes. These changes occurred at the scale of (1) individual wellbeing—increased mindfulness and physical activity; (2) collective wellbeing—improved relationships, community participation and contribution to organisations; and (3) planetary wellbeing—connection to nature. These findings align with the GENIAL theoretical framework, which defines wellbeing from a biopsychosocial ecological perspective across multiple levels of scale. The findings support the need for healthcare providers—including neurorehabilitation services—to enhance interventions for patients by incorporating novel factors that improve wellbeing, such as nature-connection.

Human well-being and natural capital indictors for Great Lakes waterfront revitalization

Revitalization of natural capital amenities at the Great Lakes waterfront can result from sediment remediation, habitat restoration, climate resilience projects, brownfield reuse, economic redevelopment and other efforts. Practical indicators are needed to assess the socioeconomic and cultural benefits of these investments. We compiled U.S. census-tract scale data for five Great Lakes communities: Duluth/Superior, Green Bay, Milwaukee, Chicago, and Cleveland. We downloaded data from the US Census Bureau, Centers for Disease Control and Prevention, Environmental Protection Agency, National Oceanic and Atmospheric Administration, and non-governmental organizations. We compiled a final set of 19 objective human well-being (HWB) metrics and 26 metrics representing attributes of natural and seminatural amenities (natural capital). We rated the reliability of metrics according to their consistency of correlations with metric of the other type (HWB vs. natural capital) at the census-tract scale, how often they were correlated in the expected direction, strength of correlations, and other attributes. Among the highest rated HWB indicators were measures of mean health, mental health, home ownership, home value, life success, and educational attainment. Highest rated natural capital metrics included tree cover and impervious surface metrics, walkability, density of recreational amenities, and shoreline type. Two sociodemographic covariates, household income and population density, had a strong influence on the associations between HWB and natural capital and must be included in any assessment of change in HWB benefits in the waterfront setting. Our findings are a starting point for applying objective HWB and natural capital indicators in a waterfront revitalization context.

Modeling the spatial variation of urban park ecological properties using remote sensing data

Parks perform a wide range of ecosystem services in urban environments. The functional importance of parks depends on the composition and structure of the tree stand and the specific influence on soil and microclimatic conditions. The article reveals the dependence of soil and microclimatic properties on the structure of the crown space of a park stand. Spectral indices were also shown to be applicable for predicting the spatial variability of soil and climatic properties and indicators of crown space. Soil properties (temperature, moisture, and electrical conductivity in the 5–7 cm layer) and microclimatic parameters (light exposure, air temperature, and atmospheric humidity) were measured in the park plantation using a quasi-regular grid. The canopy structure and gap light transmission indices were extracted from the true-colour fisheye photographs. Thirty species of trees and shrubs were detected in the stand and understory. Robinia pseudoacacia L. was found most frequently (24.5% of all tree records). Acer negundo L. and A. platanoides L. were also frequent (12.4% and 15.5%, respectively). The first four principal components, whose eigenvalues exceeded unity, were extracted by the principal components analysis of the variability of ecological properties and vegetation indices. The principal component 1 explained 50.5% of the variation of the traits and positively correlated with the spectral vegetation indices. The principal component 1 reflected the variability of tree cover densities due to the edaphic trophicity. The principal component 2 described 13% of the variation in the feature space. This component correlated positively with the spectral indices. The principal component 2 was interpreted as a trend of vegetation cover variability induced by moisture variation. The principal component 3 described 8.6% of trait variation. It was most strongly correlated with the atmospheric humidity. An increase in atmospheric humidity was associated with an increase in the soil moisture and electrical conductivity and a decrease in the soil and atmospheric temperature. The principal component 4 described 7.5 % of the variation of traits. An increase in the values of principal component 4 was associated with an increase in the soil moisture and electrical conductivity and atmospheric moisture and was associated with a decrease in the soil and atmospheric temperature. The combinations of the trophotope and hygrotope create the optimal conditions for specific tree species, which is a condition for achieving the maximization of ecosystem services. The mineral nutrition conditions of plants and soil moisture exhibit spatial patterns that allow them to be considered in the design and management of park plantations. The ecological indices measured in the field were shown to be predicted using the vegetation indices. Multiple regression models were able to explain 11–61% of indicator variation. The regression relationships between markers of soil and microclimatic conditions and vegetation predictors are important for monitoring the condition of park plantations and evaluating the performance of park plantation management tools.

Bibliometric Analysis and Systematic Review of Indigenous Knowledge from a Comparative African Perspective: 1990–2020

Globally, indigenous knowledge (IK) has been shown to be a critical factor in economic growth and sustainable development and is as important as scientific knowledge. However, when it comes to the African narrative, IK research still seems to fall short, even with the great recognition and interest it is attracting. IK has always been underprivileged and marginalized, treated as an unsubstantiated type of knowledge that cannot provide any scientific solutions. Consequently, the aim of this paper is to provide an insight into the importance of IK research from a comparative African perspective from 1990 to 2020. The paper used a combination of bibliometric analysis and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol to provide a comprehensive view of IK research. The VOSviewer software was used to provide a visualization of the bibliometric analysis through network maps. The findings suggest that while IK is a globally recognized concept, the African narrative is missing and not told by Africans. Most researched studies on IK in Africa are on ethnobotany, customs, traditions, agroforestry, and agriculture. Moreover, most of the IK research is from Southern Africa. There is a need for the integration of IK and scientific knowledge to develop well-informed approaches, methodologies, and frameworks that cater to indigenous communities and resilient ecological development. The research outcomes provide valuable insights for future research trends; they further highlight opportunities for building research partnerships for strengthening policy generation and implementation.

Psychological Well-Being and Nature Relatedness

The way people perceive contact with nature may impact their environmental attitudes and psychological well-being (WB). Nature relatedness (NR) refers to the affective, cognitive, and experiential aspects of individuals’ connection to nature. The aim of the presented research concentrates on the assessment of the relationship between well-being, self-control and connectedness with the natural environment. The data was collected via online questionnaire between March and April 2022. In the study, we combined descriptive statistics with analysis of variance. We also quantitatively assessed correlations between major components of NR scale and psychological WB across men’ and women’ inquires. The results showed that there is a statistically significant relationship between the general index of NR and overall psychological WB. Furthermore, correlation between specific aspects of NR and WB subscales were also observed. These interactions are considerable among both men and women. We have also identified a major correlation between NR and self-control, which indicates the link between the way a person approaches oneself and natural environment. Finally, the analysis provides evidence that women are on average more related to nature, although the men may benefit more from this kind of relationship. Further gender differences could be observed in terms of nature-relatedness perspective component, general self-control, score and overall NR score These relationships are highly vital among men while irrelevant among women.

Impact of Contact With Nature on the Wellbeing and Nature Connectedness Indicators After a Desertic Outdoor Experience on Isla Del Tiburon

Nature connectedness is determined by the representation individuals have about themselves within nature. This concept is often studied in relation to the direct contact individuals have with natural environment, which according to some studies have demonstrated to generate positive effects by fostering a feeling of connecting and bonding with nature, as well as improving their wellbeing. The main focus of this study was to calculate and assess the relation between Nature Connectedness and wellbeing of participants. The methodological approach of this research reaches quantitative data comparing results obtained from both samples, as well as correlations between the variables. The sample for this study was composed by two groups of university students (M = 25 years old). Both contrast group (n = 32) and experience group (n = 29) filled the questionnaire in two separate moments and in different environments. First data collection moment for both groups was held inside a university classroom. A second moment of data collection was carried out after a month from the first application, having the contrast group answer the questionnaire on a classroom again whilst the experience group responded it during an excursion to Isla Del Tiburon in Northwestern Mexico after performing some recreational activities being totally immersed in a local desertic environment. Questionnaire was composed by a 6 point Likert type scale measuring Nature Connectedness through concepts such as Nature relatedness and Love and care for the natural, as well as Subjective and Psychological Wellbeing of participants. Results show that both wellbeing and Nature Connectedness are positively influenced by performing activities out in the natural environment. This work was also conducted in response to the need to understand the full extent of Contact and Connectedness to nature, carrying out an exploratory study in desertic settings when much of the early work centers around the study of these variables in green nature environments.

Multi-Dimensional Evaluation Framework for the Sustainable Development of Forest Health Bases and Site Selection for Application in China

In the context of global aging, people’s awareness of health is deepening, and the rapid economic development has drawn widespread attention to the health tourism industry. As a way of experiencing health, forest health tourism is becoming increasingly favored, and the site selection and construction of forest health bases (FHBs) have also developed accordingly. To ensure sustainability in the process of the site selection and construction of FHBs, the suitability of regional development and the relative coordination of the market, environment, and resource levels should be considered. Although there have been numerous studies on sustainable forestry management, a comprehensive sustainability assessment framework based on development suitability and coordination in three dimensions is needed to guide the site selection and the construction of FHBs. The following tasks were carried out in this study: (1) based on market sustainability goals, environmental optimization goals, and ecological resource sustainability goals, a comprehensive sustainability evaluation framework for development suitability indicators and coordination indicators in three dimensions was established; (2) via the use of this framework, the construction potential of FHBs in 41,636 towns in China was evaluated; the evaluation results show that the towns in Anhui, Jiangxi, Guangdong, Guangxi, Fujian, Zhejiang, Hunan, Hubei, Guizhou, and other provinces of China generally have superior conditions for the development of FHBs; (3) a multi-dimensional comprehensive analysis of FHB site selection sustainability based on development suitability and coordination was carried out for four batches of approved pilots. The comprehensive analysis results demonstrate the worsening evaluation results of the four batches. The proposed framework can provide a reference for FHB development policies for countries worldwide.

Residential Greenspace Is Associated with Lower Levels of Depressive and Burnout Symptoms, and Higher Levels of Life Satisfaction: A Nationwide Population-Based Study in Sweden

Population-based studies of individual-level residential greenspace and mental health outcomes are still limited. Thus, the present study investigates greenspace–mental health associations—including depressive symptoms, burnout symptoms, and life satisfaction—in a population-based sample of adults, the Swedish Longitudinal Occupational Survey of Health, in 2016 (n = 14,641). High-resolution land cover of greenspace and green–blue-space was assessed at 50, 100, 300 and 500 m buffers around residential addresses. Higher residential greenspace and green–blue-space were associated with lower levels of depressive and burnout symptoms among non-working individuals and with higher life satisfaction in the whole study population, after controlling for age, sex, individual income, and neighborhood socioeconomics. The immediate residential-surrounding environment (50 m) consistently showed the strongest associations with the outcomes. Having a partner was associated with better mental health outcomes and with having more residential greenspace, and adjusting for this rendered greenspace–health associations mostly statistically non-significant. In conclusion, higher levels of greenspace and green–blue-space in the immediate residential-surrounding environment were associated with better mental health outcomes in the present study, which contributes additional nuances to prior studies. The importance of residential greenspace for public health, urban planning, and development is discussed.

Assessment of Melatonin-Cultured Collagen/Chitosan Scaffolds Cross-Linked by a Glyoxal Solution as Biomaterials for Wound Healing

Chitosan (CTS) and collagen (Coll) are natural biomaterials that have been extensively used in tissue engineering or wound healing applications, either separately or as composite materials. Most methods to fabricate CTS/Coll matrices employ chemical crosslinking to obtain solid and stable scaffolds with the necessary porosity and mechanical properties to facilitate regeneration. In this study, we comparatively assessed the physicochemical properties of 3D scaffolds loaded with a cross-linker, glyoxal. Using a scanning electron microscope, we evaluated the microstructure of resultant matrices and their mechanistic testing by the determination of the compressive modulus (E_mod), the maximum force (F_max), thermogravimetric analysis (TG), Fourier Transform Infrared Spectroscopy–Attenuated Total Reflectance (FTIR-ATR), and proliferation rate in vitro using human epidermal keratinocytes and dermal fibroblasts cultured in presence of melatonin solution (10⁻⁵ M). We observed that enhanced content of collagen (50CTS/50Coll or 20CTS/80Coll compared to 80CTS/20Coll) significantly elevated the physicochemical capacities of resultant materials. Besides, presence of 5% glyoxal increased porosity, E_mod and F_max, compared to scaffolds without glyoxal. Finally, keratinocytes and dermal fibroblasts cultured on subjected matrices in presence of melatonin revealed a prominently enhanced growth rate. This indicates that the combination of glyoxal and melatonin make it imperative to consider these materials as a promising approach for targeting skin tissue engineering or regenerative dermatology.

A Systematic Review on the Local Wisdom of Indigenous People in Nature Conservation

The local wisdom of indigenous people in nature conservation plays a critical part in protecting the planet’s biodiversity and the overall health of the ecosystems. However, at the same time, indigenous people and their lands are facing immense threats through modernization and globalization. This study aims to systematically review and analyze the local wisdom of the indigenous people in nature conservation. The present study integrated multiple research designs, and the review was based on the published standard, namely the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). This study used Web of Science (WoS) and Scopus as the main databases in searching for the required articles. Through content analysis, this study can be divided into seven main categories: (a) forest management, (b) flora and fauna conservation, (c) food security, (d) water management, (e) land management, (f) weather forecasting, and (g) others. The findings offer some basics on how academics can adopt and adapt the existing local wisdom of indigenous people in nature conservation into the scientific framework and design to answer the Sustainable Development 2030 Agenda.

Nature-Based Physical Activity and Hedonic and Eudaimonic Wellbeing: The Mediating Roles of Motivational Quality and Nature Relatedness

The current study evaluated the degree to which nature-based physical activity (NPA) influenced two distinct types of psychological wellbeing: hedonic wellbeing and eudaimonic wellbeing. The type of motivation an individual experiences for physical activity, and the extent to which individuals have a sense of relatedness with nature, have been shown to influence the specific type of psychological wellbeing that is experienced as a result of NPA. However, the role of these two variables in the relationship between NPA and psychological wellbeing has not been examined. Thus, this study assessed the potential mediating influence of (1) motivational quality and (2) nature relatedness on the relationships between NPA and hedonic and eudaimonic wellbeing, respectively. Participants (N = 262) completed an online survey assessing hedonic and eudaimonic wellbeing, NPA, intrinsic motivation, autonomous extrinsic motivation, and nature relatedness. Data were analysed using Partial Least Squares Structural Equation Modelling. Results showed that motivational quality and nature relatedness both fully mediated the relationships between NPA and hedonic and eudaimonic wellbeing. Specifically, intrinsic motivation positively mediated the relationship between NPA and hedonic wellbeing. Autonomous extrinsic motivation and nature relatedness positively mediated the relationship between NPA and eudaimonic wellbeing. These findings suggest that the associations between NPA and eudaimonic wellbeing and hedonic wellbeing, respectively, are driven by different mechanisms relating to an individual's (1) underlying motivation and (2) sense of connection to nature. These findings suggest that promoting distinct types of wellbeing (hedonic vs. eudaimonic) through NPA requires distinct approaches. Emphasising enjoyment, pleasure, and positive kinaesthetic experiences within NPA may be more conducive to hedonic wellbeing, while highlighting opportunities for connecting with nature or experiencing valued outcomes of NPA may be more conducive to eudaimonic wellbeing.

Nurtured in Nature: a Pilot Randomized Controlled Trial to Increase Time in Greenspace among Urban-Dwelling Postpartum Women

Spending time in nature is associated with numerous mental health benefits, including reduced depression and improved well-being. However, few studies examine the most effective ways to nudge people to spend more time outside. Furthermore, the impact of spending time in nature has not been previously studied as a postpartum depression (PPD) prevention strategy. To fill these gaps, we developed and pilot tested Nurtured in Nature, a 4-week intervention leveraging a behavioral economics framework, and included a Nature Coach, digital nudges, and personalized goal feedback. We conducted a randomized controlled trial among postpartum women (n = 36) in Philadelphia, PA between 9/9/2019 and 3/27/2020. Nature visit frequency and duration was determined using GPS data. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS). Participants were from low-income, majority Black neighborhoods. Compared to control, the intervention arm had a strong trend toward longer duration and higher frequency of nature visits (IRR 2.6, 95%CI 0.96-2.75, p = 0.059). When analyzing women who completed the intervention (13 of 17 subjects), the intervention was associated with three times higher nature visits compared to control (IRR 3.1, 95%CI 1.16-3.14, p = 0.025). No significant differences were found in the EPDS scores, although we may have been limited by the study's sample size. Nurture in Nature increased the amount of time postpartum women spent in nature, and may be a useful population health tool to leverage the health benefits of nature in majority Black, low-resourced communities.

Managing the Covid-19 pandemic in South African Schools: turning challenge into opportunity

This article reports on challenges faced today by the South African schooling system due to the Covid-19 pandemic, with the emphasis on the public school system. Its aim is to show the extent and nature of these challenges and how they exacerbate existing challenges and impact the quality of post-matric study and tertiary education. A number of specific challenges are focused on such as large class sizes, physical distancing requirements, and the use of online and digital learning platforms to facilitate education, and how this style of teaching and training is not practical for most of the South African school population. The discrepancy between the real situation in schools and the applicability of Covid-19 protocols is also examined. In addition, I discuss the problems posed by the schooling time that has been lost, the effect of curriculum trimming, and the long-term price post-Grade 12 study and tertiary teaching and learning may have to pay. Finally, looking through a positive, future-oriented lens, I endeavour to place the overall situation in South African education in perspective.

Thinking Like a Mountain: Exploring the Potential of Relational Approaches for Transformative Nature Conservation

Building on a review of current mainstream paradigms of nature conservation, the essence of transformations necessary for effective and lasting change are presented—namely, convivial solutions (or ‘living with others’), in which relationality and an appreciation of our interdependencies are central, in contrast to life-diminishing models of individualism and materialism/secularism. We offer several areas for improvement centred on regenerative solutions, moving beyond conventional environmental protection or biophysical restoration and focusing instead on critical multidimensional relationships—amongst people and between people and the rest of nature. We focus, in particular, on the potential of people’s values and worldviews to inform morality (guiding principles and/or beliefs about right and wrong) and ethics (societal rules defining acceptable behaviour), which alone can nurture the just transformations needed for nature conservation and sustainability at all scales. Finally, we systematize the potential of regenerative solutions against a backdrop of relational approaches in sustainability sciences. In so doing, we contribute to current endeavours of the conservation community for more inclusive conservation, expanding beyond economic valuations of nature and protected areas to include more holistic models of governance that are premised on relationally-oriented value systems.

Understanding Wildlife Crime from Eco-Existential and African Perspectives: A Psycho-Philosophical Investigation

Wildlife crime has huge consequences regarding global environmental changes to animals, plants and the entire ecosystem. Combatting wildlife crime effectively requires a deep understanding of human-wildlife interactions and an analysis of the influencing factors. Conservation and green criminology are important in reducing wildlife crime, protecting wildlife and the ecosystem and informing policy-makers about best practices and strategies. However, the past years have shown that wildlife crime is not easy to combat and it is argued in this article that there are underlying existential "givens" and culture-specific aspects that need to be investigated to understand why wildlife crime is still on the rise. This theoretical article explores (eco-)existential perspectives, Greening's four givens and selected African philosophical concepts, aiming to understand the complexities behind the prevalence of wildlife crime within global and African contexts.

Human kidney stones: a natural record of universal biomineralization

GeoBioMed - a new transdisciplinary approach that integrates the fields of geology, biology and medicine - reveals that kidney stones composed of calcium-rich minerals precipitate from a continuum of repeated events of crystallization, dissolution and recrystallization that result from the same fundamental natural processes that have governed billions of years of biomineralization on Earth. This contextual change in our understanding of renal stone formation opens fundamentally new avenues of human kidney stone investigation that include analyses of crystalline structure and stratigraphy, diagenetic phase transitions, and paragenetic sequences across broad length scales from hundreds of nanometres to centimetres (five Powers of 10). This paradigm shift has also enabled the development of a new kidney stone classification scheme according to thermodynamic energetics and crystalline architecture. Evidence suggests that ≥50% of the total volume of individual stones have undergone repeated in vivo dissolution and recrystallization. Amorphous calcium phosphate and hydroxyapatite spherules coalesce to form planar concentric zoning and sector zones that indicate disequilibrium precipitation. In addition, calcium oxalate dihydrate and calcium oxalate monohydrate crystal aggregates exhibit high-frequency organic-matter-rich and mineral-rich nanolayering that is orders of magnitude higher than layering observed in analogous coral reef, Roman aqueduct, cave, deep subsurface and hot-spring deposits. This higher frequency nanolayering represents the unique microenvironment of the kidney in which potent crystallization promoters and inhibitors are working in opposition. These GeoBioMed insights identify previously unexplored strategies for development and testing of new clinical therapies for the prevention and treatment of kidney stones.

Motivation Interview Effectiveness and Optimism Efficiency on the Quality of Life of Type 2 Diabetes Mellitus

AIM: This study aims to analyze the quality of life of people with type 2 diabetes mellitus (T2DM) through the intervention of motivational interview and efficacy of optimism. METHODS: The type of research is Quasi Experimental - Non-Randomized Control Group Pretest Posttest Design. The sample was T2DM patients, while the treatment was carried out on 50 respondents. Interventions were given in motivational interviews and the effectiveness of optimism. The statistical test used is the two-dependent difference test and two independent mean difference test. RESULTS: The statistical test of the difference between the two independent means showed the sig. value (two tailed) of 0.006. It pointed to a significant difference in post-test between DM patients’ quality of life in the intervention and control groups. Based on the two dependent difference test, the mean showed that the value of sig. (two tailed) 0.000 means a significant difference between DM patients’ quality of life in the intervention and control groups after the post-test. CONCLUSION: There was a substantial relationship between motivational interviewing and optimism efficacy on the quality of diabetes mellitus patients.

Perceived urban green and residents' health in Beijing

Green space serves urban residents in various functions including promoting health, but the roles of different types of green space are unclear. A survey titled "Healthy Neighborhood" was conducted in Beijing from May to July 2019 to examine and compare the associations between three types of perceived green space (park green, public-square green and utility green) and three aspects of residents' health (physical health, mental health and social health). Results from the multilevel modeling (MLM) analysis show that the perceived park green has a positive correlation with mental health, and all three types of perceived green space correlate with social health positively. No significant correlation of any type of green space is detected on participants' physical health, nor any relation of public-square green or utility green to their mental health. Overall the role of urban green space is stronger on social health than physical and mental health. The findings support the complementary roles of different types of green space, and suggest that expansion in utility greens could be as effective as investing in more costly park and public-square greens, especially in their benefit in promoting social health.

Spiritual Dimensions in Exploring the Human-Geosphere Relationship under a Values-Based Approach in Lake Turgoyak, Southern Urals, Russia

Surrounded by mountains and forests, Lake Turgoyak in the Southern Urals (Russia) is a popular tourist destination. However, the many resorts and camps as well as the high number of visitors have had a negative environmental impact on the lake. Taking Lake Turgoyak as a case study, the research examines the values in the human-geosphere relationship, framed as a geoethical dilemma revisiting the concept of the noosphere. The formulation of geoethical dilemmas, as a way to explore the values that underpin the technocratic artifacts on which humans relate to the geosphere, reveals a spiritual dimension that shapes cultural identities that, in turn, unfold in eco-ideologies of resistance in hope.

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

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

Are environmental pollution and biodiversity levels associated to the spread and mortality of COVID-19? A four-month global analysis

On March 12th, 2020, the WHO declared COVID-19 as a pandemic. The collective impact of environmental and ecosystem factors, as well as biodiversity, on the spread of COVID-19 and its mortality evolution remain empirically unknown, particularly in regions with a wide ecosystem range. The aim of our study is to assess how those factors impact on the COVID-19 spread and mortality by country. This study compiled a global database merging WHO daily case reports with other publicly available measures from January 21st to May 18th, 2020. We applied spatio-temporal models to identify the influence of biodiversity, temperature, and precipitation and fitted generalized linear mixed models to identify the effects of environmental variables. Additionally, we used count time series to characterize the association between COVID-19 spread and air quality factors. All analyses were adjusted by social demographic, country-income level, and government policy intervention confounders, among 160 countries, globally. Our results reveal a statistically meaningful association between COVID-19 infection and several factors of interest at country and city levels such as the national biodiversity index, air quality, and pollutants elements (PM10, PM2.5, and O3). Particularly, there is a significant relationship of loss of biodiversity, high level of air pollutants, and diminished air quality with COVID-19 infection spread and mortality. Our findings provide an empirical foundation for future studies on the relationship between air quality variables, a country's biodiversity, and COVID-19 transmission and mortality. The relationships measured in this study can be valuable when governments plan environmental and health policies, as alternative strategy to respond to new COVID-19 outbreaks and prevent future crises.

The impact of liquefaction disaster on farming systems at agriculture land based on technical and psychosocial perspectives

This research aims to determine the attitudes of the farmers whose lands are affected by liquefaction in Jono Oge, Central Sulawesi Province, The Republic of Indonesia. The methods used here were integrated survey and experimental design. The survey approach was intended to figure out the attitudes of the farmers viewpoints: (1) to return to their activities on the agricultural lands affected by liquefaction; (2) to consume their own agricultural products; and (3) of their willingness to be relocated. The experimental design approach was used to figure out the effectiveness of organic material input combined with the SP-36 fertilizer. The obtained results were analyzed using the Likert Scale, diversity test, correlational test, and regression test. The results showed that the farmers persevered farming on the lands affected by liquefaction (Index = 88.82%) yet refused to consume their own agricultural products with the reason that corpses remained buried beneath their lands (Index = 27.82%); and they also refused to be relocated (Index = 28.80%). The continued production suitability of the affected land was also investigated. Terrain profile identification results in Jono Oge showed the disaster impact was dominantly landslide as it still showed a clear characteristic horizon between the topsoil and the sub soil. This contrasts to terrain at Petobo, Central Sulawesi Province, where the high mix of the topsoil with the sub soil of agricultural land affected by liquefaction, prevented demarcation of the horizon. The land treatment of organic material and SP-36 fertilizer showed that the combined dose (M) of 40-kg ha-1 with P 300-kg ha-1 had the highest effect by changing the field pH from 5.7 to 6.41, increased the availability of P and increased the corncob indicator plant weight. Based on these indications, the lands affected by the liquefaction in Jono Oge can still be used as agricultural lands through restoration, from both social and technical aspects.

Benefits of Outdoor Sports in Blue Spaces. The Case of School Nautical Activities in Viana do Castelo

Participating in outdoor sports in blue spaces is recognized to produce a range of significant social benefits. This case study empirically analyzes the social benefits associated with the School Nautical Activities project carried out in Viana do Castelo (Portugal) in school-age children and adolescents. It consisted of a 4 year program in which scholars took part in nautical activities (surfing, rowing, sailing, and canoeing) in blue spaces once a week during a semester as a part of their physical education course. The methods used for data collection were as follows: (1) a survey answered by 595 participants in the program and (2) five focus groups (FG): two FGs with participants (seven on each FG), two FGs with their parents (eight participants each), and one FG with the physical education teachers (five participants). Interviews were transcribed and qualitative analysis with NVivo software was developed. Results revealed clear evidence on the social benefits for school-age children and adolescents associated with participation in outdoor activities in blue spaces both in the overall health and in all the following analyzed categories: mental health and well-being, education, active citizenship, social behavior, and environmental awareness. More than 40% state that their overall health is much better now (13.4%) or somewhat better now (29.9%) due to their participation in the program. Thus, this article provides support for the anecdotal recognition of the benefits for school-age children and adolescents from participating in sports in the outdoors and especially in blue spaces.

Impact of biological education and gender on students' connection to nature and relational values

The new concept of relational values (RVs) is gaining more and more attention in environmental research, but empirical analyses are still rare. However, this type of research is necessary because the RVs have an influence on environmental behavior. To evaluate the impact of biological education on attributing higher importance to RVs and connectedness to nature, we compared the connection to nature scores (using the inclusion of nature scale (INS) and connectedness to nature scale (CNS)) and RV scores of biologically interested high school students (n = 417) with first year (n = 593) and advanced biology (n = 223) students. While high school students showed significant lower connection to nature scores than university students, there was no significant difference in RVs between the test groups. These results suggest that there is a lack of factors in the university study of biology that can change RVs. The gender comparison of RVs and connection to nature showed a significant higher RV score for females while INS and CNS did not show a gender difference. Thus, the study makes an important contribution to the research, as it was able to prove that gender has an influence on a person's RVs but not on their connection to nature.

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

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

Applying the Mandala of Health in the Anthropocene

Issue addressed

The Anthropocene is a new era in which human activity has been the dominant influence on climate and the environment. The negative impact humans have on the earth's systems pose significant threats to human health. Health promotion is a discipline well placed to respond to planetary health challenges of the Anthropocene. The overarching aim of this paper is to describe the elements of 21st century socio‐ecological health and apply them in a revised socio‐ecological framework for health promotion.

Methods

A qualitative description study design was employed to explore the significance of ecological and cultural determinants of health and review models in contemporary health promotion to inform the development of a revised Mandala of Health. Purposeful sampling was used to recruit ten experts from across Australia including academics and practitioners working at the nexus of health promotion, environmental management and sustainability. Data were analysed thematically, using deductive and inductive methods.

Results

A revised Mandala of Health could address existing gaps in health promotion theory and practice. Ecological and cultural determinants of health were considered essential components of health promotion that is often lacking in socio‐ecological frameworks. Indigenous Knowledge Systems were considered immensely important when addressing ecological and cultural determinants of health.

Conclusions

A revised Mandala of Health could encourage development of contemporary health models, assisting health promotion to evolve with the health and environmental issues of the Anthropocene. This study highlights the need for more theoretical development and empirical research regarding ecological and cultural determinants of health in a health promotion context.

So what?

In the context of the Anthropocene, this study highlights the potential gaps in health promotion theory and practice in terms of the natural environment and health and emphasises the need of a paradigm shift to embed ecological and cultural determinants with other determinants of health.

A Framework for Improving Policy Priorities in Managing COVID-19 Challenges in Developing Countries

The COVID-19 pandemic has brought unprecedented challenges to societies and threatened humanity and global resilience. All countries are challenged, but low-income and developing countries are facing a more challenging situation than others due to their limited health infrastructure, limited financial and human resources, and limited capacity of governments to respond. Further, the interconnected nature of the COVID-19 pandemic crisis demands an integrated approach and coordinated action, which complicates decision making even more. Identifying the best set of policies and instruments to address COVID-19 challenges, and aligning them with broader social goals will be critically important for sustainable recovery from the pandemic. The key practical challenge facing the policy makers of developing countries is how to prioritize policies to achieve the interconnected goals of managing the health crisis, recovering the economy, and achieving environmental sustainability. We present a framework for identifying and prioritizing policy actions to address the COVID-19 challenges and ensure sustainable recovery. The framework outlines principles and criteria and provides insights into developing shared policy goals, identifying smart strategies, assessing policy compatibility, aligning policy instruments, and factoring sustainability into short and long-term policy decisions. This framework can assist policy makers in linking short and long-term goals, mapping the interactions of different policy options, and assessing anticipated consequences and cross-sectoral implications. This will enable policy makers to prioritize policy choices and allocate limited resources in such a way that they are directed toward actions that generate synergy and co-benefits, have multiplier effects, and achieve interconnected solutions for health, the economy and environment.

Could Self-Consciousness Be Enhanced in Alzheimer’s Disease? An Approach from Emotional Sensorial Stimulation

Alzheimer’s disease (AD) provides a valuable field of research into impairment of self-consciousness (SC), because AD patients have a reduced capacity to understand their mental world, to experience and relive previous personal events, as well as to interpret thoughts, feelings, and beliefs about themselves. Several studies observed that AD patients had an altered SC, but not a complete abolition of it. Emotions are an integral part of the construction of personal identity, therefore of Self. In general, most studies on emotion in AD patients have observed that emotion is not completely abolished and it lets them better remember autobiographical events with greater emotional charge. The positive effect of autobiographical memories rich in emotional content, evoked directly/automatically by sensorial stimuli such as familiar odors or music, could be used to reestablish/reinforce the permanence and coherence of the Self in AD. We studied the research of empirical evidence supporting the power of the sensorial cues associated with emotion, which could be capable of enhancing the SC in AD. We presented the studies about “Emotional stimulations” using odor, music, or taste cues in AD. All studies have shown to have a positive impact on SC in AD patients such as odor-evoked autobiographical memories, taste/odor-evoked autobiographical memories, emotional sensorial stimulation using musical cues, and multi-sensorial stimulations using healing gardens. We found research supporting the notion that emotional sensorial stimulations can even temporarily exalt memory, affective state, and personal identity, that is, the SC in AD. The emotional sensory stimulations could be used as a tool to activate the SC in AD and hence improve the quality of life of patients and caregivers.

Veterans' interests, perceptions, and use of mindfulness

Objective:

Mindfulness-based interventions are an evidence-based approach utilized in health care. There is developing evidence for effective use with military Veterans. However, little is known about Veterans’ view of mindfulness. This study aims to understand their interests, perceptions, and use of mindfulness to enhance educational outreach and treatment engagement.

Methods:

A cross-sectional study was conducted across the Veterans Health Administration in Salt Lake City, UT by administering a questionnaire to military Veterans. The questionnaire included the following themes: (1) demographics and respondents’ mindfulness practice; (2) respondents’ perceptions and beliefs about mindfulness; and (3) respondents’ knowledge and interest in learning about mindfulness.

Results:

In all, 185 military Veterans were surveyed; 30% practiced mindfulness in the past year, mainly for stress, posttraumatic stress disorder, sleep, and depression. Over 75% who practiced reported perceived benefit. Veterans rarely reported negative beliefs about mindfulness; 56% perceived an understanding of mindfulness and 46% were aware of Veterans Health Administration mindfulness offerings. In all, 55% were interested in learning about mindfulness, 58% were interested in learning how it could help, and 43% were interested in combining mindfulness with a pleasurable activity.

Conclusion:

Educational engagement approaches should be directed toward the benefits of mindfulness practice with minimal need to address negative beliefs. Outreach including education, with an experiential component, about mindfulness classes, availability of evening and weekend classes, individual sessions, and virtual offerings into Veteran’s homes, may enhance engagement in mindfulness-based interventions. Mindfulness-based interventions that combine mindfulness training with an experiential pleasurable activity may be one mechanism to enhance treatment engagement.

A Theoretical Framework for Bolstering Human-Nature Connections and Urban Resilience via Green Infrastructure

Demand for resources and changing structures of human settlements arising from population growth are impacting via the twin crises of anthropogenic climate change and declining human health. Informed by documentary research, this article explores how Urban Resilience Theory (URT) and Human-Nature Connection Theory (HNCT) can inform urban development that leverages urban green infrastructure (UGI) to mitigate and meditate these two crises. The findings of this article are that UGI can be the foundation for action to reduce the severity and impact of those crises and progress inclusive and sustainable community planning and urban development. In summary, the URT promotes improvement in policy and planning frameworks, risk reduction techniques, adaptation strategies, disaster recovery mechanisms, environmentally sustainable alternatives to fossil fuel energy, the building of social capital, and integration of ecologically sustainable UGI. Further, the HNCT advocates pro-environmental behaviors to increase the amount and accessibility of quality remnant and restored UGI to realize the human health benefits provided by nature, while simultaneously enhancing the ecological diversity and health of indigenous ecosystems. The synthesis of this article postulates that realizing the combined potential of URT and HNCT is essential to deliver healthy urban settlements that accommodate projected urban population growth towards the end of the 21st-century.

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

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

Nature As Medicine: Mind, Body, and Soil

Editor's Note: Debate over the evidence supporting integrative care interventions not infrequently references the challenges funding research on natural agents and practices that are not patentable. The subject of this column goes to the mother of all such interventions, nature herself. Yet in this case, the authors report an awakening of research that affirms nature's power in health and well-being. This is the eighth commentary through JACM's column partnership with the Osher Collaborative for Integrative Medicine through which we seek to stimulate critical conversations via perspectives from the leaders of the Collaborative's seven prominent academically based integrative centers. The author team came together from three of the centers: David Victorson, PhD, at the Northwestern University Feinberg School of Medicine, Christina Luberto, PhD, at the Harvard Medical School, and Karen Koffler, MD, at the University of Miami Miller School of Medicine. While providing readers an understanding of how to examine nature as medicine, they propose a "goodness of fit" between the precepts of the integrative field and the natural world.-Editor-in-Chief, John Weeks (johnweeks-integrator.com).

Land and nature as sources of health and resilience among Indigenous youth in an urban Canadian context: a photovoice exploration

BACKGROUND

Population and environmental health research illustrate a positive relationship between access to greenspace or natural environments and peoples' perceived health, mental health, resilience, and overall well-being. This relationship is also particularly strong among Canadian Indigenous populations and social determinants of health research where notions of land, health, and nature can involve broader spiritual and cultural meanings. Among Indigenous youth health and resilience scholarship, however, research tends to conceptualize land and nature as rural phenomena without any serious consideration on their impacts within urban cityscapes. This study contributes to current literature by exploring Indigenous youths' meaning-making processes and engagements with land and nature in an urban Canadian context.

METHODS

Through photovoice and modified Grounded Theory methodology, this study explored urban Indigenous youth perspectives about health and resilience within an inner-city Canadian context. Over the course of one year, thirty-eight in-depth interviews were conducted with Indigenous (Plains Cree First Nations and Métis) youth along with photovoice arts-based and talking circle methodologies that occurred once per season. The research approach was also informed by Etuaptmumk or a "two-eyed seeing" framework where Indigenous and Western "ways of knowing" (worldviews) can work alongside one another.

RESULTS

Our strength-based analyses illustrated that engagement with and a connection to nature, either by way of being present in nature and viewing nature in their local urban context, was a central aspect of the young peoples' photos and their stories about those photos. This article focuses on three of the main themes that emerged from the youth photos and follow-up interviews: (1) nature as a calming place; (2) building metaphors of resilience; and (3) providing a sense of hope. These local processes were shown to help youth cope with stress, anger, fear, and other general difficult situations they may encounter and navigate on a day-to-day basis.

CONCLUSIONS

This study contributes to the literature exploring Indigenous youths' meaning-making process and engagements with land and nature in an urban context, and highlights the need for public health and municipal agencies to consider developing more culturally safe and meaningful natural environments that can support the health, resilience, and well-being of Indigenous youth within inner-city contexts.

How do natural features in the residential environment influence women's self-reported general health? Results from cross-sectional analyses of a U.S. national cohort

BACKGROUND

The relationship between health and human interaction with nature is complex. Here we conduct analyses to provide insights into potential health benefits related to residential proximity to nature.

OBJECTIVES

We aimed to examine associations between measures of residential nature and self-reported general health (SRGH), and to explore mediation roles of behavioral, social, and air quality factors, and variations in these relationships by urbanicity and regional climate.

METHODS

Using residential addresses for 41,127 women from the Sister Study, a U.S.-based national cohort, we derived two nature exposure metrics, canopy and non-gray cover, using Percent Tree Canopy and Percent Developed Imperviousness from the National Land Cover Database. Residential circular buffers of 250 m and 1250 m were considered. Gradient boosted regression trees were used to model the effects of nature exposure on the odds of reporting better SRGH (Excellent/Very Good versus the referent, Good/Fair/Poor). Analyses stratified by urbanicity and regional climate (arid, continental, temperate) and mediation by physical activity, social support, and air quality were conducted.

RESULTS

A 10% increase in canopy and non-gray cover within 1250 m buffer was associated with 1.02 (95% CI: 1.00-1.03) and 1.03 (95% CI: 1.01-1.04) times the odds of reporting better SRGH, respectively. Stronger associations were observed for the urban group and for continental climate relative to other strata. Social support and physical activity played a more significant mediation role than air quality for the full study population.

DISCUSSION

Findings from this study identified a small but important beneficial association between residential nature and general health. These findings could inform community planning and investments in neighborhood nature for targeted health improvements and potential societal and environmental co-benefits.