[Effect of forest bathing (shinrin-yoku) on human health: A review of the literature]. / Effets des forêts et des bains de forêt (shinrin-yoku) sur la santé humaine : une revue de la littérature.

Humans have enjoyed forest environments for ages because of the quiet atmosphere, beautiful scenery, mild climate, pleasant aromas, and fresh, clean air. In Japan, since 2004, serial studies have been conducted to investigate the effects of forest environments on human health. We have established a new medical science called Forest Medicine. The Forest Medicine is a new interdisciplinary science, belonging to the categories of alternative medicine, environmental medicine and preventive medicine, which encompasses the effects of forest environments on human health. It has been reported that forest environments have the following beneficial effects on human health:1. Increase human natural killer (NK) activity, the number of NK cells, and the intracellular levels of anti-cancer proteins, suggesting a preventive effect on cancers.2. Reduce blood pressure, heart rate, and stress hormones, such as urinary adrenaline and noradrenaline and salivary cortisol.3. Increase the activity of parasympathetic nerves and reduce the activity of sympathetic nerves.4. Increase the levels of serum adiponectin and dehydroepiandrosterone sulfate.5. In the Profile of Mood States (POMS) test, reduce the scores for anxiety, depression, anger, fatigue, and confusion, and increase the score for vigor, showing psychological effects as well.These findings suggest that forest environments may have preventive effects on lifestyle-related diseases.

Reflections on the development of a therapeutic recreation-based bereavement camp for families whose child has died from serious illness.

While bereavement camps serve as a support for children, this study examines a therapeutic recreation-based camp for families who have lost a child. The study triangulated documents, researcher reflection, and staff interviews to highlight the themes of Searching & Finding, Getting to Know, Finding the Balance, and Joining. Developing opportunistically through internal and external factors, the camp's evolution represents a closing of the loop, from supporting families of living children to also supporting the families of children who have died. Understanding the camp's evolution may facilitate other programs by highlighting the challenges in developing the program and the lessons learned.

Willingness to Interact After Therapeutic Recreation in a Patient With Schizophrenia.

The study aim was to describe how a patient with schizophrenia who had been in a psychiatric hospital for an extended period of time changed in his desire to interact with others after participating in the therapeutic recreation program, and to interpret his inner process based on symbolic interactionism theory. Data from a patient who showed marked changes in narratives of an interview held after the program and through observation during sessions were analyzed. The patient gained a sense of willingness, including the desire to interact with others and began to act accordingly.

Factors that bring meaning to mementos created by elders.

OBJECTIVES: Reminiscing activity groups are commonly seen in various elder care settings This study addresses the impact of reminiscence activity groups, specifically a program where group members create their own mementos, on healthy Jewish elders' sense of satisfaction and meaning. In particular, this research focused on the specific factors involved in creating the mementos themselves. METHOD: In this mixed methods study, occupational therapy graduate students synthesized relevant aspects of commonly used activity analysis forms into a matrix to analyze the activities. From a pool of 30 activities, students chose seven representing many factors and levels of complexity. With a matrix composed of a Likert scale and open-ended questions, students and Jewish elders explored the elders' perceptions of factors significantly related to their experiences when creating the seven mementos. RESULTS: Memento-making was most satisfying when elders were replicated in some way, such as with hand casting. Least satisfying activities were those that could lead to talents being appraised, such as painted self-portraits. Unanticipated factors such as social participation and educating others appeared to be as important as making the mementos themselves. CONCLUSION: While the research questions were partially answered, factors such as meaning and creativity were difficult constructs to measure because they lacked clear definitions. However, this preliminary exploration supports the concept that the use of an activity analysis matrix can enable activities directors and occupational therapists to systematically ascertain which factors positively impact well-being and social participation to meet the unique needs of aging client populations.

Effectiveness of group music therapy versus recreational group singing for depressive symptoms of elderly nursing home residents: pragmatic trial.

OBJECTIVES: Several studies have suggested positive effects of music therapy in dementia, but research on age-related depression has been limited and of insufficient quality. The aim of this study was to examine the effect of interactive group music therapy versus recreational group singing on depressive symptoms in elderly nursing home residents. METHOD: Residents of two German nursing homes with sufficient length of stay who were not bedridden were invited to participate in a pragmatic trial. A total of 117 participants, grouped into four clusters (based on their wards), were randomised to interactive group music therapy (n = 62; 20 units of 40 minutes, 2×/week) or recreational group singing (n = 55; 10 units of 90 minutes, 1×/week). The level of depressive symptoms was assessed using the Montgomery-Åsberg Depression Rating Scale at baseline (47% with at least mild depression) and follow-up in the 6th and 12th weeks. There was no blinding of assessors. RESULTS: The level of depressive symptoms improved significantly more in those assigned to music therapy (n = 60) than in recreational singing (n = 53), both in 6th week (mean difference 3.0 scores, 95% CI 1.21 to 4.79, p = 0.001) and 12th week (mean difference 4.50 scores, 95% CI 2.51 to 6.50, p < 0.001). CONCLUSION: The results suggest that music therapy decreases depressive symptoms in elderly people in nursing homes more effectively than recreational singing.

Innovative Mental Health Clinical Placement: Developing Nurses' Relationship Skills.

Engagement in clinical placements is mandatory for all pre-registration nursing programs. Although clinical placements can be valuable, recent literature illustrates that placements within a mental health setting can vary in their educational development. The aim of the current study was to examine the potential learning benefit of 20 pre-registration nursing students in an innovative, university-accredited mental health clinical placement called Recovery Camp. Recovery Camp is a 5-day immersive clinical placement, grounded in therapeutic recreation, which involves all participants engaging in a variety of activities focused on enhancing personal recovery. Qualitative data were collected using individual interviews, reflective journals, and researcher field notes. Analysis of data was conducted using an inductive thematic approach. Analysis of data revealed five themes: (a) Initial Anxiety/Nervousness, (b) Diffusion of Power, (c) Student Perceptions of Consumers, (d) Interaction and Communication, and (e) Resource Shift as a Result of Camp. Developing the professional learning of pre-registration nurses through immersion in effective clinical placements is paramount. Findings demonstrate that pre-registration nurses may benefit from clinical placements that provide immersive and collaborative experiences that allow for the development of relationship-oriented skills that can facilitate person-centered care. [Journal of Psychosocial Nursing and Mental Health Services, 55(2), 36-43.].

Efficacy of recreational football on bone health, body composition, and physical functioning in men with prostate cancer undergoing androgen deprivation therapy: 32-week follow-up of the FC prostate randomised controlled trial.

UNLABELLED: Androgen deprivation therapy (ADT) for prostate cancer (PCa) impairs musculoskeletal health. We evaluated the efficacy of 32-week football training on bone mineral density (BMD) and physical functioning in men undergoing ADT for PCa. Football training improved the femoral shaft and total hip BMD and physical functioning parameters compared to control. INTRODUCTION: ADT is a mainstay in PCa management. Side effects include decreased bone and muscle strength and increased fracture rates. The purpose of the present study was to evaluate the effects of 32 weeks of football training on BMD, bone turnover markers (BTMs), body composition, and physical functioning in men with PCa undergoing ADT. METHODS: Men receiving ADT >6 months (n = 57) were randomly allocated to a football training group (FTG) (n = 29) practising 2-3 times per week for 45-60 min or to a standard care control group (CON) (n = 28) for 32 weeks. Outcomes were total hip, femoral shaft, femoral neck and lumbar spine (L2-L4) BMD and systemic BTMs (procollagen type 1 amino-terminal propeptide, osteocalcin, C-terminal telopeptide of type 1 collagen). Additionally, physical functioning (postural balance, jump height, repeated chair rise, stair climbing) was evaluated. RESULTS: Thirty-two-week follow-up measures were obtained for FTG (n = 21) and for CON (n = 20), respectively. Analysis of mean changes from baseline to 32 weeks showed significant differences between FTG and CON in right (0.015 g/cm(2)) and left (0.017 g/cm(2)) total hip and in right (0.018 g/cm(2)) and left (0.024 g/cm(2)) femoral shaft BMD, jump height (1.7 cm) and stair climbing (-0.21 s) all in favour of FTG (p < 0.05). No other significant between-group differences were observed. CONCLUSIONS: Compared to standard care, 32 weeks of football training improved BMD at clinically important femoral sites and parameters of physical functioning in men undergoing ADT for PCa.

Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months.

BACKGROUND: The number of obese children in the US remains high, which is problematic due to the mental, physical, and academic effects of obesity on child health. Data indicate that school-age children, particularly underserved children, experience unhealthy gains in BMI at a rate nearly twice as fast during the summer months. Few efforts have been directed at implementing evidence-based programming to prevent excess weight gain during the summer recess. METHODS: Camp NERF is an 8-week, multi-component (nutrition, physical activity, and mental health), theory-based program for underserved school-age children in grades Kindergarten - 5th coupled with the USDA Summer Food Service Program. Twelve eligible elementary school sites will be randomized to one of the three programming groups: 1) Active Control (non-nutrition, physical activity, or mental health); 2) Standard Care (nutrition and physical activity); or 3) Enhanced Care (nutrition, physical activity, and mental health) programming. Anthropometric, behavioral, and psychosocial data will be collected from child-caregiver dyads pre- and post-intervention. Site-specific characteristics and process evaluation measures will also be collected. DISCUSSION: This is the first, evidence-based intervention to address the issue of weight gain during the summer months among underserved, school-aged children. Results from this study will provide researchers, practitioners, and public health professionals with insight on evidence-based programming to aid in childhood obesity prevention during this particular window of risk. TRIAL REGISTRATION: NCT02908230/09-19-2016.

Perceived Control among People with Severe Mental Illness: A Comparative Study.

BACKGROUND: Given the importance of perceived control to mental health and recovery, research is needed to determine strategies to increase perceived control for people with a mental illness. AIM: Investigate the implications of a therapeutic recreation program on the perceived control of people with a mental illness. METHOD: Participants of an intervention group (n=27) and comparison group (n=18) completed the Perceived Control Across Domains Scale at three time intervals. Subscale and total scores were analysed. RESULTS AND DISCUSSION: Significant variation occurred in the perceived control areas of substance use, personal cognition and personal empowerment. IMPLICATIONS: A unique nurse led therapeutic recreation initiative, such as Recovery Camp, can improve and maintain facets of perceived control among people with mental illness.

Camps and Their Benefit to Pediatric Nephrology Patients.

Children with end stage renal disease (ESRD) frequently miss great amounts of school due to hospitalizations and three-times-a week hemodialysis (if that is their modality); thus, they miss opportunities to be with their peers and learn normal social interactions with other students. Because of this lack of normal socialization, many children with ESRD are behind in development in contrast to their peers and need opportunities to enhance their growth and development. One way this can occur for children with ESRD is by providing them opportunities to attend age-appropriate and disease-appropriate camps.

Participation in a social and recreational day programme increases community integration and reduces family burden of persons with acquired brain injury.

PRIMARY OBJECTIVE: To describe and evaluate a new day programme for persons living with an acquired brain injury (ABI), including persons exhibiting challenging behaviours. Activities were designed to reduce participants' social isolation, increase participation in community activities and increase social and leisure skills. It was expected that community integration would increase and challenging behaviours and family burden would decrease for day programme participants. METHODS AND PROCEDURES: Pre-post convenience sample design. Sixty-one participants and family members completed questionnaires before starting the day programme and after 6-month participation. MEASURES: Community Integration Questionnaire, Overt Behaviour Scale, Burden Assessment Scale, Goal Attainment Scaling. RESULTS: Participants had increased community integration (p = 0.000) and decreased family burden (p = 0.006). There was a trend to decreased severity of challenging behaviour. Participants and family members were very satisfied. Results suggest that the programme was effective in reducing participants' social isolation and increasing appropriate interpersonal behaviours. CONCLUSIONS: Participation increased community integration and reduced burden on family caregivers. ABI day programmes help fill the void left after other rehabilitation services end and provide survivors with opportunities to engage in a variety of activities. Persons living with ABI have need for ongoing social, recreational and life skill coaching services after formal rehabilitation has been completed.

The effect of out-of-home activity intervention delivered by volunteers on depressive symptoms among older people with severe mobility limitations: a randomized controlled trial.

OBJECTIVES: To examine the effects of an individualized outdoor activity intervention carried out by volunteers on depressive symptoms among community-living older people with severe mobility limitations who have difficulties accessing the outdoors independently. METHODS: Secondary analyses of the 'Volunteering, Access to Outdoor Activities and Wellbeing in Older People' (VOW) data (ISRCTN56847832). VOW was a randomized single blinded two-arm controlled trial conducted in Jyväskylä, Finland, in 2009-2011. At baseline, 121 people aged 67-92 years with severe mobility limitations were interviewed at home and randomized into either an intervention or waiting list control group. Volunteers (n = 47) had retired from regular work and were trained for the study. A volunteer assisted the participant in attending recreational out-of-home activities once a week for three months. Depressive symptoms were assessed using the Center for the Epidemiological Studies Depression Scale (CES-D). RESULTS: In the intervention group the CES-D score did not change during the intervention (from 15.1 ± standard error 0.9 to 15.1 ± 0.9), while in the control group it increased from 17.0 ± 1.3 to 19.1 ± 1.4 (intervention effect p = .096). Among the subgroups with minor depressive symptoms at baseline (CES-D score 16-20), the CES-D score decreased in the intervention group and increased in the control group (p = .025). CONCLUSION: A three-month outdoor activity intervention may improve mood among older people with severe mobility limitations. More randomized controlled trials of the topic are needed.

Physical and psychosocial function in residential aged-care elders: effect of Nintendo Wii Sports games.

This mixed-methods, quasi-experimental pilot study examined whether the Nintendo Wii Sports (NWS) active video game (exergame) system could significantly improve the functional ability, physical activity levels, and quality of life of 34 older adults (4 men and 30 women, 83 ± 8 yr) living in 2 residential aged-care (RAC) centers. Change score analyses indicated the intervention group had significantly greater increases in bicep curl muscular endurance, physical activity levels, and psychological quality of life than the control group (p < .05). Analysis of the quotes underlying the 3 themes (feeling silly, feeling good; having fun; and something to look forward to) suggested that intervention group participants developed a sense of empowerment and achievement after some initial reluctance and anxiousness. They felt that the games were fun and provided an avenue for greater socialization. These results add some further support to the utilization of NWS exergames in the RAC context.

Contributing to 'a sense of purpose' - Evaluating consumer recovery progress after attending a therapeutic-recreation intervention programme: A quantitative analysis.

INTRODUCTION: The recommended objective for mental health plans and policies is the adoption of recovery approaches to mental healthcare. Mental health recovery is no longer defined by symptom resolution but as a journey towards a meaningful life from the consumer's own perspective. Recovery approaches focus on consumers' strengths, feelings of well-being and the achievement of personal goals. Designing recovery-oriented interventions is crucial for supporting people in their personal recovery journey. AIM: This study sought to evaluate how attending a recovery-oriented intervention impacts the recovery of attending people living with serious mental illness. METHODS: A quasi-experimental approach was utilised to examine changes in self-reported recovery progress in a purposive sample of consumers living with enduring mental illness (N = 105). Recovery progress was evaluated via the Recovery Assessment Scale - Domains and Stages (RAS-DS). Data were collected at entry and exit to a therapeutic recreation programme grounded in principles of recovery-oriented care and social contact theory. Pre-post scores were analysed via a repeated-measures multivariate analysis of variance (RM-MANOVA) per the four RAS-DS recovery domains. RESULTS: After attending the therapeutic recreation programme, consumer recovery scores significantly increased in the functional, personal, and social recovery RAS-DS domains as measured by 'Doing Things I Value', 'Looking Forward', and 'Connecting and Belonging' (respectively). No changes were observed to consumers' clinical recovery progress, as assessed via the recovery domain 'Mastering my Illness'. CONCLUSION: The results of this study demonstrate that therapeutic recreation camps can provide a recovery-based approach to mental healthcare, with positive effects on the three areas of: a purposeful life; connection and belonging; and optimism and hope. Recovery Camp has been previously identified by the Productivity Commission as having potential person-centred recovery benefits for mental health consumers. The results of this study now establish these benefits as evidence based and can be used to guide mental health practice and policy for the implementation of therapeutic recreation camps for mental health recovery.

Group therapy utilization in inpatient spinal cord injury rehabilitation.

OBJECTIVE: To describe group therapy utilization in spinal cord injury (SCI) inpatient rehabilitation. DESIGN: Prospective observational study. SETTING: Six inpatient rehabilitation facilities. PARTICIPANTS: Patients (N=1376) receiving initial rehabilitation after traumatic SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Time spent in group versus individual therapy for physical therapy (PT), occupational therapy (OT), therapeutic recreation (TR), and psychology (PSY) therapies. RESULTS: The majority (98%) of patients participated in at least 1 group therapy session, with 83%, 81%, 80%, and 54% of patients receiving group PT, OT, TR, and PSY, respectively. On average, 24% of treatment sessions and 27% of treatment time was provided in group sessions, with TR providing the greatest percent of its time in groups. Group therapy time and time spent in specific activities varied among patient subgroups with different injury characteristics. Group therapy time also varied widely among centers (range, 1.2-6.6h/wk). Across all injury subgroups, individual and group therapy hours per week were negatively correlated for OT and positively correlated for TR. Patient characteristics, clinician experience, and treatment center predicted 32% of variance in group hours per week. PT and OT strengthening/endurance interventions and TR outings were the most common group activities overall. CONCLUSIONS: While the majority of inpatient SCI rehabilitation consists of individual sessions, most patients participate in group therapy, which contributes significantly to total therapy time. Patterns of group utilization fit with functional expectations and clinical goals. A trade-off between group and individual therapy may occur in some disciplines. Utilization of group therapy varies widely among centers, and further study is needed to identify optimal patterns of group therapy utilization.

Improved metabolic and cardiorespiratory fitness during a recreational training program in obese children.

Physical activity may protect from the adverse effects of obesity. In obese children, an increased adherence and a decreased drop-out rate during exercise could be achieved with adapted activities. We studied a recreational 12-week controlled training program for sedentary obese children, including interactive video games. We enrolled 22 obese subjects (13.23±1.76 years) in an exercise program, implemented twice a week for a 12-week period. The program consisted of a combination of circuit-based aerobics, strength and resistance exercises; specifically soccer, rugby, volleyball and basketball and interactive video game exercises. Outcome measurements included body composition, metabolic profile and cardiorespiratory fitness. During the 12-week training program there was a significant decrease in body mass index (BMI) (p=0.002), SDS-BMI (p=0.003), waist circumference (p=0.004), waist circumference/height ratio (p=0.001),% fat mass (p=0.001), blood glucose (p=0.001), homeostasis model assessment for insulin resistance (HOMA-IR) (p=0.04), triglycerides (p=0.03) and systolic pressure (p=0.04) before and after exercise. Improvement in estimated maximum oxygen consumption (VO2max) (p<0.001) correlated with a decrease in fat mass (p=0.01), triglycerides (p=0.04) and insulin resistance (p=0.02). Exercise improved metabolic and cardiorespiratory fitness in obese children. Exercise training does not necessarily need to be vigorous, recreational programs are also effective and may encourage children to participate in physical activity and limit initial drop-out.

The impact of recreational video game play on children's and adolescents' cognition.

Current empirical findings show linkages between recreational video game play and enhanced cognitive skills, primarily among young adults. However, consideration of this linkage among children and adolescents is sparse. Thus, discussions about facilitating transfer of cognitive skills from video game play to academic tasks among children and adolescents remains largely uninformed by research. To inform this discussion, we review available research concerning the cognitive benefits of video game play among children and adolescents and their impressions of video games as learning tools as these impressions may impact their application of cognitive skills used during game play to academic tasks.

Relationship of therapeutic recreation inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: the SCIRehab project.

OBJECTIVE: To investigate associations of therapeutic recreation (TR) interventions during inpatient rehabilitation for patients with traumatic spinal cord injury (SCI) with functional, participation, and quality of life outcomes. METHODS: In this prospective observational study, data were obtained from systematic recording of TR services by certified TR specialists, chart review, and patient interview. RESULTS: TR interventions, including exposure to community settings and leisure activities, add to the variance explained (in addition to the strong predictors of injury classification, admission motor Functional Independence Measure (FIM), and other patient characteristics) in outcomes at the time of rehabilitation discharge (FIM, discharge to home) and at the 1-year injury anniversary (FIM, working or being in school, residing at home, and societal participation as measured by the Craig Handicap Assessment and Reporting Technique (CHART)). They also are associated with less rehospitalization and less pressure development after discharge. In addition, more time spent in specific TR activities during rehabilitation is associated with more participation in the same type of activities at the 1-year injury anniversary. CONCLUSION(S): Greater participation in TR-led leisure skill and community activities during rehabilitation is a positive predictor of multiple outcomes at rehabilitation discharge and the 1-year injury anniversary demonstrating that TR activities are associated with a return to a productive and healthy life after SCI. Further research should focus on the impact of TR on longer-term outcomes to determine whether relationships continue or change as persons continue to adapt to their life after SCI. Note: This is the fourth of nine articles in the SCIRehab series.

User experiences of mobile controlled games for activation, rehabilitation and recreation of elderly and physically impaired.

The purpose of this paper was to study how aged people experience mobile controlled game as a method of rehabilitation and recreation. The target group contained persons 70+ years of age living in assisted living conditions (N=34). The average age of the participants was 85.9 years. Women (n=17) and men (n=17) were equally presented in the sample group. Only 12 % (n=4) of participants were involved in an active weekly-based rehabilitation, light physical sitting exercises 38% (n=13). Three (n=3) of the participants (9%) used computers (net banking), and 20 (59%) used mobile phones on daily basis. Social activities and physical activation seem to be rather inadequate and traditional in assisted living organizations. The overall experiences of mobile controlled game described in this paper appeared to be a successful experiment also proving that the elderly are not as reluctant to use technical devices or playing virtual games as often thought. The game was reckoned very motivating, interesting, and entertaining both by the aged and the staff. Activation, rehabilitation and recreation in the elderly homes or assisted living organizations could benefit from utilization of new technology providing new ways and solutions that motivate the users and offer also possibilities for measuring and follow-up of the physical impacts. The future goals to improve the game were set according to the feedback given in this survey: a) wider variety of controlling modes for the game, b) developing various difficulty levels, c) developing the game to support different kinds of body movements, d) easily modified according to the individual user's exercising or rehabilitation needs as well as e) emphasizing the social aspects of the game by producing multiplayer versions.

[Health and recreational localities in the republic of altai and prospects for the development of spa-and-resort services on their basis].

The objective of the present work was to explore low- and mid-altitude valleys and depressions in the northern and central bioclimatic provinces of Gorny Altai for the identification of the health and recreational localities most promising in terms development of spa-and-resort services. The integral estimation of landscape and climatic conditions in conjunction with the quality of hydromineral resources of therapeutic value provided the data that were used by the authors to propose recommendations for the creation of the system of mountain-climate health resorts and touristic-recreational complexes of regional and federal significance at the territory of the Republic of Altai.