Farming for Life Quality and Sustainability: A Literature Review of Green Care Research Trends in Europe

Greenspaces and Health: Scoping Review of studies in Europe

Objectives

Access to greenspaces and contact with nature can promote physical activity and have positive effects on physical and mental health. This scoping literature review aims to examine current evidence linking greenspaces and (a) behaviour change, (b) health outcomes and (c) co-benefits.

Methods

This review was conducted in accordance with the PRISMA scoping review guidelines. Searches were conducted through PubMed and EMBASE databases for studies published between 2000 and March 2023 with a focus on Europe.

Results

122 scientific articles and grey literature reports were identified. Access to greenspaces is positively associated with physical and mental health, and reduced risk of all-cause mortality and some non-communicable diseases. Greenspace quality is associated with increased physical activity and reduced risk of obesity. Nature-based therapies or green prescription are effective in improving mental health outcomes and overall health. Importantly, numerous co-benefits of greenspaces are identified.

Conclusion

Increasing access to greenspaces for populations with particular attention to greenspace quality is important for co-benefits. Responsible governance and use of greenspaces are crucial to minimize public health risks and human disturbance of nature.

Utilizing the physical green care environment to support activities of daily living for nursing home residents: a focused ethnographic case study

BACKGROUND

The nursing home residents' ability to carry out Activities of Daily Living (ADLs) is influenced by the physical care environment. One emerging area of interest in scientific research is the green care environment within nursing home care, where agricultural activities such as gardening and animal care are integrated alongside daily care. Previous research has neglected to explore how these environments can be employed to enhance ADL performance. This study, therefore, explores how a green care environment, specifically one with an animal shelter, can be used to support nursing home residents in their ADLs.

METHODS

A focused ethnographic case study was conducted in one nursing home. Data was collected employing participatory observations, informal conversations, and semi-structured interviews, which we analyzed by employing a thematic analysis.

RESULTS

Overall, 25 residents were observed for a total time of 89h, and interviews were conducted with 10 staff members. The nursing home integrates activities in the green care environment into daily care for a broad scope of residents. The analysis revealed four themes: (1) The (in)visibility of ADL, (2) Reciprocal care dynamics: Fostering ADL performance through connection and teamwork, (3) Seized and missed opportunities for meaningful integration of ADL in the physical green care environment, and Theme (4) Professional fulfillment and ADL task obligation: Views from staff and management.

CONCLUSIONS

This physical green care environment carries the potential to enhance the residents' daily activities and foster better staff-resident relationships. Yet, there are varying views among staff and management regarding its integration into the residents' lives and care.

Why nature matters: A systematic review of intrinsic, instrumental, and relational values

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research.

Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health

Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.

Challenges and Perspectives of Social Farming in North-Eastern Italy: The Farmers’ View

In the European framework of multifunctional agriculture, Social Farming (SF) has constantly been spreading. In Italy, these practices are legally connected to Animal Assisted Interventions (AAI), creating new perspectives and challenges for farmers and their territories. In this paper, we report the results of a pilot study conducted in the Veneto Region to understand farmers’ opinions about the opportunities and challenges of SF and AAI. Participants were convened by the Italian farmers’ trade organization Coldiretti. All of them provide social/healthcare services on their farms, including human–animal interaction, and have attended the regional training courses for Social Farming providers. Data were collected during two focus groups that were videotaped and subsequently analyzed by two researchers to categorize and dope out relevant topics. Results show a mismatch between what is stated by national and regional laws and the current situation reported by farmers. They are faced with many economic challenges as well as barriers in their relationship with traditional healthcare services. However, farmers have a strong motivation and believe in the benefits that AAI and SF offer to society in rural and urban areas.

Animal Assisted Interventions in the Green Care Framework: A Literature Review

Green Care (GC) and Animal Assisted Interventions (AAI) are recognised practices useful to enhance the wellbeing of people through interaction with nature and animals. This study aims at understanding the interconnections between GC and AAI by analysing deeply which interaction with animals is conducted. Therefore, we carried out a literature search through Web of Science and Google Scholar that allowed retrieval of 993 records; after the PRISMA selection process, 42 were included. Relevant information was extracted: year of publication, geographical location, objectives, settings in agricultural environment, animal species, characteristics of users involved, type of human–animal interaction, coexistence of other activities without animals, animal health and welfare issues. From the review emerged that research on GC with animals is common in high-income countries and that the line between AAI and occupational therapy is often vague. Moreover, the most common setting for these interventions appears to be the farm, and frequently animals involved are not selected according to their ethological characteristics. Users in this context are extremely various and not only involved in activities with animals. Within the included studies, we noted a lack in the consideration of animal welfare that indicates the need for increased awareness among practitioners and a more ethical approach when animals are involved.

The potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation

Purpose: The aim was to examine the potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation.Materials and methods: Interpretive description was applied as the methodology in a 5-month ethnographic fieldwork study, and guided by social practice theory. In total, 115 people with disabilities were included for participant observation, of which 15 participants were recruited for individual walking interviews.Results: Analysis revealed four overlapping themes. Firstly, "Revisiting the Outdoors" appeared to be an overarching theme, which created a basis for "Building Autonomy" among the participants. The varied outdoor experiences empowered the participants to take a more active role in their rehabilitation. These experiences afforded unique opportunities for "Connecting with Community" and, finally, "Embodied Learning" - that could be transferred to home and to other everyday contexts.Conclusion: Outdoor contexts within community-based rehabilitation appeared to hold strong potential for connecting people with disabilities to communities. Although barriers exist, we argue that revisiting the outdoors supports collective awareness and action with the capacity to influence community attitudes more broadly.IMPLICATIONS FOR REHABILITATIONOutdoor contexts within community-based rehabilitation for people with disabilities capitalise on the features of both indoor and outdoor environments with activities that meet shifting individual priorities and needs.Outdoor contexts within community-based rehabilitation offer people with disabilities empowering experiences that are part of the landscape of everyday life and transfer well to home and other environments.Community-based rehabilitation directly involving outdoor contexts and supported by professional skills provides a crucial bridge from individual rehabilitation to community belonging.

The Autumn Low Milk Yield Syndrome in High Genetic Merit Dairy Cattle: The Possible Role of a Dysregulated Innate Immune Response

Simple Summary

Milk yield worldwide is dominated by few cosmopolitan dairy cattle breeds producing high production levels in the framework of hygiene standards that have dramatically improved over the years. Yet, there is evidence that such achievements have gone along with substantial animal health and welfare problems for many years, exemplified by reduced life expectancy and high herd replacement rates. Also, these animals are very susceptible to diverse environmental stressors, among which hot summer climate plays a central role in the occurrence of diverse disease cases underlying early cull from the herd. Milk production is also affected by heat stress, both directly and indirectly, as shown by low milk yield in the following autumn period. This article highlights the low milk yield syndrome and sets it into a conceptual framework, based on the crucial role of the innate immune system in the response to non-infectious stressors and in adaptation physiology at large.

Abstract

The analysis of milk yield data shows that high genetic merit dairy cows do not express their full production potential in autumn. Therefore, we focused on metabolic stress and inflammatory response in the dry and peripartum periods as possible causes thereof. It was our understanding that some cows could not cope with the stress imposed by their physiological and productive status by means of adequate adaptation strategies. Accordingly, this study highlights the noxious factors with a potential to affect cows in the above transition period: hot summer climate, adverse genetic traits, poor coping with unfavorable environmental conditions, outright production diseases and consequences thereof. In particular, the detrimental effects in the dry period of overcrowding, photoperiod change and heat stress on mammary gland development and milk production are highlighted in the context of the autumn low milk yield syndrome. The latter could be largely accounted for by a “memory” effect on the innate immune system induced in summer by diverse stressors after dry-off, according to strong circumstantial and indirect experimental evidence. The “memory” effect is based on distinct epigenetic changes of innate immunity genes, as already shown in cases of bovine mastitis. Following a primary stimulation, the innate immune system would be able to achieve a state known as “trained immunity”, a sort of “education” which modifies the response to the same or similar stressors upon a subsequent exposure. In our scenario, the “education” of the innate immune system would induce a major shift in the metabolism of inflammatory cells following their reprogramming. This would entail a higher basal consumption of glucose, in competition with the need for the synthesis of milk. Also, there is strong evidence that the inflammatory response generated in the dry period leads to a notable reduction of dry matter intake after calving, and to a reduced efficiency of oxidative phosphorylation in mitochondria. On the whole, an effective control of the stressors in the dry period is badly needed for better disease control and optimal production levels in dairy cattle.

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.

Eco-Social Agriculture for Social Transformation and Environmental Sustainability: A Case Study of the UPAS-Project

Rural areas are facing vulnerabilities and changes caused by negative social, economic and ecological externalities resulting from industrial agriculture systems. Locally embedded farms and bottom-linked approaches such as social cooperatives that act in the field of social agriculture are small, but valuable models to counteract these trends. This article is based on a case study conducted within the transdisciplinary research and development project Unlocking the Potential of Social Agriculture (UPAS), 2017–2020—financed by the Free University of Bolzano. The main focus of the case study is to determine the impact of social agriculture initiatives on social and healthcare systems, the natural environment and the communities in which they act. Data collection includes a literature review, observations and interviews carried out on 35 case studies of social agriculture initiatives, mainly located in Italy. The field research points out that actors in the sector of social agriculture predominantly aim to integrate disadvantaged people socially and in terms of their labor, base their production on organic methods, and that social agriculture has the potential to foster eco-social transformation and development of rural areas by the combination of social and ecological concerns. Thus, we use the term “eco-social” agriculture to describe these approaches. Furthermore, five components of eco-social agriculture have been defined, which, together, offer an ideal set of acting principles, namely: (1) the empowerment and integration of disadvantaged people, (2) the promotion of environmentally friendly agricultural practices, (3) the protection of nature, resources and cultural landscape, (4) support to the local community, and (5) education for sustainable development.

Social Farming Evolutionary Web: from Public Intervention to Value Co-Production

The organization of multifunctional agriculture for the provision of social/health/educational services is spreading throughout Europe and elsewhere. This concept is not new, and the organization of practices differs according to each country’s welfare model. The aim of this paper is to reflect on the existing practices and trends and to provide a suitable comprehensive framework. Starting from long-term research action on this topic started in 1999 and from participation in European research projects and networks, this paper reflects on the features of existing practices and distinguishes emerging social farming models. Specific attention is given to the potential of social farming for both global change and the re-organization of local societies and welfare organizations. The diverse social farming models and their interactions with emerging constraints and needs during times of challenge and crisis, such as those we are currently experiencing, are considered in order to understand their basic principles (from direct support to co-production models), as well as how they correlate with the ongoing process of welfare reorganization and evolutionary societal demands.

Italian Social Farming: the Network of Coldiretti and Campagna Amica

For the last ten years, Social farming (SF) has become an innovative practice able to connect multifunctional agriculture and novel social services for urban and rural areas in Italy and the EU. By looking at the experience from Italy, it is possible to note that SF has not developed homogeneously along the national territory. It is characterized by a wide range of practices and activities related to the development of a welfare in which several topics such as subsidiarity, the value of relationship, and co-production find multiple meanings and applications. This paper provides a further contribution to the knowledge on this type of activity and opens the way to deeper considerations on the topic. The information reported in this study refers to a project born in 2018 and carried out by Fondazione Campagna Amica, a foundation promoted by Coldiretti, the main organization of agricultural entrepreneurs in Italy. This paper focuses on the analysis of data collected during this project, through in-depth interviews carried out from July 2018 to March 2019 among 229 agricultural enterprises, as well as meetings with representatives of the regional offices of Coldiretti that are involved in SF. This study aims to reach a better understanding of the development of SF in Italy through the perspective of a national network of farmers and to compare SF practices across regions in order to examine their similarities and differences. The most important results show big individual farms with a great variety of agricultural activities and livestock systems, with a clear predominance of horticulture. These SF farms mainly provide direct sales and educational activities and are involved in training and job placement services.

Social Farming: Heterogeneity in Social and Agricultural Relationships

Social farming (SF) has emerged as a social innovation practice shaping heterogeneous approaches and results. This study discusses the complexity of SF policy and practices, and it is led by the main hypothesis that the relationship between agricultural and social dimensions might be very heterogeneous, not only in different national contexts but also within the same national and local level. SF policy and practices are investigated testing the hypothesis of three main different modalities of interaction according to how the social and the agricultural perspectives interact. In the first, social target is not involved in the production system of the farm and the farm is the context where actions and measures of a social nature take place. In the second type of interaction, the farm employs the beneficiaries in some of its production activities collaborating with the social services. The third is where the farm organizes its activities to actively employ targeted people to enhance their social inclusion and integration in the community. Italian SF policy and practices are analyzed as case study, through the lens of sociological critical discourse analysis regarding the regional regulatory documents, and interviews for local case studies. The results of the study show that SF policy and practices might be very heterogeneous also within the same national and local level, outlining different hybridization of social and agriculture actions that can be properly analyzed through the three SF model proposal. This study contributes to the broader debate on the various dimensions of sustainability, suggesting the need for further research on the efficiency of SF as local development model sustainable in economic, social and environmental terms.

Migrants Workers and Processes of Social Inclusion in Italy: The Possibilities Offered by Social Farming

The agricultural sector, even though it has been greatly reduced and is in constant transformation, continues to be of strategic importance. Although it does not represent a quantitatively relevant employment sector, the dynamics are interesting because they reflect the structural, economic, and social transformations that are affecting the sector in recent years; there is a growing need for external labor that corresponds to a massive recourse of foreigners to work. Innovative approaches are required to explore the capacity of social farming to create a sustainable and inclusive workplace for migrants. The overall methodological approach of the paper seeks to synthesize fieldwork research and qualitative interviewing to validate the Italian inclusive model. To do this, we have selected four experiences of Italian social agriculture in which migrants are included.

The Wildman Programme. A Nature-Based Rehabilitation Programme Enhancing Quality of Life for Men on Long-Term Sick Leave: Study Protocol for a Matched Controlled Study In Denmark

Many men have poor mental health and need help to recover. However, designing a rehabilitation intervention that appeals to men is challenging. This study protocol aims to describe the ‘Wildman Programme’, which will be a nature-based rehabilitation programme for men on long-term sick leave due to health problems such as stress, anxiety, depression, post-cancer and chronic cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, or diabetes type II. The programme will be a nature-based rehabilitation initiative combining nature experiences, attention training, body awareness training, and supporting community spirit. The aim of the study will be to examine whether the ‘Wildman Programme’ can help to increase quality of life and reduce stress among men with health problems compared to treatment as usual. The study will be a matched control study where an intervention group (number of respondents, N = 52) participating in a 12-week nature-based intervention will be compared to a control group (N = 52) receiving treatment as usual. Outcomes are measured at baseline (T1), post-treatment (T2), and at follow up 6 months post-intervention (T3). The results of this study will be important to state whether the method in the ‘Wildman Programme’ can be implemented as a rehabilitation offer in the Danish Healthcare System to help men with different health problems.

Caring in, for, and with Nature: An Integrative Framework to Understand Green Care Practices

Green Care practices have received increasing scholarly attention in the last decade. Yet most studies are concerned with the aspect of human well-being, with less attention given to other caring dimensions and their relation to sustainability. This paper aims to contribute to an integrative understanding of Green Care by proposing an analytical framework inspired by the ethics of care literature and, in particular, Tronto’s five stages of caring (about, for, with, giving, and receiving). The goal is to use a relational lens to appreciate the diverse caring practices and their potential in three Finnish cases studies—a care farm, a biodynamic farm, and a nature-tourism company. We apply the framework on data gathered during three years through an in-depth participatory action-oriented research. Findings show that: (a) Green Care practitioners share sustainability concerns that go beyond human well-being and that translate into practices with benefits for the target users, wider community, and ecosystems; (b) caring is a relational achievement attained through iterative processes of learning. Two concluding insights can be inferred: a care lens sheds light on practitioners’ moral agency and its sustainability potential; in-depth creative methods are needed for a thorough and grounded investigation of human and non-human caring relations in Green Care practices.

Care Farming for People with Dementia; What Can Healthcare Leaders Learn from This Innovative Care Concept?

There is growing recognition that traditional dementia care models fall short for people with dementia and their family caregivers. This has led to a call for new dementia care approaches. In response to this call, innovations in long-term dementia care are taking place both in the community and in residential care. One of these innovations is the care concept called “care farming.” Care farms are farms that combine agricultural activities with care and support services for a variety of client groups, including people with dementia. Although the concept is being implemented in an increasing number of countries, the Netherlands and Norway are still front-runners in providing and researching this innovative dementia care approach. Over the last couple of years, several research projects have been carried out in these countries addressing a wide range of issues related to dementia care provision at care farms and using a wide range of research methods. This paper synthesizes the knowledge that has been generated in these research projects. By sharing the knowledge obtained in the Netherlands and Norway, we hope to inspire leaders in healthcare undertaking similar efforts to innovate care for the increasing number of people with dementia. By providing starting-points for future research, we additionally hope to contribute to a research agenda to further advance the field.

Social Farming: An Inclusive Environment Conducive to Participant Personal Growth

Social farming can ameliorate the everyday life of people engaged in farming activities, including perceived changes in mood or behavior. It can also be therapeutic, as it can address a range of public health and service provision issues. This paper presents the findings of an Italian project that explored the impact of social farming on the well-being of the participants and their ability to perform certain tasks linked to agricultural activities. In addition, this paper tries to evaluate how the organization of the network system around the participants helps them to improve their relational capabilities. Participant observations were made in class rooms and farms where the participants carried out their agricultural activities. Such observations focused on the way in which participants and other subjects (i.e., tutors and training staff) inside the network system interacted. A number of in-depth interviews were carried out with tutors and trainers in order to understand if the participants would play a relevant role in social farming activities and what that role would be.

‘I want to make myself useful’: the value of nature-based adult day services in urban areas for people with dementia and their family carers

Nature-based adult day services (ADSs) in urban areas are relatively new services in the Netherlands. Since knowledge about these services is still scarce, this study aimed to elucidate their value for people with dementia and their family carers in terms of health and wellbeing. We interviewed 39 people with dementia attending nature-based ADSs in urban areas and their family carers, and 17 providers of these services. Respondents indicated that nature-based ADSs in urban areas positively affected the health and wellbeing of people with dementia. According to them, these services support contact with nature and animals, activity engagement, physical activity, structure, social interactions, healthy eating, a sense of meaning in life and a focus on normal daily life. Respondents further indicated that these services stimulate respite, reassurance and maintenance of family carers’ own activities and social contacts. We conclude that nature-based ADSs in urban areas have a wide range of benefits that might affect the health and wellbeing of people with dementia and their family carers. Worldwide, demand is growing for innovative practices in dementia care. It is therefore worthwhile monitoring the development of dementia care innovations, such as nature-based ADSs, and for countries to exchange lessons learned from these services.