Cultivating Reciprocity Between People and Planet: Habit-Stacking Planetary Health Prescriptions Into Existing Nature RX Encounters During Integrative Health Visits.

The reported benefits of nature contact on human health and well-being have prompted the rise of nature prescriptions with health professionals recommending nature exposure. Due to the success of nature prescriptions and calls for greater reciprocity between people and the planet, this essay proposes to leverage health behavior promotion strategies to integrate planetary health prescriptions (Earth RX) into existing nature prescription frameworks with a vision to counsel patients on both the health and well-being benefits of nature contact as well as earth-sustaining behaviors, all of which fosters a compassionate interdependence between personal and planetary well-being. The essay emphasizes the importance of co-designed stakeholder collaboration for program success, addressing factors such as trust, perceived benefits, and accessibility. Finally, this essay concludes that integrating Earth RX in nature prescription programs strategically aligns with the principles of integrative health, acknowledging the reciprocal relationship between human health and well-being and planetary well-being.

From immune equilibrium to tumor ecodynamics.

Objectives: There is no theory to quantitatively describe the complex tumor ecosystem. At the same time, cancer immunotherapy is considered a revolution in oncology, but the methods used to describe tumors and the criteria used to evaluate efficacy are not keeping pace. The purpose of this study is to establish a new theory for quantitatively describing the tumor ecosystem, innovating the methods of tumor characterization, and establishing new efficacy evaluation criteria for cancer immunotherapy. Methods: Based on the mathematization of immune equilibrium theory and the establishment of immunodynamics in a previous study, the method of reverse immunodynamics was used, namely, the immune braking force was regarded as the tumor ecological force and the immune force was regarded as the tumor ecological braking force, and the concept of momentum in physics was applied to the tumor ecosystem to establish a series of tumor ecodynamic equations. These equations were used to solve the fundamental and applied problems of the complex tumor ecosystem. Results: A series of tumor ecodynamic equations were established. The tumor ecological momentum equations and their component factors could be used to distinguish disease progression, pseudoprogression, and hyperprogression in cancer immunotherapy. On this basis, the adjusted tumor momentum equations were established to achieve the equivalence of tumor activity (including immunosuppressive activity and metabolic activity) and tumor volume, which could be used to calculate individual disease remission rate and establish new efficacy evaluation criteria (ieRECIST) for immunotherapy of solid tumor based on tumor ecodynamics. At the same time, the concept of moving cube-to-force square ratio and its expression were proposed to calculate the area under the curve of tumor ecological braking force of blood required to achieve an individual disease remission rate when the adjusted tumor ecological momentum was known. Conclusions: A new theory termed tumor ecodynamics emphasizing both tumor activity and tumor volume is established to solve a series of basic and applied problems in the complex tumor ecosystem. It can be predicted that the future will be the era of cancer immune ecotherapy that targets the entire tumor ecosystem.

Supporting Personal Growth in Childhood, Adolescent and Young-Adult Cancer Survivors Through Challenges in Nature - A Qualitative Study of WAYA Wilderness Programme Participation.

Background: Childhood, adolescent and young-adult (AYA) cancer survivors often experience health problems due to late or long-term effects of their cancer or the treatment thereof. The general population gains health benefits from immersion in nature, and nature-based programmes seem to be an intervention that can promote health among childhood and AYA cancer survivors. Objective: To explore the impact of the WAYA wilderness programme on the health of childhood and AYA cancer survivors. Methods: The study had a qualitative approach, with data from individual interviews (n = 18) 3 months after completion of the WAYA programme. In addition, case report data was collected during follow-up talks (1, 2 and 12 months after the programme) (n = 19). The WAYA programme consisted of an 8-day expedition, followed 3 months later by a 4-day base camp. The programme included activities such as hiking, backpacking, kayaking, rock climbing, bushcraft and mindfulness. Data was analysed according to a qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed. Results: An overarching theme was identified: "Personal growth from challenges in nature supported by deep connections with others". In 4 additional themes, participants' experiences describe how deep personal connections arose, as they developed a feeling of being able and competent in nature. Nature provided a space that supported relaxation and respite from everyday challenges and stimuli, which also led to an experience of being more connected to nature. Conclusion: The WAYA programme was experienced as being of support to childhood and AYA cancer survivors. The programme provided them with skills and tools to be safe in nature. When connected to nature, the participants developed trust and self-confidence, personal growth, relaxation and recovery from stress. Their engagement in outdoor activities continued after completion of the programme, when they returned to everyday life at home.

Green space for public mental health: an ethnographic study of ecotherapy in Wales.

AIMS: In recent years, there has been a growing interest in the ways that human health intersects with exposure to nature. This article reports the findings of a research study investigating the experiences of people in South and West Wales who were engaged in a specific type of nature and health intervention: ecotherapy. METHODS: Ethnographic methods were used to develop a qualitative account of the experiences of participants in four specific ecotherapy projects. Data collected during fieldwork included notes from participant observations, interviews with both individuals and small groups, and documents produced by the projects. RESULTS: Findings were reported using two themes: 'smooth and striated bureaucracy' and 'escape and getting away'. The first theme focused on how participants negotiated tasks and systems related to gatekeeping, registration, record keeping, rule compliance, and evaluation. It was argued that this was experienced differently along a spectrum between striated, in which it was disruptive to time and space, and smooth, in which it was much more discrete. The second theme reported on an axiomatic perception that natural spaces represented an escape or refuge; in terms of both reconnecting with something beneficial in nature, and also disconnecting from pathological aspects of everyday life. In bringing the two themes into dialogue, it could be seen that bureaucratic practices often undermined the therapeutic sense of escape; and that this was more acutely experienced by participants from marginalised social groups. CONCLUSIONS: This article concludes by reasserting that the role of nature in human health is contested and arguing for a greater emphasis on inequities in access to good quality green and blue space. Specific interventions like ecotherapy need funding models that avoid striated bureaucratic processes, and the stress associated with these. Inclusive models of ecotherapy practice could contribute to public health goals related to population engagement with healthy environments.

What is Nature-Based Medicine and What Does It Do?

One's personal health and well-being can improve with activity in natural environments or decline without it. Many chronic illnesses to which personal nature deficiency contributes-including anxiety, depression, attention deficit, diabetes, hypertension, myopia, and obesity-have been exacerbated with the pandemic. That those illnesses may be preventable, treatable, and even reversible with an added nature-based approach may seem novel, but it is not. Though the field of nature-based medicine is just emerging in the U.S., it has been taught and practiced in Asia and the EU for decades. As the prescriptive, evidence-based use of natural settings and nature-based interventions, it aims to prevent and treat disease and improve well-being. Nature-based medicine blends particular activity in nature with the science of medicine to attempt to empower self-care safely, effectively, and happily. Its vision is to be readily available to all, regardless of proximity to blue (water-related) or green (land-related) space. The common sense of nature-based medicine belies its scientific evidence base, which is growing but not well-known, so it may seem unfamiliar to prescribe nature to patients. It will take education, training and practice to help patients access nature-based medicine and to help clinicians prescribe it.

The role of campus greenspace and meditation on college students' mood disturbance.

Objective To determine whether students who engage in a sedentary task in an urban park-like setting experience improved mood and whether this effect is moderated by mindfulness meditation. Participants: 234 (133 females) undergraduate students, who either engaged in outdoor recreation frequently or infrequently. Methods: Participants engaged in 20 minutes of mindfulness meditation or a control task, either in a campus park-like setting or in a quiet room indoors. Before and after the activity, total mood disturbance (TMD) was assessed with the Profile of Mood States Questionnaire. Results: Being outside or meditating reduced TMD for those who frequently recreated outside. Those who infrequently recreated outside experienced decreased TMD if they meditated inside and increased TMD if they did not. When outside, TMD decreased regardless of activity. Conclusions: Spending time outside and practicing meditation may be effective approaches for improving college students' mental health, particularly for students who infrequently go outside.

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

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

Validating Visual Stimuli of Nature Images and Identifying the Representative Characteristics.

This study fills a void in the literature by both validating images of nature for use in future research experiments and examining which characteristics of these visual stimuli are found to be most representative of nature. We utilized a convenience sample of university students to assess 129 different nature images on which best represented nature. Participants (n = 40) viewed one image per question (n = 129) and were asked to rate images using a 5-point Likert scale, with the anchors "best represents nature" (5) and "least represents nature" (1). Average ratings across participants were calculated for each image. Canopies, mountains, bodies of water, and unnatural elements were identified as semantic categories of interest, as well as atmospheric perspectives and close-range views. We conducted the ordinary least squares (OLS) regression and the ordered logistic regression analyses to identify semantic categories highly representative of nature, controlling for the presence/absence of other semantic categories. The results showed that canopies, bodies of water, and mountains were found to be highly representative of nature, whereas unnatural elements and close-range views were inversely related. Understanding semantic categories most representative of nature is useful in developing nature-centered interventions in behavioral performance research and other neuroimaging modalities. All images are housed in an online repository and we welcome the use of the final 10 highly representative nature images by other researchers, which will hopefully prompt and expedite future examinations of nature across multiple research formats.

The Cost Effectiveness of Ecotherapy as a Healthcare Intervention, Separating the Wood from the Trees.

Internationally, shifts to more urbanised populations, and resultant reductions in engagements with nature, have been a contributing factor to the mental health crisis facing many developed and developing countries. While the COVID-19 pandemic reinforced recent trends in many countries to give access to green spaces more weight in political decision making, nature-based activities as a form of intervention for those with mental health problems constitute a very small part of patient pathways of care. Nature-based interventions, such as ecotherapy, are increasingly used as therapeutic solutions for people with common mental health problems. However, there is little data about the potential costs and benefits of ecotherapy, making it difficult to offer robust assessments of its cost-effectiveness. This paper explores the capacity for ecotherapy to be cost-effective as a healthcare intervention. Using a pragmatic scoping review of the literature to understand where the potential costs and health benefit lie, we applied value of information methodology to identify what research is needed to inform future cost-effectiveness assessments. We show that there is the potential for ecotherapy for people with mild to moderate common mental health problems to be cost-effective but significant further research is required. Furthermore, nature-based interventions such as ecotherapy also confer potential social and wider returns on investment, strengthening the case for further research to better inform robust commissioning.

"Recovering With Nature": A Review of Ecotherapy and Implications for the COVID-19 Pandemic.

Connection with nature has been considered beneficial for psychological well-being since times of evolution. Differences in Indian and Western thoughts have viewed natural elements in different lights, varying between eco-centrism to anthropocentrism. The intrusion of technology and digitalized lives as a result of globalization has decreased connectedness with nature. Ecotherapy is a novel form of psychotherapeutic technique based on explicit environmental or ecological interventions. Social and therapeutic horticulture, animal-assisted interventions, care farming, green exercise, environmental conservation and wilderness therapy are some of the ecosystem-based approaches used in mental health. Based on the principles of positive and client-centered psychology, ecotherapy-related techniques have been shown to be effective in medical disorders like hypertension, obesity, post-surgical recovery and psychosocial conditions like depression, stress reduction, post-traumatic stress disorder (PTSD), attention deficit hyperkinetic disorder (ADHD) and adjustment disorders. The principles of ecotherapy have been integrated into other psychotherapeutic techniques for better efficacy. This review attempts provides an overview of techniques, applications and challenges related to ecotherapy in psychology. The implications of its use during the ongoing Coronavirus 2019 (COVID-19) crisis, social isolation and consequent psychosocial aftermath are also discussed.

Radical Self-Care for Social Workers in the Global Climate Crisis.

Gradual environmental degradation, more extreme climate change events, and related environmental injustices affect individuals and communities every day. Social work entities around the world are increasingly highlighting professional responsibilities for addressing the global climate crisis. Often, social workers experience vicarious trauma from work with those immediately affected. Working within the context of the global climate crisis brings further risk. Social workers may be personally affected, or experiencing their own challenges, such as climate anxiety and eco-grief. Thus, radical self-care is a dire need as social workers promote sustainable communities and environments and seek ecological justice for all. This article discusses the health and mental health impacts of the compounding factors of the climate crisis, modern technology, and current political contexts. Activism for change and ecotherapeutic strategies are presented as radical self-care for social workers, in both academic and practice-based settings. These strategies are essential for recognizing, legitimizing, and addressing the need for radical self-care practices in the global climate crisis.

Ecotherapy - A Forgotten Ecosystem Service: A Review.

Natural ecosystems provide important services upon which humans depend. Unfortunately, some people tend to believe that these services are provided by nature for free; therefore, the services have little or no value. One nearly forgotten ecosystem service is ecotherapy - the ability of interaction with nature to enhance healing and growth. While we do not pay for this service, its loss can result in a cost to humans resulting in slower recovery times, greater distress and reduced well-being. Losses in these images of nature can diminish our basic happiness. Little is understood or, at least, appreciated concerning the potential ecotherapy benefits of the natural environment and its ecosystem services. The complex and interactive relationship of ecosystems, their services and human well-being is poorly acknowledged in the broad social, philosophical, psychological and economic well-being literature. In this article, we examine the role of nature and its ecosystem services in ecotherapy and its associated enhancement of recovery from physical and mental illness through a review of studies evaluating this ecosystem service-recovery connection.

Sowing the seeds or failing to blossom? A feasibility study of a simple ecotherapy-based intervention in women affected by breast cancer.

Engaging in nature-based activities is recognised as providing the basis for easily accessible, cost-effective interventions which can have other important physical and psychological health outcomes. The aim of the reported feasibility study was to explore the acceptability and potential psychological benefits of a simple ecotherapy-based intervention for individuals affected by cancer. A total of seven women from an existing breast cancer support group agreed to take part in the study by cultivating and customising a garden bowl for three months, maintaining a diary, and participating in a focus group at the end of the project. The analysis of the focus group data revealed four main themes that suggested that the women found engaging with the intervention to be therapeutic on a number of different levels: reflecting their cancer journey, a source of positivity, making meaning through memories, and a sense of control provided by engagement with the intervention. Engagement with the diary-writing element of the intervention, however, was not as widely endorsed by the group, as participants were even reluctant to make use of an online forum to share experiences of engaging with the intervention. Overall, the study suggests that the flexibility of level of engagement with an intervention is an important factor in developing acceptable interventions, and that the value of targeted recruitment to improve engagement with novel interventions is paramount.

¿Cuál es el efecto de la implementación de huertos en espacios comunitarios para la salud de la población?: síntesis rápida de evidencia / What is the effect of the implementation of community gardens on the health of the population?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO Los huertos comunitarios se han implementado en algunos países con el objetivo de fortalecer los vínculos sociales y mejorar el acceso a entornos verdes y saludables dentro de las comunidades, como una intervención para la promoción de la salud. En este contexto, el Departamento de Promoción de la Salud solicita una síntesis de evidencia que tiene como objetivo evaluar la implementación de huertos comunitarios como programa para mejorar el estado de la salud de la comunidad, y de esta manera informar la toma de decisiones respecto de los efectos que tendría la implementación de huertos comunitarios. METODOLOGÍA Se formuló una estrategia de búsqueda la cual se utilizó en las bases de datos HealthSystemsEvidence, HealthEvidence, Epistemonikos, la Biblioteca Cochrane, y PubMed con el objetivo de identificar revisiones sistemáticas que abordaran la pregunta formulada. Como las revisiones sistemáticas no siempre reportaron adecuadamente los resultados presentados, se extrajeron los datos de los estudios primarios. Se utiliza la metodología de certeza de evidencia GRADE. Se incluyeron todos los tipos de intervenciones dirigidas al cultivo de huertos en ambientes comunitarios, que involucraran a las personas en su cuidado y que buscaran la ingesta de frutas y verduras, conocimientos nutricionales y mejora en el estado de salud. Se excluyeron intervenciones que se realizaran en espacios no comunitarios como residencias privadas, establecimientos educacionales u hospitales. Además, se excluyeron intervenciones dirigidas a personas con problemas de salud mental, y se utilizó como comparador las intervenciones habituales para este tipo de población. RESULTADOS Se utilizan 4 Revisiones sistemáticas, de las cuales se obtuvieron los siguientes resultados: -Las estrategias para regular la contaminación del aire podrían reducir las tasas de mortalidad en la población -Es incierto si las políticas regulatorias mejoran el desarrollo neurológico de los niños, porque la certeza en la evidencia es muy baja. -Dentro de las políticas para reducir la contaminación del aire, Chile cuenta con medidas que regulan las emisiones de gases. De esta forma, se podría explorar estrategias para mejorar el cumplimiento de este tipo de iniciativas, en caso de que esto se considere como un elemento relevante para la política.