A Review of the Benefits of Nature Experiences: More Than Meets the Eye

Green space attributes and their impact on perceived stress in Poland

Inconsistent findings and limited research from various countries highlight the need for further investigation of the relationship between Satisfaction with Green Space Attributes (SGSA) and Perceived Stress (PS) levels, which is crucial for informing urban planning strategists to improve residents' mental health using green areas. Presented study explored these relationships and differences in greenery usage and preferences in connection with self-perceived stress levels in the study area of post-socialist cities and other settlements units in Poland-the country belonging to the former block of Socialist Countries of People's Democracy (specific type of urbanism and influence on mentality of residents). Data collected in 2022 via Computer-Assisted Web Interviewing (CAWI) covered demographics, green space utilization, SGSA, and PS levels using the Perceived Stress Scale (PSS-10). Statistical analyses, including Kruskal-Wallis rank ANOVA, Mann-Whitney U-test and multiple regression, revealed that lower PS levels were correlated with higher SGSA across various greenery elements. Individuals with low stress levels spent more time in green spaces for leisure activities, mainly walking. However, satisfaction with greenery decreased with increasing stress levels, especially regarding the decrease of cleanliness, aesthetics and greenery amount. Multiple regression identified significant predictors of stress levels, such as health, greenery aesthetics satisfaction, income, and green area accessibility for children. The study underscores the importance of well-designed, diversified green infrastructure to enhance residents' mental well-being. Accessible, well-maintained green spaces creating a network within urban environments are crucial for stress reduction. It is a guideline for policymakers and urban planners to create continuous green infrastructure consisting of various size and character green areas/elements and this green network should be as dense as possible, occupying every possible place.

The importance of nature and wishes for nature-based experiences among older adults in assisted living facilities

Nature-based interventions potentially support physical, mental, and social health. Understanding the needs of the target group is essential when developing such methods as part-of-care. This cross-sectional mixed method survey explores the wishes for nature-based experiences among older adults in assisted living facilities, 854 respondents were included. Diagnoses were confirmed from medical records, while functioning, wellbeing and the meaning of nature were inquired. Respondents' average age was 83 years; 73% were women, and 54% had dementia. Only 24% could move about outdoors independently, 55% suffered from loneliness, and 45% felt depressed at least sometimes. In thematic analyses, open-ended answers highlighted the multifaceted meaning of nature. Nature is a valued source of resilience and a place for physical activity. Although 96% considered nature important, only 51% could have nature contact as often as desired. Respondents provided clear, feasible wishes for activities and 83% were interested in participating in nature-based interventions.

Natural five-sense experience and positive and negative emotions: the mediating role of nature connectedness

Nature experience is a relatively easy and beneficial measure for improving emotions. Individuals experience nature through proximal senses (tactile, gustatory, and olfactory) and distal senses (vision and audition). This study examined the relationships between diverse natural senses experience and individuals' positive and negative emotions, along with the mediating role of nature connectedness. We recruited 978 college students (Mage = 20.09 ± 1.09 years old) from Beijing, China. The results showed that tactile experience (e.g. touching trees and water) was negatively related to negative emotions, while gustatory experience (e.g. tasting fresh fruits) was positively correlated with positive emotions. Furthermore, nature connectedness mediated the relationship between other natural sensory experiences and positive and negative emotions, except for the insignificant mediation between olfactory experiences and negative emotions. Therefore, individuals should emphasize the role of the proximal senses (especially tactile and gustatory experiences) during nature experiences and increase nature connectedness to maintain positive emotions.

A generational relational model of nature and mental wellbeing: results of a qualitative analysis

Introduction

There is a developing evidence base for the benefits of natural environments for health and mental wellbeing. However, given the increasing urbanisation of our planet and subsequent disconnection from our natural world, there is a danger that we may ultimately suffer from a nature 'generational amnesia'. The facets and mechanisms underpinning these relationships are poorly understood and theoretical frameworks are needed to aid further research. There is a paucity of research into the lived experiences of people with good wellbeing and their nature experiences, which has the potential to elucidate key elements of the nature-wellbeing relationship.

Methods

The current study used a qualitative design to explore themes concerning the lived experiences with nature, of 12 people with self-reported good wellbeing. Semi-structured interviews were carried out and data were analysed using thematic analysis.

Results

Two overarching themes of human-nature relationship and self-regulation encapsulated the data. Within the first, there were two superordinate themes of developmental and nature interconnectedness. Self-regulation consisted of managing health and flourishing.

Discussion

A theoretical model is proposed to help better understand these relational themes in a generational context. The model is informed by Cognitive Analytic Therapy and attachment theory and generates testable hypotheses for future research.

Psychophysiological and psychological responses of touching plant behavior by tactile stimulation according to the foliage type

Urbanization-related stress has spurred interest in natural therapies, such as horticultural therapy, which leverages multisensory exposure to plants to enhance well-being through physical, psychological, and cognitive benefits. This study aimed to measure and compare the psychophysiological and psychological responses to tactile stimuli through plant contact based on the foliage type. Thirty adults (average age: 24.86 ± 2.68) participated in the study, and the foliage was categorized into four groups: soft (e.g., Stachys byzantina, Adiantum raddianum, and Asparagus plumosus var. nanus), smooth (e.g., Peperomia obtusifolia, Ficus benghalensis, and Epipremnum aureum), stiff (e.g., Chamaeshparis thyoides Red Star, Platycladus orientalis, and Cupressus macrocarpa), and rough (e.g., Rhapis excelsa, Nephrolepis cordifolia 'Duffii', and Ardisia pusilla 'Variegata') plant groups. The participants touched the plants for 90 s, and the concentration of oxyhemoglobin (oxy-Hb) in the prefrontal cortex (PFC) was measured using functional near-infrared spectroscopy (fNIRS). Additionally, a semantic differential method (SDM) evaluation tool was used to assess the psychological responses of each treatment group. When comparing the four tactile treatment groups (soft, smooth, stiff, and rough), the oxy-Hb concentration in the PFC area was lowest during tactile stimulation of smooth plants and highest during soft plant stimulation. Sex-based comparison of oxy-Hb concentrations showed significant differences in the overall PFC area for all four tactile treatment groups in males (p < 0.001). Specifically, when touching soft plants, the oxy-Hb concentration in females was significantly lower than that in males (p < 0.001). According to the SDM, the tactile stimulation of soft and smooth plants elicited the most relaxation, comfort, and favorable responses (p < 0.001). When touching smooth plants, the oxy-Hb concentration of the participant was the lowest, and according to the SDM, they reported the most soothing response. Summarily, the participants in the smooth plant group exhibited a trend of decreased oxy-Hb concentrations and concurrently experienced a sense of psychological stability. We established those tactile stimuli based on foliage texture resulted in different psychophysiological and psychological responses depending on the plant treatment group and sex.

Socioeconomic profile and environmental perception of Amazon beach users about solid waste

Studies on environmental perception can contribute to managing solid waste on beaches, as they elucidate the nuances of the interaction between humans and the environment, highlighting the necessary transformations aligned with user preferences. The objective was to determine the socioeconomic profile of users and identify these actors environmental perceptions of solid waste of bathers on the beaches of Rio Negro and identify their environmental perception about the incorrect disposal of solid waste in these environments. Interviews were conducted on Ponta Negra, Lua, Tupé and Paricatuba beaches. Women predominated on Ponta Negra and Lua beaches, and men on Paricatuba and Tupé. On the Tupé and Lua beaches, people between 31 and 40 years old stood out. The majority (70%) responded that they completed high school and received up to two minimum wages. Users frequent Ponta Negra beach during the high-water season and the naturally formed beaches in the low waters of the Rio Negro. Most seek out beaches as leisure and consider cleanliness an essential factor. More than 80% stated that they do not leave trash on the beach, in practice, this information was not observed. Plastic was the main item reported. We evidenced that users have little awareness regarding environmental education on Amazon beaches and that educational actions must be carried out.

Harnessing the therapeutic effects of nature for chronic Pain: A role for immersive virtual reality? A narrative review

BACKGROUND AND OBJECTIVE

There is a growing interest in the relationship between nature and pain relief. Evidence from environmental psychology, neuroscience and physiology-based studies point towards analgesic effects of nature being mediated through various cognitive, affective and/or autonomic factors. Being able to harness these therapeutic effects using immersive virtual reality (VR) could help to optimize and improve accessibility of nature-based environments as part of chronic pain management plans. In this narrative review, we present evidence supporting a new theoretical framework for nature-based analgesia and suggest ways for applying this through immersive VR.

DATABASES AND DATA TREATMENT

We provide an overview of the evidence on (1) the therapeutic effects of nature on pain, (2) environmental psychology theory that underpins the health benefits of nature, (3) key mechanistic evidence from nature neuroimaging and physiology-based studies, (4) previous studies that have used VR-based nature in pain research and (5) how to design effective VR interventions that can be used to integrate nature into immersive 360 environments.

RESULTS

We have demonstrated how environmental psychology, neuroscience and physiology-based research can be used to form a novel theoretical framework for nature-based analgesia. Using this framework, we identify how key aspects of nature can act as analgesic and how this can be harnessed using immersive VR.

CONCLUSIONS

Through developing this theoretical framework, we have provided a foundation on which to guide future experimental and clinical studies as well as helping to improve the accessibility of nature for chronic pain patients through immersive VR technologies.

SIGNIFICANCE

This review article summarizes key multidisciplinary evidence to help understand how nature exerts beneficial effects on pain processing. The use of this theoretical framework alongside advances in immersive VR technologies provides a springboard for future research and can be used to help develop new nature-based therapeutics using VR.

A grounded theory exploration of programme theory within Waves of Wellness surf therapy intervention

OBJECTIVE

Poor mental health represents a large proportion of disease burden faced by young Australians, which has been further exacerbated by the Covid-19 pandemic and the reluctance of this population to seek support. Surf therapy is a novel form of intervention targeting mental health. The objective of this study was to interrogate programme theory within surf therapy, as delivered by the Waves of Wellness Foundation (WOW) in Australia.

METHODS AND MEASURES

The study utilised grounded theory to understand or develop theoretical mediators for WOW surf therapy based on interviews exploring the experiences of previous intervention participants (n = 16; mean age = 18.4 years, SD = 2.8, range 14-24). Data were analysed through constant comparative analysis.

RESULTS

Five categories emerged from participant data as foundational to WOW programme theory: (a) Safe Space, (b) Social Support, (c) Sensory Grounding, (d) Mastery and (e) Respite. These categories have novel theoretical and practical implications for both surf therapy and wider clinical practice, especially around concepts such as delivering 'mental health by stealth' and fostering longer term 'mental health maintenance' for participants.

CONCLUSION

The study developed an initial WOW programme theory, highlighting the importance of foundational therapeutic structures beyond simply going surfing.

Factors Associated With Outdoor Frequency Among U.S. Community-Dwelling Medicare Beneficiaries: A Cross-Sectional Study

PURPOSE

Despite the benefits of outdoor activity in older adults, a paucity of research explores factors associated with the frequency of older adults going outdoors. The aim of the current study was to investigate if factors of cognitive status, physical performance, and neighborhood characteristics were associated with outdoor frequency among older adults.

METHOD

This cross-sectional study used National Health and Aging Trends Study data to characterize outdoor frequency among Medicare beneficiaries by participant demographics, health, and neighborhood characteristics, and estimated relationships between participant factors and outdoor frequency.

RESULTS

The sample included 3,368 participants. The majority (51.6%) were aged 75 to 84 years and female (57.2%). Most (60.4%) participants went outside daily. Probable dementia, physical limitations, and presence of street disorder and sidewalk continuity were associated with decreased outdoor frequency.

CONCLUSION

Research is needed to develop interventions addressing neighborhood conditions and promoting outdoor activity among older adults living with dementia and physical limitations. [Research in Gerontological Nursing, 18(1), 40-52.].

Effect of Outdoor Cycling, Virtual and Enhanced Reality Indoor Cycling on Heart Rate, Motivation, Enjoyment and Intention to Perform Green Exercise in Healthy Adults

Background: Despite the benefits of physical activity (PA), Italy ranks low in leisure-time PA among European countries. Integrating virtual (VR)/enhanced (ER) reality with exercise equipment could boost PA engagement. Limited studies have explored how VR/ER-integrated cycling activity, compared to outdoor settings, influences PA among university students. Therefore, this study aimed to evaluate the acute effects of a brief cycling session outdoors and indoors on psychological and physiological outcomes, and secondly, investigate the potential of VR/ER-mediated nature experiences as a tool to promote green exercise. Methods: In February 2024, thirty-one subjects (20 M and 11 F; age 24.3 ± 3.2 years; BMI 23.5 ± 3.6 kg/m2) were involved in this randomized crossover-controlled trial, where they were assigned to three different conditions: ER cycling (ERC), VR cycling (VRC), and outdoor cycling (OUTC). Heart rate (HR), Physical Activity Enjoyment (PACE), Intrinsic Motivation Inventory (IMI), and Intention to Perform Green Exercise (INT-GE) were assessed at the end of each condition. Results: The OUTC condition showed significantly greater PACE, IMI, and INT-GE than ERC/VRC (p < 0.001), lower HRmean than ERC/VRC (p < 0.001 and p < 0.05, respectively), and lower HRmax than ERC (p < 0.05). Conclusions: VRC and ERC enhanced engagement and physiological responses during indoor cycling, but outdoor cycling offered superior benefits in motivation, enjoyment, and future engagement intentions. No significant differences were found between VRC and ERC in promoting intentions for outdoor activities, suggesting both technologies could be equally effective.

A framework for understanding the human experience of nature through cognitive mapping

Human behavior is a key driver of the biodiversity crisis, and addressing it requires changing individual choices and actions. Yet, the same processes that imperil biodiversity (e.g., urbanization) also alienate people from the experience of nature, eroding care for the natural world. Although averting this extinction of experience is increasingly recognized as a major contemporary conservation challenge, understanding of what constitutes nature experience remains elusive and few empirical studies have explored it directly. Most researchers have used nature interactions as a stand-in for experience, even though experience extends beyond interactions. We aimed to determine what constitutes the experience of nature and to propose a holistic, empirically derived framework that incorporates the multiple dimensions and components of the experience of nature. Using a mixed-method approach across 3 countries (the United States, Switzerland, and Israel), we conducted a multistage, conceptual content, cognitive mapping (3CM) exercise with 106 participants. This methodology included developing a prompt to capture participants' perceptions of nature experiences and subsequently refining and organizing their input into distinct components and underlying dimensions through an iterative engagement process. Beyond multisensory interactions with nature, experience of nature consisted of 2 dimensions: the circumstances in which interactions occur and the internal responses that encompass various cognitive, affective, and restorative benefits associated with nature interactions. These 3 dimensions had 33 components that occurred consistently across participants in the 3 countries. Frequently mentioned components included seeing animals, landscapes, or scenery; lack of human influence; weather conditions; relaxing, recharging; feeling good; and awe for nature. Fear and nature experienced at home were the least mentioned components. Together, our results showed that nature experience is a combination of nature interactions, circumstances, and internal responses. The emphasized components underscore the significance of offering access to extensive, less human-influenced natural spaces. This in turn can foster a profound nature experience, cultivating feelings of connectedness and care for nature.

Wilding cities for biodiversity and people: a transdisciplinary framework

Accelerating urbanisation and associated lifestyle changes result in loss of biodiversity and diminished wellbeing of people through fewer direct interactions and experiences with nature. In this review, we propose the notion of urban wilding (the promotion of autonomous ecological processes that are independent of historical land-use conditions, with minimal direct human maintenance and planting interventions) and investigate its propensity to improve biodiversity and people-nature connections in cities. Through a large interdisciplinary synthesis, we explore the ecological mechanisms through which urban wilding can promote biodiversity in cities, investigate the attitudes and relations of city dwellers towards urban wild spaces, and discuss the integration of urban wilding into the fabric of cities and its governance. We show that favouring assembly spontaneity by reducing planting interventions, and functional spontaneity by limiting maintenance practices, can promote plant diversity and provide ecological resources for numerous organisms at habitat and city scales. These processes could reverse biotic homogenisation, but further studies are needed to understand the effects of wilding on invasive species and their consequences. From a socio-ecological perspective, the attitudes of city dwellers towards spontaneous vegetation are modulated by successional stages, with grassland and woodland stages preferred, but dense shrubby vegetation stages disliked. Wild spaces can diversify physical interactions with nature, and enrich multi-sensory, affective and cognitive experiences of nature in cities. However, some aspects of wild spaces can cause anxiety, feeling unsafe, and the perception of abandonment. These negative attitudes could be mitigated by subtle design and maintenance interventions. While nature has long been thought of as ornamental and instrumental in cities, urban wilding could help to develop relational and intrinsic values of nature in the fabric of cities. Wildness and its singular aesthetics should be combined with cultural norms, resident uses and urban functions to plan and design urban spatial configurations promoting human-non-human cohabitation. For urban wilding to be socially just and adapted to the needs of residents, its implementation should be backed by inclusive governance opening up discussion forums to residents and urban workers. Scientists can support these changes by collaborating with urban actors to design and experiment with new wild spaces promoting biodiversity and wellbeing of people in cities.

Long-acting antipsychotic treatments: focus on women with schizophrenia

Effective management of schizophrenia (SZ) requires long-term treatment with antipsychotics (APs) to prevent clinical relapse, attain remission and improve patients' personal and social functioning, and quality of life. Although APs remain the cornerstone treatment for patients with SZ, despite their potential benefits, long-acting injectable APs (LAI-APs) remain underused, most notably in women with SZ. The efficacy and tolerability of APs differ significantly between men and women, and some of these differences are more noticeable depending on the patient's age and the stage of the disorder. Although sex differences may influence treatment outcomes in SZ, their pertinence has been insufficiently addressed, especially regarding the use of LAI-APs. Some biological and social experiences, such as pregnancy, lactation, contraception and menopause, are specific to women, but these remain under-researched issues. Implications of this disorder in parenting are also of special pertinence regarding women; therefore, taking sex differences into account when treating SZ patients is now recommended, and improving personalized approaches has been proposed as a priority in the management of psychosis. In this narrative, critical review, we address some aspects specific to sex and their implications for the clinical management of women with SZ, with a special focus on the potential role of LAI-AP treatments.

A comprehensive review of the environmental benefits of urban green spaces

This detailed analysis highlights the numerous environmental benefits provided by urban green spaces, emphasizing their critical role in improving urban life quality and advancing sustainable development. The review delves into critical themes such as the impact of urban green spaces on human health, the complex interplay between urban ecology and sustainability, and the evaluation of ecosystem services using a comprehensive review of existing literature. The investigation thoroughly examines various aspects of green infrastructure, shedding light on its contributions to social cohesion, human well-being, and environmental sustainability in general. The analysis summarizes the study's findings and demonstrates the critical role of urban green spaces in urban ecology, which significantly mitigates environmental challenges. The intricate links between these green spaces and human health are thoroughly investigated, with benefits ranging from enhanced mental and physical well-being to comprehensive mental health. Furthermore, the analysis emphasizes how green spaces benefit urban development by increasing property values, boosting tourism, and creating job opportunities. The discussion also considers possible futures, emphasizing the integration of technology, the advancement of natural solutions, and the critical importance of prioritizing health and well-being in the design of urban green spaces. To ensure that urban green spaces are developed and maintained as essential components of resilient and sustainable urban environments, the assessment concludes with practical recommendations for communities, urban planners, and legislators.

Discovering the sensory, emotional, and interactive experiences of a place

This article proposes a data collection technique for describing experiences of a built environment. Besides the experiences of the visual and physical aspects of the place, this technique helps describe the sensory, bodily, emotional, interactive, and social experiences occurring during the human-environment encounter. The enabling technique presented is called Reactions and Actions Description Survey (RADES). It employs 120 images depicting people going through different situations involving all the senses, showing expressions related to positive and negative emotions, and realizing varied activities. Forty-five participants visited the esplanade in the exterior of a historic building called Obispado. The case study is located on a hill and is a scenic viewpoint of Monterrey, Mexico. The participants answered the RADES and the Environmental Description Survey (ENVIDES), which focuses on describing the qualities of the place and the appraisals with which it is experienced. The comments about the experiences of the place obtained through both surveys were grouped into 133 categories. Qualitative and quantitative data about the experiences of the place were obtained through both techniques. A quantitative analysis of the data was realized since the participants not only described their experiences with words but also indicated numerically the intensity of such experiences. Spearman correlations between the experiences were calculated, and a general map of the experiences of the place was created through multidimensional scaling analysis (MDS). The study revealed the connections between the elements and qualities of the site and the views with specific positive and negative experiences occurring during the visit. Furthermore, MDS allowed the discovery of 10 dimensions of environmental experience-pleasure/displeasure, high/low arousal, dominance/submissiveness, knowing/inhabiting, environment/self, higher/lower cognition, spatiality/materiality, states/processes, natural/built, and visual/sensory. The presented techniques and the findings obtained through them can assist architects in recognizing valuable environmental features for the design of livable spaces.

Impact of "blue-green diet" on human health and wellbeing: A systematic review of potential determinants in shaping the effectiveness of blue-green infrastructure (BGI) in urban settings

Discourses concerning the potential health benefits of blue-green infrastructure (BGI) have gained momentum, highlighting its positive influence on human health and wellbeing. While studies have explored the concept of "Nature Pyramid" and the role of exposure to natural environments in promoting health, the role of water elements remains underexplored. Rooted in this concept, this study proposed a notion of "blue-green diet" as a framework to understand the intricate mechanisms and determinants of optimal blue-green exposure. Understanding the relationship between these determinants and their health-related impacts can facilitate the enhancement of BGI design, leading to greater effectiveness in promoting health and wellbeing and supporting sustainable urban development strategies. To enhance the comprehension of the "blue-green diet", this study conducted a systematic literature review to grasp the underlying mechanisms behind its beneficial effects, focusing on two key determinants of "blue-green diet", which are also derived from the concept of the "Nature Pyramid": (1) the type of BGI and (2) the mode of interaction with and within BGIs. Under the search of BGI's overall health impacts, this study selected 54 journal publications concerning BGI's type and interaction mode from Web of Science and Scopus since 2010. The review revealed significant disparities in the health benefits provided by different types of BGI (in terms of artificial extent and scale) and between active and passive interaction modes. It examines how to balance natural and artificial elements for enhancing the benefits of BGI and discusses the attributes of BGI that encourage diverse and meaningful interaction patterns. These efforts collectively aim to optimize BGI design and planning, increase its capacity to promote health, and extend its benefits to a wider range of individuals. Future research should encompass a broader spectrum of determinants, such as diverse BGI settings, visit frequency and duration, and user's social-cultural backgrounds.

A feasibility study on indoor therapeutic horticulture to alleviate sleep and anxiety problems: The impact of plants and activity choice on its therapeutic effect

INTRODUCTION

Therapeutic horticulture (TH) is increasingly being applied for sub-health or patient mental health care. Whether plant and activity type will affect TH's effectiveness is unclear.

AIM

To evaluate the feasibility of an indoor TH for alleviating the anxiety symptoms and sleeping problems of people with poor sleep quality, and explore the potential affection of plant and activity type on health benefits.

METHOD

Thirty subjects (all with sleep problems and half with anxiety problems) were randomly assigned to three groups to do horticultural activities with ornamental plants, general aromatic plants, or aromatic plants with reported mental health functions, respectively. Six indoor TH activities were then held sequentially within two weeks. Psychological scales, subjective feedback questionnaires, and physiological indicators were used as evaluation indexes before and after horticulture activities.

RESULTS

The TH relieved subjects' sleep and anxiety problems and was particularly effective in alleviating anxiety among people with high anxiety levels. Using ornamental plants was more effective in relieving stress while functional aromatic plants performed better in sleep improvement and satisfaction to TH. Each horticultural activity could improve mood state but showed different effects on the vitality of the participants.

CONCLUSION

The above findings provided some basis for the potential benefits of selecting plants and activities based on psychological care needs in the development of TH plans. Future research that expands upon the current project is warranted. A larger sample size is beneficial for obtaining more powerful statistical results.

Preferences for woodland activities and forest features as predictors of well-being after forest visits: Evidence from a nationally representative survey in Slovakia

The link between subjective well-being (SWB) and forest visits is increasingly driving the development and preservation of restorative forest environments in numerous countries. However, there is limited knowledge regarding the effect of people's preferences for forest patterns and activities on this connection. Here we investigated whether associations exist between the preferences for certain forest features and activities, and the SWB increase and stress reduction in response to forest visits. A nationwide digital survey was administered to a representative sample of the Slovak population. The recollection-based data obtained from one thousand respondents were analysed through agglomerative clustering and ordinal regression. The analyses revealed that improved SWB and stress reduction were associated with preferences for uneven-aged forests, forest smell, as well as recreational, but not provisioning forest activities. The respective interrelationships explained up to 20% of SWB increase and stress reduction after forest visits. The results suggest that recollection-based study findings can be generalized for real-world forests and that forest management can contribute to the well-being of forest visitors by shaping the diversity of woodlands and their sensory experiences.

Effects of natural sound exposure on health recovery: A systematic review and meta-analysis

Listening to natural sounds, both live and recorded, in either a natural or built environment is considered natural sound exposure (NSE). Sound is closely related to daily life, and research on the restorative effects of natural sounds is expanding. However, there is a lack of quantitative and comprehensive analysis on the impact of NSE on health recovery. This study systematically reviewed and conducted a meta-analysis on the impact of NSE on health recovery. Fifteen studies (1285 participants) were selected for the meta-analysis out of the 1157 literatures about the recovery of the NSE, searched from the Web of Science and Science Direct. The results indicate that NSE has certain positive effects: (a) In terms of emotional changes, NSE significantly reduces anxiety as measured by both the Visual Analog Scale (VAS) -2.31 (95 % CI -2.83, -1.79) and the State Anxiety Inventory (SAI) -12.22 (95 % CI -22.46, -1.98). (b) In terms of physiological reaction, NSE resulted in reduced heart rate (HR) -5.46 (95 % CI -9.62, -1.31), systolic blood pressure (SBP) -11.74 (95 % CI -15.51, -7.97), diastolic blood pressure (DBP) -13.98 (95 % CI -24.96, -2.99) and respiratory rate (RR) -1.58 (95 % CI -3.06, -0.10). (c) While the potential for restoration of cognitive performance by NSE was found, no consistent conclusions have been reached yet. However, there was significant heterogeneity between studies, primarily attributed to variations in study populations and methodologies. Because of the limited literature, we did not conduct subgroup analysis and meta-regression analysis. It is recommended that future studies address this heterogeneity by including more and higher-quality literature and employing rigorous methodologies to establish a robust foundation for evidence-based medicine. This will be of great significance for the application natural sounds in landscape planning and medical rehabilitation environments, and has the potential to promote improvements in public health.

A systematic review of audit tools for evaluating the quality of green spaces in mental health research

Research showing the relationship between exposure to green space and health has yielded conflicting results, possibly due to the oversight of green space quality in quantitative studies. This systematic review, guided by the PRISMA framework (registered under Prospero ID CRD42023279720), focused on audit tools for green space quality in mental health research. From 4028 studies, 13 were reviewed, with 77 % linking better mental health outcomes to higher green space quality. Eight tools, especially Public Open Space and Dillen et al. tools demonstrated strong correlations with mental health. Certain green space qualities like grass, pathways, and water elements showed positive health associations. Future research should aim for standardized quality metrics and robust methodologies to support causal inferences and efficient assessments.

Understanding park visitors' soundscape perception using subjective and objective measurement

Environmental noise knows no boundaries, affecting even protected areas. Noise pollution, originating from both external and internal sources, imposes costs on these areas. It is associated with adverse health effects, while natural sounds contribute to cognitive and emotional improvements as ecosystem services. When it comes to parks, individual visitors hold unique perceptions of soundscapes, which can be shaped by various factors such as their motivations for visiting, personal norms, attitudes towards specific sounds, and expectations. In this study, we utilized linear models and geospatial data to evaluate how visitors' personal norms and attitudes, the park's acoustic environment, visitor counts, and the acoustic environment of visitors' neighborhoods influenced their perception of soundscapes at Muir Woods National Monument. Our findings indicate that visitors' subjective experiences had a greater impact on their perception of the park's soundscape compared to purely acoustic factors like sound level of the park itself. Specifically, we found that motivations to hear natural sounds, interference caused by noise, sensitivity to noise, and the sound levels of visitors' home neighborhoods influenced visitors' perception of the park's soundscape. Understanding how personal factors shape visitors' soundscape perception can assist urban and non-urban park planners in effectively managing visitor experiences and expectations.

Nature-based social interventions to address loneliness among vulnerable populations: a common study protocol for three related randomized controlled trials in Barcelona, Helsinki, and Prague within the RECETAS European project

BACKGROUND

The negative effects of loneliness on population health and wellbeing requires interventions that transcend the medical system and leverage social, cultural, and public health system resources. Group-based social interventions are a potential method to alleviate loneliness. Moreover, nature, as part of our social and health infrastructure, may be an important part of the solutions that are needed to address loneliness. The RECETAS European project H2020 (Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces) is an international research project aiming to develop and test the effectiveness of nature-based social interventions to reduce loneliness and increase health-related quality of life.

METHODS

This article describes the three related randomized controlled trials (RCTs) that will be implemented: the RECETAS-BCN Trial in Barcelona (Spain) is targeting people 18+ from low socio-economic urban areas; the RECETAS-PRG Trial in Prague (Czech Republic) is addressing community-dwelling older adults over 60 years of age, and the RECETAS-HLSNK trial is reaching older people in assisted living facilities. Each trial will recruit 316 adults suffering from loneliness at least sometimes and randomize them to nature-based social interventions called "Friends in Nature" or to the control group. "Friends in Nature" uses modifications of the "Circle of Friends" methodology based on group processes of peer support and empowerment but including activities in nature. Participants will be assessed at baseline, at post-intervention (3 months), and at 6- and 12-month follow-up after baseline. Primary outcomes are the health-related quality-of-life according to 15D measure and The De Jong Gierveld 11-item loneliness scale. Secondary outcomes are health and psychosocial variables tailored to the specific target population. Nature exposure will be collected throughout the intervention period. Process evaluation will explore context, implementation, and mechanism of impact. Additionally, health economic evaluations will be performed.

DISCUSSION

The three RECETAS trials will explore the effectiveness of nature-based social interventions among lonely people from various ages, social, economic, and cultural backgrounds. RECETAS meets the growing need of solid evidence for programs addressing loneliness by harnessing the beneficial impact of nature on enhancing wellbeing and social connections.

TRIAL REGISTRATION

Barcelona (Spain) trial: ClinicalTrials.gov, ID: NCT05488496. Registered 29 July 2022. Prague (Czech Republic) trial: ClinicalTrials.gov, ID: NCT05522140. Registered August 25, 2022. Helsinki (Finland) trial: ClinicalTrials.gov, ID: NCT05507684. Registered August 12, 2022.

Treatments and regulatory mechanisms of acoustic stimuli on mood disorders and neurological diseases

Acoustic stimuli such as music or ambient noise can significantly affect physiological and psychological health in humans. We here summarize positive effects of music therapy in premature infant distress regulation, performance enhancement, sleep quality control, and treatment of mental disorders. Specifically, music therapy exhibits promising effects on treatment of neurological disorders such as Alzheimer's disease (AD) and Parkinson's disease (PD). We also highlight regulatory mechanisms by which auditory intervention affects an organism, encompassing modulation of immune responses, gene expression, neurotransmitter regulation and neural circuitry. As a safe, cost-effective and non-invasive intervention, music therapy offers substantial potential in treating a variety of neurological conditions.

Inequalities in noise will affect urban wildlife

Understanding how systemic biases influence local ecological communities is essential for developing just and equitable environmental practices that prioritize both human and wildlife well-being. With over 270 million residents inhabiting urban areas in the United States, the socioecological consequences of racially targeted zoning, such as redlining, need to be considered in urban planning. There is a growing body of literature documenting the relationships between redlining and the inequitable distribution of environmental harms and goods, green space cover and pollutant exposure. However, it remains unknown whether historical redlining affects the distribution of urban noise or whether inequitable noise drives an ecological change in urban environments. Here we conducted a spatial analysis of how urban noise corresponds to the distribution of redlining categories and a systematic literature review to summarize the effects of noise on wildlife in urban landscapes. We found strong evidence to indicate that noise is inequitably distributed in redlined urban communities across the United States, and that inequitable noise may drive complex biological responses across diverse urban wildlife, reinforcing the interrelatedness of socioecological outcomes. These findings lay a foundation for future research that advances relationships between acoustic and urban ecology through centring equity and challenging systems of oppression in wildlife studies.

Customized virtual reality naturalistic scenarios promoting engagement and relaxation in patients with cognitive impairment: a proof-of-concept mixed-methods study

Being immersed in a natural context has a beneficial and pervasive impact on well-being. Virtual Reality (VR) is a technology that can help expose people to naturalistic scenarios virtually, overcoming obstacles that prevent them from visiting real natural environments. VR could also increase engagement and relaxation in older adults with and without cognitive impairment. The main aim of this study is to investigate the feasibility of a customized naturalistic VR scenario by assessing motion-sickness effects, engagement, pleasantness, and emotions felt. Twenty-three individuals with a diagnosis of cognitive impairment living in a long-term care home participated in our study. At the end of the entire VR experimental procedure with older adults, five health staff operators took part in a dedicated assessment phase focused on evaluating the VR procedure's usability from their individual perspectives. The tools administered were based on self-reported and observational tools used to obtain information from users and health care staff professionals. Feasibility and acceptance proved to be satisfactory, considering that the VR experience was well-tolerated and no adverse side effects were reported. One of the major advantages emerged was the opportunity to deploy customized environments that users are not able to experience in a real context.Trial Registration: National Institute of Health (NIH) U.S. National Library of Medicine, ClinicalTrials.gov NCT05863065 (17/05/2023).

The effect of brief exposure to virtual nature on mental wellbeing in adolescents

Adolescence is a time of multiple transitions and a vulnerability period for mental health difficulties. There are many barriers to the treatment of mental health conditions which is one reason for developing alternatives to help improve efficacy in treatment and prevention. One approach is to use nature-based interventions (NBIs) to improve mental wellbeing. In this experimental proof-of-principle intervention study, we randomly allocated a sample of adolescents to brief exposure (6 min) to either a virtual woodland nature video or a busy train journey and tested the effect on mental wellbeing. Results showed beneficial effects in the nature condition on several self-reported outcomes including stress, relaxation, affect, mood, attention, nature connection and nature spirituality. The intervention was mainly acceptable and feasible to do suggesting that overall brief virtual nature interventions may have utility in a range of mental health contexts for adolescents including as self-help universal or targeted prevention strategies, adjunct to psychological therapy and as preparation for more intensive NBIs. Additionally, brief virtual nature interventions support accessibility for those who may be limited on time, unable to access real-life nature or who may be more biophobic.

Protective effect of restorative possibilities on cognitive function and mental health in children and adolescents: A scoping review including the role of physical activity

Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.

Multisensory Stimuli, Restorative Effect, and Satisfaction of Visits to Forest Recreation Destinations: A Case Study of the Jhihben National Forest Recreation Area in Taiwan

The perceived quality of the restorative environment of forest resources should be a key consideration for forest recreational areas in managing ecosystem services to provide health benefits to visitors. However, previous studies on utilizing forests as a resource for restorative services have rarely explored the simultaneous integration of on-site sensory experiences from a multisensory perspective or evaluated visitor satisfaction from a service-oriented standpoint. Therefore, this study aimed to understand the association among multisensory stimuli, perceived restorativeness, and satisfaction with visits to forest recreation areas and clarify the mediating role of perceived restorativeness in the relationship between multisensory stimuli and satisfaction. This study deployed a questionnaire and collected 458 valid responses from visitors to the Jhihben National Forest Recreation Area in Taiwan. Structural equation modeling was conducted to test the study hypotheses. The results indicated that visual sensations, auditory sensations, olfactory sensations, and tactile sensations had significant positive effects on perceived restorativeness and satisfaction and that perceived restorativeness also had a significant positive effect on satisfaction. Perceived restorativeness played a partial mediating role in this causal model. This study verified the psychological model of the relationships among a natural setting's multisensory stimuli, perceived restorativeness, and satisfaction. In practice, the findings of this study offer guidance for forest recreation areas to develop strategies for ecological services, encompassing the establishment of restorative environmental management and visitor service management approaches.

Effect of Nature-Based Sound Therapy on Stress and Physiological Parameters in Patients with Myocardial Infarction

Background

Non-pharmacological interventions in clinical practice, such as Nature-Based Sounds (N-BS), can be an efficient way to reduce stress in patients with Myocardial Infarction (MI). This study was an attempt to investigate the effect of N-BS on stress and physiological parameters in patients with MI.

Materials and Methods

This double-blind, randomized clinical trial was conducted on 80 patients with MI from two selected hospitals. Using headphones, the subjects in the intervention group listened to 30 minutes of N-BS twice a day for 3 days. The control group, on the other hand, wore headphones playing no sound. The data were collected using the Persian version of the Depression, Anxiety, and Stress Scale. The significance level was set at 0.05.

Results

The repeated measure analysis showed that the within group effect is statistically significant for Systolic Blood Pressure (SBP) (F = 113.32, p < 0.001), Diastolic Blood Pressure (DBP) (F = 67.22, p < 0.001), Heart Rate (HR) (F = 28.52, p < 0.001), respiration rate (F = 36.41, p < 0.001), and stress (F = 102.82, p < 0.001). The reciprocal effect was statistically significant for SBP (F = 11.76, p < 0.001) and stress (F = 5.31, p < 0.001).

Conclusions

N-BS can provide an effective, inexpensive, and non-invasive method of reducing stress in patients with MI. Nurses can incorporate N-BS intervention into the daily care of patients with MI in order to reduce their stress and lower their SBP and HR.

Time in Nature: A Prescription for the Prevention or Management of Hypertension

Growing evidence suggests time in nature may positively influence a broad range of health outcomes including blood pressure. The mechanism(s) by which nature exerts this influence is not fully understood, but it has been proposed that nature or natural environments promote health due to opportunities for physical activity and stress reduction. Experimental and observational studies suggest that time in forests or other green spaces is associated with reduced blood pressure, lower prevalence of hypertension, and reduced odds of using antihypertensive medications. Therefore, prescribing time in nature for patients at risk or diagnosed with hypertension may have substantial benefits.

Sensory emotion regulation

Decades of evidence reveal intimate links between sensation and emotion. Yet, discussion of sensory experiences as tools that promote emotion regulation is largely absent from current theorizing on this topic. Here, we address this gap by integrating evidence from social-personality, clinical, cognitive-neuroscience, and animal research to highlight the role of sensation as a tool that can be harnessed to up- or downregulate emotion. Further, we review evidence implicating sensation as a rapid and relatively effortless emotion regulation modality and highlight future research directions. Notably, we emphasize the need to examine the duration of sensory emotion regulation effects, the moderating role of individual and cultural differences, and how sensory strategies interact with other strategies.

Evaluation of Satisfaction with the Built Environment of University Buildings under the Epidemic and Its Impact on Student Anxiety

Anxiety on college campuses has increased due to the COVID-19 epidemic's profound effects on society. Much research has been conducted on how the built environment influences mental health; however, little has been undertaken on how it affects student mental health in the context of the epidemic from the architectural scale perspective of academic buildings. Based on online survey data, this study develops multiple linear regression and binary logistic regression models to investigate students' satisfaction ratings of the academic buildings' physical environments during the epidemic and how these satisfaction ratings affect students' anxiety tendencies. According to the study's findings regarding the natural exposure perspective, students who perceived the academic building's poor semi-open space view (p = 0.004, OR = 3.22) as unsatisfactory factors were more likely to show anxiety tendencies. In terms of the physical conditions, students who were dissatisfied with the noise level in the classroom (p = 0.038, OR = 0.616) and the summer heat in semi-open spaces (p = 0.031, OR = 2.38) were more likely to exhibit anxiety tendencies. Additionally, even after controlling for confusing distractions, the general satisfaction rating of the academic building's physical environments (p = 0.047, OR = 0.572) was still able to significantly and negatively affect students' anxiety tendencies. The study's findings can be used in the architectural and environmental planning of academic buildings focusing on mental health.

Physiotherapy and ecosystem services: improving the health of our patients, the population, and the environment

INTRODUCTION

The relevance of ecosystems to physiotherapy has traditionally been overlooked, despite its potential for health impacts relevant to conditions often managed by physiotherapists.

PURPOSE

The purpose of this article is to introduce the concept of ecosystem services to physiotherapists, and to discuss how understanding ecosystem services may improve patient care, and population and planetary health.

DISCUSSION AND CONCLUSION

Physiotherapists with an understanding of ecosystem services may improve patient care by value-adding to management through patient education, empathy, advocacy, and broader population health approaches. Physiotherapists are also well placed to promote the conservation and restoration of ecosystem through participation, advocacy, and the development of public health measures, to the benefit of global sustainability and population health. Further research is required into how physiotherapists currently use nature-based interventions, and the barriers and enablers to their use. To be adequately prepared to meet the challenges that climate change and environmental degradation pose to patient care, population health and health systems, both current and future physiotherapists need to take a broader view of their practice. By including consideration of the potential role of the environment and green space exposure in particular on their patient's health, physiotherapists can ultimately contribute more to population and planetary health.

Investigating the Impact of Occupational Technostress and Psychological Restorativeness of Natural Spaces on Work Engagement and Work-Life Balance Satisfaction

The COVID-19 pandemic has necessitated lockdowns and mandatory working from home, as well as restrictions on travel and recreation. As a result, many people have had to use their home as an office and have increased their use of Information Communications Technology (ICT) for work purposes. Nature and accessing natural spaces are known to be beneficial for human health and wellbeing, as a result of their restorative properties. Access to local outdoor spaces was permitted under restrictions, and use of such spaces increased during lockdown. This survey study investigated whether the perceived restorativeness of natural spaces and exposure to technostress predicted the levels of work engagement and work-life balance satisfaction (WLBS) during the period of COVID-19 restrictions adopted in 2020. Analyses conducted on a sample of 109 people employed in the UK revealed that technostress negatively impacted WLBS, whilst perceived psychological restorativeness positively predicted work engagement. The study highlights the benefits of having access to natural spaces to improve employees' work engagement and potentially negate the negative effects of technostress, particularly during a period of intensive working from home. The results contribute to the understanding of the linkages between restorativeness and work engagement, paving the way for synergies across these research fields.

Mothers' accounts of the impact of being in nature on postnatal wellbeing: a focus group study

BACKGROUND

The postnatal period is a vulnerable time for mothers to experience stress and mental health difficulties. There is increasing evidence that spending time in nature is beneficial for wellbeing. Nature-based interventions have been developed to support mental health, but not specifically tailored for mothers during the postnatal period. Understanding mothers' views and experiences of nature would help determine the suitability for and potential impact of such interventions on postnatal wellbeing.

AIMS

To explore mothers' views on the impact of spending time in nature on their postnatal mental wellbeing.

METHODS

Focus groups were held with mothers of young children (under five), including mothers from migrant and refugee communities, mothers living with mental health difficulties, and disabled mothers. Data were analysed using reflexive thematic analysis.

RESULTS

Four focus groups were held, with a total of 30 participants. Six themes were developed: (1) mothers' experiences of what constitutes 'nature'; (2) sensing nature improves wellbeing; (3) natural spaces facilitate human connection; (4) nature provides escape and relief from daily indoor stressors; (5) nature allows new perspectives; and (6) mothers face a variety of environmental, practical, psychological, physical, socioeconomic, and cultural barriers to spending time in nature during the postnatal period.

CONCLUSIONS

Mothers report significant benefits to their postnatal wellbeing when spending time in nature. Further research is warranted to understand whether nature-based interventions have the potential to support postnatal wellbeing, socially, mentally, and physically.

Green Physical Activity Indicator: Health, Physical Activity and Spending Time Outdoors Related to Residents Preference for Greenery

Spending time in the natural outdoor environment is a part of a healthy lifestyle. This study focused on identifying elements of green infrastructure that have a positive impact on both increasing physical activity, spending time outdoors and improving overall health. The aim of the research was to identify which elements of the settlement units' green and blue infrastructure, related to residents' preferences for greenery, influence more physical activity and spending time in green spaces and improve the healthy feeling of users as perceived by respondents. A total of 721 respondents from Poland took part in the survey. Using multiple regression models, the factors that influence an increase in outdoor physical activity Green Physical Activity Index (GPAI) were: using green spaces for exercise, spending time outdoors, exposure to nature and sufficiently large amounts of green space in the neighborhood and proximity to places to walk the dog. In contrast, physical activity has been shown to improve feeling healthy (health declaration). The main findings show that the increase in physical activity outdoors (GPAI) is positively influenced by factors related to respondents' reasons for being outdoors, rather than the attractiveness and availability of green infrastructure. The research confirmed the necessity of arranging green areas with rich offerings in terms of a variety of activities for leisure visitors, to give them more opportunities for being outdoors.

Nature, smells, and human wellbeing

The link between nature and human wellbeing is well established. However, few studies go beyond considering the visual and auditory underpinnings of this relationship, even though engaging with nature is a multisensory experience. While research linking smell to wellbeing exists, it focuses predominantly on smells as a source of nuisance/offence. Smells clearly have a prominent influence, but a significant knowledge gap remains in the nexus of nature, smell, and wellbeing. Here, we examine how smells experienced in woodlands contribute to wellbeing across four seasons. We show that smells are associated with multiple wellbeing domains, both positively and negatively. They are linked to memories, and specific ecological characteristics and processes over space/time. By making the link between the spatiotemporal variability in biodiversity and wellbeing explicit, we unearth a new line of enquiry. Overall, the multisensory experience must be considered by researchers, practitioners, policy-makers and planners looking to improve wellbeing through nature.

La demande pour des espaces de nature en situation de pandémie

INTRODUCTION

The extent of the health benefits of contact with nature came to the fore during the health crisis. However, studies do not fully appreciate the effect of the type of natural environment to which individuals are exposed. The studies often use a very vague category of &#8220;green space&#8221; for the purpose.

PURPOSE OF RESEARCH

We apply social sciences analytical concepts to analyze demands for recreational uses of both forests and ocean beaches in a time of sanitary crisis. Our studies use data from two regional surveys applied to a representative sample of the Aquitaine population.

RESULTS

We underline the social inequalities with regard to access to forest and ocean beaches, even though outdoor recreation is free of charge most of the time. We also identify salient differences between uses, motivations, and risk perceptions in both of the natural settings. We discuss how such discrepancies are inherited from previously constructed social representations.

CONCLUSIONS

We believe that public health studies could benefit greatly from the achievements of several decades of research in the field of outdoor studies.

How Do Nature-Based Activities Benefit Essential Workers during the COVID-19 Pandemic? The Mediating Effect of Nature Connectedness

Although many studies have suggested that nature-based activities have a healing effect on human beings, there is little research on the underlying mechanism. This study investigated the role of nature connectedness in the relationship between the perception of nature and individuals' physical and psychological health. We recruited essential workers who participated in disease prevention and control during the COVID-19 pandemic and their family members as the subjects for this study. The stress levels experienced by this group made them an ideal sample. The results of a survey-based study showed that nature-based activities had a positive effect on alleviating state anxiety levels. The results also showed that nature-based activities affected perceived restoration via the feeling of nature connectedness. This study examined the healing effect of nature-based activities that stimulate the five senses and nature connectedness and explored the potential of nature-based treatments for people experiencing high levels of stress.

Social prescribing of nature therapy for adults with mental illness living in the community: A scoping review of peer-reviewed international evidence

Social prescribing of nature therapy "green social prescribing" facilitates access to local nature-based activities that improve biopsychosocial wellbeing outcomes, are affordable, accessible, and can be adapted to context. These are becoming increasingly popular and gray literature is emerging, however, peer-reviewed scientific evidence is exiguous. This scoping review aimed to identify and critique peer-reviewed evidence for green social prescribing interventions and develop recommendations for research and clinical practice. Included studies were published in peer-reviewed journals in English on/after 1 January 2000. Participants were community-living adults with mental illness; Intervention was any green social prescribing program; Comparator was not restricted/required; Outcomes were any biopsychosocial measures; and any/all Study Designs were included. Twelve databases were searched on 15 October 2022; these were Academic Search Premier, APA PsycArticles, APA PsycINFO, CINAHL, Cochrane Library, Google Scholar, JSTOR, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Mixed Methods Appraisal Tool was used to assess quality. Seven publications describing 6 unique studies (5 UK, 1 Australia) were identified including 3 mixed-methods, 2 qualitative, and 1 RCT. Participants included 334 adults (45% female, aged 35-70 years); sample sizes ranged from 9 to 164. All studies showed improvements in biopsychosocial wellbeing, and participants from most studies (n = 5) reported increased connection to the earth and intention to further access nature. Participant demographics and diagnoses were poorly reported, and intervention activities and assessments varied considerably. However, MMAT scores were good overall suggesting these studies may reliably demonstrate intervention outcomes. We conclude that socially prescribed nature therapy can improve biopsychosocial wellbeing and is a potentially important intervention for mental illness. Recommendations for research and clinical practice are provided.

Scoping review of the use of virtual reality in intensive care units

BACKGROUND

A wide range of reviews have demonstrated the effectiveness and tolerability of Virtual Reality (VR) in a range of clinical areas and subpopulations. However, no previous review has explored the current maturity, acceptability, tolerability, and effectiveness of VR with intensive care patients.

AIMS

To identify the range of uses of VR for intensive care patients, classify their current phase of development, effectiveness, acceptability, and tolerability.

METHODS

A scoping review was conducted. A multi-database search was undertaken (inception to January 2021). Any type of study which examined the use of VR with the target application population of intensive care patients were included. Screening, data extraction, and assessment of quality were undertaken by a single reviewer. A meta-analysis and a descriptive synthesis were undertaken.

RESULTS

Six hundred and forty-seven records were identified, after duplicate removal and screening 21 studies were included (weak quality). The majority of studies for relaxation, delirium, and Post Traumatic Stress Disorder (PTSD) were at the early stages of assessing acceptability, tolerability, and initial clinical efficacy. Virtual Reality for relaxation and delirium were well-tolerated with completion rates of target treatment of 73.6%, (95% CI:51.1%-96%, I2  = 98.52%) 52.7% (95% CI:52.7%-100%, I2  = 96.8%). The majority of reasons for non-completion were due to external clinical factors. There were some potential benefits demonstrated for the use of VR for relaxation, delirium, and sleep.

CONCLUSION

Virtual Reality for intensive care is a new domain of research with the majority of areas of application being in the early stages of development. There is great potential for the use of VR in this clinical environment. Further robust assessment of effectiveness is required before any clinical recommendations can be made.

RELEVANCE TO CLINICAL PRACTICE

Virtual reality for ICU patients is in its infancy and is not at a stage where it should be used as routine practice. However, there is early evidence to suggest that virtual reality interventions have good acceptability and tolerability in intensive care patients for relaxation, delirium, and improving sleep.

Effect of nature-based physical activity on post-traumatic growth among healthcare providers with post-traumatic stress

The purpose of this randomized control trial was to observe the effect of nature-based physical activity in achieving post traumatic growth and to estimate the combined effect of nature and physical activity on the psychophysiological outcomes. A 3-month therapy was provided to participants meeting eligibility criteria to receive the walk-in nature (experimental group) or sit-in nature (control group) in the 1:1 ratio. At baseline and 3-month follow-up, participants were assessed with Trauma Symptom Checklist 40, Traumatic Stress Scale, Post-Traumatic Growth Inventory (PTGI), Cortisol, C-Reactive Protein (CRP), Interleukin-6 (IL-6), Brain-Derived Neurotropic Factor (BDNF) and heart rate variability. There was a significant effect of nature-based physical activity on traumatic stress and post-traumatic growth in comparison with the sit-in control. A significant post-interventional difference was observed in the mean PTGI score [F = 5.412, p = 0.022] between the experimental and control groups after 3 months of intervention. All the biochemical estimates, including CRP, BDNF, IL-6, and cortisol levels, were significantly altered in both post-intervention study groups (p < 0.01). Taken together, these results show that nature-based physical activity significantly improves psychophysiological outcomes induced as a result of post-traumatic growth and also reduces traumatic stress.

Indoor nature integration for stress recovery and healthy eating: A picture experiment with plants versus green color

AIM

Urbanized environments may stimulate unhealthy food choices and stress. Several theories explain that exposure to green nature can counter these stress effects. Since we spend most time indoors, integrating nature in the interior could be a promising health promotion tool. Hence, we tested whether the beneficial effect of nature for stress recovery is also present in indoor settings via the use of plants or green colors, and whether it is applicable on eating behavior as a new outcome.

METHODS

The 92 participants (18-30y, 16% men) were divided into four groups. Each viewed a 6-min slideshow with room pictures containing either green plants, green objects, greyscale plants or greyscale objects to allow distinction between color- and plant-effects. Group differences were tested for the perceived restorativeness scale, psychological recovery and eating behavior. To allow psychological recovery testing, participants were exposed to a stressor before the picture slideshow via the Trier Social Stress Test. The change of self-reports (stress, positive and negative affect) and psychophysiology (heart rate and vagal-induced heart rate variability RMSSD) post-slideshow versus pre-slideshow was checked. Eating behavior outcomes included change in hunger, craving, and food choice (for fruits, vegetables and snacks).

RESULTS

From the four picture sets, the green plants pictures were reported as most mentally restorative and appeared most beneficial for post-stressor recovery of positive affect, but not for negative affect or stress recovery. The green plants group also had higher preference for vegetables and lower preference or craving for (unhealthy) snacks. Those significant group differences were mainly due to the presence of plants and only occasionally due to the green color.

CONCLUSION

Indoor green plant pictures were associated with higher mental restorativeness and healthier food choices. Integrating plants in the interior seems to be a relevant health promotion approach, while applying green colors seems less relevant.

Biophilic Experience-Based Residential Hybrid Framework

There has been increasing academic interest in biophilic design in response to recent environmental and climate change issues, including the COVID-19 pandemic. However, discussions of the utilization of digital technology in providing universal access to nature, and opportunities to experience more diverse nature, are lacking. This study aimed to compare and analyze major theoretical systems for biophilic experiences in a residential environment, and to propose a hybrid framework that combines physical and digital design techniques for comparison and analysis. This paper discusses framework application strategies in line with scales of residential environments. Based on a systematic literature review, this study integrated and derived key elements of biophilic experience for a better quality of life in a modern residential environment and proposed a hybrid framework and strategy based on this. As a result, a hybrid framework of 15 integrated factors for three biophilic experiences was derived, and various strengths and potential opportunities were identified in terms of application depending on the scales. At the unit scale, it was found that the well-being and health of residents improved; at the building scale, the potential for sustainability was highlighted; at the complex scale, there was a contribution to higher residential competitiveness in multi-dimensional aspects. In particular, the biophilic experience-based hybrid framework in this study provided insights into addressing the weaknesses and threats discussed in the existing biophilic design.