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

Exposure to urban green spaces and mental health during the COVID-19 pandemic: evidence from two low and lower-middle-income countries

Introduction

The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns. This study investigated changes in green space access and associations with mental health recovery in Bangladesh and Egypt across the pandemic.

Methods

An online survey was conducted between January and April 2021 after the first lockdown was lifted in Bangladesh (n = 556) and Egypt (n = 660). We evaluated indoor and outdoor greenery, including the number of household plants, window views, and duration of outdoor visits. The quantity of greenness was estimated using the normalized difference vegetation index (NDVI). This index was estimated using satellite images with a resolution of 10x10m during the survey period (January-April 2021) with Sentinel-2 satellite in the Google Earth Engine platform. We calculated averages within 250m, 300m, 500m and 1000m buffers of the survey check-in locations using ArcGIS 10.3. Multiple linear regression models were used to evaluate relationships between changes in natural exposure and changes in mental health.

Results

The results showed that mental health improved in both countries after the lockdown period. People in both countries increased their time spent outdoors in green spaces after the lockdown period, and these increases in time outdoors were associated with improved mental health. Unexpectedly, changes in the number of indoor plants after the lockdown period were associated with contrasting mental health outcomes; more plants translated to increased anxiety and decreased depression. Refocusing lives after the pandemic on areas other than maintaining indoor plants may assist with worrying and feeling panicked. Still, indoor plants may assist with depressive symptoms for people remaining isolated.

Conclusion

These findings have important implications for policymakers and urban planners in LMICs, highlighting the need to increase access to natural environments in urban areas to improve mental health and well-being in public health emergencies.

Does increasing biodiversity in an urban woodland setting promote positive emotional responses in humans? A stress recovery experiment using 360-degree videos of an urban woodland

Green spaces can support human stress reduction and foster positive emotional well-being. Previous research has suggested that biodiversity (i.e. the variety of species of plants and animals in a given location) can enhance recovery from stress even further. However, there is limited experimental evidence testing this hypothesis and results, to date, have been mixed. This study aimed to provide further understanding of the role of biodiversity (actual or perceived) on human well-being by experimentally manipulating species richness and stress. Participants (372 in total) took part in an online experiment, where they received an episode of mild stress before watching a 360-degree video to recover. The video showed the same location, an urban woodland, but at one of four artificially manipulated levels of biodiversity. The participants reported their Positive and Negative Affect before and after the stress induction and after watching the video, providing a measure of their stress and well-being throughout the experiment. Participants also reported their perceptions of biodiversity (i.e. how diverse they thought the location was) and elaborated on their responses with brief comments. Repeated Measure Analysis of Variance revealed that exposure to all levels of biodiversity reduced the participants' Negative Affect, but with no significant difference between the conditions. However, the analysis showed higher Positive Affect in those participants who perceived the environment as more biodiverse. Comments from participants indicated that those who reported noticing flowers and trees in the environment also showed higher Positive Affect. This suggests that perceiving biodiversity promotes more positive emotions, but critically one needs to actually notice (engage with) the components of biodiversity to elicit these extra benefits.

Development and effects of a non-face-to-face forest therapy program for nurses during the COVID-19 pandemic

AIM

In this study, we developed a non-face-to-face forest therapy program using videos and applied it to nurses working in hospitals during the prolonged COVID-19 situation to confirm the effect on their mental health.

METHOD

This study was a randomized control group pretest-posttest, and 27 clinical nurses in the experimental group and 28 clinical nurses in the control group participated. The program developed forest therapy videos and three city videos each. The experimental group watched the forest therapy video and the control group watched the city video and stress and happiness were measured through pre-test and post-test.

RESULTS

The stress level of clinical nurses who applied the non-face-to-face forest therapy program had a significant reduction effect compared to the control group on day 2 (t = -2.239 P = .026) and day 3 (t = -3.188, P = .003). On the other hand, there was no significant effect in happiness in both groups. In addition, repeated measures analysis of variance statistical analysis confirmed that the stress level of the experimental group significantly decreased over time (F = 10.578, P < .001).

CONCLUSION

The non-face-to-face forest therapy program is significant in that it had a positive effect on relieving stress by conducting a randomized controlled study targeting clinical nurses working in various hospitals.

Conceptualizing the socio-cultural impacts of marine plastic pollution on human well-being - A perspective

Marine plastic pollution is one of the major environmental problems globally, with adverse impacts on human well-being but socio-cultural impacts remain poorly conceptualized and little understudied. This perspective paper argues for a more nuanced understanding of the socio-cultural dimensions of impacts beyond direct and quantitatively measured impacts. The paper provides a working definition of and a conceptual framework for categorizing the socio-cultural impacts of marine plastic pollution. It also highlights three dimensions of socio-cultural impacts (lifestyle, mental health, and cultural and heritage impacts), and characterizes and suggests ways socio-cultural impacts can be assessed and recognized. The paper is meant to provoke productive debate and policy and management options for addressing the impacts of marine plastic pollution in socially meaningful and equitable ways.

A systematic review of the anxiety-alleviation benefits of exposure to the natural environment

Research suggests that exposure to natural environments can be beneficial for health, such as reducing physical illness and improving mood and cognitive ability. The potential benefits of nature have come into focus at a time when mental health issues are growing globally. Here, we have selected 24 studies from four databases for meta-analysis to explore the effects of exposure to the natural environment on the anxiety of the human body and summarize the influencing factors on the anxiety relief effect. A random-effect meta-analysis of anxiety state changes before and after exposure to natural environment shows that natural exposure effectively alleviated human anxiety (SMD -1.28, 95% CI: -1.65 to -0.92). The overall quality of the included papers, assessed using the PEDro scale, is considered to vary considerably, but most of the papers are rated between 4 and 7 which is considered fair or good. In addition, we have also investigated the potential moderators of anxiety-relieving effects of the nature. Our results shows that the age and exposure time of the subjects are related to the effect of anxiety relief. The results of the subgroup analysis of moderators prove that compared with the middle-aged people (SMD -0.63, 95% CI: -1.13 to -0.12), young people (SMD -1.50, 95% CI: -1.90 to -1.10) get better anxiety alleviation effect in the natural environment. In terms of exposure time, compared with 0.5-2 h (SMD -0.18, 95% CI: -0.59 to -0.23) and >2 h (SMD -0.84, 95% CI: -1.40 to -0.27) exposure periods, subjects get the maximum anxiety relief benefit when they spent <0.5 h (SMD -1.60, 95% CI: -1.93 to -1.27) in the natural environment. However, the quality of the included studies varies greatly and there is a significant heterogeneity in the meta-analysis. Study location, natural environment type and other moderator factors have no obvious correlation with anxiety-alleviation effect of the nature. A higher quality and more comprehensive study needs to be carried out to find out more moderators about the effects of the natural environment on anxiety alleviation. Further experimental studies should also be conducted to determine the mechanism by which natural exposure reduces anxiety so as to provide strong support for the construction and improvement of healthy natural environment.

Natural environments, psychosocial health, and health behaviors in a crisis - A scoping review of the literature in the COVID-19 context

The COVID-19 outbreak led to major restrictions globally, affecting people's psychosocial health and their health behaviors. Thus, the purpose of this scoping review was to summarize the available research regarding nature and health in the COVID-19 context. Keywords relating to natural environments and COVID-19 were combined to conduct a systematic online search in six major databases. Eligibility criteria were a) published since 2020 with data collected in the COVID-19 context b) peer-reviewed, c) original empirical data collected on human participants, d) investigated the association between natural environments and psychosocial health or health behaviors, and e) English, German, or Scandinavian languages. Out of 9126 articles being screened, we identified 188 relevant articles, representing 187 distinct studies. Most research focused on adults in the general population and was predominantly conducted in the USA, Europe, and China. Overall, the findings indicate that nature may mitigate the impact of COVID-19 on psychological health and physical activity. Through a systematic thematic analysis of the extracted data, three primary themes were identified: 1) type of nature assessed, 2) psychosocial health and health behaviors investigated, and 3) heterogeneity in the nature-health relationship. Research gaps in the COVID-19 context were identified regarding I) nature characteristics that promote psychosocial health and health behaviors, II) investigations of digital and virtual nature, III) psychological constructs relating to mental health promotion, IV) health-promoting behaviors other than physical activity, V) underlying mechanisms regarding heterogeneity in the nature-health relationship based on human, nature, and geographic characteristics, and VI) research focusing on vulnerable groups. Overall, natural environments demonstrate considerable potential in buffering the impact of stressful events on a population level on mental health. However, future research is warranted to fill the mentioned research gaps and to examine the long-term effects of nature exposure during COVID-19.

Increased appreciation of forests and their restorative effects during the COVID-19 pandemic

Public expectations of forests as high-quality restorative environments that facilitate subjective well-being and stress relief along with numerous health benefits have been rising sharply during recent decades. In addition, the COVID-19 pandemic and its accompanying restrictive measures also transformed forests into some of the few places to spend time away from home. The presented study drew on the assumption that the pandemic situation and a rise in the number of forest visits would affect the experience, recognition, and appreciation of the well-being aspects related to spending time in forests. The study goal was to elucidate the potential effects of the COVID-19 pandemic on the relationships between forest visits, well-being and stress relief, emotions, perception of nature and forest value and importance, pro-environmental behavior, and societal expectations of the role of forests and forest ecosystem services. A survey using a digital questionnaire was conducted several months after the pandemic outbreak on a representative sample of the Slovak population. The Wilcoxon test and ordinal regression analysis were used to identify significant relationships, e.g., between the recency of anger episodes and the number of forest visits. The results showed that the pandemic strengthened the perception of forests as a high-quality restorative environment and that emotions associated with forest visits played an important role in the perceived importance of forests and their possible overexploitation. The results underscore the urgent need to put demands for forest recreation on par with the forest bioeconomy and to sensitize forest visitors to management and conservation requirements.

Effects of immersion in a simulated natural environment on stress reduction and emotional arousal: A systematic review and meta-analysis

Background

Although the mental health benefits of exposure to simulated natural environments are well established by researchers from environmental psychology, landscape architecture, and public health, it is unclear whether and to what extent technological immersion affects these benefits.

Methods

Systematical literature searches were conducted in May 2022 from six databases. The risk of bias was evaluated using the Cochrane's Risk of Bias tool 2.0 and the Risk of Bias in Non-randomized Studies of Interventions tool. We performed a random-effects meta-regression to investigate the heterogeneity. The immersion levels of included studies were classified by projection devices and motion capture, and then subgroup analysis was conducted.

Results

Twenty-six publications were included. Exposure to simulated nature was confirmed to be associated with increased positive affect 0.40 [95% confidence interval (CI): 0.22, 0.58], vigor 0.58 (95% CI: 0.30, 0.86), calmness 0.54 (95% CI: 0.17, 0.92) and decreased perceived stress -0.38 (95% CI: -0.71, -0.06), total mood disturbance -0.87 (95% CI: -1.17, -0.57), tension -0.70 (95% CI: -0.99, -0.41), fatigue -0.60 (95% CI: -0.91, -0.28), anxiety -0.72 (95% CI: -1.43, -0.02), depression -0.33 (95% CI: -0.52, -0.14), confusion -0.79 (95% CI: -1.19, -0.40), and anger -0.54 (95% CI: -0.76, -0.31). Gender, health status, study design, mean age, and single exposure duration were not significant when entered in a meta-regression. For positive affect, medium immersion was observed to produce a larger effect than low and high immersion. All included studies had a moderate to high risk of bias.

Conclusion

Audio-visual exposure to simulated nature contributes to stress relief and emotional arousal. The immersion level explains the heterogeneity of positive affect triggered by simulated nature. Focusing on the technical features will open up new possibilities for combining actual and simulated nature's mental health benefits.

Is indoor and outdoor greenery associated with fewer depressive symptoms during COVID-19 lockdowns? A mechanistic study in Shanghai, China

Increasing numbers of studies have observed that indoor and outdoor greenery are associated with fewer depressive symptoms during COVID-19 lockdowns. However, most of these studies examined direct associations without sufficient attention to underlying pathways. Furthermore, few studies have combined different types of indoor and outdoor greenery to examine their effects on the alleviation of depressive symptoms. The present study hypothesized that indoor and outdoor exposure to greenery increased the perceived restorativeness of home environments, which, in turn, reduced loneliness, COVID-related fears, and, ultimately, depressive symptoms. To test our hypotheses, we conducted an online survey with 386 respondents in Shanghai, China, from April to May 2022, which corresponded to strict citywide lockdowns that resulted from the outbreak of the Omicron variant. Indoor greenery measures included the number of house plants, gardening activities, and digital nature exposure as well as semantic image segmentation applied to photographs from the most viewed windows to quantify indoor exposure to outdoor trees and grass. Outdoor greenery measures included total vegetative cover (normalized difference vegetation index [NDVI]) within a 300 m radius from the home and perceived quality of the community's greenery. Associations between greenery and depressive symptoms/clinical levels of depression, as measured by the Patient Health Questionnaire-9 (PHQ-9), were examined using generalized linear and logistic regression models. Structural equation modeling (SEM) was used to test pathways between greenery exposure, restorativeness, loneliness, fear of COVID-19, and depressive symptoms. The results showed that: 1) indoor and outdoor greenery were associated with fewer depressive symptoms; 2) greenery could increase the restorativeness of the home environment, which, in turn, was associated with fewer COVID-related mental stressors (i.e., loneliness and fear of COVID-19), and ultimately depressive symptoms; and 3) gender, education, and income did not modify associations between greenery and depressive symptoms. These findings are among the first to combine objective and subjective measures of greenery within and outside of the home and document their effects on mental health during lockdowns. Comprehensive enhancements of greenery in living environments could be nature-based solutions for mitigating COVID-19 related mental stressors.

The Feasibility and Impact of Practising Online Forest Bathing to Improve Anxiety, Rumination, Social Connection and Long-COVID Symptoms: A Pilot Study

BACKGROUND

Long-COVID affects over 144 million people globally. In the absence of treatments, there is a need to establish the efficacy of therapies that improve patient outcomes. Forest bathing has been demonstrated to improve physical and mental outcomes but there is no evidence in Long-COVID patients. Accordingly, this pilot study sought to determine the feasibility and effectiveness of online forest bathing in adults with Long-COVID.

METHODS

Feasibility was assessed by monitoring retention rates and participant feedback. In a waitlist controlled, repeated measures design, 22 Long-COVID patients completed weekly online surveys during a four-week waitlist control period, before engaging in four weekly online forest bathing sessions, completing post-intervention surveys following each session.

RESULTS

In terms of retention, 27% did not provide post-intervention data, reasons for non-adherence were: feeling too ill, having medical appointments, or having career responsibilities. Compared with the waitlist control period, there were statistically significant improvements in Anxiety (49% decrease), Rumination (48% decrease), Social Connection (78% increase), and Long-COVID symptoms (22% decrease). Written qualitative comments indicated that participants experienced feelings of calm and joy, felt more connected socially and with nature, and experienced a break from the pain and rumination surrounding their illness.

CONCLUSIONS

Online Forest bathing resulted in significant improvements in well-being and symptom severity and could be considered an accessible and inexpensive adjunct therapy for Long-COVID patients. Where people have limited access to in-person nature, virtual nature may offer an alternative to improve health and well-being outcomes.

Nature's contributions in coping with a pandemic in the 21st century: A narrative review of evidence during COVID-19

While COVID-19 lockdowns have slowed coronavirus transmission, such structural measures also have unintended consequences on mental and physical health. Growing evidence shows that exposure to the natural environment (e.g., blue-green spaces) can improve human health and wellbeing. In this narrative review, we synthesized the evidence about nature's contributions to health and wellbeing during the first two years of the COVID-19 pandemic. We found that during the pandemic, people experienced multiple types of nature, including both outdoors and indoors. Frequency of visits to outdoor natural areas (i.e., public parks) depended on lockdown severity and socio-cultural contexts. Other forms of nature exposure, such as spending time in private gardens and viewing outdoor greenery from windows, may have increased. The majority of the evidence suggests nature exposure during COVID-19 pandemic was associated with less depression, anxiety, stress, and more happiness and life satisfaction. Additionally, nature exposure was correlated with less physical inactivity and fewer sleep disturbances. Evidence was mixed regarding associations between nature exposure and COVID-related health outcomes, while nature visits might be associated with greater rates of COVID-19 transmission and mortality when proper social distancing measures were not maintained. Findings on whether nature exposure during lockdowns helped ameliorate health inequities by impacting the health of lower-socioeconomic populations more than their higher-socioeconomic counterparts for example were mixed. Based on these findings, we argue that nature exposure may have buffered the negative mental and behavioral impacts of lockdowns during the COVID-19 pandemic. Recovery and resilience during the current crises and future public health crises might be improved with nature-based infrastructure, interventions, designs, and governance.

Nature's contributions in coping with a pandemic in the 21st century: A narrative review of evidence during COVID-19

While COVID-19 lockdowns have slowed coronavirus transmission, such structural measures also have unintended consequences on mental and physical health. Growing evidence shows that exposure to the natural environment (e.g., blue-green spaces) can improve human health and wellbeing. In this narrative review, we synthesized the evidence about nature's contributions to health and wellbeing during the first two years of the COVID-19 pandemic. We found that during the pandemic, people experienced multiple types of nature, including both outdoors and indoors. Frequency of visits to outdoor natural areas (i.e., public parks) depended on lockdown severity and socio-cultural contexts. Other forms of nature exposure, such as spending time in private gardens and viewing outdoor greenery from windows, may have increased. The majority of the evidence suggests nature exposure during COVID-19 pandemic was associated with less depression, anxiety, stress, and more happiness and life satisfaction. Additionally, nature exposure was correlated with less physical inactivity and fewer sleep disturbances. Evidence was mixed regarding associations between nature exposure and COVID-related health outcomes, while nature visits might be associated with greater rates of COVID-19 transmission and mortality when proper social distancing measures were not maintained. Findings on whether nature exposure during lockdowns helped ameliorate health inequities by impacting the health of lower-socioeconomic populations more than their higher-socioeconomic counterparts for example were mixed. Based on these findings, we argue that nature exposure may have buffered the negative mental and behavioral impacts of lockdowns during the COVID-19 pandemic. Recovery and resilience during the current crises and future public health crises might be improved with nature-based infrastructure, interventions, designs, and governance.

Effects of Forest-Based Interventions on Mental Health: A Meta-Analysis of Randomized Controlled Trials

Forest-based interventions are a promising alternative therapy for enhancing mental health. The current study investigated the effects of forest therapy on anxiety, depression, and negative and positive mental condition through a meta-analysis of recent randomized controlled trials, using the PRISMA guideline. Of 825 articles retrieved from databases including PubMed, EMBASE, CINAHL, Cochrane, and PsycINFO, 6 met the inclusion criteria. The results of this study showed that forest-based interventions improved the mental health of participants in the intervention groups when compared to those in the control groups. Thirty-four outcome variables were analyzed from six studies. The overall effect size of the forest therapy programs was 1.25 (95% CI = 0.93−1.57, p < 0.001), which was large and statistically significant. These findings imply that forest-based interventions can improve mental health as a nonpharmacological intervention. This study is significant in that it is a meta-analysis of mental health that included only high-quality domestic and international RCTs. In future studies, more RCTs related to various forest interventions and studies involving many participants should be undertaken, which will complement heterogeneity in future meta-analysis studies.

COVID Feel Good: Evaluation of a Self-Help Protocol to Overcome the Psychological Burden of the COVID-19 Pandemic in a German Sample

The COVID-19 pandemic has severe consequences for physical as well as mental well-being. In times of restricted social contact, online self-help programs offer a low-threshold first aid to cope with the psychological burden. This current study evaluates the online self-help protocol “COVID Feel Good” in a German sample. The multicentric study was designed as a single cohort with a waiting list control condition. The convenience sample consisted of 38 German individuals who experienced at least two months of restrictions during the COVID-19 pandemic. The 7-day self-help protocol included the VR video “Secret Garden” as well as a social or cognitive exercise each day. General distress, depression, anxiety, stress, and hopelessness were assessed as primary outcomes. Social connectedness and fear of coronavirus were measured as secondary outcomes. Results showed a significant decrease in all primary outcomes except for hopelessness. Furthermore, the results indicated a significant improvement in social connectedness. Treatment effects on general distress, depression, stress, and anxiety persisted for two weeks after participation. The present study indicates that VR-based self-help protocols can mitigate the psychological burden associated with the pandemic, supporting recent findings.

Rapid Evidence Review of Community Engagement and Resources in the UK during the COVID-19 Pandemic: How Can Community Assets Redress Health Inequities?

Community engagement, such as participating in arts, nature or leisurely activities, is positively associated with psychological and physiological wellbeing. Community-based engagement during the COVID-19 pandemic facilitated informal and local mutual aid between individuals. This rapid evidence review assesses the emergence of community-based arts, nature, music, theatre and other types of cultural engagement amongst UK communities in response to the COVID-19 pandemic. Here, we focus on all community engagement with a sub-focus on provisions accessed by and targeted towards vulnerable groups. Two hundred and fifty-six resources were included that had been created between February 2020 and January 2021. Resources were identified through Google Scholar, PubMed, Web of Science, MedRXic, PsycharXiv and searches for grey literature and items in the public domain. The majority reported services that had been adapted to become online, telephone-based or delivered at a distance from doorsteps. Several quality assessment frameworks were used to evaluate the quality of data. Whilst a number of peer-reviewed, grey literature and public domain articles were identified, less than half of the identified literature met quality thresholds. The pace of the response to the pandemic may have meant that robust evaluation procedures were not always in place.

The Healing Power of Clean Rivers: In Silico Evaluation of the Antipsoriatic Potential of Apiin and Hyperoside Plant Metabolites Contained in River Waters

Humanity may benefit greatly from intact riverine ecosystems not only because they supply water to be used in the most common human activities, but also for the effects that clean rivers can have on human health. Herein, we used a computational approach to show that some phytochemicals produced by riparian plants as secondary metabolites, which are naturally released into river waters, can have therapeutic properties. These include antipsoriatic activities which we demonstrated in silico by modelling the interaction of apiin, guanosine and hyperoside, a few main river plant metabolites, with NF-kB, IL-17 and IL-36, which are recognized targets involved in psoriasis disease. In particular, we found that apiin and hyperoside are endowed with docking energies and binding affinities which are more favorable than the known reference inhibitors of the three protein targets whilst, in silico, guanosine shows comparable activity with respect to the inhibitors of IL-36 and NF-kB. The low skin permeation (logKp < −8) we predicted for apiin and hyperoside led us to hypothesize their possible utilization as topic antipsoriatic therapeutics, and in particular after PAINS (pan-assay interference compounds) score evaluation, we reached the conclusion that apiin, with no predicted tendency to react nonspecifically with the numerous targets involved in the biological cellular pathways, is particularly interesting for the desired therapeutic application.

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.

The impact of the Covid-19 lockdown on the human experience of nature

The Covid-19 pandemic has resulted in extensive lockdowns implemented all around the world and billion of people have been asked to stay at home for several weeks. Although this global confinement has had potentially huge unintended consequences on the environment and on its associated wildlife, this study shows that it has also impacted the human experience of nature. Based on an online questionnaire, this study aims to assess how the significant changes in people's everyday lives induced by the French lockdown impacted their relationship with other species. Participants did not only observe and interact more with non human species, but also discovered new traits characterizing them, and felt less lonely thanks to them. The impact of the lockdown was stronger on people's relationship with their pets, farm animals, home plants and with birds than with other plants and animals. This study further demonstrates that participants with different profiles have been affected differently. In particular, women and people with better access to nature were clearly more sensitive to changes and have been more positively impacted in their relationships with other species. Acting as a real world experiment, the lockdown reveals to which extent our experience of nature is embedded in social, cultural and political contexts.

Effects of forest environment (Shinrin-yoku/Forest bathing) on health promotion and disease prevention -the Establishment of "Forest Medicine"

Humans have enjoyed forest environments for ages because of the quiet atmosphere, beautiful scenery, mild climate, pleasant aromas, and fresh, clean air. In Japan, since 2004, serial studies have been conducted to investigate the effects of forest environments (Forest bathing/Shinrin-yoku) on human health. My research team has established a new medical science called Forest Medicine. The Forest Medicine is a new interdisciplinary science, belonging to the categories of alternative medicine, environmental medicine and preventive medicine, which studies the effects of forest environments (Forest bathing/Shinrin-yoku) on human health. It has been reported that Forest bathing/Shinrin-yoku has the following beneficial effects on human health:1 Shinrin-yoku increases human natural killer (NK) activity, the number of NK cells, and the intracellular levels of anti-cancer proteins, suggesting a preventive effect on cancers. 2 Shinrin-yoku reduces blood pressure and heart rate showing preventive effect on hypertension and heart diseases. 3 Shinrin-yoku reduces stress hormones, such as urinary adrenaline and noradrenaline and salivary/serum cortisol contributing to stress management. 4 Shinrin-yoku increases the activity of parasympathetic nerves and reduces the activity of sympathetic nerves to stabilize the balance of autonomic nervous system. 5 Shinrin-yoku improve sleep. 6 Shinrin-yoku increases the levels of serum adiponectin and dehydroepiandrosterone sulfate. 7 In the Profile of Mood States (POMS) test, Shinrin-yoku reduces the scores for anxiety, depression, anger, fatigue, and confusion, and increases the score for vigor, showing preventive effects on depression. 8 Shinrin-yoku may apply to rehabilitation medicine 9 Shinrin-yoku in city parks also has benefits on human health. 10 Shinrin-yoku may have preventive effect on COVID-19 by boosting immune function and by reducing mental stress.Taken together, these findings suggest that Shinrin-yoku may have potential preventive effects on non-communicable diseases.

Short-Term Effects of Forest Therapy on Mood States: A Pilot Study

Immersion in forest environments was shown to produce beneficial effects to human health, in particular psychophysical relaxation, leading to its growing recognition as a form of integrative medicine. However, limited evidence exists about the statistical significance of the effects and their association with external and environmental variables and personal characteristics. This experimental study aimed to substantiate the very concept of forest therapy by means of the analysis of the significance of its effects on the mood states of anxiety, depression, anger and confusion. Seven forest therapy sessions were performed in remote areas and a control one in an urban park, with participants allowed to attend only one session, resulting in 162 psychological self-assessment questionnaires administered before and after each session. Meteorological comfort, the concentration of volatile organic compounds in the forest atmosphere and environmental coherence were identified as likely important external and environmental variables. Under certain conditions, forest therapy sessions performed in remote sites were shown to outperform the control session, at least for anxiety, anger and confusion. A quantitative analysis of the association of the outcomes with personal sociodemographic characteristics revealed that only sporting habits and age were significantly associated with the outcomes for certain psychological domains.

The Influence of the Urban Environment on Mental Health during the COVID-19 Pandemic: Focus on Air Pollution and Migration-A Narrative Review

The coronavirus disease 2019 (COVID-19) pandemic caused a crisis worldwide, due to both its public health impact and socio-economic consequences. Mental health was consistently affected by the pandemic, with the emergence of newly diagnosed psychiatric disorders and the exacerbation of pre-existing ones. Urban areas were particularly affected by the virus spread. In this review, we analyze how the urban environment may influence mental health during the COVID-19 pandemic, considering two factors that profoundly characterize urbanization: air pollution and migration. Air pollution serves as a possibly risk factor for higher viral spread and infection severity in the context of urban areas and it has also been demonstrated to play a role in the development of serious mental illnesses and their relapses. The urban environment also represents a complex social context where minorities such as migrants may live in poor hygienic conditions and lack access to adequate mental health care. A global rethinking of the urban environment is thus required to reduce the impact of these factors on mental health. This should include actions aimed at reducing air pollution and combating climate change, promoting at the same time a more inclusive society in a sustainable development perspective.

Effect of sensorimotor rehabilitation based on an immersive virtual reality model on mental health

The aim of this study was to determine the immersive virtual reality-based sensorimotor rehabilitation (IVR-SRB) effect on mental health (global mental health, depression, anxiety and well-being) in older adults.

METHODS

This study was experimental, with a sample of 111 older adults (control-experimental), considering an application of IVR-SRB in four different virtual settings with exteroceptive synchronization, proprioceptive and vestibular stimuli, for 6 weeks.

OUTCOME VARIABLES

symptoms associated with depression and anxiety; positive mental health (psychological well-being). A descriptive and inferential approach was used to analyze the data, and the ANCOVA test was used to compare the post-intervention groups, controlled by the baseline; In case of baseline moderation, a linear regression model was applied to identify the level of moderation and a region of significance analysis.

RESULTS

An IVR-SRB positive net effect was found in the reduction of symptoms of global mental health (p < 0.0001) and depression (p < 0.0001), without baseline moderation. The anxiety scores showed moderation at the beginning (p < 0.0001; b = -0.53), identifying that the greater the presence of anxiety symptoms, the greater the effect of IVR-SRB in reducing these symptoms; its effect is present from scores of 2.9 (Goldberg-12). There were no changes in well-being.

CONCLUSION

IVR-SRB is recognized as a great intervention tool among elderly population, showing its multidimensional approach capacity, properly responding to the reduction of symptoms associated with mental disorders.

The Impact of Social Support on Public Anxiety amidst the COVID-19 Pandemic in China

The recent coronavirus outbreak has captured worldwide attention. This study investigated the anxiety of the Chinese public and its relationship with social support during the early stage of the COVID-19 pandemic, thereby providing empirical support for interventions on improving the public's mental health. On the basis of an online questionnaire survey conducted on 10-18 February 2020, this study shows that 19.8%, 68.5%, and 11.1% of the respondents suffered mild anxiety, moderate anxiety, and severe anxiety, respectively. Significant differences are reported in state anxiety between people with different household incomes. There are significant differences in trait anxiety and state anxiety between different social support groups. Social support and trait anxiety are negatively correlated. Social support and state anxiety are negatively correlated. Social support affects state anxiety both directly and indirectly (through the mediation of trait anxiety). Therefore, during the COVID-19 pandemic, increasing public support for society can effectively reduce public anxiety.