Indoor nature exposure and influence on physiological stress markers.

Spending time in nature is beneficial for stress reduction and recovery. Using the properties of biophilic design, this study examined the influence of a nature-based indoor environment on physiological stress systems. An experimental study was designed to assess the influence of indoor natural elements on autonomic activity (heart rate variability or HRV), self-reported environmental assessments. No differences in heart rate variability were found between participants assigned to either condition. The room with natural elements was rated more positively than the room without natural elements. Participant preference had more impact on changes in HRV for participants without exposure to natural elements. The results suggest that natural elements in indoor environments may influence the regulation of stress response via environmental preference.Abbreviations: ANCOVA: Analysis of Covariance; ANS: Autonomic Nervous System; AVNN: Average of NN; DST: Digit Span Test; EAS: Environmental Assessment Scale; ECG: Electrocardiograph; fMRI: Functional magnetic resonance imaging; HF: High Frequency; HRV: Heart Rate Variability; INE: Indoor Nature Exposure; NR: Nature-Relatedness Scale; PANAS: Positive and Negative Affect Schedule; SAM: Search and Memory Test; SLSI: Student Life Stress Inventory; SMT: Sentence Making Test.

Understanding, teaching and assessing the elements of the CanMEDS Professional Role: canadian program directors' views.

BACKGROUND: Physicians are required to maintain and sustain professional roles during their careers, making the Professional Role an important component of postgraduate education. Despite this, this role remains difficult to define, teach and assess. OBJECTIVE: To (a) understand what program directors felt were key elements of the CanMEDS Professional Role and (b) identify the teaching and assessment methods they used. METHODS: A two-step sequential mixed method design using a survey and semi-structured interviews with Canadian program directors. RESULTS: Forty-six program directors (48% response rate) completed the questionnaire and 10 participated in interviews. Participants rated integrity and honesty as the most important elements of the Role (96%) but most difficult to teach. There was a lack of congruence between elements perceived to be most important and most frequently taught. Role modeling was the most common way of informally teaching professionalism (98%). Assessments were most often through direct feedback from faculty (98%) and feedback from other health professionals and residents (61%). Portfolios (24%) were the least used form of assessment, but they allowed residents to reflect and stimulated self-assessment. CONCLUSION: Program directors believe elements of the Role are difficult to teach and assess. Providing faculty with skills for teaching/assessing the Role and evaluating effectiveness in changing attitudes/behaviors should be a priority in postgraduate programs.

Distinct trajectories of light and moderate to vigorous physical activity in heart disease patients: results from the Activity Correlates afTer cardIac hospitalizatiON (ACTION) trial.

OBJECTIVES: Research suggests that light and moderate to vigorous physical activity (MVPA) has beneficial effects concerning longevity in heart disease patients. Yet, very little is known about the physical activity trajectories of patients who do not attend cardiac rehabilitation programs and whether the demographic/clinical predictors of these trajectories are similar for light and MVPA. DESIGN: Longitudinal. METHODS: Patients (N=269) completed a questionnaire assessing demographic, clinical, and physical activity variables at baseline, three, six, nine, and 12 months after hospitalization for heart disease. Charts were reviewed for height, weight and clinical diagnosis. RESULTS: Latent class growth analyses showed two classes of patients emerged for light physical activity (i.e., patients who remained inactive and patients whose physical activity levels significantly declined) and MVPA (i.e., patients whose physical activity significantly increased and patients whose activity levels significantly decreased). Light intensity class membership was predicted by diagnosis (OR=2.22), whereas MVPA class membership was predicted by gender (OR=.15). Finally, dual trajectory analyses showed that patients whose activity levels declined for one intensity had a high probability of transitioning into the declining group for the other intensity. CONCLUSIONS: Physical activity trajectories for heart disease patients vary as a function of intensity as do the demographic/clinical predictors of these trajectories.

Community SES, perceived environment, and physical activity during home-based cardiac rehabilitation: is there a need to consider the urban vs. rural distinction?

Physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) remain problematic. Consequently, the present study examined the association between MVPA and urban vs. rural residential status and the perceived environment in patients attending home-based CR. A total of 280 patients completed a questionnaire assessing demographic, clinical, MVPA, and perceived environmental variables measured at baseline and 3 months later. Patient addresses were geocoded and linked to the 2006 Canadian census to establish the urban/rural distinction. Results showed that urban and rural patients had similar baseline MVPA and improvements in MVPA by 3 months. Several perceived environmental variables were significantly related to MVPA throughout home-based CR that were common and urban/rural-specific. Therefore, although there does not appear to be an urban vs. rural advantage in MVPA levels during home-based CR, there does appear to be environmental/MVPA-specific relationships specific to urban and rural patients that may warrant attention.