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Baskerville R, Castell L, Bermon S. Sports and Immunity, from the recreational to the elite athlete. Infect Dis Now 2024; 54:104893. [PMID: 38531477 DOI: 10.1016/j.idnow.2024.104893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/22/2024] [Indexed: 03/28/2024]
Abstract
The pivotal role of the immune system in physical activity is well-established. While interactions are complex, they tend to constitute discrete immune responses. Moderate intensity exercise causes leukocytosis with a mild anti-inflammatory cytokine profile and immunoenhancement. Above a threshold of intensity, lactate-mediated IL-6 release causes a proinflammatory state followed by a depressed inflammatory state, which stimulates immune adaptation and longer term cardiometabolic enhancement. Exercise-related immune responses are modulated by sex, age and immunonutrition. At all ability levels, these factors collectively affect the immune balance between enhancement or overload and dysfunction. Excessive training, mental stress or insufficient recovery risks immune cell exhaustion and hypothalamic pituitary axis (HPA) stress responses causing immunodepression with negative impacts on performance or general health. Participation in sport provides additional immune benefits in terms of ensuring regularity, social inclusion, mental well-being and healthier life choices in terms of diet and reduced smoking and alcohol, thereby consolidating healthy lifestyles and longer term health. Significant differences exist between recreational and professional athletes in terms of inherent characteristics, training resilience and additional stresses arising from competition schedules, travel-related infections and stress. Exercise immunology examines the central role of immunity in exercise physiology and straddles multiple disciplines ranging from neuroendocrinology to nutrition and genetics, with the aim of guiding athletes to train optimally and safely. This review provides a brief outline of the main interactions of immunity and exercise, some influencing factors, and current guidance on maintaining immune health.
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Affiliation(s)
| | - Linda Castell
- Green Templeton College, University of Oxford, Oxford, UK
| | - Stéphane Bermon
- World Athletics Health and Science Department, Monaco and LAMHESS, University Côte d'Azur, Nice, France
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Vashist M, Kumar TV, Singh SK. A comprehensive review of urban vegetation as a Nature-based Solution for sustainable management of particulate matter in ambient air. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:26480-26496. [PMID: 38570430 DOI: 10.1007/s11356-024-33089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
Air pollution is one of the most pressing environmental threats worldwide, resulting in several health issues such as cardiovascular and respiratory disorders, as well as premature mortality. The harmful effects of air pollution are particularly concerning in urban areas, where mismanaged anthropogenic activities, such as growth in the global population, increase in the number of vehicles, and industrial activities, have led to an increase in the concentration of pollutants in the ambient air. Among air pollutants, particulate matter is responsible for most adverse impacts. Several techniques have been implemented to reduce particulate matter concentrations in the ambient air. However, despite all the threats and awareness, efforts to improve air quality remain inadequate. In recent years, urban vegetation has emerged as an efficient Nature-based Solution for managing environmental air pollution due to its ability to filter air, thereby reducing the atmospheric concentrations of particulate matter. This review characterizes the various mitigation mechanisms for particulate matter by urban vegetation (deposition, dispersion, and modification) and identifies key areas for further improvements within each mechanism. Through a systematic assessment of existing literature, this review also highlights the existing gaps in the present literature that need to be addressed to maximize the utility of urban vegetation in reducing particulate matter levels. In conclusion, the review emphasizes the urgent need for proper air pollution management through urban vegetation by integrating different fields, multiple stakeholders, and policymakers to support better implementation.
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Affiliation(s)
- Mallika Vashist
- Department of Environmental Engineering, Delhi Technological University, Bawana Road, Shahbad Daulatpur, Delhi, India, 110042.
| | | | - Santosh Kumar Singh
- Department of Environmental Engineering, Delhi Technological University, Bawana Road, Shahbad Daulatpur, Delhi, India, 110042
- Rajasthan Technical University, Kota (Rajasthan), India
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Khandibharad S, Singh S. Single-cell ATAC sequencing identifies sleepy macrophages during reciprocity of cytokines in L. major infection. Microbiol Spectr 2024; 12:e0347823. [PMID: 38299832 PMCID: PMC10913457 DOI: 10.1128/spectrum.03478-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/31/2023] [Indexed: 02/02/2024] Open
Abstract
The hallmark characteristic of macrophages lies in their inherent plasticity, allowing them to adapt to dynamic microenvironments. Leishmania strategically modulates the phenotypic plasticity of macrophages, creating a favorable environment for intracellular survival and persistent infection through regulatory cytokine such as interleukin (IL)-10. Nevertheless, these effector cells can counteract infection by modulating crucial cytokines like IL-12 and key components involved in its production. Using sophisticated tool of single-cell assay for transposase accessible chromatin (ATAC) sequencing, we systematically examined the regulatory axis of IL-10 and IL-12 in a time-dependent manner during Leishmania major infection in macrophages Our analysis revealed the cellular heterogeneity post-infection with the regulators of IL-10 and IL-12, unveiling a reciprocal relationship between these cytokines. Notably, our significant findings highlighted the presence of sleepy macrophages and their pivotal role in mediating reciprocity between IL-10 and IL-12. To summarize, the roles of cytokine expression, transcription factors, cell cycle, and epigenetics of host cell machinery were vital in identification of sleepy macrophages, which is a transient state where transcription factors controlled the epigenetic remodeling and expression of genes involved in pro-inflammatory cytokine expression and recruitment of immune cells.IMPORTANCELeishmaniasis is an endemic affecting 99 countries and territories globally, as outlined in the 2022 World Health Organization report. The disease's severity is compounded by compromised host immune systems, emphasizing the pivotal role of the interplay between parasite and host immune factors in disease regulation. In instances of cutaneous leishmaniasis induced by L. major, macrophages function as sentinel cells. Our findings indicate that the plasticity and phenotype of macrophages can be modulated to express a cytokine profile involving IL-10 and IL-12, mediated by the regulation of transcription factors and their target genes post-L. major infection in macrophages. Employing sophisticated methodologies such as single-cell ATAC sequencing and computational genomics, we have identified a distinctive subset of macrophages termed "sleepy macrophages." These macrophages exhibit downregulated housekeeping genes while expressing a unique set of variable features. This data set constitutes a valuable resource for comprehending the intricate host-parasite interplay during L. major infection.
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Affiliation(s)
- Shweta Khandibharad
- Systems Medicine Lab, National Centre for Cell Science, SP Pune University Campus, Pune, India
| | - Shailza Singh
- Systems Medicine Lab, National Centre for Cell Science, SP Pune University Campus, Pune, India
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Sterckx A, Delbaere B, De Blust G, Spacova I, Samson R, Remmen R, Keune H. Quality criteria of nature-based interventions in healthcare facilities: a scoping review. Front Public Health 2024; 11:1327108. [PMID: 38274513 PMCID: PMC10808570 DOI: 10.3389/fpubh.2023.1327108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Implementing integrated nature-based interventions that simultaneously serve human health and the restoration of biodiversity in healthcare facilities is considered a promising strategy. As an emerging field of research and practice in healthcare, identification of quality criteria is necessary to support desired outcomes related to biodiversity, human health and intervention processes. This study is part of a larger research project in collaboration with the Flemish Agency of Nature and Forest in Belgium. Methods A scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, in PubMed, Medline, Web of Science and Scopus. A step-by-step tabular screening process was conducted to identify relevant studies and reviews of nature-based interventions, published in English between January 2005 and April 2023. A qualitative content analysis was conducted and the results were then presented to the project steering group and a panel of stakeholders for refinement. Results After filtering on the eligibility criteria, and with focus on healthcare facilities, 14 articles were included in this study. A preliminary nature-based interventions quality framework with a set of quality indicators has been developed. Discussion When designing integrated nature-based interventions, a needs analysis of users and the outdoor environment should be conducted. Next, the integration of a One Health and biodiversity perspective and the application of a complex intervention framework, could support the quality of the design and implementation of nature-based interventions in healthcare facilities and facilitate their assessment. In future work, more rigorous research into the design and implementation of integrated nature-based interventions is needed to test and refine the quality criteria in practice.
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Affiliation(s)
- Ann Sterckx
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ben Delbaere
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Geert De Blust
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Irina Spacova
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Roeland Samson
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Roy Remmen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hans Keune
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Houweling L, Maitland-Van der Zee AH, Holtjer JCS, Bazdar S, Vermeulen RCH, Downward GS, Bloemsma LD. The effect of the urban exposome on COVID-19 health outcomes: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 240:117351. [PMID: 37852458 DOI: 10.1016/j.envres.2023.117351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The global severity of SARS-CoV-2 illness has been associated with various urban characteristics, including exposure to ambient air pollutants. This systematic review and meta-analysis aims to synthesize findings from ecological and non-ecological studies to investigate the impact of multiple urban-related features on a variety of COVID-19 health outcomes. METHODS On December 5, 2022, PubMed was searched to identify all types of observational studies that examined one or more urban exposome characteristics in relation to various COVID-19 health outcomes such as infection severity, the need for hospitalization, ICU admission, COVID pneumonia, and mortality. RESULTS A total of 38 non-ecological and 241 ecological studies were included in this review. Non-ecological studies highlighted the significant effects of population density, urbanization, and exposure to ambient air pollutants, particularly PM2.5. The meta-analyses revealed that a 1 μg/m3 increase in PM2.5 was associated with a higher likelihood of COVID-19 hospitalization (pooled OR 1.08 (95% CI:1.02-1.14)) and death (pooled OR 1.06 (95% CI:1.03-1.09)). Ecological studies, in addition to confirming the findings of non-ecological studies, also indicated that higher exposure to nitrogen dioxide (NO2), ozone (O3), sulphur dioxide (SO2), and carbon monoxide (CO), as well as lower ambient temperature, humidity, ultraviolet (UV) radiation, and less green and blue space exposure, were associated with increased COVID-19 morbidity and mortality. CONCLUSION This systematic review has identified several key vulnerability features related to urban areas in the context of the recent COVID-19 pandemic. The findings underscore the importance of improving policies related to urban exposures and implementing measures to protect individuals from these harmful environmental stressors.
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Affiliation(s)
- Laura Houweling
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Anke-Hilse Maitland-Van der Zee
- Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands
| | - Judith C S Holtjer
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Somayeh Bazdar
- Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands
| | - Roel C H Vermeulen
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - George S Downward
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lizan D Bloemsma
- Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands
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Li M, Masri S, Chiu CH, Sun Y, Wu J. Mapping wild vascular plant species diversity in urban areas in California using crowdsourcing data by regression kriging: Examining socioeconomic disparities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:166995. [PMID: 37717761 PMCID: PMC10947671 DOI: 10.1016/j.scitotenv.2023.166995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/09/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
Biodiversity is crucial for human health, but previous methods of measuring biodiversity require intensive resources and have other limitations. Crowdsourced datasets from citizen scientists offer a cost-effective solution for characterizing biodiversity on a large spatial scale. This study has two aims: 1) to generate fine-resolution plant species diversity maps in California urban areas using crowdsourced data and extrapolation methods; and 2) to examine their associations with sociodemographic factors and identify subpopulations with low biodiversity exposure. We used iNaturalist observations from 2019 to 2022 to calculate species diversity metrics by exploring the sampling completeness in a 5 × 5-km2 grid and then computing species diversity metrics for grid cells with at least 80 % sample completeness (841 out of 4755 grid cells). A generalized additive model with ordinary kriging (GAM OK) provided moderately reliable estimates, with correlations of 0.64-0.66 between observed and extrapolated metrics, relative mean absolute errors of 21 %-23 %, and relative root mean squared errors of 27 %-30 % for grid cells with ≥80 % sample completeness from 10-fold cross-validation. GAM OK was further applied to extrapolate species diversity metrics from saturated grid cells (N = 841) to the remaining grid cells with <80 % sample completeness (N = 3914) and generate diversity maps that cover the grid. Further, generalized linear mixed models were used to examine the associations between species diversity and sociodemographic indicators at census tract level. The wild vascular plant species diversity metrics were inversely associated with neighborhood socioeconomic status (i.e., unemployment, linguistic isolation, educational attainment, and poverty rate). Minority populations (i.e., African American, Asian American, and Hispanic) and children had significantly lower diversity exposure in their neighborhoods. Crowdsourcing data offers a cost-effective solution for characterizing large-scale biodiversity in urban areas.
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Affiliation(s)
- Mengyi Li
- Department of Disease Prevention, Program in Public Health, University of California, Irvine, CA, USA
| | - Shahir Masri
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - Chun-Huo Chiu
- Department of Agronomy, National Taiwan University, Taipei, Taiwan
| | - Yi Sun
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA; Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA.
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Jacobsen SS, Vilhelmsen M, Lottrup L, Brandt M. Facilitators and barriers for using outdoor areas in the primary work tasks of eldercare workers in nursing homes. BMC Health Serv Res 2023; 23:1300. [PMID: 38001468 PMCID: PMC10675903 DOI: 10.1186/s12913-023-10308-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Eldercare workers in nursing homes report high musculoskeletal disorders, stressful work, and sickness absence. Initiatives that can accommodate these issues are needed. Current studies point out that nature contact may offer a range of human health benefits, potentially promoting healthier work among eldercare workers. Therefore, this study aimed to investigate facilitators and barriers for using outdoor areas as part of the daily work among eldercare workers in Danish nursing homes. METHODS In this multiple case study, we collected data from three nursing homes, conducting three semi-structured focus group interviews with eldercare workers and three individual interviews with nursing home managers. Furthermore, we conducted observations of the daily work and mappings of the nursing homes' outdoor environments to gain in-depth knowledge of eldercare workers' and managers' perspectives on using outdoor areas in their daily work. The data was thematically analysed using 'The Behaviour Change Wheel' (BCW), more specifically the COM-B model, as a theoretical foundation for exploring facilitators and barriers for the use of outdoor areas. RESULTS Frequently mentioned facilitators were facilities, traditions or repetitive events, positive experiences with residents ('star moments'), and knowledge about the residents. Frequently mentioned barriers were insufficient staffing, hierarchy in the work tasks, professional identity, and lack of ideas. CONCLUSIONS The identified facilitators and barriers should be considered when designing initiatives for increased use of outdoor areas or activities of eldercare workers. TRIAL REGISTRATION According to the Danish ethics committee (Law of committee, (komitéloven) paragraph 14, Sect. 2), qualitative interviews, which do not include human biological materials, do not need neither approval by ethical and scientific committee or informed consent (The Danish National Centre for Ethics).
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Affiliation(s)
- Sandra Schade Jacobsen
- National Research Centre for the Working Environment, Lersø Parkalle 105, Copenhagen, Denmark
| | - Maja Vilhelmsen
- National Research Centre for the Working Environment, Lersø Parkalle 105, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Frederiksberg, Denmark
| | - Lene Lottrup
- Outdoor Institute, Silkeborg, Denmark
- Sundhedslandskab, Aarhus, Denmark
| | - Mikkel Brandt
- National Research Centre for the Working Environment, Lersø Parkalle 105, Copenhagen, Denmark.
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Cartanyà-Hueso À, de Celis Alonso B, Hidalgo Tobón SS, Miranda Lora AL, Klünder Klünder M, López Martínez B, Dies Suárez P, Barragán Pérez E, So PW, Delgado-Saborit JM. Cross-sectional evaluation of the association between greenness and cognitive performance in Mexican pre-pubertal boys. ENVIRONMENTAL RESEARCH 2023; 237:116968. [PMID: 37625541 DOI: 10.1016/j.envres.2023.116968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Evidence shows that greenspace exposure benefits children's health and cognitive development. However, evidence assessing this association in young children in low- and middle-income economies is scarce. OBJECTIVE To assess the association between exposure to greenness and cognitive performance in pre-pubertal boys living in Mexico City. METHODS Cross-sectional study using data from 144 boys aged 6-11 years living in Mexico City in 2017 and enrolled in the "MetCog" study. Cognitive performance was evaluated through selected Wechsler Scale for Intelligence in Children Fourth Edition (WISC-IV) and Neuropsychological Assessment of Children (Evaluación Neuropsicológica Infantil, ENI) tests. Exposure to greenness was assessed through Normalised Difference Vegetation Index (NDVI) at 300, 500, 1500, 2000, and 3000 m buffer zones from children's residences. Multiple linear regression analysis was undertaken to assess associations between cognitive performance and greenness (aβ) with 95% confidence intervals (CI) and adjusted for potential confounding variables. Significance was set at q < 0.05 after False Discovery Rate (FDR) correction. RESULTS A positive association was found between the NDVI Interquartile Range (IQR) at 2000 m and the WISC-IV block design test score (aβ 2000 = 1.18, 95% CI = 0.31, 2.06; q < 0.05), which assesses perceptual reasoning. Positive associations were found with NDVI IQR at 1500 m and WISC-IV block design (aβ1500 = 1.00, 95% CI = 0.14, 1.86) and matrix reasoning (aβ1500 = 0.83, 95% CI = 0.06, 1.61) scores, but neither survived FDR correction. No significant associations were found between NDVI IQR at any buffer size with other WISC-IV and ENI task scores. CONCLUSIONS Greater exposure to greenness was associated with higher perceptual reasoning skills in 144 pre-pubertal boys living in Mexico City. Thus, urban planning should consider increasing vegetation in megacities, especially in neighbourhoods with high percentages of young children.
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Affiliation(s)
- Àurea Cartanyà-Hueso
- Group of Perinatal Epidemiology, Environmental Health, and Clinical Research, Department of Medicine, School of Health Sciences, Universitat Jaume I, Av. Vicent Sos Baynat, s/n 12071 Castelló de La Plana, Spain
| | - Benito de Celis Alonso
- Faculty of Physical and Mathematical Sciences, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Silvia Sandra Hidalgo Tobón
- Departamento de Imagenología, Hospital Infantil de México Federico Gómez, Mexico City Mexico; Departamento de Física de La Universidad Autónoma de México Iztapalapa, Mexico City, Mexico
| | - América Liliana Miranda Lora
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, CDMX, Mexico
| | - Miguel Klünder Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Briceida López Martínez
- Subdirección de Servicios Auxiliares de Diagnóstico, Hospital Infantil de México Federico Gómez, CDMX, Mexico
| | - Pilar Dies Suárez
- Departamento de Imagenología, Hospital Infantil de México Federico Gómez, Mexico City Mexico
| | - Eduardo Barragán Pérez
- Departamento de Neurología, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Po-Wah So
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Juana Maria Delgado-Saborit
- Group of Perinatal Epidemiology, Environmental Health, and Clinical Research, Department of Medicine, School of Health Sciences, Universitat Jaume I, Av. Vicent Sos Baynat, s/n 12071 Castelló de La Plana, Spain.
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Oomen-Welke K, Hilbich T, Schlachter E, Müller A, Anton A, Huber R. Spending time in the forest or the field: qualitative semi-structured interviews in a randomized controlled cross-over trial with highly sensitive persons. Front Psychol 2023; 14:1207627. [PMID: 38022960 PMCID: PMC10661274 DOI: 10.3389/fpsyg.2023.1207627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The effects of spending time in forests have been subject to investigations in various countries around the world. Qualitative comparisons have been rarely done so far. Methods Sixteen healthy highly sensitive persons (SV12 score ≥ 18) aged between 18 and 70 years were randomly assigned to groups spending 1 h in the forest and in the field at intervals of one week. Semi-structured interviews were conducted after each intervention and analyzed using a mixed-methods approach of content analysis and grounded theory. Results Both natural environments induced feelings of inner calmness, inner cleansing, joy, freedom, connectedness, strengthening qualities, and heightened body awareness. The forest environment additionally offered emotional shelter, and showed advantages in promoting inner strength and self-concentration. Discussion People with previous negative experiences in the forest may feel safer in fields because of the wider view and better overview. Important preconditions are enough time and the absence of a judgmental authority. The two environments induced in part different but also similar emotions which might be useful to promote psychological well-being differentially.
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Affiliation(s)
- Katja Oomen-Welke
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tina Hilbich
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Evelyn Schlachter
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexander Müller
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Anton
- Institute for Frontier Areas of Psychology and Mental Health (IGPP), Freiburg, Germany
| | - Roman Huber
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Lopez-Escamez JA, Vela J, Frejo L. Immune-Related Disorders Associated With Ménière's Disease: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2023; 169:1122-1131. [PMID: 37272729 DOI: 10.1002/ohn.386] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/11/2023] [Accepted: 05/04/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To analyze evidence supporting an association between immune-related diseases and Ménière's disease (MD) since it has long been thought to be related to autoimmune disorders and allergies. DATA SOURCES We retrieved records from Pubmed, Web of Science, Scopus, and Cochrane Library to identify studies published between January 2002 and October 2022. REVIEW METHODS Articles were independently assessed by 2 reviewers and verified by a third reviewer. Published cross-sectional studies, cohort/longitudinal studies, case series, and noncomparative cohort studies were considered eligible for inclusion. We conducted a systematic review and meta-analysis according to a registered protocol on the International Prospective Register of Systematic Reviews and Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Selected studies were classified into 2 groups: epidemiological and genetic association studies. Relative frequencies and odds ratios (ORs) for each autoinflammatory/autoimmune disease or genetic marker reported to be associated with MD. RESULTS Fifteen studies from 6 countries met our inclusion criteria. Nine are epidemiological studies and 6 are genetic association studies. The epidemiological studies were used to perform 3 different meta-analyses. Airway allergic disease and autoimmune thyroid disease showed a significant association with MD (OR = 2.27 [2.08-2.48] and OR = 1.35 [1.25-1.46]); while rheumatoid arthritis did not (OR = 0.63 [0.28-1.41]). Other comorbidities also showed a significant association with MD like chronic obstructive pulmonary disease, vitiligo, fibromyalgia, arthritis, and psoriasis. CONCLUSION Epidemiological evidence supports an association between MD and immune-related disorders in European and Asian populations, with population-specific effects. The evaluation of thyroid diseases, airway allergic diseases, and other inflammatory diseases should be implemented in the clinical management of MD patients.
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Affiliation(s)
- Jose A Lopez-Escamez
- Department of Surgery, Division of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.GRANADA, Universidad de Granada, Granada, Spain
- Meniere's Disease Neuroscience Research Program, Faculty of Medicine and Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
- Otology and Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer, University of Granada, Junta de Andalucía, PTS, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
| | - Jesus Vela
- Department of Surgery, Division of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.GRANADA, Universidad de Granada, Granada, Spain
- Otology and Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer, University of Granada, Junta de Andalucía, PTS, Granada, Spain
| | - Lidia Frejo
- Department of Surgery, Division of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.GRANADA, Universidad de Granada, Granada, Spain
- Meniere's Disease Neuroscience Research Program, Faculty of Medicine and Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
- Otology and Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer, University of Granada, Junta de Andalucía, PTS, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
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White MP, Hartig T, Martin L, Pahl S, van den Berg AE, Wells NM, Costongs C, Dzhambov AM, Elliott LR, Godfrey A, Hartl A, Konijnendijk C, Litt JS, Lovell R, Lymeus F, O'Driscoll C, Pichler C, Pouso S, Razani N, Secco L, Steininger MO, Stigsdotter UK, Uyarra M, van den Bosch M. Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health. ENVIRONMENT INTERNATIONAL 2023; 181:108234. [PMID: 37832260 DOI: 10.1016/j.envint.2023.108234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/09/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.
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Affiliation(s)
- Mathew P White
- Cognitive Science HUB, University of Vienna, Austria; European Centre for Environment & Human Health, University of Exeter, UK.
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | - Leanne Martin
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Sabine Pahl
- Urban and Environmental Psychology Group, University of Vienna, Austria
| | | | - Nancy M Wells
- Department of Human Centered Design, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | | | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, UK
| | | | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Jill S Litt
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebecca Lovell
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Freddie Lymeus
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | | | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Sarai Pouso
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Nooshin Razani
- University of California San Francisco, San Francisco, CA, United States
| | - Laura Secco
- Department of Territorio e Sistemi Agro-Forestali (TESAF), University of Padua, Padua, Italy
| | | | - Ulrika K Stigsdotter
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Denmark
| | - Maria Uyarra
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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12
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Sandifer PA. Linking coastal environmental and health observations for human wellbeing. Front Public Health 2023; 11:1202118. [PMID: 37780424 PMCID: PMC10540068 DOI: 10.3389/fpubh.2023.1202118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/24/2023] [Indexed: 10/03/2023] Open
Abstract
Coastal areas have long been attractive places to live, work, and recreate and remain so even in the face of growing threats from global environmental change. At any moment, a significant portion of the human population is exposed to both positive and negative health effects associated with coastal locations. Some locations may be "hotspots" of concern for human health due to ongoing climatic and other changes, accentuating the need for better understanding of coastal environment-human health linkages. This paper describes how environmental and health data could be combined to create a coastal environmental and human health observing system. While largely based on information from the US and Europe, the concept should be relevant to almost any coastal area. If implemented, a coastal health observing system would connect a variety of human health data and environmental observations for individuals and communities, and where possible cohorts. Health data would be derived from questionnaires and other personal sources, clinical examinations, electronic health records, wearable devices, and syndromic surveillance, plus information on vulnerability and health-relevant community characteristics, and social media observations. Environmental data sources would include weather and climate, beach and coastal conditions, sentinel species, occurrences of harmful organisms and substances, seafood safety advisories, and distribution, proximity, and characteristics of health-promoting green and blue spaces. Where available, information on supporting resources could be added. Establishment of a linked network of coastal health observatories could provide powerful tools for understanding the positive and negative health effects of coastal living, lead to better health protections and enhanced wellbeing, and provide significant benefits to coastal residents, including the historically disadvantaged, as well as the military, hospitals and emergency departments, academic medical, public health, and environmental health programs, and others. Early networks could provide best practices and lessons learned to assist later entries.
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Affiliation(s)
- Paul A. Sandifer
- Center for Coastal Environmental and Human Health, College of Charleston, Charleston, SC, United States
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13
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Veldheer S, Whitehead-Zimmers M, Bordner C, Weinstein O, Choi H, Spreenberg-Bronsoms K, Davis J, Conroy DE, Schmitz KH, Sciamanna C. Growing Healthy Hearts: a single-arm feasibility study of a digitally delivered gardening, cooking, and nutrition intervention for adults with risk factors for cardiovascular disease. Pilot Feasibility Stud 2023; 9:152. [PMID: 37653532 PMCID: PMC10470136 DOI: 10.1186/s40814-023-01380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/22/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Food gardening may positively influence cardiovascular disease (CVD) risk-related behaviors. However, the vast majority of existing gardening interventions have used an in-person delivery model which has limitations for scalability. It is not known whether a digitally delivered gardening intervention would be feasible or acceptable to participants. The purpose of this pilot study was to assess the feasibility of a digitally delivered gardening intervention in three domains: participant acceptability, demand, and practicality. METHODS A single-arm, pre-post-study design was used. Participants (n = 30) were aged 20 + with no plans to garden in the coming season and had at least 1 CVD risk factor. The intervention included ten 1-h video-conferencing sessions, written materials, and access to a study website. Content focused on gardening skills, cooking skills, and the Dietary Approaches to Stop Hypertension (DASH) diet. Feasibility outcomes included acceptability (post-program ratings), demand (session attendance rate), and practicality (ability to start a garden and grow F&V). The study was considered feasible if the following criteria were met: ≥ 70% rated the intervention as good or excellent, overall session attendance rate was ≥ 70%, and > 70% were able to start a garden and grow F&V. We also assessed pre-post-program changes in behavioral mediators (gardening confidence, gardening enjoyment, cooking confidence, and nutrition knowledge). Descriptive statistics were calculated. Pre-post differences were evaluated with means and 95% confidence intervals (95% CI). Effect sizes were calculated (Cohen's d). RESULTS All feasibility criteria were met. A total of 93.3% of participants rated the intervention as good or excellent, 96% started a garden and grew F&V, and the overall session attendance rate was 81%. The largest mean pre-post changes were in gardening confidence (pre 7.1 [95% CI: 6.4, 7.9], post 9.0 [95% CI: 8.6, 9.5], Cohen's d = 1.15), gardening enjoyment (pre: 6.3 [95% CI: 5.9, 6.7], post: 7.5 [95% CI: 7.1, 7.9], Cohen's d = 1.69), and cooking self-efficacy (pre: 4.7 [95% CI: 4.3, 5.1], post: 7.7 [95% CI: 7.3, 8.0], Cohen's d = 3.0). CONCLUSION A digitally delivered gardening intervention was feasible, acceptable to participants, and they had meaningful changes in behavioral mediators. The next step is to evaluate the impact of the intervention in a future randomized controlled trial.
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Affiliation(s)
- Susan Veldheer
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA.
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | | | - Candace Bordner
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | | | - Hena Choi
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, 17033, USA
| | | | - Jason Davis
- Department of Early, Middle, and Exceptional Education, Millersville University, Millersville, PA, USA
| | - David E Conroy
- Department of Kinesiology, Penn State University, State College, PA, USA
| | | | - Christopher Sciamanna
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
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14
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Tomasso LP, Spengler JD, Catalano PJ, Chen JT, Laurent JGC. In situ psycho-cognitive assessments support self-determined urban green exercise time. URBAN FORESTRY & URBAN GREENING 2023; 86:128005. [PMID: 37483383 PMCID: PMC10358366 DOI: 10.1016/j.ufug.2023.128005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Prescribed nature walks frequently yield improvements to mood and cognition as observed in experimental studies. Research that uses real life settings such as self-determined time exercising outdoors for restorative health benefits may more accurately elicit effects than time-specified study protocols. This study examined in situ psycho-cognitive outcomes of routine walks in urban greenspace to test the concept that self-set exposure duration and not context alone is related to magnitude of psycho-cognitive benefit. Pre-post measurements taken on a diverse participant pool of individuals walking in urban parks and recruited on random days over a two-week period found significant associations between outdoor activity duration and cognitive and mood improvements. Greater outdoor walking duration linearly predicted stronger processing speeds but non-linearly in tests of other cognitive domains. Results of fixed effects model for mean mood change following green exercise show outdoor walking influenced mood change at highest levels of significance, even after accounting for individual level variability in duration. Mood improved for all durations of outdoor walking under a random effects model with high significance. Untethering fixed intervals of outdoor exercise from formal study design revealed briefer but more frequent nature engagement aligned with nature affinity. The influence of unmeasured factors, e.g., nature affinity or restorative conditioning, for prescriptive durations of urban green exercise merits further investigation toward designing wellbeing interventions directed at specific urban populations.
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Affiliation(s)
- Linda Powers Tomasso
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Dr, Boston, MA 02215, United States
- Population Health Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - John D. Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Dr, Boston, MA 02215, United States
| | - Paul J. Catalano
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
- Department of Data Science, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, United States
| | - Jarvis T. Chen
- Population Health Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, United States
| | - Jose Guillermo Cedeño Laurent
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Dr, Boston, MA 02215, United States
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, United States
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15
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Veldheer S, Tuan WJ, Al-Shaar L, Wadsworth M, Sinoway L, Schmitz KH, Sciamanna C, Gao X. Gardening Is Associated With Better Cardiovascular Health Status Among Older Adults in the United States: Analysis of the 2019 Behavioral Risk Factor Surveillance System Survey. J Acad Nutr Diet 2023; 123:761-769.e3. [PMID: 36323395 PMCID: PMC10752423 DOI: 10.1016/j.jand.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Gardening benefits health in older adults, but previous studies have limited generalizability or do not adequately adjust for sociodemographic factors or physical activity (PA). OBJECTIVE We examined health outcomes, fruits and vegetables (F&V) intake, and 10-year mortality risk among gardeners and exercisers compared with nonexercisers. DESIGN Cross-sectional data of noninstitutionalized US adults in the 2019 Behavioral Risk Factor Surveillance System was collected via landline and cellular phone survey. PARTICIPANTS/SETTING Adults 65 years and older reporting any PA (n = 146,047) were grouped as gardeners, exercisers, or nonexercisers. MAIN OUTCOME MEASURES Outcomes included cardiovascular disease (CVD) risk factors, mental and physical health, F&V intake, and 10-year mortality risk. STATISTICAL ANALYSES Summary statistics were calculated and adjusted logistic regression models were conducted to calculate adjusted odds ratios (aORs) and 95% CIs, accounting for the complex survey design. RESULTS The sample included gardeners (10.2%), exercisers (60.0%), and nonexercisers (30.8%). Gardeners, compared with nonexercisers, had significantly lower odds of reporting all studied health outcomes and higher odds of consuming 5 or more F&V per day (CVD: aOR 0.60, 95% CI 0.53 to 0.68; stroke: aOR 0.55, 95% CI 0.47 to 0.64; heart attack: aOR 0.63, 95% CI 0.55 to 0.73, high cholesterol: aOR 0.86, 95% CI 0.79 to 0.93; high blood pressure: aOR 0.74, 95% CI 0.68 to 0.81; diabetes: aOR 0.51, 95% CI 0.46 to 0.56; body mass index ≥25: aOR 0.74, 95% CI 0.68 to 0.80; poor mental health status: aOR 0.50, 95% CI 0.43 to 0.59; poor physical health status: aOR 0.35, 95% CI 0.31 to 0.39; 5 or more F&V per day: aOR 1.56, 95% CI 1.40 to 1.57; high 10-year mortality risk: aOR 0.39, 95% CI 0.36 to 0.42). Male and female gardeners had significantly lower odds of reporting diabetes even when compared with exercisers. CONCLUSIONS Among adults 65 years and older, gardening is associated with better CVD health status, including lower odds of diabetes. Future longitudinal or interventional studies are warranted to determine whether promoting gardening activities can be a CVD risk reduction strategy.
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Affiliation(s)
- Susan Veldheer
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
| | - Wen-Jan Tuan
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania
| | - Laila Al-Shaar
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Martha Wadsworth
- Department of Psychology, Penn State University, State College, Pennsylvania
| | - Lawrence Sinoway
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania
| | - Kathryn H Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania; Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania
| | - Christopher Sciamanna
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania; Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania
| | - Xiang Gao
- Department of Nutritional Sciences, Fudan University, Shanhai, China; Department of Nutrition and Food Hygiene, Fudan University, Shanhai, China; Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanhai, China
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16
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Donelli D, Meneguzzo F, Antonelli M, Ardissino D, Niccoli G, Gronchi G, Baraldi R, Neri L, Zabini F. Effects of Plant-Emitted Monoterpenes on Anxiety Symptoms: A Propensity-Matched Observational Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2773. [PMID: 36833470 PMCID: PMC9957398 DOI: 10.3390/ijerph20042773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 06/12/2023]
Abstract
Immersive experiences in green areas, particularly in forests, have long been known to produce beneficial effects for human health. However, the exact determinants and mechanisms leading to healthy outcomes remain to be elucidated. The purpose of this observational cohort study was to investigate whether inhaling plant-emitted biogenic volatile compounds, namely monoterpenes (MTs), can produce specific effects on anxiety symptoms. Data from 505 subjects participating in 39 structured forest therapy sessions at different Italian sites were collected. The air concentration of monoterpenes was measured at each site. STAI state questionnaires were administered before and after the sessions as a measure of anxiety. A propensity score matching analysis was then performed, considering an above-average exposure to inhalable air MTs as the treatment. The estimated effect was -1.28 STAI-S points (95% C.I. -2.51 to -0.06, p = 0.04), indicating that the average effect of exposure to high MT air concentrations during forest therapy sessions was to decrease anxiety symptoms.
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Affiliation(s)
- Davide Donelli
- Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, I-43126 Parma, Italy
| | - Francesco Meneguzzo
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
- Central Scientific Committee, Italian Alpine Club, 19 Via E. Petrella, I-20124 Milano, Italy
| | - Michele Antonelli
- Department of Public Health, AUSL-IRCCS of Reggio Emilia, I-42122 Reggio Emilia, Italy
| | - Diego Ardissino
- Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, I-43126 Parma, Italy
| | - Giampaolo Niccoli
- Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, I-43126 Parma, Italy
| | - Giorgio Gronchi
- Section of Psychology, Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 12 Via di San Salvi, I-50135 Firenze, Italy
| | - Rita Baraldi
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
| | - Luisa Neri
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
| | - Federica Zabini
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
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17
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Huntsman JL, Bulaj G. Health education via "empowerment" digital marketing of consumer products and services: Promoting therapeutic benefits of self-care for depression and chronic pain. Front Public Health 2023; 10:949518. [PMID: 36703812 PMCID: PMC9871258 DOI: 10.3389/fpubh.2022.949518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Increasing health care costs and high economic burden exemplify the impact of chronic diseases on public health. Multifaceted approaches to treating chronic diseases include pharmaceutical drugs, digital therapeutics, and lifestyle medicine. Chronic diseases are largely preventable, and health promotion yields positive outcomes. However, despite positive return on investment (ROI) and cost-to-benefit ratio (CBR) for health promotion (median ROI 2.2, median CBR 14.4), commercial marketing of healthy lifestyles and self-care is limited. The objective of this perspective article is to discuss how digital marketing of consumer goods and services that support therapeutic self-care can also bridge public health and for-profit interests. We describe how "empowerment" marketing campaigns can provide evidence-based associations between products/services and self-care benefits for people living with chronic pain and depression. Such a "health education as marketing" strategy is illustrated by educational ads describing how contact with nature, music, and yoga can improve chronic pain and reduce depressive symptoms. Creating associations between health-related benefits of these activities with products (outdoor and yoga apparel, audio equipment) and services (music streaming services, music mobile apps, eco-tourism, yoga studios) that support them expand their value proposition, thus incentivizing profit-driven companies to engage in public health campaigns. Long-term success of companies that incorporate evidence-based health education as marketing and branding strategies will depend on following ethical considerations and advertising guidelines defined by consumer protection regulatory agencies, such as the Federal Trade Commission (FTC). In conclusion, integration of health education about self-care and commercial marketing can support health care outcomes and disease prevention.
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Affiliation(s)
| | - Grzegorz Bulaj
- OMNI Self-care, LLC, Salt Lake City, UT, United States,L. S. Skaggs College of Pharmacy, University of Utah, Salt Lake City, UT, United States,*Correspondence: Grzegorz Bulaj ✉
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18
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Suligowski R, Ciupa T. Five waves of the COVID-19 pandemic and green-blue spaces in urban and rural areas in Poland. ENVIRONMENTAL RESEARCH 2023; 216:114662. [PMID: 36374652 PMCID: PMC9617687 DOI: 10.1016/j.envres.2022.114662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/18/2022] [Accepted: 10/23/2022] [Indexed: 05/19/2023]
Abstract
Several waves of COVID-19 caused by different SARS-CoV-2 variants have been recorded worldwide. During this period, many publications were released describing the influence of various factors, such as environmental, social and economic factors, on the spread of COVID-19. This paper presents the results of a detailed spatiotemporal analysis of the course of COVID-19 cases and deaths in five waves in Poland in relation to green‒blue spaces. The results, based on 380 counties, reveal that the negative correlation between the indicator of green‒blue space per inhabitant and the average daily number of COVID-19 cases and deaths was clearly visible during all waves. These relationships were described by a power equation (coefficient of determination ranging from 0.83 to 0.88) with a high level of significance. The second important discovery was the fact that the rates of COVID-19 cases and deaths were significantly higher in urban counties (low values of the green-blue space indicator in m2/people) than in rural areas. The developed models can be used in decision-making by local government authorities to organize anti-COVID-19 prevention measures, including local lockdowns, especially in urban areas.
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Affiliation(s)
- Roman Suligowski
- Institute of Geography and Environmental Sciences, Jan Kochanowski University in Kielce, Poland.
| | - Tadeusz Ciupa
- Institute of Geography and Environmental Sciences, Jan Kochanowski University in Kielce, Poland.
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19
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Yang Y, Lu Y, Jiang B. Population-weighted exposure to green spaces tied to lower COVID-19 mortality rates: A nationwide dose-response study in the USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158333. [PMID: 36041607 PMCID: PMC9420198 DOI: 10.1016/j.scitotenv.2022.158333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 05/29/2023]
Abstract
The COVID-19 pandemic has caused a huge loss of human life globally. However, few studies investigated the link between exposure to green space and risk of COVID-19 mortality rate, while also distinguishing the effects of various types of green space, considering the spatial distribution of human population and green space, and identifying the optimal buffer distances of nearby green space. It is critical and pressing to fill these significant knowledge gaps to protect and promote billions of people's health and life across the world. This study adopted a negative binomial generalized linear mixed-effects model to examine the association between the ratios of various types of green space, population-weighted exposure to those various types of green space, and COVID-19 mortality rates across 3025 counties in the USA, adjusted for sociodemographic, pre-existing chronic disease, policy and regulation, behavioral, and environmental factors. The findings show that greater exposure to forest was associated with lower COVID-19 mortality rates, while developed open space had mixed associations with COVID-19 mortality rates. Forest outside park had the largest effect size across all buffer distances, followed by forest inside park. The optimal exposure buffer distance was 1 km for forest outside park, with per one-unit of increase in exposure associated with a 9.9 % decrease in COVID-19 mortality rates (95 % confidence interval (CI): 6.9 %-12.8 %). The optimal exposure buffer distance of forest inside park was 400 m, with per one-unit of increase in exposure associated with a 4.7 % decrease in mortality rates (95 % CI: 2.4 %-6.9 %). The results suggest that greater exposure to green spaces, especially to nearby forests, may mitigate the risk of COVID-19 mortality. Although findings of an ecological study cannot be directly used to guide medical interventions, this study may pave a critical new way for future research and practice across multiple disciplines.
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Affiliation(s)
- Yuwen Yang
- Urban Environments and Human Health Lab, HKUrbanLabs, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong SAR
| | - Yi Lu
- Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong SAR
| | - Bin Jiang
- Urban Environments and Human Health Lab, HKUrbanLabs, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong SAR.
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20
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Herchet M, Varadarajan S, Kolassa IT, Hofmann M. How Nature Benefits Mental Health. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2022. [DOI: 10.1026/1616-3443/a000674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract. We present an overview of the evidence of how nature benefits mental health, popular theories used to explain the effects, and the development potential of these theories. A large body of evidence highlights the beneficial effects of nature on mental health, with observed outcomes ranging from alleviating the symptoms of psychiatric disorders to improvements in cognitive abilities. The theoretical backbone for these salutary effects of nature consists of a set of models, mainly the attention restoration theory (ART), the stress reduction theory (SRT), and the Biophilia hypothesis. However, these high-level models are only loosely related and lack a pronounced biopsychological basis. While biopsychological measurements have been used widely in recent years, these efforts have not sufficiently been reflected in theories aiming to explain the benefits of nature contact for mental health. This paper seeks to encourage interdisciplinary work and further theory development to guide both research and practice toward strategically green and healthy living conditions.
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Affiliation(s)
- Marilisa Herchet
- Center for Open Digital Innovation and Participation (CODIP), Technische Universität Dresden (TU Dresden), Germany
| | - Suchithra Varadarajan
- Clinical & Biological Psychology, Institute of Psychology & Education, Ulm University, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology & Education, Ulm University, Germany
| | - Mathias Hofmann
- Center for Open Digital Innovation and Participation (CODIP), Technische Universität Dresden (TU Dresden), Germany
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Oomen-Welke K, Schlachter E, Hilbich T, Naumann J, Müller A, Hinterberger T, Huber R. Spending Time in the Forest or the Field: Investigations on Stress Perception and Psychological Well-Being-A Randomized Cross-Over Trial in Highly Sensitive Persons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15322. [PMID: 36430041 PMCID: PMC9690301 DOI: 10.3390/ijerph192215322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Research suggests that stays in a forest promote relaxation and reduce stress compared to spending time in a city. The aim of this study was to compare stays in a forest with another natural environment, a cultivated field. Healthy, highly sensitive persons (HSP, SV12 score > 18) aged between 18 and 70 years spent one hour in the forest and in the field at intervals of one week. The primary outcome was measured using the Change in Subjective Self-Perception (CSP-14) questionnaire. Secondary outcomes were measured using the Profile Of Mood States (POMS) questionnaire and by analyzing salivary cortisol. We randomized 43 participants. Thirty-nine were allocated and included in the intention-to-treat analysis (90% female, mean age 45 years). CSP-14 in part showed significant differences-total score (p = 0.054, Cohen's d = 0.319), item "integration" (p = 0.028, Cohen's d = 0.365)-favoring the effects of the forest. These effects were more pronounced in summer (August). In October, during rainfall, we detected no relevant differences. POMS only showed a significant difference in the subcategory "depression/anxiety" in favor of the field. The amount of cortisol in saliva was not different between the groups. A short-term stay in a forest in summer caused a greater improvement in mood and well-being in HSP than in a field. This effect was not detectable during bad weather in the fall.
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Affiliation(s)
- Katja Oomen-Welke
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Evelyn Schlachter
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Tina Hilbich
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Johannes Naumann
- Interdisciplinary Center for Treatment and Research in Balneology, European Institute for Physical Therapy and Balneology (EIPB), Sonnenbergstr. 35, 79117 Freiburg im Breisgau, Germany
| | - Alexander Müller
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
| | - Thilo Hinterberger
- Forschungsbereich Angewandte Bewusstseinswissenschaften, Abteilung für Psychosomatische Medizin, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Roman Huber
- Center for Complementary Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg im Breisgau, Germany
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22
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Tomasso LP, Chen JT. Toward a Theory of Nature Experience and Health. ECOPSYCHOLOGY 2022; 14:282-297. [PMID: 36590863 PMCID: PMC9793414 DOI: 10.1089/eco.2022.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/19/2022] [Indexed: 01/26/2023]
Abstract
This article presents an integrated theoretical framework to study the socioenvironmental attributes of the nature experience as a basic health behavior. After first reviewing existing literature on theories behind nature exposure, we discuss social cognitive theory (SCT) to explain individual nature experience through the model's triadic dynamic of environment, cognitions, and behaviors. We then expand beyond SCT's focus on the individual to examine structural and societal spheres of influence on nature experience found in ecological systems theory and ecosocial theory. In moving from proximal to distal influences, we identify the core constructs of each theory that may reinforce or deter decisions inclining individuals toward nature engagement. In synthesizing aspects of these three theories, we propose an integrated theoretical framework of nature experience distinguished by three ideas. First, individual-level formative influences in nature pervade higher level ecologies as a learned social behavior. Second, nature experience happens within multiple systems and timepoints. Third, social relationships within historical processes shape contextual factors of the nature experience, resulting in disparities in nature access and nature responses that manifest heterogeneously. Theorizing behind nature experience can inform why this occurs. We offer suggestions for further research to build on the groundwork put forth here: for hypothesizing around present observations, for collecting data to confirm and/or refute parts of the theory, and for further hypothesis generation inspired by the theory to inform the research agenda. In conclusion, we consider the practical implications of theory underlying nature experience as a health behavior relevant to research, interventions, and policy.
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Affiliation(s)
- Linda Powers Tomasso
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Population Health Sciences Program, Harvard University, Boston, Massachusetts, USA.,Address correspondence to: Linda Powers Tomasso, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA
| | - Jarvis T. Chen
- Population Health Sciences Program, Harvard University, Boston, Massachusetts, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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23
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Jones RJF, Littzen COR. An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12740. [PMID: 36232042 PMCID: PMC9566272 DOI: 10.3390/ijerph191912740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Chronic pain results from a complex series of biomechanical, inflammatory, neurological, psychological, social, and environmental mechanisms. Pain and pain-related diseases are the leading causes of disability and disease burden globally. Employing nature-based interventions for the treatment of pain is an emerging field. Current theory driving the suggested mechanism(s) linking the pain reducing effects of nature-based interventions is lacking. A two-step approach was taken to complete a theoretical review and analysis. First, a literature review was completed to gather a substantive amount of research related to theoretical frameworks on the topic of nature-based interventions and pain. Secondly, a theoretical analysis as proposed by Walker and Avant was completed to explore current theoretical frameworks accepted in the literature on nature-based interventions and pain. Stress reduction theory and attention restoration theory were the most common theoretical frameworks identified. Neither theoretical framework explicitly identifies, describes, or intends to adequately measure the concept of pain, revealing a limitation for their application in research with nature-based interventions and pain. Theoretical development is needed, as it pertains to nature-based interventions and pain. Without this development, research on nature-based interventions and pain will continue to use proxy concepts for measurement and may result in misrepresented findings.
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Affiliation(s)
- Reo J. F. Jones
- School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA
- School of Nursing and Health Innovations, The University of Portland, Portland, OR 97203, USA
| | - Chloé O. R. Littzen
- School of Nursing and Health Innovations, The University of Portland, Portland, OR 97203, USA
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24
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Sciulli N, Goullet D, Snell T. Working from Home with a View of Nature (and Sunlight) Benefits People's Well-Being. ECOPSYCHOLOGY 2022. [DOI: 10.1089/eco.2022.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Nathan Sciulli
- School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - David Goullet
- School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Tristan Snell
- School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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25
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Chawla L. Passive patient or active agent? An under-explored perspective on the benefits of time in nature for learning and wellbeing. Front Psychol 2022; 13:942744. [PMID: 35928412 PMCID: PMC9343847 DOI: 10.3389/fpsyg.2022.942744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
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26
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Agache I, Sampath V, Aguilera J, Akdis CA, Akdis M, Barry M, Bouagnon A, Chinthrajah S, Collins W, Dulitzki C, Erny B, Gomez J, Goshua A, Jutel M, Kizer KW, Kline O, LaBeaud AD, Pali‐Schöll I, Perrett KP, Peters RL, Plaza MP, Prunicki M, Sack T, Salas RN, Sindher SB, Sokolow SH, Thiel C, Veidis E, Wray BD, Traidl‐Hoffmann C, Witt C, Nadeau KC. Climate change and global health: A call to more research and more action. Allergy 2022; 77:1389-1407. [PMID: 35073410 DOI: 10.1111/all.15229] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 12/15/2022]
Abstract
There is increasing understanding, globally, that climate change and increased pollution will have a profound and mostly harmful effect on human health. This review brings together international experts to describe both the direct (such as heat waves) and indirect (such as vector-borne disease incidence) health impacts of climate change. These impacts vary depending on vulnerability (i.e., existing diseases) and the international, economic, political, and environmental context. This unique review also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and environmental justice and education. This scholarly resource explores these issues fully, linking them to global health in urban and rural settings in developed and developing countries. The review finishes with a practical discussion of action that health professionals around the world in our field can yet take.
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27
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Ross AM, Jones RJF. Simulated Forest Immersion Therapy: Methods Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095373. [PMID: 35564767 PMCID: PMC9105281 DOI: 10.3390/ijerph19095373] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023]
Abstract
Shinrin-yoku, forest bathing, may provide relief from chronic and breakthrough pain in patients with axial spondyloarthritis and improve immune function through increasing NK cell numbers and activity and their downstream effectors, perforin and granulysin, after chemo- or radiation therapy in breast and prostate cancer patients. The aim of this paper is to describe the study protocol for a simulated forest immersion therapy using virtual reality and atomized phytoncides, volatile organic compounds found in forested areas designed to effect positive change for these two patient populations. The setting, including the room set up and samples with inclusion/exclusion specific to this type of intervention, is outlined. Measures and calibration procedures pertinent to determining the feasibility of simulated forest immersion therapy are presented and include: ambient and surface room temperatures and relative humidity in real time, ambient ultrafine particulate matter, ambient droplet measurement that coincides with volatile organic compounds, specific phytoncides, and virtual reality and atomization of phytoncide set up. Particular lessons learned while training and setting up the equipment are presented. Simulated forest immersion therapy is possible with attention to detail during this early phase when development of methods, equipment testing, and feasibility in deploying the intervention become operational. The expected outcome of the development of the methods for this study is the creation of a standardized approach to simulating forest therapy in a controlled laboratory space.
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28
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Balanzá-Martínez V, Cervera-Martínez J. Lifestyle Prescription for Depression with a Focus on Nature Exposure and Screen Time: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095094. [PMID: 35564489 PMCID: PMC9104582 DOI: 10.3390/ijerph19095094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 12/10/2022]
Abstract
Recent lifestyles changes have favored increased time in contact with screens and a parallel reduction in contact with natural environments. There is growing awareness that nature exposure and screen time are related to depression. So far, the roles of how these environmental lifestyles affect depressive symptoms and disorders have not been reviewed simultaneously. The aim of this review was to gather the literature regarding the role of nature exposure and screen time in depression. An emphasis was made on clinical samples of patients with well-defined depression and the different methodological approaches used in the field. A second goal was to suggest an agenda for clinical practice and research. Studies were included if they assessed depressive symptoms in patients with a clinical diagnosis of depression. An overview of the published literature was conducted using three scientific databases up to December 2021. Several interventions involving nature exposure have shown positive effects on depressive symptoms and mood-related measures. The most consistent finding suggests that walks in natural environments may decrease depressive symptoms in patients with clinical depression. Less researched interventions, such as psychotherapy delivered in a forest or access to natural environments via virtual reality, may also be effective. In contrast, fewer observational studies and no experimental research on screen time have been conducted in patients with clinical depression. Thus, recommendations for practice and research are also discussed. Scarce research, diverse interventions, and several methodological shortcomings prevent us from drawing conclusions in this area. More high-quality experimental research is needed to establish interventions with proven efficacy in clinical depression. At this stage, it is too early to formulate practice guidelines and advise the prescription of these lifestyles to individuals with depression. The present findings may serve as a basis to develop strategies based on nature exposure and screen time targeting clinical depression.
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Affiliation(s)
- Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, 46010 Valencia, Spain
- Correspondence: ; Tel.: +34-963-983-349
| | - Jose Cervera-Martínez
- Department of Medicine, University of Valencia, 46010 Valencia, Spain;
- Hospital de Denia-Marina Salud, 03700 Denia, Spain
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29
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Moyers SI, Abildso CG, Kelley GA. Context, classification and study methodologies in research into nature-based therapies: protocol for a scoping review. BMJ Open 2022; 12:e060734. [PMID: 35393333 PMCID: PMC8991050 DOI: 10.1136/bmjopen-2021-060734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nature provides an array of health benefits, and recent decades have seen a resurgence in nature-based interventions (NBI). While NBI have shown promise in addressing health needs, the wide variety of intervention approaches create difficulty in understanding the efficacy of NBI as a whole. This scoping review will (1) identify the different nomenclature used to define NBI, (2) describe the interventions used and the contexts in which they occurred and (3) describe the methodologies and measurement tools used in NBI studies. METHODS AND ANALYSIS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews, four databases will be searched (PubMed, Web of Science, Scopus, ProQuest Dissertations and Theses Global) as well as cross-referencing for published and unpublished (masters theses and dissertations) studies on NBI in humans. Eligible studies must employ intervention or observational designs, and an English-language abstract will be required. Database searches will occur from inception up to the date of the search. Animal-based therapies and virtual-reality therapies involving simulated nature will be excluded. Independent dual screening and data abstraction will be conducted. Results will be analysed qualitatively as well as with simple descriptive statistics (frequencies and percentages). ETHICS AND DISSEMINATION Since this is a scoping review of previously published summary data, ethical approval for this study is not needed. Findings will be published in a peer-reviewed journal. This protocol has been registered with Open Science Framework (https://osf.io/mtzc8).
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Affiliation(s)
- Samantha I Moyers
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - Christiaan G Abildso
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
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30
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Swami V, Tran US, Stieger S, Voracek M. Developing a model linking self-reported nature exposure and positive body image: A study protocol for the body image in nature survey (BINS). Body Image 2022; 40:50-57. [PMID: 34844138 DOI: 10.1016/j.bodyim.2021.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 01/07/2023]
Abstract
Exposure to natural environments has been shown to be associated with more positive body image, but much of the existing research is limited to Western European nations and little is known about the robustness of these associations in other national contexts. In this protocol paper, we present a conceptual model of the direct and indirect associations (i.e., via self-compassion, connectedness to nature, and restorative experiences in nature) between nature exposure and body appreciation. This model brings together conceptualisations from existing research, but also extends it in a number of important ways. The model will be tested through the Body Image in Nature Survey (BINS), a researcher-crowdsourced project involving researchers in multiple nations worldwide. Data collection began in December 2020 and is expected to be completed in February 2022. Data will be analysed to examine the extent to which our conceptual model is robust across nations, as well as other sociodemographic characteristics. We will also determine the extent to which key variables included in our survey are invariant across nations and associated with cultural, socioeconomic, and gender-related factors. The BINS will likely have important implications for the development of nature-based interventions to promote healthier body appreciation in diverse national contexts.
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Affiliation(s)
- Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, Malaysia; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia.
| | - Ulrich S Tran
- Department of Cognition, Emotion, and Methods in Psychology, School of Psychology, University of Vienna, Vienna, Austria
| | - Stefan Stieger
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Martin Voracek
- Department of Cognition, Emotion, and Methods in Psychology, School of Psychology, University of Vienna, Vienna, Austria
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31
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Evaluating Potential Respiratory Benefits of Forest-Based Experiences: A Regional Scale Approach. FORESTS 2022. [DOI: 10.3390/f13030387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: Several studies have suggested the possibility of obtaining specific respiratory benefits by experiencing forests and other natural resources. Despite this, forests have never been considered according to such potential. This study aims to compare municipalities by considering the absence/presence of tree species generating ‘above threshold’ potential respiratory benefits. Methods: The autonomous Region of Friuli Venezia Giulia in Italy has been assumed as a research area. The natural resource based view (NRBV), postulating the strategic role played by natural resources in achieving both above-average (thus ‘valuable’) and ‘concentrated’ (thus ‘rare’ among competitors) performance, has been adopted. The literature reviews dealing with potential respiratory benefits of biogenic organic compounds (BVOCs) emitted by trees, published within the ‘forest therapy’ research field, have been adopted. Three analysis models rating tree species by their potential respiratory benefits in ‘holistic-general’ (P1), ‘particular’ (P2), and ‘dynamic” terms (P3) have been outlined. The resulting overall potentials of tree species have been assessed by adopting the well-rooted Hollerith distance (HD) model. Tree species have been rated “1” when they satisfy one or more of 58 potential respiratory benefits. Municipalities have been ranked by considering the surface area covered by forest types whose dominant tree species achieve above-average potential respiratory benefits. QGIS software has been adopted to geographically reference the results obtained. Results: (P1) Valuable municipalities include those covered by both coniferous and deciduous forests; (P2–3) Municipalities achieving the highest potential respiratory benefits, in both particular and dynamic terms, have been mapped. Discussion: Forest-based initiatives that are running in the preselected municipalities can be both further improved and diversified in a targeted way. Conclusions: Despite some limitations mostly embedded in the concept of ‘model’, this study allows scholars to reduce uncertainties when locating municipalities in which to conduct local-scale experiments.
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32
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Yang BY, Zhao T, Hu LX, Browning MHEM, Heinrich J, Dharmage SC, Jalaludin B, Knibbs LD, Liu XX, Luo YN, James P, Li S, Huang WZ, Chen G, Zeng XW, Hu LW, Yu Y, Dong GH. Greenspace and human health: An umbrella review. Innovation (N Y) 2021; 2:100164. [PMID: 34622241 PMCID: PMC8479545 DOI: 10.1016/j.xinn.2021.100164] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 09/05/2021] [Indexed: 12/17/2022] Open
Abstract
Multiple systematic reviews on greenspace and health outcomes exist, but the overall evidence base remains unclear. Therefore, we performed an umbrella review to collect and appraise all relevant systematic reviews of epidemiological studies on greenness exposure and health. We searched PubMed, Embase, and Web of Science from inception to June 28, 2021, and screened references of relevant articles. Systematic reviews with or without meta-analyses of epidemiological studies that examined the associations of greenness with any health outcome were included. Two independent investigators performed study selection and data extraction. We also evaluated the methodological quality of the included systematic reviews using the “Assessing the Methodological Quality of Systematic Reviews 2” checklist. A total of 40 systematic reviews and meta-analyses were included, of which most were cross-sectional studies conducted in high-income countries. Greenspace exposure was estimated with various objective and subjective parameters. Beneficial associations of greenspace with all-cause and stroke-specific mortality, CVD morbidity, cardiometabolic factors, mental health, low birth weight, physical activity, sleep quality, and urban crime were observed. No consistent associations between greenspace and other health outcomes (e.g., cancers) were observed. Most of the included systematic reviews and meta-analyses had one or more limitations in methodology. Our findings provide supportive evidence regarding the beneficial effects of greenspace exposure on some aspects of human health. However, the credibility of such evidence was compromised by methodological limitations. Better performed systematic reviews and meta-analyses as well as longitudinal designed primary studies are needed to validate this conclusion. The evidence concerning greenspace and health outcomes remains unclear We performed an umbrella review of 40 systematic reviews on greenspace and health Greenspace exposure was estimated with various objective and subjective parameters Greenspace was beneficially associated with several aspects of human health
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Affiliation(s)
- Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Tianyu Zhao
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Comprehensive Pneumology Center (CPC) Munich, member, German Center for Lung Research (DZL), Munich 80036, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Li-Xin Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Matthew H E M Browning
- Department of Park, Recreation, and Tourism Management, Clemson University, Clemson, SC 29634, USA
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Comprehensive Pneumology Center (CPC) Munich, member, German Center for Lung Research (DZL), Munich 80036, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe NSW 2037, Australia; Population Health, South Western Sydney Local Health District, Liverpool NSW 2170, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW 2052, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Xiao-Xuan Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ya-Na Luo
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Wen-Zhong Huang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510080, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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Cardiorespiratory Interaction and Autonomic Sleep Quality Improve during Sleep in Beds Made from Pinus cembra (Stone Pine) Solid Wood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189749. [PMID: 34574675 PMCID: PMC8472742 DOI: 10.3390/ijerph18189749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 12/27/2022]
Abstract
Cardiorespiratory interactions (CRIs) reflect the mutual tuning of two important organismic oscillators—the heartbeat and respiration. These interactions can be used as a powerful tool to characterize the self-organizational and recreational quality of sleep. In this randomized, blinded and cross-over design study, we investigated CRIs in 15 subjects over a total of 253 nights who slept in beds made from different materials. One type of bed, used as control, was made of melamine faced chipboard with a wood-like appearance, while the other type was made of solid wood from stone pine (Pinus cembra). We observed a significant increase of vagal activity (measured by respiratory sinus arrhythmia), a decrease in the heart rate (as an indicator of energy consumption during sleep) and an improvement in CRIs, especially during the first hours of sleep in the stone pine beds as compared to the chipboard beds. Subjective assessments of study participants’ well-being in the morning and sub-scalar assessments of their intrapsychic stability were significantly better after they slept in the stone pine bed than after they slept in the chipboard bed. Our observations suggest that CRIs are sensitive to detectable differences in indoor settings that are relevant to human health. Our results are in agreement with those of other studies that have reported that exposure to volatile phytochemical ingredients of stone pine (α-pinene, limonene, bornyl acetate) lead to an improvement in vagal activity and studies that show a reduction in stress parameters upon contact with solid wood surfaces.
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Short-Term Effects of Forest Therapy on Mood States: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189509. [PMID: 34574446 PMCID: PMC8470271 DOI: 10.3390/ijerph18189509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 01/05/2023]
Abstract
Immersion in forest environments was shown to produce beneficial effects to human health, in particular psychophysical relaxation, leading to its growing recognition as a form of integrative medicine. However, limited evidence exists about the statistical significance of the effects and their association with external and environmental variables and personal characteristics. This experimental study aimed to substantiate the very concept of forest therapy by means of the analysis of the significance of its effects on the mood states of anxiety, depression, anger and confusion. Seven forest therapy sessions were performed in remote areas and a control one in an urban park, with participants allowed to attend only one session, resulting in 162 psychological self-assessment questionnaires administered before and after each session. Meteorological comfort, the concentration of volatile organic compounds in the forest atmosphere and environmental coherence were identified as likely important external and environmental variables. Under certain conditions, forest therapy sessions performed in remote sites were shown to outperform the control session, at least for anxiety, anger and confusion. A quantitative analysis of the association of the outcomes with personal sociodemographic characteristics revealed that only sporting habits and age were significantly associated with the outcomes for certain psychological domains.
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Pálsdóttir AM, Spendrup S, Mårtensson L, Wendin K. Garden Smellscape-Experiences of Plant Scents in a Nature-Based Intervention. Front Psychol 2021; 12:667957. [PMID: 34290648 PMCID: PMC8288369 DOI: 10.3389/fpsyg.2021.667957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/19/2021] [Indexed: 12/29/2022] Open
Abstract
This study explores how participants suffering from stress-related mental disorders describe their perception, interaction, and lived experience of garden smellscape during their nature-based rehabilitation. Natural elements, and especially nature smells, have been found to have a profound effect on stress reduction, suggesting an interesting link between odor in nature and stress reduction. The study was conducted as a longitudinal case-study, running over a period of 5 years, investigating participants' perceptions of a garden smellscape, after completing a 12-weeks nature-based rehabilitation in Alnarp Rehabilitation Garden, Sweden. All participants were treated for stress-related mental disorders. Data were collected through retrospective semi-structured individual interviews and analyzed according to interpretative phenomenological analysis. The results revealed in what way nature odor (odor in nature) evoked associations, emotions, and physical reactions and provide examples of how nature scents function as a catalyst for sensory awareness and memories. Findings supported the understanding that experiencing the smell of plants, especially pelargonium, may facilitate stress reduction and support mental recovery in a real-life context. The results of the study can be used for several purposes; thus, they are relevant for actors within the development of nature-based therapy, as well as stakeholders within the horticultural industry.
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Affiliation(s)
- Anna María Pálsdóttir
- Department of People and Society, Swedish University of Agricultural Sciences, Lomma, Sweden
| | - Sara Spendrup
- Department of People and Society, Swedish University of Agricultural Sciences, Lomma, Sweden
| | - Lennart Mårtensson
- Faculty of Natural Sciences, Kristianstad University, Kristianstad, Sweden
| | - Karin Wendin
- Faculty of Natural Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
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