The Oxytocinergic System as a Mediator of Anti-stress and Instorative Effects Induced by Nature: The Calm and Connection Theory

Psychiatric spaces: a phenomenological case study of staff perspectives after relocation to a new mental health facility

INTRODUCTION

Patients in mental health care rely on staff for their well-being, security, and quality of treatment. However, staff's perspective of the physical environment where care takes place remains underexplored. Their insights are crucial to understanding how the environment impacts the quality of care. Therefore, the aim of this study is to explore the meanings of the physical environment for inpatient care according to staff shortly after relocation to a new mental health facility.

METHODS

The study employed a phenomenological approach and focus group interviews with 20 staff working in a newly built mental health facility. Data were analysed using van Manen's existentials and guided by the theory of affordances.

RESULTS

The primary findings were as follows: (a) attempting to provide a therapeutic atmosphere, (b) design as symbolism, (c) altering the physical environment means altering time, (d) offering spaces for connection and communication, and (e) embodying the new mental health facility.

CONCLUSION

The findings indicate that regardless of whether affordances are actualized, opportunities and obstacles in the hospital environment impact the staff's ability to provide inpatient care according to their standards. Conflict arose due to obstacles inherent in the organization and structure of the new mental health facility that limited opportunities to utilize possible affordances.

Oxytocin in horse saliva: validation of a highly sensitive assay and a pilot report about changes in equine gastric ulcer syndrome

BACKGROUND

Equine gastric ulcer syndrome (EGUS) is a frequent disease in horses that comprises two different entities: equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD). This disease considerably reduces the quality of life of affected horses and can negatively affect performance. Saliva contains biomarkers, such as oxytocin, that have been used as a welfare indicator and can develop a function as a protective factor against stress-induced changes in gastric function due to its gastric antisecretory and antiulcer effects. The objective of this work was to evaluate changes in salivary oxytocin concentrations in healthy and EGUS horses. For this purpose, an immunoassay based on AlphaLISA technology was validated for the quantification of salivary oxytocin and applied in a total of 102 horses divided into 5 groups: 25 with both EGUS, 23 with only EGGD, 21 with only ESGD, 19 horses with other diseases, and 14 healthy horses.

RESULTS

The analytical validation of the method showed good precision and linearity under dilution. Salivary oxytocin concentrations in healthy horses were higher compared to horses with both ESGD and EGGD and only EGGD. Salivary oxytocin concentrations in horses with only ESGD were higher compared to horses with both ESGD and EGGD and horses with only EGGD. In addition, salivary oxytocin concentrations in horses with other diseases different from ESGD were significantly increased compared to horses with both ESGD and EGGD and horses with only EGGD.

CONCLUSIONS

This report validates a new assay that can measure oxytocin in saliva in horses in a precise and accurate way. The lower oxytocin values in horses with EGGD and both EGGD and ESGD than in horses with ESGD, horses with other diseases, and healthy horses could indicate a possible relation of oxytocin with this disease.

Stakeholders' perceptions of value of nature-based interventions in promoting health in people with stress-related illness: a qualitative study

Stress-related illness is a common and increasing cause for sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Accordingly, nature-based interventions (NBI) for people with stress-related illness have been developed and implemented in southern Scandinavia; however, such interventions are uncommon in the Circumpolar North. Previous studies have examined the effects and experiences of participating in NBI, but research about different stakeholders' perspectives on NBI is lacking. The aim of this study was to explore different key stakeholders' perceptions of the value of NBI in promoting health in people with stress-related illness. Data were collected through semi-structured interviews with 11 persons with stress-related illness experience, 14 healthcare professionals, and 11 entrepreneurs offering NBI. Qualitative content analysis resulted in four categories: Providing opportunity for recovery, Offering new perspectives and opportunity for reflection, Empowering balance and control in life, and Enabling one to overcome barriers. Although the study was conducted in a region where NBI is not widely implemented, the different stakeholders expressed similar perceptions of the value of NBI, indicating that NBI may be a valuable complement to health care which reaches people with stress-related illness needs and promotes their health.

Oxytocin in growth, reproduction, restoration and health

This article summarizes my scientific work and describes some personal experiences during this period. After my basal medical training (MD) (1971), I obtained a PhD in pharmacology (1976) and ended up as a professor of Physiology. My initial studies were within the field of gastroenterology. I showed that the gastrointestinal hormone gastrin, which stimulates HCL secretion in the stomach, was released in response to stimulation of the vagal nerve. Later I showed that the entire endocrine system of the gastrointestinal (GI) tract that promotes digestion and anabolic metabolism and growth was under vagal nerve control. I also showed that activation of the vagal nerve inhibits the function of the inhibitory substance somatostatin. 10 years later, after some big changes in my personal life, my research focus changed. I became interested in female physiology, particularly the role of oxytocin. In addition, I became aware of the situation of female scientists and started to work with questions regarding equality between women and men. I gathered a group of interested female medical students and midwives around me. We demonstrated that breastfeeding and touch (e.g., between mother and baby), via stimulation of sensory nerves in the skin, activated the endocrine system of the GI tract and, thereby, anabolic processes and growth. The effects were exerted via a vagal mechanism and involved activation of parvocellular oxytocinergic neurons from the paraventricular nucleus (PVN). We also showed that the gastrointestinal hormone cholecystokinin stimulated the release of oxytocin in a calorie-dependent way via an afferent vagal mechanism. In summary, there is a bidirectional, vagally mediated connection between the endocrine system of the GI tract and the oxytocin producing neurons in the supraoptic (SON) and paraventricular (PVN) nuclei of the hypothalamus.1. Oxytocinergic neurons from the PVN enhances the activity of the endocrine system of the GI tract and thereby growth and regeneration. The effect is exerted via efferent vagal fibers which inhibit the release of somatostatin. 2. Food in the duodenum triggers a release of cholecystokinin (CCK), which via a vagal afferent mechanism stimulates the release and function of oxytocin. This mechanism is not activated in the absence of food intake. Administration of oxytocin induces a multitude of actions, i.e., anxiolytic and sedative effects, increased pain threshold, lowering of cortisol and blood pressure and an increased activity of the endocrine system of the GI tract. Repeated administration of oxytocin may induce long-term effects and "secondary" mechanisms such as an increased activity of alpha-2- adrenoceptors are involved. Oxytocin released by suckling during breastfeeding or by touch during social interaction will induce a similar effect spectrum. Activation of the parvocellular neurons will stimulate some aspects of social behavior, induce calm and well-being, and decrease levels of fear, stress, and pain. In addition, vagal functions and the activity of the endocrine system of the GI tract will be stimulated. Together, these effects are consistent with the oxytocin-mediated calm and connection response and, in a long-term perspective, with the promotion of well-being and health. A second period of professional difficulties occurred in the late 1990s. I moved to the Swedish University of Agriculture, where I started to investigate the role of oxytocin in interactions between humans and pets, as this type of interaction had been shown to promote health. I continued to study the role of oxytocin in female reproduction, in particular, the role of oxytocin during labor and birth and in the peripartum period. In addition, I started to write books about different aspects of oxytocin. I also wanted to establish a role for oxytocin in the treatment of vaginal atrophy. Several clinical studies show that local intravaginal application of oxytocin in women with vaginal atrophy increases the regeneration of vaginal mucosal cells and function.

Healing Architecture in Birthing Rooms: A Scoping Review

AIM

The purpose of this scoping review is to map the knowledge about the multisensory birthing room regarding the birth experience and birth outcomes.

BACKGROUND

The concept of multisensory birthing rooms is relatively novel, making it relevant to explore its impact.

METHODS

Five databases were searched. The search was limited to articles in English, Danish, Norwegian, and Swedish. There were no time limitations. Fourteen relevant articles were identified providing knowledge about multisensory birthing rooms.

RESULTS

Eight articles focused on birth experience, six articles focused on birth outcome, and one on the organization of the maternity care. Seven of the studies identified that sensory birthing rooms have a positive impact on the birth experience and one qualitative study could not demonstrate a better overall birth experience. Five articles described an improvement for selected birth outcomes. On the other hand, a randomized controlled trial study could not demonstrate an effect on either the use of oxytocin or birth outcomes such as pain and cesarean section. The definition and description of the concept weaken the existing studies scientifically.

CONCLUSIONS

This scoping review revealed that multisensory birthing rooms have many definitions and variations in the content of the sensory exposure; therefore, it is difficult to standardize and evaluate the effect of its use. There is limited knowledge concerning the multisensory birthing room and its impact on the birth experience and the birth outcome. Multisensory birthing rooms may have a positive impact on the birth experience. Whereas there are conflicting results regarding birth outcomes.

Wolf-Dog-Human: Companionship Based on Common Social Tools

Wolves, dogs and humans share extremely social and cooperative minds. These similarities are rooted in phylogenetic homology and in the convergence of neuronal and physiological mechanisms, particularly the brain, in the functioning and communication of basic affects and in the mechanisms of stress and calming. The domesticated wolves called dogs are particularly close companion animals. Both Palaeolithic humans and wolves were hypercursorial hunters, cooperating in complex and prosocial ways within their clans with respect to hunting, raising offspring, and defending against conspecific and heterospecific competitors and predators. These eco-social parallels have shaped the development of similar social mindsets in wolves and humans. Over the millennia of domestication, this social match was fine-tuned, resulting in the socio-cognitive specialists humans and dogs, possessing amazingly similar social brains and minds. Therefore, it can be concluded that the quality of their relationships with their human masters is a major factor in the wellbeing, welfare and even health of dogs, as well as in the wellbeing of their human partners. Based on their strikingly similar social brains and physiologies, it can be further concluded that anthropomorphically applying human empathy to dogs in an educated manner may not be as inappropriate as previously thought.

Effects of Interactions with Cats in Domestic Environment on the Psychological and Physiological State of Their Owners: Associations among Cortisol, Oxytocin, Heart Rate Variability, and Emotions

Interactions with animals, including cats, is believed to influence human health. However, studies that investigate the psychological and physiological effects of interacting with cats in their household environment are limited. In this remote study, 32 cat owners in Japan participated from June to October 2021. They completed two tasks, each on separate days in their homes: one simulating daily cat communication (Interaction condition) and another with no interactions (Rest condition). We quantified emotions (arousal level and pleasure level) before and after each condition using the Two-Dimensional Mood Scale Short-term as well as salivary cortisol and oxytocin levels of owners using enzyme-linked immune-sorbent assay. Autonomic nervous activity (sympathetic and parasympathetic) was also quantified by heart rate variability analysis. The free interaction with cats decreased emotional arousal and parasympathetic activity, and lead to increased heart rates in owners. There was a positive correlation between heart rate and cortisol concentration, and between cortisol and oxytocin concentration. Furthermore, the frequency of petting the cats was negatively correlated with the rate of change in the parasympathetic activity. In contrast, the parasympathetic nerves in the owners were activated under the Rest condition. Hence, the mechanism of health-enhancing effects of cat ownership includes an arousing effect, in contrast to the previously proposed stress-reduction effect. This result can aid in future developments in cat-human relationship studies. However, a detailed study with a larger sample size is needed to draw definite conclusions.

Odor Perception and Descriptions of Rose-Scented Geranium Pelargonium graveolens 'Dr. Westerlund'-Sensory and Chemical Analyses

A recent study found that the natural scent from the rose-scented geranium Pelargonium graveolens 'Dr. Westerlund' had positive effects on stress reduction. Essential oils from many pelargonium species are known to have phytochemical properties and pharmacological activities. No study has, so far, explored and identified the chemical compounds and the sensory perception of these compounds in 'Dr. Westerlund' plants. Such knowledge would be an important contribution to an increased understanding of the effects of plants' chemical odor properties on human well-being, and link this to the expressed perceived scents. This study aimed to identify the sensory profile and suggest responsible chemical compounds of Pelargonium graveolens 'Dr. Westerlund'. The sensory and chemical analysis results revealed sensory profiles of Pelargonium graveolens 'Dr. Westerlund's and provided suggestions for the chemical compounds attributed to the sensory profiles. Further studies are recommended to investigate the correlation between volatile compounds and possible stress reduction in humans.

Nature-Based Therapy in Individuals with Mental Health Disorders, with a Focus on Mental Well-Being and Connectedness to Nature-A Pilot Study

In times of social and ecological crises, such as COVID-19 with lockdowns and implementing the impact of climate change, mental health degrades. Being outdoors in nature can be health-promoting, can decrease depression, and increase mental well-being. This pilot study investigated the relationships between nature-based therapy, mental health, and individuals' connectedness to nature. We hypothesize that nature-based therapy has a positive impact on individual mental health and connectedness to nature. A mixed-method approach was used to evaluate the effectiveness of nature-based therapy for young psychosomatic patients. The results demonstrated improvements in mental well-being and connectedness to nature through therapy. Additionally, depression scores decreased. Patients reported the importance of the therapist setting the space, the supportive environment, the poems that fostered the nature connection, improvement at the soul level, and overall doing something meaningful. Every patient experienced nature-based therapy as effective. To conclude, the study gives a first insight into the processes of nature-based therapy in the German population at work and the effectiveness of nature-based therapy. Further questions, e.g., season effects, longitudinal effects, and whether patients with low connectedness to nature gain more out of the intervention remain unanswered.

Nature-based interventions to promote health for people with stress-related illness: An integrative review

BACKGROUND

Stress-related illness is increasing and is a common cause of sick leave. Spending time in nature have a positive effect on health and well-being for instance by reducing stress. Specific programmes with nature-based interventions (NBI) with the intention to involve people in activities in a supportive natural environment have been developed for people with stress-related illness.

AIM

To identify and summarise scientific studies of NBIs to promote health for people with stress-related illness.

METHOD

The design used in this study is integrative literature review. Scientific studies focusing on any type of NBI for people with stress-related illness were sought in Cinahl, PubMed, PsycInfo, AMED and Scopus. In total, 25 studies using both qualitative and quantitative designs were included in the review.

RESULT

The reviewed studies focused on garden or forest interventions. In the majority of the studies, NBIs were performed in groups, including individual activities, and the length of programmes varied. Interventions in natural environments have unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. NBIs offer restoration that reduces stress, improves health and well-being and strengthen self-efficacy and work ability. Connectedness with nature support existential reflections and people with stress-related illness can achieve balance in everyday life.

CONCLUSION

In conclusion, NBIs may have advantages to promote health for people with stress-related illness and should therefore be considered as an alternative to those affected. Further research from different perspectives, including nursing, is needed to understand the possibilities of NBIs and how they can be integrated into practice.

Features of urban green spaces associated with positive emotions, mindfulness and relaxation

There is an established consensus among researchers that contact with nature improves mental health, wellbeing, and quality of life in urbanised environments. Studies tend to examine the health impacts of nature without identifying specific physical and spatial landscape features that could guide health-promoting design of urban green spaces. A growing body of evidence suggests that landscape features described in the Contemplative Landscape Model (CLM) can be used to measure therapeutic value of urban landscapes. CLM assesses urban landscapes across seven sub-scales: Layers of the Landscape, Landform, Vegetation, Color and Light, Compatibility, Archetypal Elements and Character of Peace and Silence. We exposed 74 healthy adults to six urban landscapes in laboratory (video representations) and naturalistic outdoor settings. We explored the associations between the visual quality of urban landscapes annotated with CLM, with self-reported positive emotions and brain activity consistent with mindfulness (Theta waves), relaxation (Alpha waves) and attention restoration (Beta waves), and differences between laboratory and naturalistic setting. CLM scores predicted self-reported Valence and Arousal, and low frequency power bands: Alpha and Theta in the naturalistic setting. Landscape features showing the strongest associations were Character of Peace and Silence, Layers of the Landscape and Archetypal Elements. Alpha, Theta brain reactivity and Arousal scores, were significantly different between laboratory and naturalistic settings (p < 0.05), while Valence scores between those settings were statistically identical (p = 0.22). Self-reported Valence and Arousal, but not brain activity, were significantly associated with the majority of landscape features in the laboratory setting. The results of the study provide guidelines on the urban landscape features most beneficial for human health, to inform urban green space design.

Physiological Assessment of the Health and Welfare of Domestic Cats-An Exploration of Factors Affecting Urinary Cortisol and Oxytocin

Physiological samples are beneficial in assessing the health and welfare of cats. However, most studies have been conducted in specialized environments, such as shelters or laboratories, and have not focused on cats living in domestic settings. In addition, most studies have assessed physiological stress states in cats based on cortisol, and none have quantified positive indicators, such as oxytocin. Here, we collected urine samples from 49 domestic cats and quantified urinary cortisol, oxytocin, and creatinine using ELISA. To identify factors influencing hormone levels, owners responded to questionnaires regarding their housing environment, individual cat information, and the frequency of daily interactions with their cats. Using principal component analysis, principal component scores for daily interactions were extracted. These results showed that the frequency of tactile and auditory signal-based communication by owners was positively correlated with the mean concentration of oxytocin in the urine. Additionally, this communication was more frequent in younger cats or cats that had experienced a shorter length of cohabitation with the owner. However, no factors associated with urinary cortisol concentration were identified. Our study indicates that interactions and relationships with the owner influence the physiological status of cats and suggests that oxytocin is a valuable parameter for assessing their health and welfare.

Tourism as a Tool in Nature-Based Mental Health: Progress and Prospects Post-Pandemic

The healthcare sector recognises the role of nature in mental health. The tourism sector is equipped to take people to national parks. The conservation sector gains support from visitors. Theoretical frameworks for mental health benefits from nature tourism include: tourism destinations and activities; tourist personalities and life histories; sensory and emotional components of tourist experiences; and intensity and duration of memories. Mental health deteriorated worldwide during the COVID-19 pandemic. Recovery of global economic productivity requires immediate, accessible, affordable mental health measures at national scales, and nature-based approaches provide the best option. Different countries have adopted a variety of public, private, or voluntary mechanisms. Some focus on design of activities, others on provision of facilities. Costs and implementation depend on key research questions: marginal benefits of nature tour guides or psychologists compared to self-guided nature experiences; comparisons between repeated brief visits and one-off nature holidays; effects of biodiversity, flagship species, and scenic or wilderness quality; and differences between individuals, depending on personalities, life histories, and mental health status and symptoms.

Exploring the Influence of the Visual Attributes of Kaplan’s Preference Matrix in the Assessment of Urban Parks: A Discrete Choice Analysis

A significant majority of the literature on natural environments and urban green spaces justifies the preferences that people have for natural environments using four predictors defined by Kaplan’s preference matrix theory, namely coherence, legibility, complexity, and mystery. However, there are no studies implicitly focusing on the visual attributes assigned to each of these four predictors. Thus, the aim of this study was to explore the influence of nine visual attributes derived from the four predictors of Kaplan’s matrix on people’s preferences in the context of urban parks. A discrete choice experiment was used to obtain responses from a sample of 396 students of Golestan University. Students randomly evaluated their preferences towards a set of potential scenarios with urban park images. The results of a random parameter logit analysis showed that all of the attributes of complexity (variety of elements, number of colors, and organization of elements) and one attribute each of coherence (uniformity), mystery (visual access), and legibility (distinctive elements) affect students’ choices for urban parks, while one attribute each of mystery (physical access) and legibility (wayfinding) did not affect the choices. Furthermore, the results indicated a preference for heterogeneity of the attributes. The findings of this study can provide instructions for designing parks.

Possible cytoprotective mechanisms of oxytocin against 5-fluorouracil-induced gastrointestinal mucositis

Gastrointestinal mucositis is a common and dose-limiting side effect characterized by ulcerative lesions in the mucosa of the digestive tract in patients receiving anticancer drugs such as 5-fluorouracil (5-FU), a potent antineoplastic drug. Several protocols have reported the efficacy of therapeutic interventions to prevent this side effect, although complete success has not yet been achieved and mucositis remains one of the most serious complications associated with 5-FU therapy. Oxytocin, a well-known antistress agent, has been reported to have comparable effects to ranitidine. Previous studies have shown that oxytocin inhibits gastric acid secretion and the expression of proinflammatory cytokines in rats. If oxytocin can reduce stress-induced ulcers via antioxidant, antiapoptotic, and anti-inflammatory pathways, then it may have a dose-dependent effect on gastrointestinal mucositis caused by 5-FU.

The Wildman Programme-Rehabilitation and Reconnection with Nature for Men with Mental or Physical Health Problems-A Matched-Control Study

Men with health problems refuse to participate in rehabilitation programmes and drop out of healthcare offerings more often than women. Therefore, a nature-based rehabilitation programme was tailored specific to men with mental health problems, and long-term illnesses. The rehabilitation programme combines the use of nature, body, mind, and community spirit (NBMC) and is called the 'Wildman Programme'. The presented study was designed as a matched-control study with an intervention group participating in the Wildman Programme (N = 114) compared to a control group receiving treatment as usual (N = 39). Outcomes were measured at baseline (T1), post-intervention (T2), and 6 months post-intervention (T3). The primary outcome was the participants' quality of life measured by WHOQOL-BREF, which consists of four domains: physical health, psychological health, social relationships, and environment. The secondary outcomes were the level of stress measured by the Perceived Stress Scale (PSS), and the participants' emotional experience in relation to nature, measured by the Perceived Restorativeness Scale (PRS). The intervention group improved significantly in the physical and psychological WHOQOL-BREF domains and in PSS at both follow-ups. The participants' interest in using nature for restoration increased significantly as well. The only detectable difference between the control group and the intervention group was in the WHOQOL-BREF physical domain at the 6-month follow-up. For further studies, we recommend testing the effect of the Wildman Programme in an RCT study.