The role of nature in coping with psycho-physiological stress: a literature review on restorativeness

It looks like nature - a phenomenological study of the built environment in psychotherapy from psychologists' and psychiatrists' perspective

INTRODUCTION

The study aims to examine psychologists' and psychiatrists' experiences of built environments, indoors and outdoors, in providing psychotherapy. The research explores how the environment matters in clinical practice from the perspective of psychologists and psychiatrists and seeks to comprehend the significance of the facilities where psychotherapy takes place.

METHODS

This study design is explorative and qualitative. Data is generated by eight in-depth interviews with six clinical psychologists and two psychiatrists and was analyzed using an interpretative phenomenological approach.

RESULTS

Our findings revealed that the built environment matters in clinical practice as it appears to be closely linked to fostering a more comprehensive approach and facilitating various associations and themes in psychotherapy. Three superordinate themes emerged from the data: Design as therapeutic tool, Nature as a co-therapist, and lastly, Expanding the therapeutic space, highlights the participants' perspective on the transformative potential of the built environment to become therapeutic.

CONCLUSION

The findings reveal how built environments can be actively utilized as tools in psychotherapy. Environments are not to be considered merely as neutral and passive spaces for conducting and receiving psychotherapy rather than experienced as places that may regulate and impact both therapists and patients, the relationship between them.

Crowdsourced data as a strategic approach to include the human dimension in outdoor environmental quality assessments

Outdoor environments extend living spaces as venues for various activities. Comfortable open public spaces can positively impact citizens' health and well-being, thereby improving the livability and resilience of cities. Considering the visitors' perception of these environments in comfort studies is crucial for ensuring their well-being and promoting the use of these spaces. However, traditional survey methods may be time- and resource-consuming to gather significant sample sizes, usually focusing on selected homogeneous samples. Crowdsourced data, then, has emerged as an alternative for assessing human perception, as it eases the collection of subjective feedback and potentially amplifies impact and inclusivity. This study presents a strategic approach for analyzing publicly available and willingly reported crowdsourced data from a digital mapping platform in outdoor comfort evaluations, aiming to verify whether these data are informative regarding environmental quality perception and to identify the environmental factors that people are most sensitive to. Urban parks located in New York City served as a case study. A multi-source, interdisciplinary information framework combined crowdsourced reviews with environmental data used to determine prevailing thermal conditions. Overall perception of parks was well-rated, revealing that their attractions and activities are probably the most appealing characteristics for park attendance. Regarding environmental perception, acoustic and thermal factors are clearly the most influential. Acoustics were well-rated, while the main aspect regarding the thermal domain is the recognition of shading as a mitigator for hot conditions. Environmental data provided complementary insights, particularly concerning the range of thermal sensations experienced in urban parks. The findings confirm that willingly reported crowdsourced data can provide valuable insights into urban crowd environmental perception, presenting a potentially suitable and effective method to include the human perspective in environmental quality assessments, as well as to evaluate and predict environmental-related risks.

3D built virtual arctic environment increase vigor through connectedness in older people

While the life expectancy of older people has increased significantly, this is often related to more long-term care in healthcare residences and nursing homes. Staying in these facilities can lead to a reduction in the sense of connection with others and the world around, as well as in vigor, with significant psychophysical repercussions in the long term. Although previous studies have shown that the virtual nature can benefit both, there are no significant studies that have tested its effect in generating these positive outcomes in the older population. Therefore, our study sought to investigate, in a sample of 53 older people in care at a nursing home or healthcare residence, the indirect effect of a 3D built virtual arctic environment (vs. a 3D built virtual urban environment) exposure in virtual reality on vigor through connectedness. Both the virtual scenarios were designed with a first-person view, with no translation around the environment and only in-situ rotation. Results highlighted that exposure to the 3D built virtual arctic environment leads to higher connectedness than the 3D built virtual urban environment, and this, in turn, leads to an increase in vigor. Findings were discussed based on the potential of adopting virtual nature in facilities to improve older people's sense of connectedness and, in turn, improve their well-being.

The association between green space around schools, screen time for entertainment, and adolescent depressive symptoms: A nationwide study from China

BACKGROUND

Natural green environments are beneficial to people's mental health, while too much screen time may be harmful to adolescents' mental health. However, it is not clear how green spaces and screen time affect mental health together in adolescents.

METHODS

A total of 22,868 adolescents were recruited from October to December 2021 in eight cities in China, through multistage cluster sampling. The Patient Health Questionnaire (PHQ-9) was used to investigate adolescents' depressive symptoms, and the Normalised Vegetation Index for the 200m, 500m and 1000m buffer zones around the school represents the green cover around the school. We used binary logistic regression to analyse the association between green space, screen time and depressive symptoms.

RESULTS

In fully adjusted models, the highest quartile of NDVI in the 200m, 500m and 1000m buffer zones around the school was a protective factor for depressive symptoms. For less than 2 h of recreational screen time, the highest quartiles of the NDVI and the association with depressive symptoms were negatively correlated for the 200m, 500m and 1000m buffer zones (NDVI200: 0.904(0.848-0.964)), NDVI500: 0.863(0.808-0.921), NDVI1000: 0.862(0.808-0.920)). The highest quartiles of NDVI in all buffers were not associated with depressive symptoms when the screen time was >2 h. The association between green space and depressive symptoms at lower recreational screen time was observed to be stronger in the group of adolescents with a lower family economic status (NDVI200: 0.780(0.695-0.876), NDVI500: 0.838(0.748-0.938), NDVI1000: 0.783(0.698-0.879)). No potential gender differences were observed.

CONCLUSIONS

For adolescents with less than 2 h of recreational screen time per day, the greenery around the school had a protective effect on their mental health, especially for adolescents from economically disadvantaged families. Green spaces around schools are significant in improving health inequities.

Effect of Relaxation-Based Virtual Reality on Psychological and Physiological Stress of Substance Abusers Under Detoxification: A Randomized Controlled Trial

INTRODUCTION

Substance abuse is a widespread problem, with high rates of treatment dropout. Stress plays a crucial role in this problem, so innovative interventions with stressed patients can assist them in completing treatment.

METHODS

This study is a randomized controlled trial with 60 participants who have substance abuse disorder undergoing detoxification at a residency facility in Tehran, Iran. Participants were randomly assigned to one of three groups: watching a 360° video of nature, a 360° video of a city environment, or no virtual experience. The intervention was performed only for one session. Psychological stress was measured using the Positive and Negative Affect Schedule and Perceived Stress Scale before and after the intervention. Physiological stress was assessed through respiratory rate, skin conductance, and heart rate recordings during the virtual reality (VR) experience. Data analysis was performed using R software (version 4.2).

RESULTS

Paired t-test results indicated significant psychological differences before and after virtual nature experiences, but not in the control and city groups. The repeated measure ANOVA showed a significant reduction in skin conductance (p < 0.01) and respiratory rate (p < 0.01) scores in the nature group.

CONCLUSION

The findings suggest that VR relaxation could be a potentially beneficial intervention for reducing stress in patients during detoxification.

Assessing the nonlinear impact of green space exposure on psychological stress perception using machine learning and street view images

Introduction

Urban green space (GS) exposure is recognized as a nature-based strategy for addressing urban challenges. However, the stress relieving effects and mechanisms of GS exposure are yet to be fully explored. The development of machine learning and street view images offers a method for large-scale measurement and precise empirical analysis.

Methods

This study focuses on the central area of Shanghai, examining the complex effects of GS exposure on psychological stress perception. By constructing a multidimensional psychological stress perception scale and integrating machine learning algorithms with extensive street view images data, we successfully developed a framework for measuring urban stress perception. Using the scores from the psychological stress perception scale provided by volunteers as labeled data, we predicted the psychological stress perception in Shanghai's central urban area through the Support Vector Machine (SVM) algorithm. Additionally, this study employed the interpretable machine learning model eXtreme Gradient Boosting (XGBoost) algorithm to reveal the nonlinear relationship between GS exposure and residents' psychological stress.

Results

Results indicate that the GS exposure in central Shanghai is generally low, with significant spatial heterogeneity. GS exposure has a positive impact on reducing residents' psychological stress. However, this effect has a threshold; when GS exposure exceeds 0.35, its impact on stress perception gradually diminishes.

Discussion

We recommend combining the threshold of stress perception with GS exposure to identify urban spaces, thereby guiding precise strategies for enhancing GS. This research not only demonstrates the complex mitigating effect of GS exposure on psychological stress perception but also emphasizes the importance of considering the "dose-effect" of it in urban planning and construction. Based on open-source data, the framework and methods developed in this study have the potential to be applied in different urban environments, thus providing more comprehensive support for future urban planning.

The role of emotion in urban development decision-making: A qualitative exploration of the perspectives of decision-makers

People's feelings about their neighbourhoods are important for health, but they may be undervalued in urban development decision-making. This study explores how decision-makers understand and respond to residents' emotions. Reflexive thematic analysis was conducted on a secondary dataset consisting of 123 interviews with influential professionals in urban development decision-making. We developed three themes and one subtheme: '(mis)understanding residents' emotions', 'neglecting the health impact of positive emotions', 'avoidance of emotion in community engagement' and 'sanitized emotions'. We recommend decision-makers engage directly with residents' emotions during urban development processes to ensure healthier place-making.

Nature as a therapeutic place and tool for enhancing service users' engagement in mental health services: A comprehensive synthesis of evidence

This systematic review explored how nature-based care settings influence engagement in mental health therapy. We relied on Joanna Briggs Institute's guidelines for systematic reviews to synthesise data from nine articles selected from an initial pool of 649 records retrieved from PubMed, CINAHL, ScienceDirect, SocINDEX, and JBI EPB. Synthesis revealed six analytical themes: nature as a therapeutic tool, therapeutic relationships, nature's impact on power balance, nature as a safe space, risk of nature and patient-centered care. The findings shed light on the benefits while highlighting some challenges that influence participation in mental health interventions. The findings suggest that integrating nature into mental health care could be an alternative or complementary approach to enhancing patient engagement. However, the specific types of mental health care of this impact vary. Robust clinical trials that examine the effectiveness of the reported benefits are recommended. Such studies must target specific patient groups, such as the young and the elderly. Longitudinal studies that examine the long-term effects and moderating factors are needed to strengthen the evidence base and enhance patient-centered care.

Can a nature walk change your brain? Investigating hippocampal brain plasticity after one hour in a forest

In cities, the incidence of mental disorders is higher, while visits to nature have been reported to benefit mental health and brain function. However, there is a lack of knowledge about how exposure to natural and urban environments affects brain structure. To explore the causal relationship between exposure to these environments and the hippocampal formation, 60 participants were sent on a one hour walk in either a natural (forest) or an urban environment (busy street), and high-resolution hippocampal imaging was performed before and after the walks. We found that the participants who walked in the forest had an increase in subiculum volume, a hippocampal subfield involved in stress response inhibition, while no change was observed after the urban walk. However, this result did not withstand Bonferroni correction for multiple comparisons. Furthermore, the increase in subiculum volume after the forest walk was associated with a decrease in self-reported rumination. These results indicate that visits to nature can lead to observable alterations in brain structure, with potential benefits for mental health and implications for public health and urban planning policies.

Effects of different natural soundscapes on human psychophysiology in national forest park

Most of the current soundscape research content is limited to the discussion of the restoration effect of single-element soundscapes, but it is the combination of sounds that is common in outdoor activities, and there is no evidence that the restoration of natural soundscapes is better with multi-element combinations. In this study, the Zhangjiajie National Forest Park in China was used as the research object, and the physiological indices of the subjects were collected through electroencephalogram signals, and the POMS short-form psychological scale was used to understand the subjective psychological responses of the subjects to the soundscape. The results showed that (1) The psychophysiological restorative ability of the natural soundscape of the National Forest Park was confirmed, and the subjects' psychological and physiological indices changed significantly and positively after listening to each section of the natural soundscape (p = 0.001). (2) The restorative effect of the multi-natural sound combination was ranked first in the overall ranking of the five natural soundscapes, and the multi-natural sound combination did indeed provide better restorative effects than the single-element sounds. (3) Gender does not usually have a significant effect on the restoration effect, and only Windy Sound among the four single-element nature sound landscapes and one multi-element combination of nature sound landscapes showed a significant gender difference, so in general, the effect of gender on the restoration effect of nature sound landscapes is not significant. In terms of research methodology, this study used cluster analysis to cluster the five types of natural soundscapes according to psychological and physiological recovery ability, and used ridge regression to construct mathematical models of the psychological and physiological recovery of each of the four natural soundscapes. The study of human physiological and psychological recovery from different types of natural soundscapes in China's national forest parks will provide a basis for soundscape planning, design, and policy formulation in national forest parks.

The effects of different designs of indoor biophilic greening on psychological and physiological responses and cognitive performance of office workers

Impression on biophilic designs influences the effects of indoor greening. The current study aimed to investigate the effects of different biophilic designs in office rooms on the psychological and physiological responses and the cognitive performance of office workers. Indoor greening rooms with Japanese and tropical designs were used along with the green-free (control) design in this study. The heart rate variability of the participants was not affected by green designs. However, there was improvement in impressions on tropical and Japanese designs in office rooms. In particular, the Japanese design was more effective in decreasing negative emotions than the tropical design. The electroencephalography during 5-min exposure to the greening designs showed limited frequency bands and regions of interest affected by the greenery design. Taken together with the psychological data, indoor greening with the tropical design promoted positive mood states. Meanwhile, indoor greening in the Japanese design, inhibited negative mood states. However, there were no significant differences between the two designs in terms of cognitive task performance. Hence, indoor greening increases neural efficiency during cognitive tasks.

Students' perceived restorativeness of university environment: the validation of the Rest@U scale

University students are likely to encounter mental health issues throughout their educational journey. Among the various factors that can impact students' wellbeing, the physical environment can potentially restore cognitive, physiological, and emotional resources, thereby enhancing academic performance, and overall quality of life, while reducing feelings of stress and depression. The Perceived Restorativeness Scale is the most commonly used tool to assess the level of restorativeness derived from the educational physical environment. However, a tailored measure could be a more psychometrically suitable approach to capture the context-specific characteristics of university environments for academic students. This study aimed to validate an instrument that can accurately evaluate university spaces to measure the perceived restorativeness of university students. A total sample of 685 students from two Italian universities participated in the evaluation of the psychometric properties of the Restorativeness at University scale (Rest@US), consisting of 13 items divided into four dimensions: fascination, being-away, scope, and coherence. The hypothesised four-factor model (being-away, fascination, scope, and coherence) demonstrated excellent fit indices in both the calibration and validation samples and was invariant for sex. The scale demonstrates good reliability. Furthermore, criterion validity has been confirmed, highlighting that, in a theoretically consistent manner, the perceived restorativeness of university physical environments from the point of view of students and its dimensions were negatively correlated with techno-overload and study-related workload and positively correlated with perceived performance and psycho-physical wellbeing.

Experimental Study on Emergency Psychophysiological and Behavioral Reactions to Coal Mining Accidents

Effective emergency responses are crucial for preventing coal mine accidents and mitigating injuries. This paper aims to investigate the characteristics of emergency psychophysiological reactions to coal mine accidents and to explore the potential of key indicators for identifying emergency behavioral patterns. Initially, virtual reality technology facilitated a simulation experiment for emergency escape during coal mine accidents. Subsequently, the characteristics of emergency reactions were analyzed through correlation analysis, hypothesis testing, and analysis of variance. The significant changes in physiological indicators were then taken as input features and fed into the three classifiers of machine learning algorithms. These classifications ultimately led to the identification of behavioral patterns, including agility, defensiveness, panic, and rigidity, that individuals may exhibit during a coal mine accident emergency. The study results revealed an intricate relationship between the mental activities induced by accident stimuli and the resulting physiological changes and behavioral performances. During the virtual reality simulation of a coal mine accident, subjects were observed to experience significant physiological changes in electrodermal activity, heart rate variability, electromyogram, respiration, and skin temperature. The random forest classification model, based on SCR + RANGE + IBI + SDNN + LF/HF, outperformed all other models, achieving accuracies of up to 92%. These findings hold promising implications for early warning systems targeting abnormal psychophysiological and behavioral reactions to emergency accidents, potentially serving as a life-saving measure in perilous situations and fostering the sustainable growth of the coal mining industry.

Exploring the impact of autumn color and bare tree landscapes in virtual environments on human well-being and therapeutic effects across different sensory modalities

In recent years, there has been a growing awareness of the potential health benefits of the natural environment for human well-being. Given the fast-paced nature of contemporary lifestyles, research into the use of virtual environments as a means to provide various seasonal landscapes has gained increasing importance.

OBJECTIVE

The aim of this study is to investigate the impact of different sensory modes on the preferences and therapeutic effects of virtual autumn landscapes on university campuses.

METHODS

In this study, 320 participants, with an average age of 21.11 years (±1.21 years), were exposed to virtual environments featuring autumn color landscapes and bare tree landscapes using visual, auditory, and combined conditions. A control group was included for comparison. Differences in participants' physiological indicators (EEG, heart rate) and psychological measures (POMS, PANAS, SVS, ROS) were analyzed, with the use of the Holm correction (P < 0.05).

RESULTS

(1) Autumn virtual landscapes with color had a superior therapeutic effect. (2) There were significant differences in the therapeutic effects of different sensory modes within the same season's landscape categories, suggesting that incorporating additional sensory dimensions may enhance therapeutic outcomes.

CONCLUSION

Based on the study's findings, we recommend that when designing therapeutic environments, attention should be given to seasonal variations and the integration of various sensory modes to optimize therapeutic results.

Spatial experience of cancer inpatients in the oncology wards: A qualitative study in visual design aspects

PURPOSE

This paper aims to explore how the visual characteristics of cancer wards' interior spaces can be improved based on the combined visual design themes to help cancer inpatients' spatial experience and relieved state of mind. Accordingly, we present a visual design framework that can be applied in oncology wards.

METHOD

This study adopts the Ulrich-supportive design theory as a theoretical framework using two main methodological phases: observation of cancer wards and interviews with professional caregivers. The first phase critically explores hospital cancer wards' interactive aesthetical and visual interior characteristics. Next, we adjusted the visual criteria based on the Post Occupation Evaluation (POE) method to develop the interview questions. Interviews were conducted with experienced nurses, oncologists, and a general physician, all from a cancer ward at McGill University Health Center (MUHC) in Montreal, Canada.

RESULTS

We presented 11 main themes in the categories of color and light, natural/artistic images, way-finding, and visual clutter. To present and justify our visual design framework, these main themes were then classified based on the common goals, resulting in four combined themes: applying simplicity and usability; developing naturality; creating homeyness and respecting patients' agency; and promoting trustworthiness.

CONCLUSION

Our findings suggest that-apart from the last theme, promoting trustworthiness, the rest are in line with Ulrich's supportive design theory. Therefore, further research is needed to investigate "promoting trustworthiness" in the context of cancer wards. In addition, each aspect of the visual design framework can offer practical design recommendations for future studies.

Personal dispositions explain differences in physical health benefits of nature exposure: the role of restorativeness and affect

Introduction

Urbanization processes are constantly increasing, and most of the European population currently live in urban areas. Nevertheless, evidence is consistent in highlighting the positive association between nature exposure and human wellbeing, although individual differences might affect this association.

Methods

The present study aimed to investigate the association among nature connectedness, conceptualized as Love and Care for Nature, place identity, and physical wellbeing, via restorativeness and positive and negative affect. A total of 312 visitors of an urban green area (i.e., Milan's Parco Nord) participated in the study. They completed an anonymous questionnaire.

Results

Findings showed that nature connectedness and place identity positively affect physical wellbeing, via restorativeness and positive affect, but not through the negative ones.

Discussion

Results highlight the importance of the joint role of exposure to nature and individual differences in promoting wellbeing. This study offers implications for interventions aimed at enhancing individuals' health through exposure to nature. Limitations of the study and future research developments are discussed.

Nature-based virtual reality intervention to manage stress in family caregivers of allogeneic hematopoietic stem cell transplant recipients: a two-phase pilot study protocol

Millions of family members and/or friends in the U.S. serve as unpaid caregivers for individuals with chronic conditions, such as cancer. Caregiving for someone undergoing an intense allogeneic hematopoietic stem cell transplant (HSCT) is particularly demanding, with accompanying physical and psychological stress. Increased stress and stress-related symptoms could make it difficult for caregivers to fulfill their roles and could negatively impact the health status and quality of life of themselves and the recipients. Virtual reality (VR) is a promising technology increasingly used for treatment and wellness in various medical settings. There is growing evidence that studies have reported the positive effects of the VR intervention in managing and reducing stress among diverse populations in various clinical scenarios; however, no published studies have focused on family caregivers of patients with cancer. The study aims to assess the feasibility and acceptability of a four-week nature-based VR intervention and to examine the effectiveness of the VR intervention on stress in HSCT caregivers. This study comprises two phases. Phase I of the study will be a single-arm pre-post design focused on assessing the feasibility and acceptability of the VR intervention. Phase II of the study will be a prospective randomized controlled group design to examine the effectiveness of the VR intervention on perceived stress. Adults (≥ 18 years) who serve as primary caregivers for a person who will undergo an allogeneic HSCT will be recruited. Fifteen participants will be enrolled for Phase I and 94 participants for Phase II (Active VR arm N=47; Sham VR arm N=47). The nature-based immersive VR program contains 360° high-definition videos of nature scenes along with nature sounds through a head-mounted display (HMD) for 20 minutes every day for four weeks. Primary outcome is perceived stress measured by the Perceived Stress Scale. Secondary/exploratory outcomes are stress-related symptoms (e.g., fatigue, sleep disturbance) and physiological biomarkers (e.g., cortisol, alpha-amylase). The importance and innovativeness of this study consist of using a first-of-its-kind, immersive VR technology to target stress and investigating the health outcomes assessed by validated objective biomarkers as well as self-report measures of the nature-based intervention in the caregiver population.

Clinical trial registration

ClinicalTrials.gov, identifier NCT05909202.

Assessing nature exposure: a study on the reliability and validity of a Portuguese version of the nature exposure scale

Introduction

Engaging with nature has been widely acknowledged for its positive impact on well-being. Traditionally, assessments of nature exposure focus on estimating green space exposure and outdoor time. However, the Nature Exposure Scale (NES) offers a unique approach by evaluating the quality of nature experiences, encompassing both deliberate and spontaneous encounters.

Methods

This study aimed to assess the validity and reliability of the NES in the context of Portugal. Exploratory Factor Analysis (PCA) and Confirmatory Factor Analysis (CFA) were employed to examine the underlying structure of the scale. Additionally, reliability assessments, along with tests of convergent and divergent validity, were conducted. Data were collected from a sample of 558 adults and 241 adolescents between 2016 and 2018.

Results

The findings revealed strong internal consistency of the NES, supported by acceptable correlation values and robust factor loadings within a unidimensional model. The scale effectively predicted variations in nature exposure across diverse professional activities.

Discussion

In summary, the 4-item NES emerged as a reliable tool for assessing nature exposure in various settings, effectively bridging a gap in the Portuguese context. The scale demonstrated potential for cross-cultural research and was particularly adept at predicting nature exposure in different professional contexts. The results suggest that the NES can enhance our understanding of the impact of nature on well-being in diverse cultural settings.

Conclusion

The study underscores the reliability of the NES in assessing nature exposure in Portugal, paving the way for further exploration in Portuguese-speaking regions. The scale holds promise for advancing research on the relationship between nature and well-being, contributing valuable insights across different cultural contexts.

A randomised controlled trial assessing the effects of weather sensitivity profile and walking in nature on the psychophysiological response to stress in individuals with coronary artery disease. A study protocol

BACKGROUND

The following protocol pertains to a pioneer study, aiming to investigate how weather sensitivity and walking in different environments affects the psychophysiological responses to the stress of individuals with coronary artery disease (CAD) during rehabilitation (WE_SENSE_THE_NATURE). This randomised control trial will provide fresh insight on the influence of the environmental exposure in CAD patients, as it is seldom investigated in association to the disease. Additionally, findings on the link between personality traits and cognitive functions (especially cognitive flexibility), and weather sensitivity may help reveal a fine-grained perspective on the treatment possibilities for individuals with CAD at risk to stress-vulnerability.

METHODS

The proposed protocol is for a randomised control trial among individuals attending a cardiac rehabilitation program. We aim to recruit 164 individuals, collecting information related to demographic characteristics, weather sensitivity, functional capacity, personality traits, subjective mental health status, cognitive function, and basal cortisol level of participating individuals. Basal cortisol level refers to cortisol concentration in saliva and will be tested in the morning and the afternoon prior to the day of the experiment. After baseline measurements, the patients will be randomly assigned to either walking outdoors or walking indoors. All measures and their sequential order will remain the same within each group, while the treatment condition (i.e., walking environment) will vary between groups. On the day of the experiment, hemodynamic parameters (assessed via 6-hour blood pressure measurements), stress level (consisting of assessments of cortisol level), and mood (assessed using visual analogues scale) will be registered. Cold stress test will be administered to evaluate the effect of walking in different environments.

DISCUSSION

The outcomes of this study may have direct clinical applications for the use of different types of exercise environments in cardiac rehabilitation programs. Awareness about the potential influence of weather sensitivity on the psychophysiological reactions to stress in individuals with CAD may contribute to a timely planning and implementation of actions leading to improved medical care services and preventive measures, especially considering the expected weather oscillations and extreme weather events due to unfolding of the climate change.

TRIAL REGISTRATION

This protocol has been retrospectively registered in ClinicalTrials.gov with identifier code: NCT06139705 on November 20, 2023.

Vitality and nature in psychiatric spaces: Challenges and prospects for 'healing architecture' in the design of inpatient mental health environments

Historically, nature has been considered central to healing and recovery in institutional mental health settings, with inpatient spaces designed to mirror the restorative forces nature may afford. Within contemporary healthcare architecture, the discourse surrounding nature's role has once again become prominent, especially in the concept of 'healing architecture'. While the literature on 'healing architecture' primarily considers how to connect recovery to nature through interventions in the built environment, less interest has been directed towards how nature is configured in design processes and what implications that has for the everyday experiences of patients and staff. In this paper we consider the design and implementation of one particular psychiatric hospital in Denmark to show that the 'nature' brought into this healthcare space can be experienced as anything but 'natural' and may reduce rather than enhance a felt sense of 'vitality' amongst patients. Based on our analysis, we end the paper by suggesting four principles for future healthcare design.

Telepresence robots as facilitators of physical exercise during COVID-19: a feasibility and acceptance study

The COVID-19 pandemic and associated restrictions on mobility and access to green space have disrupted exercise habits worldwide. According to the World Health Organization (WHO), approximately 1.4 billion adults were insufficiently physically active in 2016, with detrimental impacts on health. The proposed study investigated the use of telepresence-robot-based personal trainers to facilitate remote exercise during the pandemic-related lockdowns. Several adults aged 18-65 were recruited for a four-week intervention and thorough research investigation. The intervention involved one-hour outdoor exercise sessions held three times per week in a local park with a human instructor connected via a telepresence robot. Surveys assessed perceptions of social presence, usability, the intention to use the robot and the psychological benefits of access to green space. System logs tracked participation and technical errors. At baseline, 30% of the participants met the WHO physical activity (PA) recommendations, compared to 80% after the intervention. The study shows significant increases in many parameters. These are perceived in social presence (p < 0.021), usability (p < 0.04), intentions for long-term use (p < 0.05), and the mental health benefits of accessing green spaces (p < 0.013). Attendance was found to be 90%, with a 7% technical failure rate. This investigation demonstrates the promise of telepresence robots for safely providing remote access to green spaces. They can be used to facilitate exercise during public health crises, overcoming the barriers to maintaining PA.

Forest Bathing Increases Adolescents' Mental Well-Being: A Mixed-Methods Study

Previous research has demonstrated that practicing forest bathing has significant positive effects on adult psychological well-being. Considering the ongoing adolescents' mental health crisis of increasing anxiety and depression, determining whether forest bathing has similar effects on adolescents is an important expansion of forest bathing research. This study investigated the possibility that forest bathing could improve adolescents' mental well-being and sought to determine participants' experiences of forest bathing. It used a convergent, parallel, mixed-methods design that was partially co-created with 24 participants aged 16-18 as part of a youth participatory action research (YPAR) project in which participants practiced forest bathing three times over 3 weeks. As measured using the Warwick-Edinburgh Mental Well-Being Survey, the mean participant mental well-being increased significantly after forest bathing, with moderate to large effect sizes. Participants described reduced stress and increased feelings of relaxation, peace, and happiness. These findings correlate with previous forest bathing research involving adult participants. It is recommended that educators and others who work with adolescents consider forest bathing as a simple, low-cost way to improve adolescents' mental well-being.

Mapping wild vascular plant species diversity in urban areas in California using crowdsourcing data by regression kriging: Examining socioeconomic disparities

Biodiversity is crucial for human health, but previous methods of measuring biodiversity require intensive resources and have other limitations. Crowdsourced datasets from citizen scientists offer a cost-effective solution for characterizing biodiversity on a large spatial scale. This study has two aims: 1) to generate fine-resolution plant species diversity maps in California urban areas using crowdsourced data and extrapolation methods; and 2) to examine their associations with sociodemographic factors and identify subpopulations with low biodiversity exposure. We used iNaturalist observations from 2019 to 2022 to calculate species diversity metrics by exploring the sampling completeness in a 5 × 5-km2 grid and then computing species diversity metrics for grid cells with at least 80 % sample completeness (841 out of 4755 grid cells). A generalized additive model with ordinary kriging (GAM OK) provided moderately reliable estimates, with correlations of 0.64-0.66 between observed and extrapolated metrics, relative mean absolute errors of 21 %-23 %, and relative root mean squared errors of 27 %-30 % for grid cells with ≥80 % sample completeness from 10-fold cross-validation. GAM OK was further applied to extrapolate species diversity metrics from saturated grid cells (N = 841) to the remaining grid cells with <80 % sample completeness (N = 3914) and generate diversity maps that cover the grid. Further, generalized linear mixed models were used to examine the associations between species diversity and sociodemographic indicators at census tract level. The wild vascular plant species diversity metrics were inversely associated with neighborhood socioeconomic status (i.e., unemployment, linguistic isolation, educational attainment, and poverty rate). Minority populations (i.e., African American, Asian American, and Hispanic) and children had significantly lower diversity exposure in their neighborhoods. Crowdsourcing data offers a cost-effective solution for characterizing large-scale biodiversity in urban areas.

The outdoor office: a pilot study of environmental qualities, experiences of office workers, and work-related well-being

Outdoor office work is an emerging aspect of the concept of 'new ways of working', but only sparse data are available about the environmental qualities of the outdoor office space, experiences of office workers, and work-related well-being of outdoor office work. Here, we present an exploratory pilot study on well-being and outdoor office work in a public urban space. An outdoor office was set up in the courtyard of a university campus, and the participants (n = 16) conducted office work outdoors for 30 min and thereafter participated in an eye-tracking session for 11-15 min (n = 8) and subsequently filled out surveys (n = 16). The eye tracker allowed the discovery of natural and built elements in the outdoor environment that caught the participants' visual attention, whereas the surveys assessed aspects of their subjective experiences of the outdoor office space (its visual and spatial qualities) and the work there. The results are presented as network graphs where correlations are shown regarding different aspects of office work outdoors. The results indicate that outdoor office work in a public urban space may promote work-related well-being in terms of positive outdoor office space experiences. Based on the findings, a preliminary set of outdoor office qualities is proposed. Those qualities relate to the legibility and imageability of the outdoor office space, its focal points, and depth/spaciousness, in addition to attributes of usability and environmental richness, including if the outdoor office space affords natural contact and supports activities, in addition to social and individual interactions and relations.

Exploring the association between self-reported and objective measures in search of the restorative quality of natural environments: a systematic review

The benefits of nature contact for psychophysiological restoration have sparked a surge of scientific attention in recent years. The diverse psychophysiological mechanisms of stress recovery make assessment with a single marker impractical. The majority of restoration research employs a holistic approach, including subjective psychological and objective physiological measures concurrently. However, this association has not been decisively supported by empirical studies. The purpose of this systematic review is to determine the degree to which subjectively experienced restoration, as measured by self-reported scales, is associated with actual physiological changes. Searches for peer-reviewed primary research articles were conducted in SCOPUS and PubMed, returning 216 papers; the final synthesis includes 21 empirical studies published between 2008 and 2022. Findings show that there is a strong association between subjective and objective measures of restoration. Further analysis verified that using concurrently self-reported and objective measures in measuring restoration, notably the associations of Profile of Mood States (POMS), Perceived Restorativeness Scale (PRS), and Positive and Negative Affect Scale (PANAS) with Blood Pressure (BP) and Heart Rate (HR), resulted in the highest degree of consistency. However, there were negligible inconsistent associations, which were mainly reported by Restoration Outcome Scale (ROS) in psychological indicators and Salivary Cortisol (SC) and Electroencephalography (EEG) in physiological indicators. This suggests that the results of research that uses these measures simultaneously should be interpreted with caution.

Interdisciplinary approach to defining outdoor places of knowledge work: quantified photo analysis

Introduction

Working outdoors is an emerging, sparsely studied phenomenon in knowledge work. Office tasks have traditionally been considered to belong to indoor environments. The worldwide pandemic of COVID-19 has increased and changed attitudes toward multilocational working. The aim of this method study is 2-fold: first to define for interdisciplinary context outdoor environments when they are used as places of outdoor knowledge work and second to quantify the thematic photo analysis to support interdisciplinary understanding of the places of outdoor knowledge work.

Methods

The review of literature has been one of the methods to support the interdisciplinary approach of this article. The photographs of outdoor knowledge workplaces and views from the workstations are studied through photo analysis customized from the existing press photograph analysis.

Results

First, we defined outdoor environments when used as places of outdoor knowledge work, as unconditioned outdoor or semi-outdoor places (opposite to closed indoor spaces with stable, conditioned indoor climate) providing favorable action possibilities as sources of comfort and mitigating unfavorable conditions, for example, by microclimatic solutions. Instead of defining all spaces as outdoor environments not fulfilling a stable indoor climate (conditioned) definition, adaptation to thermal and physical environments also brought semi-outdoor space into the definition. In this context, favorable latent action possibilities (affordance) in the built environment are often related to microclimate as a source of comfort. Second, we focussed on photo analysis. The proposed model is based on journalistic photo analysis PPSA and the pOKW model, which have been further developed in this study to pOKW2 model for analyzing mobile-based collected self-reported photographs by the occupants. In this pOKW2 model, the photographs would have time-location information enabling the combining of data from other datasets and thereby reducing the number of characteristics to be analyzed from the photograph. We proposed rating (in numeric form) to detect the favorable and unfavorable characteristics in the photographs most likely supporting or hindering conditions of outdoor knowledge work. This quantification would enable the use of machine vision analysis and would support handling large quantities of photographs and their combination with other datasets in interdisciplinary research.

Discussion

The quantification of the photo analysis (pOKW2) includes the readiness to combine the analysis results with other time-location-specific datasets in an interdisciplinary research collaboration to advance our understanding of latent action possibilities for outdoor knowledge work.

Design guidelines for healing gardens in the general hospital

Introduction

Despite being recognized as a cost-effective method to enhance physical and mental health, Healing Gardens remain insufficiently popularized in outdoor spaces of hospitals. This paper aims to introduce a new perspective and offer guidelines for their implementation within general hospitals.

Methods

A methodology is proposed for formulating hospital-specific guidelines, encompassing the extraction of successful Healing Garden features from case studies, definition of key components grounded in theoretical frameworks, validation of essential features through user questionnaires, and comprehensive site analyses.

Results

The methodology was applied in a case study at Zhongnan Hospital in Wuhan. This research presents a novel perspective and robust methodology for implementing Healing Gardens in general hospital settings, potentially improving physical and mental health in a cost-efficient manner.

Discussion

This work aims to encourage the adoption of Healing Gardens as preventive medical tools in more healthcare settings. By providing a comprehensive methodology and a case study illustration, this research endeavors to stimulate broader acceptance and utilization of Healing Gardens in healthcare environments.

A systematic review and meta-analysis of randomized controlled trials on the effectiveness of immersive virtual reality in cancer patients receiving chemotherapy

PURPOSE

Immersive virtual reality (IVR) shows promise in cancer care, especially for chemotherapy patients. This systematic review and meta-analysis assesses IVR's impact on adult and pediatric cancer patients undergoing chemotherapy.

METHODS

We searched PubMed, Cochrane Library, Embase, Scopus, Web of Science, and Google Scholar for relevant randomized controlled trials (RCTs). We focused on anxiety, depression, fatigue, pain, and anxiety in adults and pain and anxiety in pediatric patients.

RESULTS

Fifteen trials were included, enrolling 607 adult and 257 pediatric cancer patients. IVR significantly reduced anxiety (SMD = -1.89, 95% CI = -2.93 to -0.85), depression (SMD = -1.85, 95% CI = -3.14 to -0.55), fatigue (SMD = -3.40, 95% CI = -5.54 to -1.26), and systolic blood pressure (MD = -3.54, 95% CI = -6.67 to -0.40) in adults. In pediatric patients, IVR significantly lowered pain (SMD = -1.17, 95% CI = -1.84 to -0.50) and anxiety (SMD = -1.18, 95% CI = -1.77 to -0.59) but not heart rate (MD = 0.48, 95% CI = -2.38 to 3.34).

CONCLUSION

IVR effectively reduces anxiety, depression, fatigue, systolic blood pressure, pain, and anxiety in cancer patients. More robust RCTs are needed for further IVR research.

Biophilic classroom environments on stress and cognitive performance: A randomized crossover study in virtual reality (VR)

The emerging Metaverse will likely increase time expenditure in indoor virtual environments, which could impact human health and well-being. The biophilia hypothesis suggests that humans have an innate tendency to seek connections with the natural world and there is increasing evidence that biophilic design such as the incorporation of green plants can yield health benefits. Recently, virtual reality (VR) has been used to regulate stress and improve overall wellness, particularly by incorporating natural settings. In this randomized crossover study, we designed five virtual classroom scenes with different biophilic elements and turbidity in VR and investigated whether the visual stimulations can affect the stress levels and cognitive functions of 30 young adults from a university in China. We measured their physiological indicators of stress reaction by wearable biomonitoring sensors (blood pressure (BP), heart rate (HR), heart rate variability (HRV), and skin conductance level (SCL)), conducted verbal cognitive tests on attention and creativity, and evaluated subjective/perceived (self-reported) stress levels and connection with nature. Albeit our results suggested no significant change in physiological stress reactions or cognitive functions induced by the biophilic and turbid interventions in VR, the addition of biophilic elements in the Metaverse could benefit students' health due to significantly decreased perceived stress levels and increased connections with nature.

Grounding the Restorative Effect of the Environment in Tertiary Qualities: An Integration of Embodied and Phenomenological Perspectives

This paper proposes an integration of embodied and phenomenological perspectives to understand the restorative capacity of natural environments. It emphasizes the role of embodied simulation mechanisms in evoking positive affects and cognitive functioning. Perceptual symbols play a crucial role in generating the restorative potential in environments, highlighting the significance of the encounter between the embodied individual and the environment. This study reviews Stress Reduction Theory (SRT) and Attention Restoration Theory (ART), finding commonalities in perceptual fluency and connectedness to nature. It also explores a potential model based on physiognomic perception, where the environment's pervasive qualities elicit an affective response. Restorativeness arises from a direct encounter between the environment's phenomenal structure and the embodied perceptual processes of individuals. Overall, this integrative approach sheds light on the intrinsic affective value of environmental elements and their influence on human well-being.

Nature in the Office: A Systematic Review of Nature Elements and Their Effects on Worker Stress Response

Work-related stress is a significant problem in many work environments and can have negative consequences for both employees and organisations. This review aimed to identify which elements of biophilic design in the workplace affect workers' stress response. To enable this, a literature search was conducted using PsycINFO, Scopus, and Medline. The search was limited to articles published from 2012 to June 2023. This review only integrated quantitative data, incorporating twelve records for qualitative synthesis. The selected studies suggest that strategies such as access to outdoor environments or the creation of outdoor areas are effective in reducing stress in the workplace. If these are not feasible, the examined research advocates the use of virtual means to recreate such relaxation or break spaces. Furthermore, aspects of interest for future research were identified, such as multisensory stimulation, including the sense of smell, the exploration of views with natural elements, the creation of shelters, or the study of biomorphic forms.

Resilience and green spaces: Association with stress among contact centre workers in the Philippines

ISSUE ADDRESSED

Philippine contact centres are rife with factors that contribute to work-related stress; health promotion strategies are needed to mitigate the impacts. With a transactional framework with the environment, this study examined the relationship of stress with resilience and the presence of urban green spaces (UGS) in the environment, while accounting for individual characteristics (ie, age, household income, exercise frequency).

METHODS

Participants include employees (Stage 1 N = 186; Stage 2 N = 89) from six contact centres in the capital region of the Philippines. A two-stage online survey included standardised instruments to measure stress (10-item Perceived Stress Scale) and resilience (Connor-Davidson Resilience Scale), customised questions to gather demographic information and probe on participants' insights. Google Earth Pro was used for satellite mapping of UGS, followed by on-site ocular inspection.

RESULTS

Participants' average stress level was categorised as high; primary stressors included client demands and workload. The objectively measured percentages of UGS in the study sites' vicinity were categorised as low. Participants found UGS visible after careful observation, and majority were aware of UGS in their workplace vicinity. Resilience, household income and awareness of UGS in the vicinity significantly predicted stress levels.

CONCLUSION

Contact centre workers experienced high stress levels and their workplaces had little accessible UGS. Resilience, household income and awareness of UGS are significant contributors to stress levels. SO WHAT?: Health promotion in Philippine contact centres could consider strategies that include building resilience, enhancing income security and promoting the awareness of UGS within the workplace vicinity.

Association of stress on eating competence in mothers during pregnancy and six months postpartum

BACKGROUND

Perceived stress is related to poor diet quality and unhealthy dietary patterns in women of reproductive age. Eating competence represents a variety of contextual skills reflecting a comfortable and flexible approach to eating and is associated with diet quality and health related behavior. In non-pregnant samples, perceived stress is negatively associated with eating competence. Given that pregnancy and the postpartum period can be periods of high stress, we hypothesized that higher stress in pregnancy would result in lower pregnancy eating competence.

METHODS

Women (n = 296, mean BMIbaseline pregnancy = 26.3 ± SD 6.0) in the Pregnancy Eating Attributes Study (PEAS) were recruited from the Chapel Hill, North Carolina area. Perceived stress was assessed using the Perceived Stress Scale and eating competence using the ecSatter Inventory at their first trimester and 6-month postpartum visits. We used a mixed effect model to assess the effect of stress by time on eating competence, controlling for baseline pregnancy BMI, race and ethnicity, poverty to income ratio, and WIC status.

RESULTS

Perceived stress was negatively associated with eating competence (b= -0.23, SE = 0.06, p < 0.001). The interaction of stress by time was negatively associated with eating competence (b = -0.15, SE = 0.08, p = 0.03), indicating that the association of stress with eating competence was stronger in postpartum than in pregnancy.

CONCLUSIONS

Perceived stress may adversely impact eating competence during both pregnancy and postpartum. Future studies intervening upon stress or eating competence during pregnancy and postpartum may inform potential causal relations.

The role of connection with nature in empirical studies with physiological measurements: a systematic literature review

It is well described that exposure to nature reduces physiological stress, and connectedness to nature can have a moderating effect. However, few studies have so far examined the construction of the connection with nature in relation to physiological processes. In this systematic review, we collected studies that used a physiological measure and included a scale to measure connectedness to nature. Our aim was to assess the role of nature relatedness at the level of physiological processes and to summarize the results published so far. Our review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in 3 different databases (PubMed, ScienceDirect and Google Scholar). As keywords, we used all the different questionnaires that measure connectedness to nature, combined with terms related to physiological measures. After final screening, 28 articles met the inclusion criteria for the review. The studies were very diverse in terms of purpose, intervention and methods, so narrative synthesis was conducted without measures of effect. We found evidence for a mediating effect of nature connectedness on the associations between nature exposure and cognitive function, brain activity, blood pressure, cortisol level and mental health. Studies investigating nature relatedness as state-like characteristics have shown that exposure to nature increases the level of connection to nature. Eye-tracking studies have confirmed that this measurement method can be used to investigate nature relatedness at a physiological level, which could be a useful complement to self-report questionnaires in future studies.

Efficacy of Baduanjin for treatment of fatigue: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Numerous studies have suggested that Baduanjin, a traditional Chinese exercise, can alleviate fatigue symptoms in patients with various illnesses. The aim of this review was to evaluate the efficacy of Baduanjin in reducing fatigue symptoms.

METHODS

A comprehensive literature search was conducted using several databases, including PubMed, Web of Science, Embase, Medline, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang, from inception to June 2023. Relevant studies reporting on the effects of Baduanjin on fatigue symptoms were included. A random-effects meta-analysis model with standardized mean differences was used to estimate the treatment effects. Moderator analyses were conducted using continuous variables and meta-regression. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023411532). Grading of recommendations, assessment, development and evaluations framework was used to assess the certainty of evidence.

RESULTS

Ten randomized controlled trials with patients diagnosed with 9 different diseases were included in the meta-analysis. The Baduanjin intervention groups showed significant improvements in total fatigue intensity (standard mean difference = -0.49, 95% confidence interval = -0.69 to -0.30, P = .000; I2 = 56%, P = .009). The statistically significant differences in the subgroup analyses, including intervention durations, age of participants, fatigue types, and practice location, remained unchanged. Meta-regression showed that practice place might have significant effect on the results. The certainty of the evidence was moderate for participants 55-year younger or in hospital training. However, fatigue, different groups, participants 55-year or older, training at home, and different fatigue types had lower evidence certainty.

CONCLUSION

Baduanjin can effectively alleviate fatigue symptoms with relatively flexible requirements. However, studies investigating the same disease types and including non-Chinese populations are scarce. Therefore, further studies with long-term interventions, larger sample sizes, and well-designed methodologies are warranted.

Mechanism and implications of pro-nature physical activity in antagonizing psychological stress: the key role of microbial-gut-brain axis

Appropriate physical activities and a biodiversity-rich environment are conducive to the relief of psychological stress, and pro-nature physical activities are a combination of the two, which has good application potential in antagonizing psychological stress, but the intervention mechanism is still unclear. The microbiota-gut-brain axis is cyclically associated with psychological stress, and psychological stress can affect the microbiota through the gut-brain pathway, and conversely, the microbiota can also affect the psychological stress-induced symptoms. It is suggested that the microbe-gut-brain axis may provide a new perspective and target for the treatment of psychological stress-related diseases. Pro-nature physical activity can improve the number of Firmicutes, short-chain fatty acids, Akkermansia bacteria, and the gut-brain barrier and further affect the HPA axis, BDNF, and serotonin pathways of gut-brain two-way communication, thereby maintaining the body's homeostasis and reducing antagonistic psychological stress. According to the comprehensive influence of physical activities on the microbiota-gut-brain axis, a "green + exercise prescription hypothesis" in line with the holistic medical concept is revealed, which is expected to be effective in the prevention, alleviation, and treatment of irritable bowel syndrome and neurodegenerative diseases. It provides new means for treating psychological stress-related diseases such as mental disorders and mood disorders. In addition, it enlightens the construction of green infrastructure that is conducive to the diversified contact of microorganisms in outdoor physical activities venues and induces healthy interaction between the human body and the microbial population in the natural ecology. However, the current research is still in its early stages, and the intervention effect and mechanism of pro-nature physical activities need further demonstration in the future.

Wilderness Is the Prototype of Nature Regardless of the Individual's Connection to Nature. An Empirical Verification of the Solastalgia Effect

(1) Background: Connectedness with Nature is a personality trait that influences our relationship with Nature. But Nature is not all the same. Wilderness is Nature in its original form, the form within which human beings have evolved as a species, while what we refer to as domesticated and urban Nature are relatively recent products of our interaction with the environment. (2) Aim: The main purpose of this study was to verify whether the individual trait "connection to Nature" influences the perception of restoration, preference for and familiarity with three types of Nature: wilderness, domesticated and urban. (3) Results: Regardless of the level of connection to Nature, wilderness is always perceived as more restorative than the domesticated or urban environment. Individuals with higher connectedness prefer wilderness more than others, and they are able to recognise the restorative value of domesticated environments more than those with medium or low levels of connectedness. Less connected individuals tend to prefer domesticated environments, although wilderness is more familiar to them. (4) Conclusions: This study shows that, despite our detachment from Nature, wilderness is the prototype of Nature, and this finding offers a plausible evolutionary explanation of solastalgia.

A pilot study on the potential for formalized nature-based instruction to mitigate stress and increase social bonds in university students

Objective: To seek to find a way to address stress and build social bonds among U.S. college students, an East Coast private institution and a West Coast state institution each offered an undergraduate Nature Rx course. Participants: Seventeen undergraduate students were enrolled in the West Coast state institution seminar, and sixteen undergraduate students were enrolled in the East Coast private institution seminar. Methods: A mixed methods approach was used to evaluate the effectiveness of the pilot such that students were given pre- and post-course questionnaires and asked to write reflective essays to describe their experiences in the class. Results: While no significant changes in self-perceived stress were reported in questionnaire items, the qualitative data indicated students attributed their participation in the course with factors that contributed to reduced stress and important social connections. These included a strengthened belief in the value of spending time in nature to reduce stress, the creation and solidification of social bonds, and an expectation that the class would have a lasting impact. Conclusion: Overall, participants indicated they experienced frequent and meaningful interactions with other students and the instructors while gaining greater familiarity with the natural elements of their respective campuses.

Resurrecting Gaia: harnessing the Free Energy Principle to preserve life as we know it

This paper applies the Free Energy Principle (FEP) to propose that the lack of action in response to the global ecological crisis should be considered a maladaptive symptom of human activity that we refer to as biophilia deficiency syndrome. The paper is organised into four parts: the characterisation of the natural world under the Gaia Hypothesis, the employment of the FEP as a description of the behavior of self-organising systems, the application of the FEP to Gaia to understand coupling dynamics between living systems and purportedly non-living planetary processes, and the offering of positive interventions for addressing the current state of ecological crisis under this framework. For the latter, we emphasize the importance of perturbing stuck states for healthy development, and the necessary appreciation of life existing as nested systems at multiple levels in a hierarchy. We propose the development of human biophilia virtue in accordance with the FEP as a practical intervention for treating biophilia deficiency syndrome and helping to safeguard the balance of planetary processes and the integrity of living systems that depend on them, offering some examples of what this might look like in practice. Overall, this paper provides novel insights into how to catalyse meaningful ecological change, proposing a deliberate and disruptive approach to addressing the dysfunctional relationship between humans and the rest of the natural world.

Prevention of the social isolation of older persons: the impact of community environmental satisfaction on social isolation

Background

To explore how to prevent the social isolation of the older adult, this study constructed a model of the influence of community environmental satisfaction on the social isolation of the older adult from the three dimensions of environmental facilities, transportation, and supporting facilities around the community. Methods: The social network scale and environmental satisfaction scale were used to collect the sample data of nine communities in Xi'an, and the maximum likelihood estimation method was used to analyze the data and test the model.

Results

(1) Environmental facilities, transportation, and community surrounding facilities promoted community environment satisfaction (R² = 0.904). Among them, environmental facilities (β = 0.869) had the greatest impact on community environmental satisfaction, followed by transportation (β = 0.118), and surrounding facilities (β = 0.084) had the least impact on community environmental satisfaction. (2) Environmental satisfaction had a direct positive impact on social isolation. Among them, the impact of environmental satisfaction on friend isolation (R² = 0.895, β = 0.829) was greater than that on family isolation (R² = 0.718, β = 0.747).

Conclusion

Environmental satisfaction can directly affect the social isolation of the older adult in the community and can be used as an intermediate variable of environmental facilities, transportation, and surrounding facilities in the community so that it can indirectly affect the social isolation of the older adult. The results of this study provide a scientific basis for the design of aging environments in the future.

Folk Festivals as Restorative Environments Based on Attention Restoration Theory-The Roles of Liminal Experience and Timing

Background

Research on the restorative environment has long focused on the natural environment, while the research on the humanistic social environment is still in its infancy. In particular, there has been no special research on the restoration of festival environments.

Methods

Based on attention restoration theory (ART), Rites of Passage, and social time, a theoretical model of the restorativeness of folk festival environments was established. Through an empirical study of the Qinhuai Lantern Festival Event, the model was tested by structural equation modeling.

Results

Overall, there were two paths, direct and indirect, for the positive prediction of restoration by being away and compatibility; fascination direct positive predict restoration, and extent could indirectly positive predict restoration through liminal experience; time of visiting played a moderating role in the positive prediction of liminal experience by being away; the direct positive prediction of restoration by extent was significant and moderating during the Lantern Festival and the lantern fair period.

Conclusion

The folk festival environment is restorative. Folk festival environment restoration has the internal mechanism of "environment restoration feature perception → liminal experience → restoration". The restoration of the folk festival environment is moderated by social time.

Significance

This is the first time that attention restoration theory (ART) has been applied to the study of a "hard fascination" humanistic social environment, thus yielding empirical evidence for the development of this theory. The results suggest management requirements for the improvement of the indication system of festival tourism destinations and the promotion of rest and leisure facilities, and management tips for the timing decision of festival activities against the background of the COVID-19 epidemic.

The effect of simulated natural environments in virtual reality and 2D video to reduce stress

Stress is a common problem associated with poor physical and psychological health. Exposure to the natural environment is one method for reducing stress. The real and simulated natural environments have a restorative effect on stress reduction. In contrast to the real environment, simulated natural environments, such as virtual reality and 2D video, provide safer and more controllable exposure. Several studies on the restorative effects of the natural environment in virtual reality and 2D video have been conducted. However, the difference between the two in reducing stress must be clarified. This study was conducted to determine the effect of the simulated natural environments in virtual reality and 2D video and their differences in reducing stress. This study hypothesizes that both simulated natural environments in virtual reality and 2D video can reduce stress, but there is a difference between them in reducing stress. Fifty-three subjects were divided into two experimental groups: 2D video (n = 28) and virtual reality (n = 25). The results indicated that simulated natural environments in virtual reality and 2D video reduced stress. However, there was no difference between the two groups regarding stress reduction.

Adolescents' Out-of-School Physical Activity Levels and Well-Being during the COVID-19 Restrictions in Greece: A Longitudinal Study

The present study aimed to identify the impact of social distancing measures on adolescents' physical activity (PA) levels and well-being during the implementation of COVID-19 restrictive measures. There were 438 participants (207 boys and 231 girls), aged 12 to 15 years old (M = 13.5, SD = 0.55). They completed online questionnaires on well-being and PA in three waves (December 2020, February 2021, and June 2021). Correlation analyses were conducted to examine the relationship between well-being and PA variables in the three measurements. Additionally, separate three-way repeated-measures ANOVAs were conducted to capture possible differences in students' moderate to vigorous physical activity (MVPA) levels, life satisfaction, and subjective vitality among the three measurements due to gender, age, and interaction between gender and age. A significant relation emerged between the MVPA variables and well-being. In all measurements, adolescents' PA levels did not meet the World Health Organization (WHO) recommendations of at least 60 min per day in MVPA. Students' MVPA levels, life satisfaction, and subjective vitality were significantly higher in the third measurement compared to the first and second ones. Moreover, significant differences emerged in life satisfaction and subjective vitality between boys and girls in the first and third measurements, respectively. The COVID-19 restrictions appeared to negatively influence adolescents' PA and well-being. Policymakers aimed at facilitating adolescents' well-being in a similar situation in the future should not adopt measures restricting the participation of adolescents in PA.

Built environment factors moderate pandemic fatigue in social distance during the COVID-19 pandemic: A nationwide longitudinal study in the United States

Non-pharmaceutical interventions (NPIs) remain some of the most effective measures for coping with the ever-changing coronavirus disease 2019 (COVID-19) pandemic. Pandemic fatigue, which manifests as the declined willingness to follow the recommended protective behaviors (e.g., keeping social distance policies, wearing masks), has commanded increasing attention from researchers and policymakers after the prolonged NPIs and COVID-19 worldwide. However, long-term changes in pandemic fatigue are not well understood, especially amidst the ever-changing pandemic landscape. Built environment factors have been shown to positively affect mental and physical health, but it is still unclear whether built environments can moderate pandemic fatigue. In this study, we used Google mobility data to investigate longitudinal trends of pandemic fatigue in social distance since the onset of NPIs enforcement in the United States. The results indicated that pandemic fatigue continuously worsened over nearly two years of NPIs implementation, and a sharp increase occurred after the vaccination program began. Additionally, we detected a significant moderation effect of greenspace and urbanicity levels on pandemic fatigue. People living in areas with high levels of greenness or urbanicity experienced lower levels of pandemic fatigue. These findings not only shed new light on the effects of greenness and urbanicity on COVID-19 pandemic fatigue, but also provide evidence for developing more tailored and effective strategies to cope with pandemic fatigue.

The Mediating Role of Perceived Comfort between Workplace Attachment Style and Perceived Stress

Past studies highlight the relevance of attachment theory to the study of workplace stress and the impact of employee assessments about the physical-spatial work environment on their health. This paper is one of a number of works studying the points of connection between Bowlby's attachment theory and the place attachment theory adopted by environmental psychologists. We proposed that a secure workplace attachment style would be negatively associated with perceived stress (and vice versa for insecure workplace attachment styles). Perceived comfort was hypothesized to mediate these effects. A convenience sample of French white-collar workers (N = 379) completed an online survey. Hypotheses were tested using the PROCESS macro. Both insecure workplace attachment styles (i.e., avoidant and preoccupied) were negatively associated with perceived comfort, which partially mediated their positive effect on perceived stress. The preventive influence of a secure workplace attachment on perceived stress was entirely mediated by its positive effect on perceived comfort. By setting different expectations regarding the work environment, workplace attachment styles could translate into a more or less stressful and comfortable employee experience. The more secure the bond employees internalize with their workplace, the more they might benefit from its comforts' restorative potential.

Understanding Connections between Nature and Stress among Conservation-Engaged Adolescents Using Photovoice Methodology

While the literature supports positive associations between nature and adolescent mental health, mechanisms are not well understood, and assessment of nature varies widely among existing studies. To partner with the most insightful informants, we enrolled eight adolescent participants from a conservation-informed summer volunteer program, applying qualitative photovoice methodology to understand their use of nature to relieve stress. Across five group sessions, participants identified four themes: (1) Nature shows us different aspects of beauty; (2) nature helps us relieve stressful experiences by balancing our senses; (3) nature gives us space to find solutions; and (4) we want to find time to enjoy nature. At the conclusion of the project, youth participants reported that the research experience was overwhelmingly positive, enlightening, and inspired appreciation of nature. We found that, while our participants unanimously reported that nature relieved their stress, prior to this project, they were not always intentional in seeking time in nature for this purpose. Through the photovoice process, these participants noted the usefulness of nature for stress relief. We conclude with recommendations for leveraging nature to decrease adolescent stress. Our findings are relevant for families, educators, students, healthcare professionals, and anyone who works with or cares for adolescents.

Enjoyed by Jack but Endured by Jill: An Exploratory Case Study Examining Differences in Adolescent Design Preferences and Perceived Impacts of a Secondary Schoolyard

The school grounds provide students opportunities for respite, relaxation and relief from daily stresses during breaks in the school day. However, it is unclear whether secondary schoolyard designs adequately support the diverse and evolving needs of adolescents, particularly at a time when they are experiencing rapid emotional and physical developmental change. To investigate this, quantitative methods were used to explore differences in perceptions of schoolyard attractiveness and restorative quality based on student gender and year level. A school-wide survey was administered to approximately 284 students in years 7 to 10 at a secondary school in Canberra, Australia. Results indicate significant declines in student perceptions of schoolyard attractiveness and restorative quality. Higher ratings of schoolyard likeability, accessibility, personal connection and restorative quality of 'being away' were associated with male students across all year levels. Further work is needed to explore how schoolyard environments can better support the design preferences and well-being needs of older and female students. Such information would help planners, designers and land managers develop schoolyard designs that are more equitable in their benefits to secondary school students of different genders and year levels.

Onsite restorative effect of a rural ecological farm versus an urban public greenery space

Accessible urban greenery allows short breaks and leisure activities while experiencing nature. Studies have shown that contact with nature elicits psychological and physical health benefits. However, the immediate impact and influence of exposure to artificial versus rural ecological nature have yet to be examined. This study investigates their psychophysiological restorative effects onsite, specifically when individuals view a ubiquitous urban public greenery space or a more indigenous ecological forest-like nature area, to compare levels of restorativeness and relaxation. Participants were asked to sit and view a scene onsite for 6 min while their facial muscle tension was recorded. The data were used to evaluate the degree of facial relaxation for both scenes. In addition, participant self-reports measured perceived restorativeness after the 6-min period. The self-reported data showed that the ecological farm scene was rated significantly higher for perceived restorativeness (t [49.136] = 9.094, p < .001) after 6 min of viewing. The muscle tension analysis showed that facial tension significantly declined when participants viewed the farm scene compared to the urban greenery space. These results, especially those on the farm, show that nature with more forest-like and rural elements elicited more powerful restorative effects and significantly lowered facial muscle tension (t [65] =  − 2.785, p < .05), thus verifying that a more ecological nature landscape provides immediate, significant health benefits through attention recovery and reduced facial muscle stress.