Physiological Effects of Visual Stimulation with Forest Imagery

Mood and physiological effects of visual stimulation with images of the natural environment in individuals with depressive and anxiety disorders

BACKGROUND

Nature therapies are gaining attention as non-pharmacological treatments for depressive and anxiety disorders, but research on their effectiveness in patients is limited. This study investigates the mood-improving effects of visual stimulation with natural environmental images in patients with depressive and anxiety disorders.

METHODS

We conducted a randomized crossover comparison trial involving 60 right-handed adult participants with depressive or anxiety disorders and receiving outpatient treatment. Visual stimuli of natural environments consisted of green-themed nature images, while the control stimuli featured urban scenes dominated by buildings. The stimulation lasted for 3 min, during which orbital prefrontal brain activity was measured using a 2-channel Near-infrared Spectroscopy (NIRS) system, and heart rate variability was assessed using fingertip accelerated plethysmography.

RESULTS

Mood enhancement effects were observed in both the depressive and anxiety disorder groups following visual stimulation with nature images. In the depression group, orbital prefrontal oxygenated hemoglobin concentration significantly increased after visual stimulation with nature images, while there were no significant changes in the anxiety group. However, in the anxiety group, a correlation was found between reduced orbital prefrontal oxygenated hemoglobin in response to nature images and increased mood-enhancement. Furthermore, the severity of depressive symptoms did not significantly affect the intervention effects, whereas heightened anxiety symptoms was associated with a smaller mood enhancement effect.

DISCUSSION

Our study demonstrates the benefits of nature image stimulation for patients with depressive and anxiety disorders. Differential orbital prefrontal brain activity impacts notwithstanding, both conditions exhibited mood enhancement, affirming the value of nature image stimulation.

Exploring the effect of different typical plant community on human stress reduction: a field experiment

Research has demonstrated the positive effect of natural environment on human restoration and well-being. Time spent in nature can often alleviate both physiological and psychological stress. However, few studies have discussed the environmental health effects of the nature's components and characteristics. Sixty volunteers were recruited and one manufactured environment and five different natural environments were randomly assigned to them, including coniferous forests (pure coniferous forest-PC and mixed coniferous forest-MC), broad-leaved forests (pure broad-leaved forest-PB and mixed broad-leaved forest-MB), and mixed forest (mixed coniferous and broad-leaved forest-MCB). Each volunteer sat in a built or natural environment and looked around the environment for 15 min. Physiological (HR, HRV, BP, pulse rate and salivary cortisol) and psychological indicators (POMS and STAI) were used to evaluate the changes in their stress level. Results indicated a strong difference in HR, HRV, POMS and STAI between the built and natural environment, which showed that natural environment can lower the stress level. MC had the best effect on relieving physiological stress, whereas MCB is most successful in improving emotional state and reducing anxiety. Broad-leaved forest and mixed forest significantly affected the DBP and vigor level of the subjects, respectively. While coniferous forest did significantly increase the concentration of salivary cortisol in subjects. The study confirmed that compared to the built environment, the natural environment can relieve the human body's physical and psychological stress and negative emotions, while significantly increasing vitality. And different plant communities also have different effects on the physiological and psychological indicators of the subjects. These results will provide scientific basis for the construction and improvement of urban green space environment.

Introducing the Chen-HAgiwara Mood Test (CHAMT): A novel, brief scale developed in Japanese populations for assessing mood variations

Understanding and assessing mood are pivotal in psychological and psychiatric research, yet existing scales often exhibit limitations such as focusing on singular dimensions of mood and introducing comparative bias through Likert scales. To address these issues, the Chen-HAgiwara Mood Test (CHAMT), a novel three-item scale, was developed. Grounded in the valence-arousal two-dimensional theory of affect, CHAMT offers a comprehensive assessment, focusing on three integral mood components: pleasure, relaxation, and vigor. This study evaluates the reliability, validity, and applicability of CHAMT in capturing mood variations post diverse experimental interventions. The results indicate that CHAMT exhibits high internal consistency and notable item-total correlations, underscoring its reliability. It demonstrated excellent same-day test-retest reliability, with variations observed on different days, implying a potential influence of temporal factors on mood assessments. The notable correlations between CHAMT's components and established external criteria such as positive affect, depression, and state anxiety substantiate its validity in assessing diverse mood dimensions. The examination of different interventions revealed a discernable impact on specific mood components, aligning with theoretical expectations, and showcasing the nuanced interplay between interventions and mood dimensions. The findings suggest that CHAMT holds substantial promise in refining mood assessments in psychological and psychiatric research, due to its brevity, multifaceted approach, and alignment with established theoretical frameworks.

Shinrin-Yoku (Forest Bathing): A Scoping Review of the Global Research on the Effects of Spending Time in Nature

Background

This Scoping review (ScR) builds upon the 2017 review conducted by Hansen et al which contributed to evidence base shinrin-yoku (SY), also known as forest bathing (FB), has many positive health effects and is becoming a prescribed dose (specific time spent in nature) by health care providers. Practice and research regarding SY, has been historically based in Asian countries with a recent increase in Europe. The need and call for more research worldwide continues to further the evidence of SY as a health promotion modality. Through this ScR the authors identified programmatic components, health information monitored and screened, time spent in nature, geographical regions, trends, and themes in SY research worldwide.

Methods

Following PRISMA-ScR guidelines we searched across 7 electronic databases for SY or FB research articles from 2017 through 2022. PubMed, CINAHL, PsycInfo, ScienceDirect, SCOPUS, Embase, JSTOR were included due to the interdisciplinary nature of SY or FB research. Each database provided unique strengths ensuring a capture of a wide range of articles. The resulting articles were screened and extracted through Covidence.

Results

Database searches returned 241 results, with 110 references removed during the deduplication process, 131 were initially screened in the title and abstract review stage. Resulting in 82 unique results deemed relevant and screened in full text. During the final stage of the review, 63 articles met all inclusion criteria and were extracted for data.

Conclusions

The practice of SY has physiological (PHYS) and psychological (PSYCH) benefits across age groups. Research findings indicate either the natural or the virtual environment (VW) has significant health benefits. Continued research is encouraged globally for short- and long-term health outcomes for all individuals. The connection with nature benefits the mind, body and soul and is supported by Henry David Thoreau's philosophy: "Our livesneed the relief of where the pine flourishes and the jay still scream."

Effects of an Integrative Day Care Clinic Program with a Focus on Nature Therapy in a Hospital Park Setting on Quality of Life in Oncological Patients-A Non-Randomized Controlled Study

Cancer often causes long-term physical and psychological impairments. Lifestyle modification and nature-based interventions (NBIs) can have a positive impact on patients' quality of life (QOL). This participants-blinded, non-randomized controlled study assessed parameters at weeks 0, 12, and 24, including, as a primary endpoint, QOL in cancer patients on the Functional Assessment of Cancer Therapy-General (FACT-G) at week 12. QOL in breast cancer patients, fatigue, well-being, stress, anxiety/depression, socio-psychological well-being, benefits of nature interaction, insomnia, self-efficacy, mindfulness, and self-compassion were assessed as secondary endpoints. N = 107 cancer patients (96.3% women; 52.5 ± 9.3 years, 80.4% breast cancer) were assigned to either a 12-week nature-based (NDC; n = 56) or conventional (DC; n = 51) oncology day care clinic program, whereby the assignment group was not known to the participants. There was no significant group difference for the primary endpoint. At week 24, QOL, fatigue, mindfulness and self-compassion scores were significantly higher, and at weeks 12 and 24, the insomnia score was significantly lower in NDC compared to DC. In conclusion, this study indicates positive and clinically relevant effects of the program on QOL, fatigue, and psychological parameters. NBIs seem to have a more pronounced effect.

Physiological adjustment effect of visual stimulation by fresh rose flowers on sympathetic nervous activity

Introduction

As modern societies are often stressful due to urbanization and artificialization, the physiological relaxing effects of natural environments or nature-derived stimuli on humans have attracted attention and scientific data are being accumulated. It is known that there is inter-individual variation in these effects. The study aim was to apply the law of initial values to investigate the physiological adjustment effect of viewing fresh roses on sympathetic nervous activity.

Methods

In this crossover study, a total of 214 high school students, office workers, healthcare workers, and elderly people were analyzed. The participants viewed fresh roses in a vase for 4 min. In the control condition, participants did not view any fresh roses during the period. To offset any order effect, participants received visual stimuli in the order of fresh roses then the control (no fresh roses) or the control and then fresh roses. ln (LF/HF) of heart rate variability (HRV) obtained from a-a interval measurements using an acceleration plethysmograph and used as an index of sympathetic nervous activity. The initial value was ln (LF/HF) of HRV during the control viewing (no fresh roses), and the change value was ln(LF/HF) of HRV during visual stimulation by fresh roses minus the control viewing.

Results and Discussion

The correlation between the two was assessed by determining Pearson's correlation coefficient r, which was significantly negative. A physiological adjustment effect was observed such that participants with high initial sympathetic nervous activity showed a decrease in activity after visual stimulation with fresh roses, whereas participants with low initial activity showed an increase.

Physiological and Psychological Responses of Viewing a Waterfall Image: A Crossover Study

Growing interest in the relaxation effect of nature has elicited demands for scientific verification of the various natural elements. This study investigated the physiological and psychological responses of 27 females in their 20 s to viewing a waterfall and urban images (control) presented via a large, high-resolution display for 90 s. High-frequency [HF] for parasympathetic nervous activity and the ratio of low-frequency (LF)/[LF + HF] for sympathetic nervous activity by heart rate variability and heart rate were recorded. Simultaneous changes in oxyhemoglobin concentration in the prefrontal cortex were recorded by near-infrared time-resolved spectroscopy. The modified semantic differential method and Profile of Mood States Second Edition were used to assess the psychological effects on the participants after viewing each image. The results showed that viewing the waterfall image, compared with viewing the urban image, (1) increased sympathetic nervous activity; (2) provided comfortable, relaxed, and natural impressions; (3) improved mood states. In conclusion, visual contact with a waterfall image physiologically activated sympathetic nervous activity and psychologically evoked positive moods and feelings.

Exposure to Nature Sounds through a Mobile Application in Daily Life: Effects on Learning Performance among University Students

Previous studies have revealed the restorative effects of exposure to natural environments on psychological well-being and cognitive performance. Recent studies have reported the effects of exposure to nature sounds (e.g., the sounds of birds, rainfall, and waves) through a mobile application on reducing students' mental fatigue and improving their cognitive performance. However, it remains unknown whether exposure to nature sounds through a mobile application may influence students' learning performance. To address the gap, we conducted a study with 71 university students. During the four-week intervention, 36 students in the experimental group were exposed to nature sounds through a free mobile application for at least 30 consecutive minutes per day when working on academic-related tasks; 35 students in the control group did not have such exposure when working on similar tasks. The results show that students in the experimental group outperformed those in the control group in their engagement in deep learning, frequency of academic procrastination, and academic self-efficacy. The findings reveal the promising effects of exposure to nature sounds through a mobile application on improving students' learning performance. The implications of the findings are discussed.

Impacts of Landscape Type, Viewing Distance, and Permeability on Anxiety, Depression, and Stress

Contact with nature is beneficial for mental health, including anxiety and stress. Exposure to virtual nature also has similar restorative traits with real nature. However, previous studies on the restorative environment mostly focus on ordinary people while caring less about patients with depressive disorders. Thus, the restorative impacts of virtual nature on patients with depression warrant examination. This research aims to study the restorative effects of virtual reality (VR) landscape type, viewing distance, and permeability on anxiety, depression, and stress in patients with depression. Study A revealed that the perceived restorative level of landscape type varies greatly: grassland > forest > water > undergrowth > urban square. Additionally, natural environments with higher openness, more green elements, more blue sky, and more sunshine exposure had higher restorative levels on perceived depression, anxiety, and stress relief. Study B found that the grassland landscape with a higher viewing distance and a medium vegetation edge permeability provides more restorative impacts for patients with depression.

Effect of Indoor Forest Bathing on Reducing Feelings of Fatigue Using Cerebral Activity as an Indicator

We created an indoor forest bathing environment in a sunlight-type environmentally controlled chamber and both physiological and psychological measurements were conducted for the evaluation of mental fatigue reduction. At first, a working memory load experiment was performed among 10 participants in a space without plants to identify an indicator correlating with feelings of fatigue, using the cerebral activity of the prefrontal cortex. Then, the indicator was used to evaluate whether a 20-min exposure to an indoor forest bathing environment reduced the level of the feeling of fatigue. The working memory load experiment demonstrated that, when mental fatigue increased, the amount of oxygenated hemoglobin (oxy-Hb) in the right prefrontal cortex and the right-left difference in oxy-Hb (ΔRL oxy-Hb) in the prefrontal cortex increased. These were proposed as indicators of mental fatigue. In the indoor forest bathing experiment, staying in an indoor green space showed that the subjective values of feeling of fatigue decreased and ΔRL oxy-Hb decreased. Since these results demonstrated an opposite effect to the increase in ΔRL oxy-Hb related to the feeling of fatigue, it was inferred that the decrease in ΔRL oxy-Hb reflected the fatigue reduction in the indoor forest bathing environment.

Effects of visual and aromatic stimulations on the perception of five fundamental tastes

Taste perception is affected by various environmental factors. In the present study, we investigated the effects of visual and aromatic stimulations on stress responses and taste perception. Fourteen young healthy participants were assessed for stress levels and taste intensities under 5 different conditions: normal (no stimuli), watching an action scene, watching a forest scene, sniffing a rosemary aroma, and sniffing a lavender aroma. Compared to participants under the action scene condition, participants under the forest scene or under the rosemary aroma condition showed significantly lower stress levels. Furthermore, the forest scene condition significantly increased the saltiness intensity, whereas the rosemary aroma condition significantly increased the bitterness intensity. A positive or negative correlation was observed between the stress level and taste intensity of sourness and saltiness, respectively. These findings indicate that visual image and aroma have the potential to change taste perception as well as modulate stress conditions.

Exploring the Physiological and Psychological Effects of Digital Shinrin-Yoku and Its Characteristics as a Restorative Environment

This study investigated the physiological and psychological therapeutic effects of a digital Shinrin-yoku environment constructed indoors in an urban facility as well as the characteristics of the environment that contribute to restorativeness (restorative traits). We measured the fluctuations in the physical and mental states of 25 subjects by obtaining both before–after measurements and continuous measurements while exposed to a digital Shinrin-yoku environment that reproduced visual, auditory, and olfactory elements. The results demonstrated that the parasympathetic nerve activity was significantly increased and that the heart rate was significantly decreased during the exposure compared with that during the resting state. As for mood, five of the six Profile of Mood States (POMS) scales (“Tension–Anxiety,” “Depression,” “Anger–Hostility,” “Fatigue,” and “Confusion”) were significantly decreased after the experience. In addition, psychological restorative effects were also confirmed, with a significant decrease in “negative affect” (measured using the Positive and Negative Affect Schedule (PANAS)) and a significant increase in the sense of restorativeness (Restorative Outcome Scale (ROS)) after the experience. In contrast, comparing the digital Shinrin-yoku environment with the actual forest environment and the urban environment using POMS, PANAS, ROS, and Perceived Restorativeness Scale (PRS), the psychological effects and environmental traits of the digital Shinrin-yoku were found to be considerably similar to those of the actual forest environment.

Psychological Cognitive Factors Affecting Visual Behavior and Satisfaction Preference for Forest Recreation Space

Background: People are paying increasing attention to urban forest landscapes, and recreational landscape spaces (providing recreation and viewing functions) are an important part of the urban forest landscape. Visual tracking technology is a flexible and accurate modern research method. When this technology is applied to forest landscape evaluation, it can assist in explaining the content that could not be studied in depth in the past and has high application value. However, although an eye tracker can tell us what the user is looking at, it cannot tell us why they are looking at it or how they feel after seeing it. To this end, we combined a 7-point spatial cognition questionnaire and satisfaction preference to understand the visual behavior (fixation point time, number of fixation points, etc.) and preference satisfactions of users in recreational landscape spaces to help designers understand what elements attract people’s visual attention and improve the design of these spaces. Methods: We used eye-tracking and cognitive questionnaires to obtain experimental data and used factor analysis and linear regression analysis of SPPS 23.0 to analyze data. Main purpose: Clarify the factors affecting people’s visual behavior and satisfaction preferences in forest recreation spaces to provide theoretical guidance for planning and designing forest landscapes. Main results: (1) Places with more frequent eye movements have relatively lower satisfaction preferences; (2) The spatial perception factors affect participants’ visual behavior, and satisfaction preference is different based on many indicators (WCB, WSO, WSN, SSH, etc.) in forest recreation space; (3) The professional background education affects the participants’ visual-behavior evaluation of the recreational landscape space and also affects the participants’ focus on the landscape preference. When the spatial type of forest recreation space changes, the spatial perception factors that affect the participants’ visual behavior and satisfaction preferences also change. Based on the above, we suggest that in forest recreation space, the spatial perception indicators should be improved according to the characteristics of space itself, then improve the satisfaction preferences for the scene in a targeted manner to make participants produce effective and positive visual behavior. Meanwhile, for a well-built forest park, we should provide the landscape node with the best visual effect and satisfaction preference for tourists from different professional backgrounds on the park’s tour route map based on the characteristics of the forest recreational landscape space.

Cities and neuroscience research: A systematic literature review

BACKGROUND

Cities are becoming the socio-economic hubs for most of the world's population. Understanding how our surroundings can mentally affect everyday life has become crucial to integrate environmental sustainability into urban development. The present review aims to explore the empirical studies investigating neural mechanisms underlying cognitive and emotional processes elicited by the exposure to different urban built and natural spaces. It also tries to identify new research questions and to leverage neurourbanism as a framework to achieve healthier and sustainable cities.

METHODS

By following the PRISMA framework, we conducted a structured search on PubMed, ProQuest, Web of Science, and Scopus databases. Only articles related to how urban environment-built or natural-affects brain activity through objective measurement (with either imaging or electrophysiological techniques) were considered. Further inclusion criteria were studies on human adult populations, peer-reviewed, and in English language.

RESULTS

Sixty-two articles met the inclusion criteria. They were qualitatively assessed and analyzed to determine the main findings and emerging concepts. Overall, the results suggest that urban built exposure (when compared to natural spaces) elicit activations in brain regions or networks strongly related to perceptual, attentional, and (spatial) cognitive demands. The city's-built environment also triggers neural circuits linked to stress and negative affect. Convergence of these findings was observed across neuroscience techniques, and for both laboratory and real-life settings. Additionally, evidence also showed associations between neural social stress processing with urban upbringing or current city living-suggesting a mechanistic link to certain mood and anxiety disorders. Finally, environmental diversity was found to be critical for positive affect and individual well-being.

CONCLUSION

Contemporary human-environment interactions and planetary challenges imply greater understanding of the neurological underpinnings on how the urban space affects cognition and emotion. This review provides scientific evidence that could be applied for policy making on improved urban mental health. Several studies showed that high-quality green or blue spaces, and bio-diverse urban areas, are important allies for positive neural, cognitive, and emotional processes. Nonetheless, the spatial perception in social contexts (e.g., city overcrowding) deserves further attention by urban planners and scientists. The implications of these observations for some theories in environmental psychology and research are discussed. Future work should take advantage of technological advancements to better characterize behavior, brain physiology, and environmental factors and apply them to the remaining complexity of contemporary cities.

The Effects of Using a Nature-Sound Mobile Application on Psychological Well-Being and Cognitive Performance Among University Students

Many university students have been struggling with multiple challenges that may cause mental fatigue. Exposure to the natural environment is found to have restorative effects on mental fatigue, which can be explained by its benefits in physiological, psychological, and cognitive aspects. While the natural environment contains both visual and auditory elements, research on the effects of auditory elements, such as nature sounds, is underdeveloped and limited to laboratory settings. It remains unclear what are the effects of exposure to nature sounds in daily life settings. The study was conducted with 71 students from a university, who were randomly assigned to the experimental group using a nature-sound mobile application in daily life and the control group not using the application. After a 4-week exposure to the intervention, the students in the experimental group outperformed their counterparts in the control group on psychological well-being reflected in positive affect, as well as cognitive performance reflected in flow state, attention (in terms of alerting) and working memory (in terms of accuracy and reaction time). The findings reveal the positive impact of exposure to relaxing nature sounds on university students' psychological well-being and cognitive performance, as well as the potential of mobile applications to provide easy exposure to nature sounds.

The Effect of Forest Video Using Virtual Reality on the Stress Reduction of University Students Focused on C University in Korea

The purpose of this study is to study the effect of forest videos using virtual reality (VR) on the stress of college students. The study subjects were 60 college students who watched two-dimensional (2D) and VR videos, and we compared their control heart rate variability (HRV) and electroencephalogram (EEG). As a result, it was found that the VR group had a positive effect on high frequency (HF), standard deviation of all NN intervals (SDNN), and root-mean-square of successive differences (RMSSD) compared with the control group, and the VR group had a positive effect on HF compared with the 2D group. Second, EEG, a physiological indicator, showed statistical differences in Relative Alpha Power (RA), Relative Beta Power (RB), and Ratio of SMR-Mid Beta to Theta (RSMT) in VR groups in intra-group analysis. Among them, it was investigated that watching forest videos on VR became a state of concentration and immersion due to the increase in RSMT. As a result of the above, it was investigated that forest videos using VR had a positive effect on the physiological stress on college students. Therefore, it is expected that a positive effect will occur if VR is used as an alternative to stress management for college students.

How Can Flowers and Their Colors Promote Individuals' Physiological and Psychological States during the COVID-19 Lockdown?

The global spread of COVID-19 has disrupted the normality of people’s daily lives, leading the population to social distancing and isolation. The closure of green areas also affected the well-being of the individual during the COVID-19 pandemic. Viewing flowers is expected to have similar positive effects to viewing natural scenery. Therefore, this study investigates how white, red, and yellow flower colors affect individuals’ psychological and physiological well-being. The experiment was conducted in an office-like setting with 50 participants. Participants looked at each flower color for 3 min. Electroencephalograms (EEGs), heart rate variability, and skin conductivity were measured to evaluate physiological responses along with both the semantic differential questionnaire (SD) and the Profile of Mood States (POMS) to assess psychological responses. EEGs showed that the mean values of alpha relative power in the prefrontal lobe were significantly higher when viewing yellow and red flowers vs. white flowers. Furthermore, heart rate variability revealed that viewing yellow and red flowers increased parasympathetic nerve activity significantly. After viewing the yellow and red flowers, the average results for each subscale of the POMS questionnaire improved. The vigor (V) subscale and overall mood status values were significantly improved. The results of the SD method revealed that viewing yellow and red flowers resulted in a significantly higher sense of relaxation, cheerfulness, and comfort than viewing white flowers.

The importance of urban planning: Views of greenness and open space is reversely associated with self-reported views and depressive symptoms

INTRODUCTION

Exposure to green spaces is beneficial to mental health in a variety of ways, ranging from stress reduction to increased attentiveness and elevated self-esteem. The impact of views of greenness, as opposed to direct exposure, has been examined, but the association between self-reported views and depressive symptoms is not known. The purpose of this study is to examine the relationship between views of greenness and Patient Health Questionnaire-9 (PHQ-9) score.

METHODS

Questionnaire responses from 191 participants in the Health, Environment, and Action in Louisville (HEAL) study were examined. Univariate statistical analyses included Mann-Whitney U, Kruskal-Wallis, and Spearman rank tests. Inferential statistical analysis was linear regression.

RESULTS

Participant satisfaction with residential greenness was significantly associated with reduced PHQ-9 score (partially adjusted: linear coefficient = -0.42; 95% CI: -0.70 - -0.14; fully adjusted: linear coefficient = -0.21; 95% CI: -0.44 - 0.02). Additionally, being satisfied with local greenness was significantly associated with having views of greenness from home (linear coefficient = 1.97; 95% CI: 1.23-2.68).

CONCLUSIONS

Though views of greenness were not directly associated with depression, satisfaction with local greenness was associated with reduced PHQ-9 score, and having views of greenness from home was crudely associated with increased greenness satisfaction. The findings suggest urban greening interventions that focus on greenness satisfaction may be a strategy to reduce depression. Further research is necessary to better understand these relationships.

The Mood-Improving Effect of Viewing Images of Nature and Its Neural Substrate

It has been recently suggested that contact with nature improves mood via reducing the activity of the prefrontal cortex. However, the specific regions within the prefrontal cortex that underlie this effect remain unclear. In this study, we aimed to identify the specific regions involved in the mood-improving effect of viewing images of nature using a 52-channel functional near-infrared spectroscopy (fNIRS). Specifically, we focused on the orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex (dlPFC), two regions associated with affective processing and control. In a randomized controlled crossover experiment, we assigned thirty young adults to view images of nature and built environments for three minutes each in a counterbalanced order. During image viewing, participants wore a fNIRS probe cap and had their oxyhemoglobin (oxy-Hb) measured. Immediately following each image viewing, participants indicated their mood in terms of comfortableness, relaxation, and vigor. Results showed that viewing images of nature significantly increased comfortableness and relaxation but not vigor compared to viewing images of built environments, with a large effect size. Meanwhile, the concentration of oxy-Hb in only the right OFC and none of the other regions significantly decreased while viewing the images of nature compared to built environments, with a medium effect size. We speculate that viewing images of nature improves mood by reducing the activity of or calming the OFC. Since the OFC is hyperactive in patients with depression and anxiety at rest, contact with nature might have therapeutic effects for them.

Using greenspace and nature exposure as an adjunctive treatment for opioid and substance use disorders: Preliminary evidence and potential mechanisms

The demand for opioid medication to effectively treat pain has contributed to the surging opioid crisis, which is a major source of morbidity and mortality in the U.S. More than 100,000 people begin opioid maintenance treatment (OMT) annually, the standard pharmacotherapy for opioid use disorder (OUD). Although OMT is the standard care for OUD, patients often experience or develop a heightened sensitivity to pain (hyperalgesia) as a result of the opioid medication, and also have high rates of stress, affective, and anxiety-related conditions. These conditions are interactive with other behavioral and environmental correlates of opioid and other substance use disorders including impulsive decision-making (e.g., harmful opioid use associated with increased delay discounting), and a lack of alternative (i.e., substance-free) and social reinforcement. Collectively these complex and multifaceted factors constitute significant predictors of lack of adherence to OMT (and other pharmacotherapies) and relapse. There is an urgent need, therefore, to develop novel adjunctive treatments that preserve the benefits of OMT and various pharmacotherapies, and simultaneously diminish continued pain and hyperalgesia, reduce stress and anxiety-related conditions, target relevant behavioral mechanism such as impulsive choice, and also serve to enhance the value of alternative and substance free activities. Here, we discuss evidence that an environmental manipulation - access to greenspace and nature - could serve as a potential adjunctive treatment to standard pharmacotherapies by targeting multiple biological and behavioral mechanisms that standard pharmacotherapies do not address.

Benefits of Indirect Contact With Nature on the Physiopsychological Well-Being of Elderly People

OBJECTIVES

Exposure to nature or to green space has positive mental health benefits. Closing of parks and green spaces during the COVID-19 pandemic has reduced options for mental health and well-being benefits and could have a greater impact on vulnerable populations, especially the elderly. The present study, therefore, explores the physiopsychological impacts of indirect contact with nature, using forest imagery, on the brain activity and autonomic nervous systems of elderly people.

STUDY DESIGN

A within-subject design experiment was used.

METHODS

Thirty-four participants aged 82.9 ± 0.78 years were asked to look at bamboo and urban images for 2 min. During the visual stimulation, α relative waves were measured using electroencephalography as an indicator of brain activity. Heart rate variability and skin conductance (SC) responses were utilized as indicators of arousal. Afterward, psychological responses were evaluated using the semantic differential and the Profile of Mood States questionnaires.

RESULTS

Visual stimulation with bamboo image induced a significant increase in α relative waves and parasympathetic nervous activity and a significant decrease in SC. In addition, a significant increase in perceptions of "comfortable," "relaxed," "cheerful," and "vigorous" feelings was observed.

CONCLUSIONS

Indirect contact with nature enhances the physiological and psychological conditions of the elderly. Findings can be used to guide the new design, renewal, and modification of the living environments of the elderly and those who are unable to get outside.

Application of Virtual Environments for Biophilic Design: A Critical Review

Biophilic design as a new design approach promotes the integration of natural elements into the built environment, leading to a significant impact on human health, well-being, and productivity. On the other hand, scholars have explored Virtual Environment (VE) to create virtual nature and provide a complex experience of exposure to natural elements virtually. However, there is a lack of understanding about such studies in general, which use VE as a reliable tool to support biophilic design. Thus, the authors conducted a literature review on the applications, capabilities, and limitations of VE for biophilic design. The literature review shows that VE is capable of supporting critical features of biophilic design studies such as representing combinations of biophilic patterns, providing multimodal sensory inputs, simulating stress induction tasks, supporting required exposure time to observe biophilic patterns, and measuring human’s biological responses to natural environment. However, factors affecting user’s experience of a virtual biophilic environment exist, such as VE experience dimensions, user-related factors, cybersickness, navigational issues, and possible limitations of VE sensory input. Overall, biophilic design studies in VEs are still limited. Nevertheless, there are many opportunities for further research in this field.

Improving Stress Management and Sleep Hygiene in Intelligent Homes

High stress levels and sleep deprivation may cause several mental or physical health issues, such as depression, impaired memory, decreased motivation, obesity, etc. The COVID-19 pandemic has produced unprecedented changes in our lives, generating significant stress, and worries about health, social isolation, employment, and finances. To this end, nowadays more than ever, it is crucial to deliver solutions that can help people to manage and control their stress, as well as to reduce sleep disturbances, so as to improve their health and overall quality of life. Technology, and in particular Ambient Intelligence Environments, can help towards that direction, when considering that they are able to understand the needs of their users, identify their behavior, learn their preferences, and act and react in their interest. This work presents two systems that have been designed and developed in the context of an Intelligent Home, namely CaLmi and HypnOS, which aim to assist users that struggle with stress and poor sleep quality, respectively. Both of the systems rely on real-time data collected by wearable devices, as well as contextual information retrieved from the ambient facilities of the Intelligent Home, so as to offer appropriate pervasive relaxation programs (CaLmi) or provide personalized insights regarding sleep hygiene (HypnOS) to the residents. This article will describe the design process that was followed, the functionality of both systems, the results of the user studies that were conducted for the evaluation of their end-user applications, and a discussion about future plans.

Time in Nature Associated with Decreased Fatigue in UK Truck Drivers

Heavy goods vehicle (HGV) driving is recognised as a highly hazardous occupation due to the long periods of sedentary behaviour, low levels of physical activity and unhealthy food options when working. These risk factors combine with shift work and concomitant irregular sleep patterns to increase the prevalence of fatigue. Fatigue is closely linked with stress and, subsequently, poor physiological and psychological health. In parallel, a wealth of evidence has demonstrated the health and wellbeing benefits of spending time in nature. Here, we sought to examine whether spending time in nature was associated with lower levels of fatigue, anxiety and depression in HGV drivers. 89 long-distance drivers (98.9% male, mean ± SD age: 51.0 ± 9 years, body mass index: 29.8 ± 4.7 kg/m²) participating in a wider health promotion programme reported time spent in nature (during and before the Covid-19 pandemic) and symptoms of occupational fatigue, depression and anxiety. After controlling for covariates, truck drivers who visited nature at least once a week exhibited 16% less chronic fatigue prior to the pandemic, and 23% less chronic fatigue and 20% less acute fatigue during the pandemic. No significant differences were observed for either anxiety or depression. As fatigue has a range of physical and mental health sequelae, we propose that increased exposure to natural settings may make a valuable contribution to interventions to promote the health and wellbeing of this underserved group.

Disentangling the Diversity of Forest Care Initiatives: A Novel Research Framework Applied to the Italian Context

In the effort to advance the knowledge of and disentangle the diversity of emerging forest-based initiatives for wellbeing, we propose (1) an umbrella definition (i.e., forest care initiatives (FCIs)), (2) a custom-made repository to collect and systematize information on FCIs in Italy, and (3) discuss a categorization scheme to cluster initiatives into three main categories according to target users, substitutability of the forest ecosystem, and the specificity of the health contributions to which they are aimed. We analyzed 232 initiatives, showing a lively panorama of Italian FCIs, mainly provided by private entities and civil society. FCI developments appear to be occasions for, but are not restricted to, rural and marginal areas delivering inclusive wellbeing services to a wide target user group and business opportunities. However, due to the novelty of this area of investigation, further research is needed to account for benefits and opportunities and to increase knowledge on enabling forest environments.

Foliage colors improve relaxation and emotional status of university students from different countries

The therapeutic advantages of seeing plants have gained increasing consideration in stressful modern societies, however, evidence-based studies on how physiological and emotional states of individuals from different nationalities change when seeing different foliage colors are limited. The study was conducted to explore the physiological and psychological advantages of foliage colors as visual stimuli. The experiment included 40 men from two nations (age: 21.34 ± 3.50 years) and was carried out using five foliage colors including green, light green, green-yellow, green-red and green-white. Participants were exposed to each color for 2 min, when seeing the foliage colors, eye movements and oxy-Hb concentrations were continuously measured. Subjective evaluations of emotions were performed utilizing a semantic differential questionnaire. A significant decrease in oxy-Hb concentration in the frontal lobe was associated with the viewing of green and green-white plants by the Japanese participants and with viewing light green and green-yellow by the Egyptian participants. Participants spent higher fixation numbers and longer durations on these colors. The findings indicate that viewing of these plant colors was positively associated with physiological relaxation. Furthermore, these colors were associated with more positive feelings, such as calmness, comfort and naturalness. Therefore, the presence of these colors in spaces may have positive impacts on relaxation and emotional status.

The Effects of an Artificial Garden on Heart Rate Variability among Healthy Young Japanese Adults

Spending time in nature might positively influence mental health by inducing a relaxed state. Recently, gardens have been created on hospital rooftops in Japan to help inpatients recover from various physical and mental aliments. However, there is little evidence regarding any positive physiological effects of artificial gardens designed for health. The purpose of this study was to assess the psychological and cardiovascular responses incited by artificial natural environments. Japanese university students (n = 38) participated in a one-group pretest post-test experiment conducted at the Yamaguchi Flower Expo in Japan in October 2018, designed to assess whether exposure to four environments (forest, flowers, ocean, and artificial garden for health) influenced heart rate variability measures. After pretesting to determine baseline measurements, participants completed a circuit through the four natural environments. Following circuit completion, post-testing determined that the low frequency/high frequency ratio was significantly lower in the overall sample and the four areas had similar influences on heart rate variability. Findings suggest that exposure to nature by walking through natural areas and in rooftop artificial gardens might enhance the balance between the sympathetic and parasympathetic nervous systems.

Comparative Study of the Restorative Effects of Forest and Urban Videos during COVID-19 Lockdown: Intrinsic and Benchmark Values

The prolonged lockdown imposed to contain the COrona VIrus Disease 19 COVID-19 pandemic prevented many people from direct contact with nature and greenspaces, raising alarms for a possible worsening of mental health. This study investigated the effectiveness of a simple and affordable remedy for improving psychological well-being, based on audio-visual stimuli brought by a short computer video showing forest environments, with an urban video as a control. Randomly selected participants were assigned the forest or urban video, to look at and listen to early in the morning, and questionnaires to fill out. In particular, the State-Trait Anxiety Inventory (STAI) Form Y collected in baseline condition and at the end of the study and the Part II of the Sheehan Patient Rated Anxiety Scale (SPRAS) collected every day immediately before and after watching the video. The virtual exposure to forest environments showed effective to reduce perceived anxiety levels in people forced by lockdown in limited spaces and environmental deprivation. Although significant, the effects were observed only in the short term, highlighting the limitation of the virtual experiences. The reported effects might also represent a benchmark to disentangle the determinants of health effects due to real forest experiences, for example, the inhalation of biogenic volatile organic compounds (BVOC).

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

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

Effect of Viewing Video Representation of the Urban Environment and Forest Environment on Mood and Level of Procrastination

A common problem among students is the problem of delaying important work activities, which is conceptualized as procrastination. Since procrastination can cause considerable costs for society, we would like to find a method to effectively alleviate the symptoms of this conditioning. It has been proven in an earlier study that staying in the forest environment increases vitality and reduces anxiety, and the negative state of these features can be associated with the intensification of procrastination symptoms. Therefore, it is likely that watching a forest video may decrease the probability or intensity of procrastination. To measure the impact of the forest environment on the level of procrastination of the subjects, a randomized experiment was carried out, in which the subjects watched in random order (on different days) one of two 15-min videos: one showing a walk in the forest area and one showing a walk in an urban environment (control). We measured the level of so-called 'fluid procrastination' including three aspects: 'lack of energy to do the work', 'inability to get to work' and 'pessimistic attitude to do the work' with a set of questions the respondents completed before and after the experiment. The results showed that one aspect of fluid procrastination ('pessimistic attitude to do the work') can be effectively lowered by watching a video showing the forest environment. In contrast, watching a video of an urban environment increased the procrastination levels for two other aspects of procrastination ('lack of energy to do the work', 'inability to get to work'). We also measured three other parameters before and after the experiment: mood state, restoration and vitality. Watching the video from forest area raised mood and restoration and watching the video from urban area, decreased mood, vitality and restoration. The study suggests that watching a video showing forest landscapes could be used as an effective remedy for problems related to procrastination among students.

Physiological and Psychological Effects of Watching Videos of Different Durations Showing Urban Bamboo Forests with Varied Structures

This study illustrated the physiological and psychological effects of watching videos of different durations showing bamboo forests with varied structures. Physiological indicators, including EEG (electroencephalogram), blood pressure, skin conductance, and pulse, were monitored in 180 Chinese university students (mean age: 20.72 ± 2.56 years) while they were watching bamboo videos. Before and after watching the videos, their psychological indicators, including positive and negative moods, were measured using the Profile of Mood States questionnaire. After watching the bamboo videos of different durations, all of the physiological indicators responded to the stimulation after only 1 min. The indicators showed different trends at 1, 3 and 5 min. EEG decreased and then was maintained at a stable level after 1 min, and the high β, low β, and α waves had no significant differences between 1, 3 and 5 min. Blood pressure dropped to a stable state after 3 min, and the decline was significantly different greater after 3 min than after 1 min. Skin conductance increased for 1 to 5 min, and it did not stabilize after a long time (5 min). Pulse decreased after 1 min but increased after 5 min. After watching the videos with bamboo of varying structures, the physiological and psychological indicators showed significantly different changes. Skin conductance significantly increased (mean value: 6.78%), and the amount of sweat was more effectively reduced, thereby reducing tension, when the students viewed videos of sympodial bamboo forests compared with monopodial bamboo forests. Bamboo forests with a higher canopy density (0.83–0.85) could significantly decrease α waves (mean value: 1.50 Hz), relaxing the human body. High β and low β waves showed greater decreases, with tension reduced more effectively, when bamboo forests with a low tilt ratio (< 1.5%) were viewed. Bamboo forests with neat undergrowth could have more beneficial physiological and psychological effects on the human body.

Physiological Benefits of Viewing Nature: A Systematic Review of Indoor Experiments

Contact with nature has been proposed as a solution to achieve physiological relaxation and stress recovery, and a number of scientific verification outcomes have been shown. Compared with studies of the other senses, studies investigating the visual effects of nature have been at the forefront of this research field. A variety of physiological indicators adopted for use in indoor experiments have shown the benefits of viewing nature. In this systematic review, we examined current peer-reviewed articles regarding the physiological effects of visual stimulation from elements or representations of nature in an indoor setting. The articles were analyzed for their stimulation method, physiological measures applied, groups of participants, and outcomes. Thirty-seven articles presenting evidence of the physiological effects of viewing nature were selected. The majority of the studies that used display stimuli, such as photos, 3D images, virtual reality, and videos of natural landscapes, confirmed that viewing natural scenery led to more relaxed body responses than viewing the control. Studies that used real nature stimuli reported that visual contact with flowers, green plants, and wooden materials had positive effects on cerebral and autonomic nervous activities compared with the control. Accumulation of scientific evidence of the physiological relaxation associated with viewing elements of nature would be useful for preventive medicine, specifically nature therapy.

Ambient Intelligence in the Living Room

The emergence of the Ambient Intelligence (AmI) paradigm and the proliferation of Internet of Things (IoT) devices and services unveiled new potentials for the domain of domestic living, where the line between “the computer” and the (intelligent) environment becomes altogether invisible. Particularly, the residents of a house can use the living room not only as a traditional social and individual space where many activities take place, but also as a smart ecosystem that (a) enhances leisure activities by providing a rich suite of entertainment applications, (b) implements a home control middleware, (c) acts as an intervention host that is able to display appropriate content when the users need help or support, (d) behaves as an intelligent agent that communicates with the users in a natural manner and assists them throughout their daily activities, (e) presents a notification hub that provides personalized alerts according to contextual information, and (f) becomes an intermediary communication center for the family. This paper (i) describes how the “Intelligent Living Room” realizes these newly emerged roles, (ii) presents the process that was followed in order to design the living room environment, (iii) introduces the hardware and software facilities that were developed in order to improve quality of life, and (iv) reports the findings of various evaluation experiments conducted to assess the overall User Experience (UX).

Physiological and Psychological Effects of Forest and Urban Sounds Using High-Resolution Sound Sources

Exposure to natural sounds is known to induce feelings of relaxation; however, only few studies have provided scientific evidence on its physiological effects. This study examined prefrontal cortex and autonomic nervous activities in response to forest sound. A total of 29 female university students (mean age 22.3 ± 2.1 years) were exposed to high-resolution sounds of a forest or city for 60 s, using headphones. Oxyhemoglobin (oxy-Hb) concentrations in the prefrontal cortex were determined by near-infrared spectroscopy. Heart rate, the high-frequency component of heart rate variability (which reflects parasympathetic nervous activity), and the ratio of low-frequency to high-frequency (LF/HF) components (which reflects sympathetic nervous activity) were measured. Subjective evaluation was performed using the modified semantic differential method and profiles of mood states. Exposure to the forest sound resulted in the following significant differences compared with exposure to city sound: decreased oxy-Hb concentrations in the right prefrontal cortex; decreased ln(LF/HF); decreased heart rate; improved feelings described as "comfortable,'' "relaxed," and "natural"; and improved mood states. The findings of this study demonstrated that forest-derived auditory stimulation induced physiological and psychological relaxation effects.

How does nature exposure make people healthier?: Evidence for the role of impulsivity and expanded space perception

Nature exposure has been linked to a plethora of health benefits, but the mechanism for this effect is not well understood. We conducted two studies to test a new model linking the health benefits of nature exposure to reduced impulsivity in decision-making (as measured by delay discounting) via psychologically expanding space perception. In study 1 we collected a nationwide U.S. sample (n = 609) to determine whether nature exposure was predictive of health outcomes and whether impulsive decision-making mediated the effect. Results indicated that Nature Accessibility and Nature Exposure From Home significantly predicted reduced scores on the Depression, Anxiety, Stress Scales (DASS) (p < .001, p = .03, respectively) and improved general health and wellbeing (p < .001, p < .01, respectively). Nature Accessibility also predicted reduced impulsive decision-making (p < .01), and Nature Accessibility showed significant indirect effects through impulsive decision-making on both the DASS (p = .02) and general health and wellbeing (p = .04). In Study 2, a lab-based paradigm found that nature exposure expanded space perception (p < .001), and while the indirect effect of nature exposure through space perception on impulsive decision-making did not meet conventional standards of significance (p < .10), the pattern was consistent with hypotheses. This combination of ecologically-valid and experimental methods offers promising support for an impulsivity-focused model explaining the nature-health relationship.

Self-Regulation of Breathing as an Adjunctive Treatment of Insomnia

Sleep is a quiescent behavioral state during which complex homeostatic functions essential to health and well-being occur. Insomnia is a very common psychiatric disorder leading to a myriad of detrimental effects including loss of concentration, memory, and performance as well as disease. Current pharmaceutical treatments can be expensive, impairing, unhealthy, and habit-forming. Relaxation techniques, such as meditation target the brain and body in contrast to pharmaceutical interventions which solely target neurotransmitter systems in the brain. In this article we present a viewpoint on the treatment of insomnia that techniques of slow, deep breathing (0.1 Hz) in adjunct to sleep hygiene and relaxation therapies may be highly effective in initiating sleep as well as facilitating falling back asleep. The autonomic nervous system is integral to sleep initiation, maintenance, and disruption. Understanding the relationship between the autonomic nervous system and sleep physiology along with the nature of sleep itself remains a challenge to modern science. We present this perspective in light of a prevailing "dysevolution" theory on the pathology of insomnia that proposes hyper-arousal characterized in part by chronic sympathetic hyperactivation and/or parasympathetic hypoactivation disrupts normal sleep onset latency, sleep quality, and sleep duration. We additionally discuss physiological mechanisms responsible for the effectiveness of the breathing treatment we describe. A better understanding of these mechanisms and autonomic pathologies of insomnia may provide support for the effectiveness of such techniques and provide relief to sufferers of this health epidemic.

A prescription for "nature" - the potential of using virtual nature in therapeutics

Many studies suggest that increased exposure to urban greenness is associated with better population health. Accessing nature can in some circumstances, however, be difficult, especially for individuals with mobility constraints. Therefore, a growing body of work is investigating the ways to replace the in vivo experience with forms of "virtual" contact, in order to provide these individuals with at least some benefits of the natural environment. The aim of this paper is to provide a review of previous use of virtual reality (VR) nature in health and care settings and contemplate the potential use of this technology in future. Our central question is whether engaging with virtual nature can contribute to enhanced physical and emotional well-being in housebound or mobility-constrained individuals. We conclude that while contact with real-world nature is preferred, VR use can be an alternative in cases when in vivo contact with nature is not possible. There are many possibilities for the use of VR technology in psychiatric and medical care; however, the risks, benefits, and cost efficiency of these attempts should be carefully assessed and the outcomes should be measured in a scientifically valid manner. The current review has nonetheless demonstrated that VR nature could play a role in each of the proposed mediating mechanisms linking natural environments and health.