Levels of Nature and Stress Response

Current methodologies of greenspace exposure and mental health research-a scoping review

Introduction

Greenspaces can provide an important resource for human mental health. A growing body of literature investigates the interaction and the influence of diverse greenspace exposures. In order to gain a comprehensive understanding of the complex connection between greenspace and mental health, a variety of perspectives and methodological combinations are needed. The aim of this review is to assess the current methodologies researching greenspace and mental health.

Methods

A scoping review was conducted. Four electronic databases (Pubmed, Embase, PsycInfo, Web of Science) were searched for relevant studies. A wide range of greenspace and mental health keywords were included to provide a comprehensive representation of the body of research. Relevant information on publication characteristics, types of greenspaces, mental health outcomes, and measurements of greenspace exposure and mental health was extracted and assessed.

Results

338 studies were included. The included studies encompassed a multitude of methods, as well as outcomes for both greenspace and mental health. 28 combinations were found between seven categories each for greenspace and mental health assessment. Some pairings such as geoinformation systems for greenspace assessment and questionnaires investigating mental health were used much more frequently than others, implying possible research gaps. Furthermore, we identified problems and inconsistences in reporting of greenspace types and mental health outcomes.

Discussion

The identified methodological variety is a potential for researching the complex connections between greenspace and mental health. Commonly used combinations can provide important insights. However, future research needs to emphasize other perspectives in order to understand how to create living environments with mental health benefits. For this purpose, interdisciplinary research is necessary.

Topoisomerase 1 Activity Is Reduced in Response to Thermal Stress in Fruit Flies and in Human HeLa Cells

In the modern world with climate changes and increasing pollution, different types of stress are becoming an increasing challenge. Hence, the identification of reliable biomarkers of stress and accessible sensors to measure such biomarkers are attracting increasing attention. In the current study, we demonstrate that the activity, but not the expression, of the ubiquitous enzyme topoisomerase 1 (TOP1), as measured in crude cell extracts by the REEAD sensor system, is markedly reduced in response to thermal stress in both fruit flies (Drosophila melanogaster) and cultivated human cells. This effect was observed in response to both mild-to-moderate long-term heat stress and more severe short-term heat stress in D. melanogaster. In cultivated HeLa cells a reduced TOP1 activity was observed in response to both cold and heat stress. The reduced TOP1 activity appeared dependent on one or more cellular pathways since the activity of purified TOP1 was unaffected by the utilized stress temperatures. We demonstrate successful quantitative measurement of TOP1 activity using an easily accessible chemiluminescence readout for REEAD pointing towards a sensor system suitable for point-of-care assessment of stress responses based on TOP1 as a biomarker.

Ecological Momentary Assessment of Midlife Adults' Daily Stress: Protocol for the Stress Reports in Variable Environments (STRIVE) App Study

BACKGROUND

Daily stressors are associated with cognitive decline and increased risk of heart disease, depression, and other debilitating chronic illnesses in midlife adults. Daily stressors tend to occur at home or at work and are more frequent in urban versus rural settings. Conversely, spending time in natural environments such as parks or forests, or even viewing nature-themed images in a lab setting, is associated with lower levels of perceived stress and is hypothesized to be a strong stress "buffer," reducing perceived stress even after leaving the natural setting. However, many studies of daily stress have not captured environmental contexts and relied on end-of-day recall instead of in-the-moment data capture. With new technology, these limitations can be addressed to enhance knowledge of the daily stress experience.

OBJECTIVE

We propose to use our novel custom-built Stress Reports in Variable Environments (STRIVE) ecological momentary assessment mobile phone app to measure the experience of daily stress of midlife adults in free-living conditions. Using our app to capture data in real time will allow us to determine (1) where and when daily stress occurs for midlife adults, (2) whether midlife adults' daily stressors are linked to certain elements of the built and natural environment, and (3) how ecological momentary assessment measurement of daily stress is similar to and different from a modified version of the popular Daily Inventory of Stressful Events measurement tool that captures end-of-day stress reports (used in the Midlife in the United States [MIDUS] survey).

METHODS

We will enroll a total of 150 midlife adults living in greater Indianapolis, Indiana, in this study on a rolling basis for 3-week periods. As those in underrepresented minority groups and low-income areas have previously been found to experience greater levels of stress, we will use stratified sampling to ensure that half of our study sample is composed of underrepresented minorities (eg, Black, American Indian, Hispanic, or Native Pacific Islanders) and approximately one-third of our sample falls within low-, middle-, and high-income brackets.

RESULTS

This project is funded by the National Institute on Aging from December 2022 to November 2024. Participant enrollment began in August 2023 and is expected to finish in July 2024. Data will be spatiotemporally analyzed to determine where and when stress occurs for midlife adults. Pictures of stressful environments will be qualitatively analyzed to determine the common elements of stressful environments. Data collected by the STRIVE app will be compared with retrospective Daily Inventory of Stressful Events data.

CONCLUSIONS

Completing this study will expand our understanding of midlife adults' experience of stress in free-living conditions and pave the way for data-driven individual and community-based intervention designs to promote health and well-being in midlife adults.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/51845.

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

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

Cardiovascular, self-report, and behavioral stress reactivity to the group-based Trier Social Stress Test with pandemic-related protocol adaptations

Research using stress induction protocols such as the Trier Social Stress Test (TSST) and the TSST for groups (TSST-G) during the coronavirus disease (COVID-19) pandemic has been challenging. While institutional review boards have provided guidance on returning to face-to-face research using COVID-19 adaptations (e.g., masking, social distancing), whether these adaptations influence the effectiveness of social-evaluative stress induction remains unknown. We conducted a secondary data analysis from a randomized controlled trial to establish whether using COVID-19 adaptations (i.e., masking, social distancing, and using a single large conference room for the duration of the experiment) to the TSST-G protocol was able to reliably induce stress across cardiovascular, self-report, and behavioral indices of stress. Young adults (N = 53) underwent the TSST-G with COVID-19 adaptations. We measured systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), self-reported, and behavioral responses to the TSST-G, and all variables indicated successful stress induction. Increases in SBP (18 mmHg) and DBP (14 mmHg) were similar in magnitude as those in standard in-person TSST protocols. Increases in HR (9 beats per minute) were smaller in magnitude than standard in-person TSST protocols, but slightly larger than increases documented in remote TSST protocols. The cardiovascular, self-report, and behavioral indices of stress reactivity provide confidence in the effectiveness of TSST-G with COVID-19 adaptations to reliably induce stress. In-person TSST protocols with COVID-19 adaptations represent an alternate option to remote TSST protocols for stress induction researchers to use during times when masking or social distancing are necessary.

Improving animal welfare status and meat quality through assessment of stress biomarkers: A critical review

Stress induces various physiological and biochemical alterations in the animal body, which are used to assess the stress status of animals. Blood profiles, serum hormones, enzymes, and physiological conditions such as body temperature, heart, and breathing rate of animals are the most commonly used stress biomarkers in the livestock sector. Previous exposure, genetics, stress adaptation, intensity, duration, and rearing practices result in wide intra- and inter-animal variations in the expression of various stress biomarkers. The use of meat proteomics by adequately analyzing the expression of various muscle proteins such as heat shock proteins (HSPs), acute phase proteins (APPs), texture, and tenderness biomarkers help predict meat quality and stress in animals before slaughter. Thus, there is a need to identify non-invasive, rapid, and accurate stress biomarkers that can objectively assess stress in animals. The present manuscript critically reviews various aspects of stress biomarkers in animals and their application in mitigating preslaughter stress in meat production.

Effects of Acoustic Environment Types on Stress Relief in Urban Parks

Urban public space environments are critical to the health of residents. In previous studies on urban park environments and health, landscape environment questionnaires have been the main method to evaluate the environmental quality and comfort of urban parks. The research on sound perception also focuses on the exploration of evaluation methods and evaluation indicators; there is little objective empirical evidence in these studies. To further explore the nature of the health role of urban parks, this study started with the sound types of urban parks, based on a field survey, combined the electrocardiogram (ECG) index with the sound type of the park through a portable intelligent device, and HR and RMSSD were selected as the ECG indicators to evaluate the stress relief status. The regression model between the type of acoustic environments and the ECG data was established through the analysis of relevant data. This paper tries to improve the physiological recovery benefit and influence mechanism of sound types in urban parks from an objective point of view and puts forward reasonable suggestions to improve the sound environment in urban parks. The preliminary results show that, in a short time frame, natural sound has a strong relieving effect on mental pressure, while mechanical sound has an obvious impediment effect on the recovery of mental pressure. The results also reveal that the human voice has no obvious impediment effect, and changes in wind and broadcast sound have little impact on the recovery of mental pressure.

Stress Concepts and Applications in Various Matrices with a Focus on Hair Cortisol and Analytical Methods

When studying stress in animals, it is important to understand the types of stress and their classification, and how to assess the stress levels in different animal species using different matrices accurately and precisely. The classification of stress types helps to distinguish between good stress (eustress) and bad stress (distress). Hence, first, it is crucial to assess the animal's level of stress in a non-intrusive manner and second to identify the type of stress that is best suited to its environment. Third, it is also important to analyze the obtained samples using a suitable method to increase the validity of stress hormone measurements. Therefore, in this review, we aim to: (1) explain the classification of stress, (2) discuss the wide range of body matrices (e.g., saliva, milk, hair, urine, feces, sweat, fins, etc.) that can be used as samples to evaluate stress levels, as well as their comparisons and limitations, and present the reliable matrices for measuring stress hormones with special emphasis on hair, (3) compare the analytical methods for measuring stress hormones after sample preparation. Despite some literature that does not include hair as a reliable matrix for evaluating stress levels, hair is one of the matrices for measuring long-term stress hormone accumulations. This review discusses some factors that influence the level of stress hormones in the hair. By understanding these issues, the scientific community will not only be able to improve the understanding of stress and biomarker evaluation but also suggest how to deal with the consequences of stress in future research.

A one-hour walk in nature reduces amygdala activity in women, but not in men

Urban dwellers are more likely to develop mental disorders such as mood and anxiety disorder as well as schizophrenia compared to rural dwellers. Moreover, it has been demonstrated that even short-term exposure to nature can improve mood and decrease stress, but the underlying neural mechanisms are currently under investigation. In the present intervention study we examined the effects of a one-hour walk in an urban vs. natural environment on activity in the amygdala, a brain region previously associated with stress processing. Before and after the walk 63 participants underwent an fMRI paradigm inducing social stress. Since there is a pronounced gap in the literature regarding interindividual differences in stress-related neural effects of urban and natural environments, we set out to explore sex differences. We observed that amygdala activity decreased after the walk in nature, but only in women, suggesting that women may profit more from salutogenic effects of nature. Moreover, performance on the arithmetic tasks improved in women after the walk in nature, whereas men performed better after the walk in the urban environment. To our knowledge, this is the first study to report differencial tendencies in men and women concerning the stress-related neural activity as an effect of acute exposure to urban vs. natural environments. Furthermore, our findings highlight the importance of sex differences when exploring effects of the environment on brain function and stress. Evidence for beneficial effects of nature on stress-related brain regions may inform urban design policies to focus on providing more accessible green areas in cities and this study suggests that sex differences in experiencing the environment should be taken into consideration.

Identification and Characterization of Elevated Expression of Transferrin and Its Receptor TfR1 in Mouse Models of Depression

Depression has become one of the severe mental disorders threatening global human health. In this study, we first used the proteomics approach to obtain the differentially expressed proteins in the liver between naive control and chronic social defeat stress (CSDS) induced depressed mice. We have identified the upregulation of iron binding protein transferrin (TF) in the liver, the peripheral blood, and the brain in CSDS-exposed mice. Furthermore, bioinformatics analysis of the Gene Expression Omnibus (GEO) database from various mouse models of depression revealed the significantly upregulated transcripts of TF and its receptor TfR1 in multiple brain regions in depressed mice. We also used the recombinant TF administration via the tail vein to detect its permeability through the blood-brain barrier (BBB). We demonstrated the permeability of peripheral TF into the brain through the BBB. Together, these results identified the elevated expression of TF and its receptor TfR1 in both peripheral liver and the central brain in CSDS-induced depressed mice, and peripheral administration of TF can be transported into the brain through the BBB. Therefore, our data provide a compelling information for understanding the potential role and mechanisms of the cross-talk between the liver and the brain in stress-induced depression.

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.

Environmentally related gender health risks: findings from citizen science cross-sectional study

Background

Public engagement in the research of environmental epidemiological problems is becoming an important measure to empower citizens to identify the local environmental and health problems and to explain different environmental exposures affect estimates for males and females. This HORIZON2020 CitieS-Health Kaunas Pilot study examines the relationship between urban built and social environment, health behaviors, and health in men and women.

Methods

This cross-sectional study included 1086 18–74-year-old participants residing in 11 districts of Kaunas city, Lithuania. Using GIS, we measured traffic flow, noise, NO2, PM2.5, PM10, and greenness NDVI for the participants’ home addresses, determined participants’ perceptions of environmental quality, linked this information with personal sociodemographic data, and used multivariate logistic regression to assess the associations with health issues (physician-diagnosed chronic disease and self-rated general health) in men and women.

Results

Men and women similar rated the quality of the neighborhood environment, except for air pollution and satisfaction with the public transport in the district. The traffic-related health associations were stronger for women than for men. The prevalence of poor health increased with the increasing age of men and women, yet no significant differences between gender health risks were found in the total sample. Perceived air pollution, irregular visits to green space, and chronic diseases were consistently associated with poor health risks in men and women, yet part-time jobs and low income had a higher impact on women’s poor health.

Conclusions

Quality of the built neighborhood, air pollution, irregular visits to the green space, and chronic disease had a joint effect on the magnitude of the prevalence of poor health in men and women. Our results suggest that decreasing air pollution and improving the urban built neighborhood supporting citizens’ physical activity in green spaces, might reduce health risks for all.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13824-3.

Selection of appropriate biomatrices for studies of chronic stress in animals: a review

Cortisol and corticosterone, hormones traditionally considered biomarkers of stress, can be measured in fluid biomatrices (e.g., blood, saliva) from live animals to evaluate conditions at sampling time, or in solid biomatrices (e.g., hair, feather) from live or dead animals to obtain information regarding long-term changes. Using these biomarkers to evaluate physiological stress responses in domestic animals may be challenging due to the diverse characteristics of biomatrices for potential measurement. Ideally, a single measurement from the biomatrix should be sufficient for evaluating chronic stress. The availability of appropriate and cost-effective immunoassay methods for detecting the biomarkers should also be considered. This review discusses the strengths and limitations of different biomatrices with regard to ensuring the highest possible reliability for chronic stress evaluation. Overall, solid biomatrices require less frequent sampling than other biomatrices, resulting in greater time- and cost-effectiveness, greater ease of use, and fewer errors. The multiplex immunoassay can be used to analyze interactions and correlations between cortisol and other stress biomarkers in the same biomatrix. In light of the lack of information regarding appropriate biomatrices for measuring chronic stress, this review may help investigators set experimental conditions or design biological research.

Human Health and Outdoor Adventure Recreation: Perceived Health Outcomes

Forests and similar types of landscapes offer a myriad of outcomes and benefits often associated with participation in outdoor adventure recreation (OAR) activities. Previous research has shown that OAR participants are able to identify, perceive, and accurately report the effects and benefits of their participation. The health benefits of outdoor experiences, both active and more passive, have received a growing research interest, both as a setting and as a setting/activity complex. Research has identified six primary forms of health and well-being from outdoor and forest-type landscapes, including emotional, environmental, intellectual, social, spiritual, and physical. The preponderance of research in the health and wellness field synthesizes these forms into two primary categories, physical/physiological and mental/psychological. This study considered the health outcomes attributed to highly active OAR participation using three popular OAR activities: mountain biking (MTB), rock climbing (RC) and whitewater paddling (WW; including whitewater kayaking, whitewater canoeing, and whitewater rafting). A survey presented in situ to OAR participants in various areas of the Midwestern and Southeastern United States yielded 288 respondents. Using health perceptions and outcomes instruments as well as semi-structured interviews, the researchers found health to be an important factor for OAR participation. These findings are congruent with previous research that suggest that OAR participants specifically recreate in forested and other natural areas for enhanced physical and psychological health outcomes. The findings in this study also support the efficacy of the participation in OAR activities toward supporting both health improvement and maintenance. With physical and psychological health continuing to be an area of concern in today’s world, this study suggests that participation in OAR on forested and similar landscapes can be a successful health intervention strategy.

Evaluation of Sweat-Sampling Procedures for Human Stress-Biomarker Detection

Sweat is a potential biological fluid for the non-invasive analytical assessment of diverse molecules, including biomarkers. Notwithstanding, the sampling methodology is critical, and it must be assessed prior to using sweat for clinical diagnosis. In the current work, the analytical methodology was further developed taking into account the sampling step, in view of the identification and level variations of sweat components that have potential to be stress biomarkers using separation by liquid chromatography and detection by tandem mass spectrometry, in order to attain a screening profile of 26 molecules in just one stage. As such, the molecule identification was used as a test for the evaluation of the sampling procedures, including the location on the body, using patches for long-term sampling and vials for direct sampling, through a qualitative approach. From this evaluation it was possible to conclude that the sampling may be performed on the chest or back skin. Additionally, possible interference was evaluated. The long-term sampling with patches can be used under both rest and exercise conditions with variation of the detected molecule’s levels. The direct sampling, using vials, has the advantage of not having interferences but the disadvantage of only being effective after exercise in order to have enough sample for sweat analysis.

Perceived stress and its predictors in women with threatened preterm labour: A cross-sectional study

AIM

To determine prevalence and predictors of perceived stress in women with threatened preterm labour.

DESIGN

Cross-sectional.

METHODS

We recruited 409 women with threatened preterm labour, hospitalized at two tertiary hospitals. We assessed their socio-demographic and obstetrics characteristics, and their perceived stress, perceived social support, experience of violence using validated scales. Multiple linear regression was used to determine the predictors.

RESULTS

Data from all recruited women were analysed. Most of them had borderline (36%) or high (42%) level stress. Overall, 17 predictors were identified explaining 89.5% of variation in the stress score. Predictors of the higher stress score included: urban living, experience of sexual and psychological violence, perceived insufficient social support, experience of vaginal bleeding during current pregnancy, abnormal results in initial pregnancy tests, having multiple roles at home, being less than 28 weeks pregnant, being parous, sleep disorders, history of health problems, insufficient income and unwanted pregnancy.

Lifelong exposure to residential greenspace and the premenstrual syndrome: A population-based study of Northern European women

BACKGROUND

The premenstrual syndrome (PMS) causes clinically relevant psychological and physical symptoms in up to 20% of women of reproductive age. To date, no studies have investigated the relationship between PMS and residential surrounding greenspace, although a green living environment has been reported to have beneficial associations with overall and reproductive health.

OBJECTIVE

To investigate whether lifelong exposure to residential surrounding greenspace is associated with PMS and whether such an association is mediated by BMI, air pollution or physical activity.

METHODS

This study used data collected in 2013-2015 from 1069 Scandinavian women aged 18-49 years, participating in RHINESSA, a European multi-centre and population-based cohort. Satellite-derived Normalised Difference Vegetation Index was used as a proxy of greenspace. Presence of eight common PMS symptoms and their sum (PMS symptom count) were used as outcomes. The associations were assessed by adjusted multilevel logistic and negative binomial regressions. Subsequently we carried out mediation analyses for physical activity, BMI and air pollution exposure.

RESULTS

Higher exposure to residential surrounding greenspace was associated with "Anxiety or tension" (Odds Ratio 0.82, 95% Confidence Interval (CI): 0.70 - 0.95), "Depression or hopelessness" (0.84, 0.73 - 0.98), "Difficulty with sleeping" (0.82, 0.68 - 1.00) and "Breast tenderness and abdominal bloating" (0.84, 0.71 - 0.99) before or around the start of the menstrual period. There was also an association with a lower PMS symptom count (Risk Ratio: 0.94, 95% CI: 0.91 - 0.99). These associations were robust to sensitivity analyses and were not mediated by BMI, physical activity or air pollution.

CONCLUSIONS

Living in greener areas may be beneficial against PMS symptoms. Further studies are needed to confirm these novel findings and to explore the underlying biological mechanisms.

Behavioral economics of substance use: Understanding and reducing harmful use during the COVID-19 pandemic

Behavioral economic research demonstrates that alcohol and drug consumption is (a) an inverse function of constraints on access to the substance and (b) a direct function of constraints on access to alternative rewards. Physical distancing interventions and economic consequences of the COVID-19 pandemic have resulted in unprecedented reductions in many of the constraints on substance use and in critical evolutionarily salient sources of alternative reward, such as social interaction, physical activity, leisure activities and hobbies, and academic and occupational pursuits. Thus, behavioral economics suggests that the pandemic and necessary public health response have created a "perfect storm" for exacerbation of individual-level and population-level substance use problems and also points to multilevel intervention strategies. We summarize this perspective and research by highlighting 3 critical behavioral processes that will influence drug and alcohol consumption. First, the sudden absence of many effective constraints on substance use (work, school, community, or service obligations) will reduce the actual and perceived cost of use. Second, physical distancing measures will reduce the availability, and increase the cost, of many rewarding substance-free activities and commodities. Third, increased uncertainty around current and future events increases discounting of delayed rewards. These effects will be especially pernicious among populations with existing health disparities. Next, we outline interventions suggested by behavioral economics to mitigate the impact of COVID-19 on substance use that are aimed at increasing perceived costs of use; increasing access to substance-free activities, including treatment; and lengthening the timeframe for behavioral allocation and altering environmental contexts to promote healthy choices. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Role of Social Context in Physiological and Psychological Restoration in a Forest: Case Study of a Guided Forest Therapy Program in Taiwan

Existing studies have demonstrated the restorative benefits of being in forests. However, most studies have designed participants to engage individually in forest walking and viewing, which neglects the social aspect of conversation. Researchers suggested that social context should be studied in order to have a better understanding how forests foster human health. To this end, we examined the role of social context using three types of forest therapy programs: a guided program, a self-guided program, and a walk alone program. A between-subject, pretest–posttest field experimental design was employed to evaluate restorative effects by measuring the physiological responses and mood states incurred in different forest therapy programs. Our findings showed, that the walk alone group exhibited a significant systolic blood pressure decrease and a significant increase in sympathetic nervous activity; the self-guided group showed a significant increase in heart rate values and significant decreases in systolic blood pressure and diastolic blood pressure; and the guided group revealed a significant decrease in systolic blood pressure. Further, the three forest therapy programs had positive effects on improving mood states, except a nonsignificant vigor–activity increase in the walk alone group. The three programs did not exhibit significant differences in changes of restorative benefits in physiological and psychological measures except for a significant difference in changes in sympathetic nervous activity between the walk alone group and guided group. The results showed the restorative benefits of forest therapy are apparent regardless of the program type. The management team should continue promoting forest therapy for public health by providing different types of forest therapy programs and experiences.

Get Outside! Promoting Adolescent Health through Outdoor After-School Activity

BACKGROUND

The Get Outside: After School Activity Program (GO-ASAP) exemplifies how a rural community can utilize its natural resources and community partnerships to promote adolescent health.

METHODS

A qualitative descriptive inquiry was conducted using convenience sampling. Data were collected from students (n = 13/2018; n = 13/2019) via focus group and art-based method (2018 only) and parent (n = 6/2018) focus group. Data were analyzed via qualitative content analysis using the applied theoretical frameworks of Social Cognitive Theory and Social Determination Theory.

RESULTS

(1) Increasing Health-Related Competencies. Students increased their physical activity, improved their sleep, perceived less stress, and reported changes in dietary habits and electronic use. (2) Increasing Social Relatedness. Students made new friends, felt more connected, and spent less time home alone after school. (3) Increasing Autonomy and Intrinsic Motivation. Students recognized their emerging capabilities, and their increased confidence stimulated more action-oriented behavior. Parent-perceived changes support and mirror student reports.

CONCLUSION

Outdoor, nature-based, activity programs are a novel upstream approach to promote adolescent health, especially in rural communities where natural resources often exceed health-service resources and community partnerships are a way of life.

Green nature effect on stress response and stress eating in the lab: Color versus environmental content

INTRODUCTION

It is still unclear which green nature aspects can counteract psychosocial stress: the green color or rather the environmental content (=nature). Since stress is often stimulating excess/unhealthy food intake, we hypothesize that green nature also buffers stress-induced eating. This study analyzed the effects of green/nature pictures on restorativeness, stress reactivity/response and stress eating in the lab.

METHODS

Before (5min) and after (8min) the Trier Social Stress Test, 81 participants (82% women, 19-30y) saw one of the four slideshows with nature or urban environments in green or black-white shades. Group differences were tested on Perceived Restorativeness Scale, five repeated measures of heart rate variability (HRV), salivary cortisol and mood, food wanting and snack buffet consumption.

RESULTS

The four groups did not differ in background and baseline values. Reported restorative power was higher in the nature pictures than urban pictures with an even better attentional/happiness restoration capacity for green versus black-white nature, while green urban pictures might induce more stress feelings than black-white urban pictures. The stress time patterns confirmed successful stress induction. Most consistent during stress induction was a higher happiness recovery in the green nature group. Nature overall was somewhat beneficial compared to urban pictures by lower HRV and negative emotions reactivity, although this might be due to unfavorable effects of green urban pictures. In food intake or wanting, no differences existed.

CONCLUSION

Nature pictures were estimated higher in restorative power and green nature pictures had a positive effect on happiness recovery. Thus for prevention, the environmental content (=nature) as such seems important while just a green color seemed not enough. Future research should examine the effect of green nature in realistic indoor settings and consider influence on fruit/vegetable intake instead of solely snacks.

Modulation of attention and stress with arousal: The mental and physical effects of riding a motorcycle

Existing theories suggest that moderate arousal improves selective attention, as would be expected in the context of competitive sports or sensation-seeking activities. Here we investigated how riding a motorcycle, an attention-demanding physical activity, affects sensory processing. To do so, we implemented the passive auditory oddball paradigm and measured the EEG response of participants as they rode a motorcycle, drove a car, and sat at rest. Specifically, we measured the N1 and mismatch negativity to auditory tones, as well as alpha power during periods of no tones. We investigated whether riding and driving modulated non-CNS metrics including heart rate and concentrations of the hormones epinephrine, cortisol, DHEA-S, and testosterone. While participants were riding, we found a decrease in N1 amplitude, increase in mismatch negativity, and decrease in relative alpha power, together suggesting enhancement of sensory processing and visual attention. Riding increased epinephrine levels, increased heart rate, and decreased the ratio of cortisol to DHEA-S. Together, these results suggest that riding increases focus, heightens the brain's passive monitoring of changes in the sensory environment, and alters HPA axis response. More generally, our findings suggest that selective attention and sensory monitoring seem to be separable neural processes.

The Effects of Open Space on Reducing Workplace Stress: Case Study of Business Park in the Post-Socialist Urban Setting

Working people spend around 54% of their waking hours at a workplace, according to recent statistics. Work-related stress is unavoidable, and it can damage the health of employees and affect business performance. In this paper, we argue that open space inside the workplace environment can have a positive influence on reducing overall stress levels in all the categories of users. To our knowledge, there is a significant lack of research considering specific business districts and the gated complexes called business parks, especially in post-socialist Eastern European cities, where there they are still a novelty. Empirical research in this study is on the single case study of Business Park “Airport city” in Belgrade, Serbia. Its main focus is on the survey conducted with 235 participants based on a questionnaire, which examines the relation between workplace stress and workplace environments. The findings from the questionnaire show that the frequency, duration, and activity of open space usage influence the stress levels of employees in this specific workplace, while it is not visible relating to their age and gender. Additionally, final implications suggest that improved open space, such as well-expected greenery, but also the urban design non-associative to workspace and the socialization and exercise amenities customized for frequent and short work breaks, can facilitate the overall well-being of employees. They are innovative elements in relatively underdeveloped research on stress measures with open space usage characteristics in the specific (gated) workplace setting.

Synthesis of Novel 2-(Isopropylamino)thiazol-4(5H)-one Derivatives and Their Inhibitory Activity of 11β-HSD1 and 11β-HSD2 in Aspect of Carcinogenesis Prevention

Glucocorticoid metabolism at the tissue level is regulated by two isoenzymes 11β-hydroxysteroid dehydrogenase (11β-HSD), which mutually convert biologically active cortisol and inactive cortisone. Recent research is focused on the role of 11β-HSD1 and 11β-HSD2 as autocrine factors of tumor cell proliferation and differentiation. Herein, we report the synthesis of novel 2-(isopropylamino)thiazol-4(5H)-one derivatives and their inhibitory activity for 11β-HSD1 and 11β-HSD2. The derivative containing the spiro system of thiazole and cyclohexane rings shows the highest degree of 11β-HSD1 inhibition (54.53% at 10 µM) and is the most selective inhibitor of this enzyme among the tested compounds. In turn, derivatives containing ethyl and n-propyl group at C-5 of thiazole ring inhibit the activity of 11β-HSD2 to a high degree (47.08 and 54.59% at 10 µM respectively) and are completely selective. Inhibition of the activity of these enzymes may have a significant impact on the process of formation and course of tumors. Therefore, these compounds can be considered as potential pharmaceuticals supporting anti-cancer therapy.

The association between natural outdoor environments and common somatic symptoms

There is growing evidence that urban natural outdoor environments (NOE) may positively impact health by reducing stress and stress-related symptoms. However, there is limited research investigating this link across a range of NOE indicators. This cross-sectional study investigated the association between neighbourhood NOE (availability, use, and satisfaction with NOE) and common somatic symptoms and the role of potential mediators. Data were analysed from 3481 adults from Barcelona (Spain), Doetinchem (Netherlands), Kaunas (Lithuania) and Stoke-on-Trent (United Kingdom). NOE data were obtained through self-reported data and environmental measurements. Common somatic symptom data were self-reported. Mixed effects regression models were used for analysis, with models adjusted for potential sociodemographic confounders. Higher satisfaction with neighbourhood NOE was associated with lower prevalence of common somatic symptoms (exp(β) 0.97; 95% CI 0.96, 0.98); an association partially mediated by mental health, social cohesion and air quality concern. A longer time spent in NOE was associated with lower prevalence of common somatic symptoms in low socioeconomic status neighbourhoods (exp(β) 0.98; 95% CI 0.96, 1.00). A higher number of neighbourhood green spaces (300m buffer) was associated with higher prevalence of common somatic symptoms (exp(β) 1.03; 95% CI 1.00, 1.05). No statistically significant associations were found for other NOE indicators. Study findings suggest that higher satisfaction with NOE may be associated with lower prevalence of common somatic symptoms, with mental health, social cohesion and concern about air quality playing partial mediating roles. Little evidence was found of an association between objective NOE measurements and common somatic symptoms, underlining the importance of perceptions of NOE for conferring health benefits.

Peripheral Vestibular Disorders: Nationwide Evidence From Taiwan

OBJECTIVES/HYPOTHESIS

This study aimed to evaluate the prevalence of peripheral vestibular disorders in an Asian population of predominantly Han Chinese ethnicity.

STUDY DESIGN

Cross-sectional study.

METHODS

Patients with a peripheral vertigo disorder were identified from the Taiwan Health Insurance Research Database, a database of all medical claims of a randomly selected, population-representative sample of 2 million enrollees of Taiwan's National Health Insurance system covering over 99% of Taiwan's citizens. In 2016, 59,986 patients received a diagnosis of peripheral vestibular disorders in Taiwan. We calculated the population-wide prevalence rates of peripheral vestibular disorders in 2016 by sex and age group (20 to 24, 25 to 29, 30 to 34, 35 to 39, 40 to 44, 45 to 49, 50 to 54, 55 to 59, 60 to 64, 65 to 69, and ≥ 70 years) stratified into five urbanization levels.

RESULTS

The prevalence rate of peripheral vestibular disorders was 2,833.4 per 100,000 population during the year. Prevalence of Meniere's disease was 70.4 per 100,000, benign paroxysmal positional vertigo, 446.4, vestibular neuritis 307.2, and other or unspecified peripheral vestibular dizziness, 2,009.5 per 100,000. Prevalence rates steadily increased with age for every type of peripheral vestibular disorder, and were higher among females compared to males. The female-to-male gender ratios were 1.84, 1.89, and 1.93 for Meniere's disease, vestibular neuritis, and other peripheral vestibular dizziness, respectively. Counties with the lowest urbanization level had the highest prevalence rates of all types of peripheral vestibular disorders except vestibular neuritis.

CONCLUSIONS

Results showed that peripheral vestibular disorders are common in Taiwan, increase with age, are predominantly female, and show higher prevalence in rural areas.

LEVEL OF EVIDENCE

2b Laryngoscope, 131:639-643, 2021.

The health impact of nature exposure and green exercise across the life course: a pilot study

BACKGROUND

Both nature exposure and green exercise (GE) provide numerous health benefits. However, there are no studies examining the impact of childhood GE on adult health.

METHODS

45 healthy adults (aged 69.8 ± 8.4 years) took part in the study, wearing a Firstbeat heart rate variability (HRV) monitor for 24 hours. Participants also completed questionnaires assessing childhood and adulthood nature exposure and GE, as well as current connectedness to nature (CN), perceived stress and well-being. Pearson's correlations and linear regression were used to examine relationships between variables.

RESULTS

Childhood nature exposure and GE significantly predicted adult nature exposure and GE (β .317, p < 0.05) as well as CN (β = .831, p < 0.01). After controlling for childhood nature exposure and GE, CN was negatively associated with the percentage of stress over the 24-hour period (r = -.363; p < 0.05) and positively associated with HRV during sleep (r = .415; p < 0.05).

CONCLUSIONS

CN is important for adult health; however childhood nature exposure and GE are essential to developing this connection.

Outdoor Recreation, Nature-Based Tourism, and Sustainability

This Special Issue addresses the intersections of outdoor recreation, nature-based tourism, and sustainability. Outdoor recreation and nature-based tourism provide essential benefits to individuals, communities, and society and thereby contribute to sustainability. Equitable provision of opportunities, cultural variations in desired experiences, barriers to outdoor recreation, and diverse perceptions of both nature and recreation add to the complexity in outdoor recreation and nature-based tourism service delivery. Outdoor recreation and nature-based tourism occur within a socioecological system with feedback loops to changing social, economic, technological, and ecological conditions. On a global scale, climate change and other disturbance factors are impacting ecosystems and opportunities, increasing the importance of adaptation strategies for longer-term planning. Population growth and regional shifts in demographics and distribution (e.g., urbanization), as well as socioeconomic trends, affect who engages in outdoor recreation and nature-based tourism, opportunities sought, nature access, and governance of outdoor services. Overall the complexity of sustainable outdoor recreation and tourism may suggest a need for different approaches to service delivery, culture change among service providers and managers of natural spaces, and novel approaches to inclusive governance and shared stewardship. Given the clear importance of outdoor recreation and nature-based tourism to society, we invite you to consider this initial introduction to our assembled collection, which is meant to advance our understanding of the intersections of outdoor recreation, nature-based tourism, and sustainability.

Physiological and Psychological Effects of Viewing Urban Parks in Different Seasons in Adults

Although the health benefits of urban parks have gained significant attention, the effects of viewing park landscape on older adult residents have not commanded much research. This study aimed to investigate the physiological and psychological effects of viewing cherry blossoms in spring and fresh greenery in early summer at urban parks. The experiments were conducted in two viewing spots in the same park in Japan during different seasons, and included 12 participants in both spring (mean age, 66.4 ± 10.5 years) and summer (mean age, 65.75 ± 10.1 years). Participants sat and viewed an urban park and city landscape for 11-15 min. Blood pressure was measured before and after the seated viewing while heart rate was measured continuously. Then, they evaluated the psychological responses using the Profile of Mood States and State-Trait Anxiety Inventory. Viewing cherry blossoms and fresh greenery in urban parks led to lower blood pressure in spring and early summer than viewing city areas in spring and early summer. Moreover, the score of vigor-activity was significantly higher; tension-anxiety was significantly lower in spring; and the state-anxiety level was significantly lower in early summer. The results of this study suggest that viewing urban parks results in physiological and psychological relaxation.

Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values

Various internal and external factors negatively affect the homeostatic equilibrium of organisms at the molecular to the whole-body level, inducing the so-called state of stress. Stress affects an organism's welfare status and induces energy-consuming mechanisms to combat the subsequent ill effects; thus, the individual may be immunocompromised, making them vulnerable to pathogens. The information presented here has been extensively reviewed, compiled, and analyzed from authenticated published resources available on Medline, PubMed, PubMed Central, Science Direct, and other scientific databases. Stress levels can be monitored by the quantitative and qualitative measurement of biomarkers. Potential markers of stress include thermal stress markers, such as heat shock proteins (HSPs), innate immune markers, such as Acute Phase Proteins (APPs), oxidative stress markers, and chemical secretions in the saliva and urine. In addition, stress biomarkers also play critical roles in the prognosis of stress-related diseases and disorders, and therapy guidance. Moreover, different components have been identified as potent mediators of cardiovascular, central nervous system, hepatic, and nephrological disorders, which can also be employed to evaluate these conditions precisely, but with stringent validation and specificity. Considerable scientific advances have been made in the detection, quantitation, and application of these biomarkers. The present review describes the current progress of identifying biomarkers, their prognostic, and therapeutic values.

Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values

Various internal and external factors negatively affect the homeostatic equilibrium of organisms at the molecular to the whole-body level, inducing the so-called state of stress. Stress affects an organism's welfare status and induces energy-consuming mechanisms to combat the subsequent ill effects; thus, the individual may be immunocompromised, making them vulnerable to pathogens. The information presented here has been extensively reviewed, compiled, and analyzed from authenticated published resources available on Medline, PubMed, PubMed Central, Science Direct, and other scientific databases. Stress levels can be monitored by the quantitative and qualitative measurement of biomarkers. Potential markers of stress include thermal stress markers, such as heat shock proteins (HSPs), innate immune markers, such as Acute Phase Proteins (APPs), oxidative stress markers, and chemical secretions in the saliva and urine. In addition, stress biomarkers also play critical roles in the prognosis of stress-related diseases and disorders, and therapy guidance. Moreover, different components have been identified as potent mediators of cardiovascular, central nervous system, hepatic, and nephrological disorders, which can also be employed to evaluate these conditions precisely, but with stringent validation and specificity. Considerable scientific advances have been made in the detection, quantitation, and application of these biomarkers. The present review describes the current progress of identifying biomarkers, their prognostic, and therapeutic values.

Impact of Frequency of Visits and Time Spent in Urban Green Space on Subjective Well-Being

Exposure to green spaces can reduce the negative effects of stress. This study examines how frequency of visits and time spent in urban green spaces (UGS) affect urban dwellers’ subjective well-being. We also investigated the numbers of respondents visiting UGS, their primary motivation, and constraints on their ability to visit. Using quota sampling, an online survey was conducted of 400 residents of Daejeon City, South Korea. ANOVA results indicated no significant interactions between visit frequency and time spent in UGS. Respondents who had visited UGS within the past two weeks expressed higher positive and lower negative emotions than did non-visitors, regardless of visit frequency, and regular visitors showed higher general life satisfaction levels. These positive effects were confirmed by estimated structural equation models. However, the time spent in UGS did not affect emotions or life satisfaction in general. Heavy users mostly visited UGS to walk, and light/non-users cited the lack of urban green spaces near their home as the major constraint on visiting UGS. The estimated structural equation models clearly show positive effects from motivation and negative effects of constraints and access time to UGS on visit frequency. To improve urban dwellers’ subjective well-being, UGS should prioritize good walking environments and accessibility.

Sounds of Nature in the City: No Evidence of Bird Song Improving Stress Recovery

Noise from city traffic is one of the most significant environmental stressors. Natural soundscapes, such as bird songs, have been suggested to potentially mitigate or mask noise. All previous studies on masking noise use self-evaluation data rather than physiological data. In this study, while respondents (n = 117) watched a 360° virtual reality (VR) photograph of a park, they were exposed to different soundscapes and mild electrical shocks. The soundscapes—“bird song”, “bird song and traffic noise”, and “traffic noise”—were played during a 10 min recovery period while their skin conductance levels were assessed as a measure of arousal/stress. No significant difference in stress recovery was found between the soundscapes although a tendency for less stress in “bird song” and more stress in “traffic noise” was noted. All three soundscapes, however, significantly reduced stress. This result could be attributed to the stress-reducing effect of the visual VR environment, to the noise levels being higher than 47 dBA (a level known to make masking ineffective), or to the respondents finding bird songs stressful. Reduction of stress in cities using masking with natural sounds requires further studies with not only larger samples but also sufficient methods to detect potential sex differences.