Benefits of a Three-Day Bamboo Forest Therapy Session on the Physiological Responses of University Students

Enhancing Self-Esteem, Well-Being, and Relaxation in the Elderly through Nature-Based Interventions

As the populations of many countries are aging, institutions providing support for the elderly increasingly often use nature-based interventions (NBIs) as part of their therapeutic activities. This study aimed to show the impact of 8-week active and passive NBI programs on self-esteem, well-being, and relaxation in the elderly. The NBI programs were conducted in two groups of elderly citizens of Poland: independent senior students and seniors requiring 24 h care. The Rosenberg's Self-Esteem Scale and the World Health Organization Well-Being Index were used to assess self-esteem and well-being before and after the programs. To assess relaxation, pre-post session measurements of pulse rate (PR) and blood oxygen saturation (SpO2) were used. Our study showed an improvement in the self-esteem, well-being, and relaxation of the participants of both active and passive NBI programs. In all study groups, self-esteem and well-being improved after the programs, regardless of the type of intervention, and after each NBI session, the elderly showed a decrease in PR and an increase in SpO2, which indicated a deeper state of relaxation. Our research showed a greater improvement in the tested parameters in the seniors participating in the passive programs in a garden. This confirms a key role of green spaces in residential areas for the elderly and in nursing homes.

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.

An Evolving Structure of Nature Immersion: Roots in Nightingale's Vital Power

Background: In Florence Nightingale's view, vital power resides in both earthy materials and human nature and is an essential element of health. Vital power is defined as a health force that manifests in states of being while doing in nature to generate well-being, but little is known about the generative process of vital force. Purpose: This secondary study explored the vital power of children who experienced well-being while doing in nature. Methods: Using a framework of the Nature Immersion Model, directed content analysis of parental reflections on their children's vital power experiences sought to explore patterns of being while doing in nature observed in association with parental reports of: (a) change in their children's well-being and (b) qualities of vital power evident in parental descriptions of those changes in well-being. Conclusions: The essence of vital power encompassed feelings of a life-spark, natural energy that prompted a healing shift. Implications for Practice: Linkage between a middle-range Theory of Nature Immersion and Nightingale's perspective adds a new avenue for integrating the spiritual-physical-mental dimension of self during creative nursing praxis.

Health effects of green prescription: A systematic review of randomized controlled trials

An increasing number of studies have examined the effects of green prescription on various health outcomes. The aim of this study was to systematically review published randomized controlled trial studies on the health benefits of green prescriptions. We searched PubMed, Scopus, and Web of Science for the relevant original articles published in English until June 30, 2023. Our search initially retrieved 26176 articles, of which 31 studies were included in our review after removing the duplicates and excluding ineligible articles based on their titles, abstracts, and full-text review. Consistent positive health benefits of green prescription were reported for psychological health and wellbeing (16 out of 24 studies), cardiometabolic health (five out of nine studies), physical activity (eight out of nine studies), and inflammation (two out of two studies). The reviewed studies did not report any significant benefits in orthopedic conditions, pain, and recovery from exhaustion disorder due to their implemented green prescriptions; however, the number of studies was too small to generalize the effect of green prescriptions on these outcomes. The quality of these studies was generally acceptable, with 28 studies having some concerns regarding their overall risk of bias and only three studies with a high risk of bias. All in all, this systematic review suggests that green prescriptions can be effective in improving various health outcomes, but further studies with larger sample sizes and objective measures are needed.

Psychophysiological Responses of College Students to Audio-Visual Forest Trail Landscapes

Forest trails provide urban residents with contact with nature that improves health and well-being. Vision and hearing are important forms of environmental perception, and visual and auditory stimuli should not be overlooked in forest trail landscapes. This study focused on the health benefits of the audio-visual perception of forest trail landscapes. Forest density (FD) and forest sounds (FS) in forest trail landscapes were examined as visual and auditory variables, respectively. FD was divided into three levels: high (Hd), medium (Md), and low density (Ld). FS were divided into four levels: quiet natural and anthropogenic sounds (QnQa), quiet natural and loud anthropogenic sounds (QnLa), loud natural and quiet anthropogenic sounds (LnQa), and loud natural and loud anthropogenic sounds (LnLa). The levels of these two variables were combined to create 12 conditions. A total of 360 college students were randomly assigned to 12 groups (mapping onto the 12 conditions; N=30 per group). All subjects performed the same 5-min high-pressure task indoors, followed by a 5-min recovery period of experiencing a simulated forest trail landscape (viewing pictures and listening to sounds). Brain waves, blood pressure, blood oxygen saturation (SpO2, measured with a finger monitor), the pulse rate, and mood indicators were collected to analyse the physiological and psychological responses to the audio-visual forest trail landscapes. The results indicated that higher FD and lower FS improved health benefits. The interaction between FD and FS revealed a pattern of combinations that facilitated stress reduction and positive mood recovery. These results are of theoretical value in that they indicate important audio-visual characteristics of forest trail landscapes. In terms of practical applications, these findings support the construction of urban forest trails to provide health benefits.

Effects of brief exposure to campus environment on students' physiological and psychological health

Experiences in natural environments can enhance human wellbeing and promote the recovery of physiological and psychological health. During the COVID-19 pandemic, university students' activity off-campus was limited, thus, the campus environment was particularly important for the recovery of students' physiological and psychological health. Although the benefits of sustained natural exposure are obvious for people's physiological and psychological health, the effects of brief exposure on physiological and psychological are unclear. In the present study, four types of campus environments, including square space, dense forest space, sparse forest space, and waterfront space, were selected to explore the transient recovery effects of different types of campus environments. Sixty university students were recruited, measuring their systolic blood pressure, diastolic blood pressure, and heart rate as physical parameters to assess stress recovery. Respondents also reported scores about their personal feelings in questionnaires to evaluate their psychological states. Both physiological and psychological indicators responded to the brief natural exposure (5 min), and physiological and psychological health was restored. However, only the recovery amounts of psychological indicators were significantly different in waterfront space, dense forest space, and sparse forest space. These results indicate that being compare with other spaces, the brief exposure in the waterfront space was the most beneficial to students' psychological health recovery. This recovery was attributed to the great role played by the sense of escape, but after the brief exposure, the attraction and compatibility of the environment would hinder the psychological health recovery. In conclusion, according to tests on both physiological and psychological aspects, the waterfront environment on campus is the best choice for students' transient health recovery.

The effects of forest bathing on psychological well-being: A systematic review and meta-analysis

Globally, around half (55%) of the population live in fast-paced urban settings where many people find it challenging to manage their stress and respond to crises with a positive mindset. This resulted in prolonged distress where anxiety and fatigue caused physical and mental health concerns. Nature walks involving immersive exposure in the forest, and green spaces have been posited to offer physiological and psychological benefits. Therefore, in this systematic review, we evaluated the effects of forest bathing on psychological and physiological outcomes. We searched four English and five non-English databases (Chinese and Korean) for peer-reviewed studies published between January 2000 and March 2021. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement 2020. The primary outcomes explored in this review were mainly psychological, including anxiety, depression, mood and quality of life. The secondary outcomes were physiological outcomes such as blood pressure and heart rate. We conducted a meta-analysis on each outcome using the random-effects model. Heterogeneity was assessed by the I² statistic. Thirty-six articles (21 in English, 3 in Chinese and 12 in Korean) with 3554 participants were included in this review. Our meta-analysis suggested that forest bathing can significantly reduce symptoms of depression and anxiety. However, we did not observe as many benefits in physiological outcomes. Against the background of the negative effects of urbanization on mental well-being, this review highlighted the potential therapeutic role of forests in the contemporary world, lending further evidence-based support for forest conservation.

Associations of forest negative air ions exposure with cardiac autonomic nervous function and the related metabolic linkages: A repeated-measure panel study

Forest environment has many health benefits, and negative air ions (NAI) is one of the major forest environmental factors. Many studies have explored the effect of forest environment on cardiac autonomic nervous function, while forest NAI in the among function and the underlying mechanism still remain unclear. To explore the associations and molecular linkages between short-term exposure to forest NAI and heart rate variability (HRV), a repeated-measure panel study was conducted among 31 healthy adults. Participants were randomly selected to stay in a forest park for 3 days and 2 nights. Individual exposures including NAI were monitored simultaneously and HRV indices were measured repeatedly at the follow-up period. Urine samples were collected for non-targeted metabolomics analysis. Mixed-effect models were adopted to evaluate associations among NAI, HRV indices and metabolites. The median of NAI concentration was 68.11 (138.20) cm^-3 during the study period. Short-term exposure to forest NAI was associated with the ameliorative HRV indices, especially the excitatory parasympathetic nerve. For instance, per interquartile range increase of 5-min moving average of NAI was associated with 9.99 % (95%CI: 8.95 %, 11.03 %) increase of power in high frequency. Eight metabolites were associated with NAI exposure. The down-regulated tyrosine metabolism was firstly observed, followed by other amino acid metabolic alterations. The NAI-related metabolic changes reflect the reduction of inflammation and oxidative stress. HRV indices were associated with 25 metabolites, mainly including arginine, proline and histidine metabolism. Short-term exposure to forest NAI is beneficial to HRV, especially to the parasympathetic nerve activity, by successively disturbing different metabolic pathways which mainly reflect the increased anti-inflammation and the reduced inflammation. The results will provide epidemiological evidences for developing forest therapy and improving cardiac autonomic nervous function.

Is altitude a determinant of the health benefits of nature exposure? A systematic review and meta-analysis

Introduction

Nature exposure is a widely accepted option for promoting public health owing to the recent surge of scientific evidence. However, the actual settings to facilitate this initiative is yet to be extensively reviewed. In this systematic review, we have aimed to provide an up-to-date summary of interventional studies investigating the psycho-physiological effects of forests and urban forests, including details on their physical settings, and investigate an effect-modifying role of altitude and summarize data on the magnitude and shape of the association.

Methods

A keyword search using five electronic academic databases (PubMed, Embase, PsycINFO, Web of Science, and Scopus) was conducted to identify relevant articles published in English from the inception year to the end of February 2022. The methodological quality was evaluated using the ROBINS-I or ROB2 tool, depending on the study design. Meta-regression and random effects model were jointly used to examine the relationship between altitude and health outcomes.

Results

We included 27 eligible studies and 31 cases extracted from 19 studies were used for the meta-analysis. In the meta-regression, we observed a non-linear association between altitude and psycho-physiological effects. Altitude had a positive quadratic association with anxiety (p < 0.000, adjusted R ² = 96.79%), depression (p < 0.000, adjusted R ² = 98.78%), and fatigue (p < 0.000, adjusted R ² = 64.74%) alleviating effects. Conversely, altitude demonstrated a negative non-linear association with the blood pressure-lowering effect (p = 0.009, adjusted R ² = 32.83%). Additionally, the thermal index (THI) and illuminance (lx) levels were significantly associated with effect sizes of psychological restoration.

Discussion

This review provides moderate-certainty evidence for an effect-modifying role of altitude. The meta-regression results suggested the optimal and minimal altitude ranges for psychological restoration and physiological relaxation, respectively. Despite some limitations, the study findings provide a significant basis for utilizing altitude, which is easily accessible and simple, to promote the health benefits of nature-based initiatives.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022310894, identifier: CRD42022310894.

Exploring the role of exposure to green and blue spaces in preventing anxiety and depression among young people aged 14-24 years living in urban settings: A systematic review and conceptual framework

Despite the growing problem of anxiety and depression amongst young people aged 14-24 years living in urban settings, reviews about the role of exposure to green and blue spaces or nature in preventing anxiety and depression tend to focus on children, adults or sometimes adolescents. This review aims to explore whether exposure to green and blue spaces reduces the risk of anxiety and depression among young people aged 14-24 years living in urban settings and provide a conceptual framework. The academic databases CINAHL plus, Global Health, MEDLINE, ProQuest: Dissertations and Theses, PsycINFO, Scopus and OpenGrey were searched for research published in English between January 2000 and June 2020. All study designs were eligible. All included studies were assessed for quality. Searches identified 9208 sources with 48 meeting the inclusion criteria for the review. Experimental studies provided evidence that walking or being in a green space improves mood and state anxiety immediately following the intervention. Non-randomised evaluations and observational studies suggest that social interaction, physical activity, and mindfulness mediate the relationship between exposure to green space and mental health. We propose that the absence of noise and restorative qualities of green spaces promotes mindfulness and interrupt rumination, which in turn reduce the risk of anxiety disorders and depression. This review and the resulting conceptual framework provide evidence to healthcare professionals about the value of contact with nature and green social prescribing. For policymakers, it provides evidence about the value of bringing the benefits of forests, vegetation and nature into cities, and ensuring that these spaces are accessible and safe for young people to use.

Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Forest therapy involves visiting forests or conducting forest-based treatment activities to improve one's health. Studies have investigated the health benefits of forests, but consensus has not been reached. This study comprised a systematic review and meta-analysis to determine how forest therapy affects the physiological and psychological health of adults. The Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline databases were searched on 31 August 2021. Systematic review and meta-analysis, risk evaluation, GRADE evaluation, and advertisement effect evaluation were performed for each article. The effect size was calculated by dividing blood pressure as a physiological indicator and depression as a psychological indicator. Of the 16,980 retrieved studies, 17 were selected based on the inclusion criteria. Of these, eight studies were included in the meta-analysis. The effect size of forest therapy on improving systolic and diastolic blood pressure was not significant; however, it significantly reduced depression. While the results have limited generalizability due to the inclusion of few studies, the effects of forest therapy on reducing depression have been confirmed. Since the application of forest therapy was heterogeneous in these studies, a moderator effect analysis or subgroup analysis in meta-analysis should be performed in the future.

The benefits of nature-based therapy for the individual and the environment: an integrative review

Purpose

This review aims to identify the commonly used nature-based therapies, the cohorts that benefit from these interventions, and the potential environmental impact of nature-based therapies.

Design/methodology/approach

An integrative review methodology was taken. The literature was analysed and synthesised through thematic analysis.

Findings

Three themes emerged from the analysis: categories of nature-based therapies; benefits of nature-based therapies; and the gains from nature-based therapies are not universal. Evidence of physiological, psychological, social, vocational and quality of life benefits from participation in nature-based therapies was evident in the literature. However, there was insufficient empirical evidence of the benefits for the environment.

Practical implications

Occupational therapists assist populations across the life course. Consequentially, they can be found working in a diverse range of clinical contexts. This review asserts that nature-based therapies could be a positive addition in many of these contexts. Further, while engagement in activities in natural environments is frequently used by occupational therapists practicing within institution environments, there is evidence to support its use in community service models and potentially in public health strategies.

Originality/value

This integrative review brings together evidence on a diverse range of nature-based therapies, cohorts, associated benefits and factors that influence these. The lack of empirical evidence on the benefits of nature-based therapies for the environment is acknowledged as a gap in the literature

An Empirical Study of the Restoration Potential of Urban Deciduous Forest Space to Youth

Urban deciduous forests are an important ecological resource and seasonal landscape in the urban environment. However, in the abundant literature on how urban green space promotes human health and well-being, research on urban seasonal deciduous forests is limited. This study aimed to investigate the physiological and psychological recovery potential provided of urban deciduous forest space for youths and the spatial preferences of youths regarding such spaces. We recruited 120 participants to study the restorative potential of two typical urban deciduous forest landscape spaces (experimental groups) and one urban road environment (control group). The results showed that after 15 min of observation, the blood pressure (especially the diastolic blood pressure (p < 0.01)) and pulse of the deciduous forest trail setting (DFTS) group effectively decreased, and the restorative mood significantly increased. Regarding change in emotional parameters, the DFTS group scored higher on “interest” and significantly higher than the other two groups on positive emotion. The correlation results show that density and level are the key factors affecting spatial preferences regarding complex deciduous forests. An increase in density reduces the mood of re-laxation, and an increase in level decreases fatigue and interest. We suggest (1) constructing foot-paths in urban deciduous forests to reduce their spatial density as to improve the relaxation effect and (2) increasing landscape diversity according to the forest space to facilitate user participation and interest. This study provides a scientific basis for the environmental restoration of deciduous landscapes and for urban forestry management decision-makers based on space type construction.

What Activities in Forests Are Beneficial for Human Health? A Systematic Review

Over the past decade, clinical trials of forest-based interventions have increased, leading to their recognition as preventive medicine. However, little is known about the differences in health effects according to the activity characteristics of interventions. This study aimed to understand the types of activities and their associated health effects to identify differences in health effects between activities. PubMed, PsycINFO, Web of Science, and Scopus databases were searched, and methodological quality was assessed using Cochrane ROB2. A total of 32 randomized controlled trials (RCTs) met the eligibility criteria. Health outcomes were collected from 6264 participants aged 6-98 years, and the sample size was 12-585. The Interventions were walking (n = 21), staying (n = 7), exercise (n = 4), indirect exposure (n = 4), and the activity time was between 10 and 240 min. Overall, walking showed consistent positive health effects, and there were differences in effects on anxiety and depression, cognitive function, stress hormone, and inflammation according to the activity. However, most of the included studies had a high risk of bias, and interventions were limited to specific activities, durations, and frequencies. Although a few limitations remain, the findings in this study are of great significance in providing the basis for the design of forest-based interventions.

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.

Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis

Mental health problems are associated with lower quality of life, increased unscheduled care, high economic and social cost, and increased mortality. Nature-based interventions (NBIs) that support people to engage with nature in a structured way are asset-based solutions to improve mental health for community based adults. However, it is unclear which NBIs are most effective, or what format and dose is most efficacious. We systematically reviewed the controlled and uncontrolled evidence for outdoor NBIs. The protocol was registered at PROSPERO (CRD42020163103). Studies that included adults (aged ≥18 years) in community-based settings with or without mental and/or physical health problems were eligible for inclusion. Eligible interventions were structured outdoor activities in green and/or blue space for health and wellbeing. We searched ASSIA, CENTRAL, Embase, Greenfile, MEDLINE, PsycINFO, and Web of Science in October 2019; the search was updated in September 2020. We screened 14,321 records and included 50 studies. Sixteen studies were randomised controlled trials (RCTs); 18 were controlled studies; and 16 were uncontrolled before and after studies. Risk of bias for RCTs was low to moderate; and moderate to high for controlled and uncontrolled studies. Random effects meta-analysis of RCTs showed that NBIs were effective for improving depressive mood -0.64 (95% CI: 1.05 to -0.23), reducing anxiety -0.94 (95% CI: 0.94 to -0.01), improving positive affect 0.95 (95% CI: 0.59 to 1.31), and reducing negative affect -0.52 (95% CI: 0.77 to -0.26). Results from controlled and uncontrolled studies largely reflected findings from RCTs. There was less evidence that NBIs improved physical health. The most effective interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 min. NBIs, specifically gardening, green exercise and nature-based therapy, are effective for improving mental health outcomes in adults, including those with pre-existing mental health problems.

Can Different Forest Structures Lead to Different Levels of Therapeutic Effects? A Systematic Review and Meta-Analysis

In recent decades, forests have expanded from natural resources for conservation and production to health-promoting resources. With the growing body of evidence supporting the therapeutic effects of forests, the number of investigations on the relationship between forest characteristics and therapeutic effects have increased. However, quantitative synthesis of primary studies has rarely been conducted due to a limited number of health studies including forest description and high heterogeneity of forest variables. In this study, we conducted a systematic review and meta-analysis to evaluate the relationship between the forest structure and the therapeutic effect. We systematically searched the studies examining the therapeutic effects of forests with different stand density and canopy density and synthesized the results. As a result of subgroup analysis, we found that stand density modifies the therapeutic effects. Emotional and cognitive restoration showed greatest improvement in low-density forests with a stand density of less than 500/ha and the therapeutic effects diminish as the stand density increases. The impact of canopy density was not found due to a lack of studies reporting canopy density. Although some limitations remain, the findings in this study have great significance in providing the basis for establishing management strategies of forests for therapeutic use.

Green Space Quality and Health: A Systematic Review

(1) Background: As cities densify, researcher and policy focus is intensifying on which green space types and qualities are important for health. We conducted a systematic review to examine whether particular green space types and qualities have been shown to provide health benefits and if so, which specific types and qualities, and which health outcomes. (2) Methods: We searched five databases from inception up to June 30, 2021. We included all studies examining a wide range of green space characteristics on various health outcomes. (3) Results: 68 articles from 59 studies were found, with a high degree of heterogeneity in study designs, definitions of quality and outcomes. Most studies were cross-sectional, ecological or cohort studies. Environment types, vegetation types, and the size and connectivity of green spaces were associated with improved health outcomes, though with contingencies by age and gender. Health benefits were more consistently observed in areas with greater tree canopy, but not grassland. The main outcomes with evidence of health benefits included allergic respiratory conditions, cardiovascular conditions and psychological wellbeing. Both objectively and subjectively measured qualities demonstrated associations with health outcomes. (4) Conclusion: Experimental studies and longitudinal cohort studies will strengthen current evidence. Evidence was lacking for needs-specific or culturally-appropriate amenities and soundscape characteristics. Qualities that need more in-depth investigation include indices that account for forms, patterns, and networks of objectively and subjectively measured green space qualities.

Physiological and Psychological Effects of Nature Experiences in Different Forests on Young People

Many studies have proved that having nature experiences in forests is conducive to human physiological and psychological health. However, currently there is little research focusing on the effects of forest characteristics and the experiential characteristics of nature experiences on changes in health. In the study, three types of forest (mixed forest; deciduous forest; coniferous forest) and an urban site were used to measure the effects of these environments on participants’ physiological and psychological restoration after nature experience activities (sitting and walking activities). The study participants were 30 young adult students from Beijing Forestry University. Restorative effects were measured by physiological indicators (blood pressure and heart rate) and four psychological questionnaires (Profile of Mood States (POMS); Restorative Outcome Scale (ROS); Subjective Vitality Scale (SVS); Warwick-Edinburgh Mental Well-being Scale (WEMWBS)). Results demonstrated that all types of forest were beneficial to lower blood pressure and heart rate as well as to reduce negative feelings while boosting positive emotions. The mixed forest was more effective in lowering blood pressure and heart rate as well as increasing vitality. The levels of restoration and positive mental health increased significantly, while all subscales of the POMS (with the exception of vigor) decreased greatly in the coniferous forest. Relative to the sitting activity, obvious decreases in blood pressure and negative emotions were observed, while significant increases in restoration, vitality and positive mental health were observed after the walking activity. In conclusion, the impact on subjects’ health restoration varied with different forest characteristics, and the experiential characteristics of exposure may be helpful for creating supportive interventions and lifting the benefits of forest therapy as people interact with the forest.

Green Space and Health in Mainland China: A Systematic Review

Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China's rapid urbanization and economic growth.

The Development of a Health Promotion Program for Unmarried Mothers Living in Residential Facilities Using Urban Forests: An Intervention Mapping Approach Based on the Transtheoretical Model

Unmarried mothers living in residential facilities (UMLFs) in Korea face complex and challenging physical, psychological, and socioeconomic issues. This study developed a physical and mental health promotion program using urban forests for UMLFs based on the transtheoretical model and evidence. We utilized an intervention mapping approach (IMA) and assessed the needs of UMLFs by analyzing previous quantitative studies. Moreover, we conducted a qualitative hermeneutic phenomenological study involving nine participants. Based on the needs assessment, important and changeable determinants were identified; further, the program performance and change objectives were classified to achieve the program goals and establish the intervention strategy. We found that physical activity using forests, self-reflection using metaphors, five-sense activities, achievement activities using natural objects, building interpersonal relationships in the forest, and designing future plans, are desirable methods for improving the health of UMLFs. The IMA was deemed appropriate for the systematic development of health promotion programs for UMLFs through clear links among change objectives, theoretical methods, and practice strategies. These results should be applied to future intervention studies.

Contributions of the health-promoting universities' movement: An integrative literature review

The objective was to identify the existing links between the conceptual proposal of the movement of health-promoting universities (HPU) and the activities carried out to increase the health of workers in higher education institutions. An integrative literature review was conducted in October 2020 in the following databases: LILACS, Scientific Electronic Library Online, Web of Science, and CINAHL and with the Boolean phrase citing, University AND "health promotion." In the initial review, 5351 studies were found, and after removing the repetitions, applying the inclusion criteria, and making the qualitative analysis, a sample of 9 articles was obtained. For the construction of the flowchart with the representation of the eligibility and inclusion of the articles, the PRISMA model was use. The findings were analyzed with the theoretical and conceptual support of the movement of HPU, which made it possible to establish the construction of three categories, to quote: full provision of social, medical, and health services; creating a favorable health environment on campus; and development of health education actions. The movement of HPU is relevant to the contemporary world; however, initiatives to incorporate these practices are still scarce, creating a gap between expectations and reality.

Public Spaces as Knowledgescapes: Understanding the Relationship between the Built Environment and Creative Encounters at Dutch University Campuses and Science Parks

The success of university campuses depends on the interrelations between creative encounters and the built environment, conceptualised here as spatial affordances for creativity. Such an interface plays a fundamental role in interactions for knowledge sharing and the exchange of ideas on campus. Due to campus public spaces generally being considered as the leftovers between buildings and classrooms, undermanaged, and overlooked, little is known about the extent to which this built environment enables or inhibits creative encounters in such spaces. The inner-city campuses and science parks (SPs) of Amsterdam and Utrecht, the case-studies of this research, differ in terms of their location relative to the city, their masterplan typologies and the arrangement of buildings. However, they are similar in terms of the aforementioned issues of public spaces. The novelty of this research is the attempt to overcome such issues using an innovative mixed-methods approach that tests the ‘spatial affordances for creativity’ with empirical data collection and analysis. This raises the importance of mapping, quantifying and analysing the spatial distribution of momentary perceptions, experiences, and feelings of people with methods such as volunteered geographic information (VGI). The results show that proximity between multiple urban functions and physical features, such as parks, cafés and urban seating are important when it comes to explaining the high frequency of creative encounters between people. Urban designers of campuses can use the applied method as a tool to plan and design attractive public spaces that provide creativity through the transfer of tacit knowledge, social well-being, positive momentary perceptions, sense of community, and a sense of place.

Health Benefits Derived from Forest: A Review

In this paper the scientific literature on the association between forests, stress relief and relaxation is reviewed with the purpose to understand common patterns of research, the main techniques used for analysis, findings relevant to forest-therapy-oriented management, and knowledge gaps. The database of studies was collected with a keyword search on the Web, which returned a set of 32 studies that were included in the analysis. The main findings and patterns were identified with a text mining analysis of the abstract to search for keyword patterns across studies. The analysis indicates that most studies compared rest and relaxation performances across urban and forest environments and used a combination of self-reported measure of stress or rest collected with validate scales, e.g., the Profile of Mood of States (POMS) and the Restoration Outcome Scale (ROS), and a minority-only set of these two groups of indicators. Results of this review indicate that primary studies identified a positive association between forest exposure and mental well-being, in particular when compared to urban environments, thus suggesting that forest are effective in lowering stress levels. This study found that, to date, the characteristics of forests and characteristics of the visit are little investigated in the literature. For this reason, more research with a focus on forest variables such as tree species composition, tree density and other variables affecting forest landscape should be further investigated to inform forest management. Similarly, the characteristics of the visits (e.g., length of visit and frequency) should be further explored to provide robust forest therapy guidelines.