Participatory Development of a Virtual Reality Exercise Program for People with Chronic Pain.

Background: By describing how a participatory process led to changes in the design of a study of a virtual reality (VR)-guided exercise and mindfulness intervention tailored to people with chronic musculoskeletal pain, this article makes the case for including end user at an early stage when planning research within this field. Methods: A multidisciplinary panel including end-user representatives, researcher, clinicians, and VR developers participated in a 1-day workshop to design a randomized study and a VR-guided intervention. Results: Through the participatory process, changes were made to the original study design with respect to experimental design, duration, content of VR interventions and mode of delivery. Conclusion: This case exemplifies the importance of including end-user participants in the early phases of planning VR interventions for people with chronic pain.

Effects of immersive virtual nature on nature connectedness: A systematic review and meta-analysis.

Objective: This study systematically summarizes the extant literature on the impacts of immersive virtual nature (IVN) on nature connectedness in the general population. Methods: Papers were considered eligible if peer-reviewed, in English language, comprising experimental or quasi-experimental trials, including at least one outcome relative to nature connectedness in the general population. Database search was conducted on Scopus, Web of Science, Google Scholar, Medline, and GreenFILE (22-28 November 2021). Risk of bias was established by the Cochrane RoB 2 tool. Data synthesis was conducted through meta-analysis according with the Cochrane Consumers and Communication Group guidelines. Results: Six eligible papers (9 studies; n = 730) were selected, in which IVN was compared to (i) non-immersive virtual nature, (ii) immersive virtual built environments, (iii) non-immersive virtual built environments, and (iv) actual nature. The risk of bias was predominantly "low" or of "some concerns." Meta-analyses showed a statistically significant overall effect for the first (g = 0.26; 95% CI = 0.06-0.45; I2 = 35%) and fourth group (g = -1.98; 95% CI = -3.21 to -0.75; I2 = 96%), the former in favor of IVN and the latter in favor of actual nature. Subgroup analyses were conducted for the first and second groups of studies to explore possible sources of heterogeneity. The small number of studies available limits the validity of the outcomes of the meta-analyses. Conclusion: The findings indicate that IVN may be an effective tool for the promotion of nature connectedness, although the evidence in this field is still limited and largely mixed. Recommendations for future research are discussed.

The significance of green exercise for the health and wellbeing of Italian immigrants in Norway: a mixed-methods study.

BACKGROUND: Green exercise (physical activity in presence of nature) has beneficial effects for health and wellbeing. Green exercise is a popular form of recreation in the Nordic countries, but participation is lower among the immigrant population from non-Western countries. However, no attention has been given to immigrants from the European Economic Area regarding this topic. Given the cultural and structural differences that surround green exercise in Italy and Norway, the case of the Italian immigrants in Norway is of interest to enrich our understanding of green exercise and its significance for health and wellbeing among immigrants in the Nordic countries. METHODS: This convergent mixed methods study investigated the pathways that link green exercise to health and wellbeing among Italian immigrants in Norway. Quantitative data were collected through an online survey (n = 321), which was oversampled to better reflect the sociodemographic profile of the reference population. Logistic regression was used to model the association of green exercise with self-rated health (SRH) or satisfaction with life (SWL) before and after controlling for selected confounders (age, gender, educational level, language proficiency, social support, and childhood experiences with green exercise). Qualitative data were collected through semi-structured in-depth interviews (n = 14) and analysed thematically. Merging of the two strands was done using a simultaneous bidirectional approach. RESULTS: The logistic regression found a significant bivariate association of green exercise with both SRH and SWL, though the association remained significant only for SWL after controlling for confounders. From the thematic analysis, three themes were identified: Green exercise opportunities contributing to overall satisfaction, Closeness to nature, and Embracing a new lifestyle. The integrated findings indicate that green exercise supported the immigrants' wellbeing, especially by providing stress relief, though socioeconomic status and acculturation may have a major impact on general health. Familiarity, appreciation of nature benefits, social support, and acculturation were identified as facilitating factors. CONCLUSIONS: This study provides novel insights into how green exercise supports health, wellbeing, and inclusion among immigrants to the Nordic countries and emphasizes the importance of developing culturally adapted strategies to enhance this health-promoting activity among immigrant populations.

Nature visits during the COVID-19 pandemic in Norway: Facilitators, motives, and associations with sociodemographic characteristics.

Introduction: The COVID-19 pandemic has been linked to increased mental health issues and reduced well-being. Researchers also reports increased frequency of nature visits during the pandemic, proposing it may mitigate some of these negative consequences. Using the case of Norway, a country with ample access to nature and relatively low levels of pandemic-related restrictions, this study sought to (i) understand how the COVID-19 crisis impacted patterns of nature visits and specific nature-based activities, (ii) examine how these patterns varied among different population groups and levels of restrictions, and (iii) explore the motives and facilitators for increased frequency of nature visits. Methods: The data were retrieved from a national cross-sectional survey conducted in June 2021, which was designed to assess participants (n = 1,005, age > 15 years) habits in relation to nature visits and outdoor recreation since the beginning of the COVID-19 crisis, and associated factors. Results: The results showed that 32 % of participants increased their frequency of nature visits during the crisis, while 11 % experienced a decrease. Multivariate logistic regression revealed significant positive associations between increased frequency of nature visits and longer duration of lockdown restrictions (OR [95% CI] = 2.35 [1.28-4.29] and 4.92 [2.77-8.74] for a few weeks and several months of lockdown, respectively). Increased frequency of nature visits was also more likely among women, younger respondents, and individuals from high-income households. A Cochran's Q test showed that the most common motive for increased frequency of nature visits was "To be physically active" (74%). The most commonly reported facilitators were the possibility of using natural environments as an alternative to gyms and organized sports alongside having more time available (58 and 49%, respectively). Conclusion: These findings suggest that nature visits provided important opportunities for physical activity during the COVID-19 crisis, but also that the mental health benefits of nature visits during such times may be under-communicated. This highlights the importance of access to natural environments to promote physical activity and health, but also suggests that campaigns that specifically communicate the beneficial effects of nature visits during lockdowns or similar stressful situations might help people cope with the situation.

Theoretical construct into blocks of actigraphic-derived sleep parameters.

Actigraphic parameters can provide indication of people's sleep quality during their daily lives. However, there is a need for clear guidelines on the understanding of the different actigraphic parameters. The present study aims to propose a conceptual and theoretical framework for known actigraphic-derived parameters, which is able to describe the alternation between rest and wake phases during the nocturnal sleep, explaining their main characteristics and interrelations that can be replicated in future studies. Forty Sport Sciences students at the University of Milan (20 males; mean age ± SD, 22 ± 3 y) completed the validated Italian version of Morningness-Eveningness Questionnaire (MEQ) and wore an actigraph (Motion Watch 8®, Cambridge Neurotechnology, Cambridge, UK) for seven days. A framework was developed to depict the interactions between the actigraphic parameters and how they objectively describe sleep, according to which the parameters are organized into three different functional blocks related to different aspects of sleep. Correlations analyses were conducted to explore the relationships among the primary actigraphic parameters within and across the functional blocks. The proposed framework is a purely theoretical construct that provides a simple interpretation of known actigraphic parameters guiding researchers and practitioners in the use of these parameters either for research or clinical purposes.

Psychophysiological mechanisms underlying the effects of outdoor green and virtual green exercise during self-paced walking.

Physical activity in the presence of nature can lead to additional, more distinct mental health benefits such as lower stress and anxiety levels and an overall better psychological state when compared to indoor physical activity. Interestingly, the brain mechanisms underlying the effects of green exercise (GE) and virtual green exercise (VGE) on psychological responses are hitherto under-researched. The present study sought to deepen our understanding of the brain mechanisms underlying the effects of GE and VGE during self-paced walking. Thirty individuals took part in the present study. Two experimental (i.e., GE and VGE) and a control condition (CO) were administered in a randomized and counterbalanced order. Participants were asked to walk for » mile at a pace of their choosing and self-report their psychological states at various timepoints during the exercise trials. Heart rate variability and the brain's electrical activity were monitored continuously throughout the experimental protocol. An accelerometer was used to identify the beginning and end of each step. The results indicate that both experimental manipulations were sufficient to influence the majority of psychological and psychophysiological parameters. The most pronounced effects were identified for GE when compared to CO and VGE. VGE was also sufficient to evoke positive emotions and partially reallocate attention externally, although such effects were less pronounced than those observed for GE. The brain mechanisms underlying the abovementioned psychophysiological responses may be associated with significant changes in theta activity throughout the cerebral cortex as well as increased connectivity in the frontal and parietal areas.

Seasonal Variations in the Effectiveness of Immersive Virtual Nature.

AIM: The aim of this study was to assess whether the outcomes of immersive virtual nature (IVN) varies between seasons. BACKGROUND: IVN has received increased interest in recent years due to its potential applications within health and design. However, factors influencing people's responses to IVN are largely unknown. Seasons affect a variety of human processes and behaviors including levels of affect and blood pressure, also in the context of human-nature interactions. These seasonal variations might influence how people interact and respond to IVN, especially since IVN allow for representations of nature that are not representative of the current real-life season. METHODS: A secondary analysis of data retrieved from two previous studies, which included three IVN conditions, was conducted. All IVNs represented late spring conditions. Measures included perceived environmental restorativeness, affect, enjoyment, heart rate, and blood pressure. A meta-analytic approach was used to assess whether there were consistent differences between participants who were exposed to the IVN in spring/summer (early June to mid-September) and autumn/winter (mid-September to December) across the three different conditions. RESULTS: There was a consistent effect of season only for one component of affect (fatigue), with larger reductions in fatigue when exposed to IVN during autumn/winter compared to spring/summer. No other significant effects of season were observed. CONCLUSION: IVNs are feasible to use across all seasons but might be more effective in reducing the feeling of fatigue during autumn and winter compared to other seasons.

Effects of immersive virtual nature on nature connectedness: A systematic review protocol.

Objective: Nature Connectedness, an individual's cognitive, affective, and behavioral connection with the natural world, has been linked to various health and well-being outcomes. As Nature Connectedness can be elicited and strengthened through direct contact with nature, in the past decade studies have investigated whether similar effects can be achieved through technologies that simulate highly immersive and realistic experiences of nature, such as Immersive Virtual Nature. This protocol describes the methodology for a systematic review that will summarize the existing evidence on the effects of Immersive Virtual Nature on Nature Connectedness in non-clinical populations. Methods: The review will be conducted following the guidelines of Preferred Reporting Items for Systematic Reviews and MetaAnalyses. Terms such as "immersive virtual environment," "natural setting*," and "contact with nature" were searched in Scopus, WebOfScience, GoogleScholar, Medline, and GreenFILE (22-28 November 2021). Papers in English, describing experimental studies, with or without control/comparison, and testing the effects of Immersive Virtual Nature interventions on Nature Connectedness outcomes in non-clinical populations were included. The risk of bias will be assessed using Cochrane's Risk of Bias 2 for randomized studies, and the Risk Of Bias In Non-randomized Studies - of Interventions. The data synthesis will be performed through meta-analysis, assuming that the Cochrane Consumers and Communication Group guidelines are met. Conclusion: The findings will be relevant for understanding the potential and challenges of Immersive Virtual Nature as a tool to promote health and well-being in the general population, providing information on the consistency and limitations of the existing literature and recommendations for future research.

Taking real steps in virtual nature: a randomized blinded trial.

Studies show that green exercise (i.e., physical activity in the presence of nature) can provide the synergistic psychophysiological benefits of both physical exercise and nature exposure. The present study aimed to investigate the extent to which virtual green exercise may extend these benefits to people that are unable to engage in active visits to natural environments, as well as to promote enhanced exercise behavior. After watching a video validated to elicit sadness, participants either performed a treadmill walk while exposed to one of two virtual conditions, which were created using different techniques (360° video or 3D model), or walked on a treadmill while facing a blank wall (control). Quantitative and qualitative data were collected in relation to three overarching themes: "Experience," "Physical engagement" and "Psychophysiological recovery." Compared to control, greater enjoyment was found in the 3D model, while lower walking speed was found in the 360° video. No significant differences among conditions were found with respect to heart rate, perceived exertion, or changes in blood pressure and affect. The analysis of qualitative data provided further understanding on the participants' perceptions and experiences. These findings indicate that 3D model-based virtual green exercise can provide some additional benefits compared to indoor exercise, while 360° video-based virtual green exercise may result in lower physical engagement.

Self-Rated Health Among Italian Immigrants Living in Norway: A Cross-Sectional Study.

Background: Most studies on immigrant health focus on immigrant groups coming from extra-European and/or low-income countries. Little attention is given to self-rated health (SRH) in the context EU/EEA migration. To know more about health among European immigrants can provide new insights related to social determinants of health in the migration context. Using the case of Italian immigrants in Norway, the aim of this study was to (i) examine the levels of SRH among Italian immigrants in Norway as compared with the Norwegian and the Italian population, (ii) examine the extent to which the Italian immigrant perceived that moving to Norway had a positive or negative impact on their SRH; and (iii) identify the most important factors predicting SRH among Italian immigrants in Norway. Methods: A cross-sectional survey was conducted among adult Italian immigrants in Norway (n = 321). To enhance the sample's representativeness, the original dataset was oversampled to match the proportion of key sociodemographic characteristics of the reference population using the ADASYN method (oversampled n = 531). A one-sample Chi-squared was performed to compare the Italian immigrants' SRH with figures on the Norwegian and Italian populations according to Eurostat statistics. A machine-learning approach was used to identify the most important predictors of SRH among Italian immigrants. Results: Most of the respondents (69%) rated their SRH as "good" or "very good". This figure was not significantly different with the Norwegian population, nor to the Italians living in Italy. A slight majority (55%) perceived that their health would have been the same if they continued living in Italy, while 23% perceived a negative impact. The machine-learning model selected 17 variables as relevant in predicting SRH. Among these, Age, Food habits, and Years of permanence in Norway were the variables with the highest level of importance, followed by Trust in people, Educational level, and Health literacy. Conclusions: Italian immigrants in Norway can be considered as part of a "new mobility" of high educated people. SHR is shaped by several interconnected factors. Although this study relates specifically to Italian immigrants, the findings may be extended to other immigrant populations in similar contexts.

Physiological recovery among workers in long-distance sleddog races: A case study on female veterinarians in Finnmarksløpet.

BACKGROUND: During Finnmarksløpet (FL, one of the longest distance sleddog races in the world), veterinarians are exposed to extreme environmental conditions and tight working schedules, with little and fragmented sleep. OBJECTIVE: The aim of this case study was to examine cardiovascular parameters and sleep-wake patterns among veterinarians working within FL, during and after (for a month) the end of the race. METHODS: Six female veterinarians volunteered for the study. The participants wore a wrist device for a total of eight weeks in order to passively and semi-continuously record physiological responses throughout the day (i.e., heart rate, heart rate variability, number of steps, and sleep quality). Moreover, perceived sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) at three time-points. RESULTS: During and for one month after completion of the FL, most veterinarians presented an alteration of cardiovascular parameters and sleep quality. The heart rate circadian rhythm returned to pre-race values within about two weeks. CONCLUSIONS: The long-lasting alteration of the veterinarians' cardiovascular parameters and sleep-wake patterns might have negative consequences for their health in the long-term, especially if similar experiences are repeated more times though the course of a year or season. More research is needed in order to understand the health risks, as well as how to prevent them, among veterinarians in long-distance sleddog races or other similar events.

Physical Activity Levels and Perceived Changes in the Context of Intra-EEA Migration: A Study on Italian Immigrants in Norway.

As mobility within the European Economic Area (EEA) is on the rise, it is important to understand migrants' health-related behaviors (such as physical activity [PA]) within this context. This study investigated i) the extent to which Italian immigrants in Norway perceive that moving had a negative or positive impact on their PA; ii) possible differences between the PA of the Italian immigrants compared with the Norwegian population; and iii) possible associations of the Italian immigrants' PA with key sociodemographic characteristics (gender, age, region of residence, and educational level). The data were retrieved from the Mens Sana in Corpore Sano study. In order to enhance the sample's representativeness, the original dataset (n = 321) was oversampled in accordance with the proportion of key sociodemographic characteristics of the reference population using the ADASYN method (resampled n = 531). The results indicate that a large majority of Italian immigrants perceived that they were as or even more physically active in Norway than they would have been if they continued living in Italy, while 20% of the Italians perceived instead a negative impact. No significant differences were found in the PA levels of the Italians in comparison with the Norwegian population, though some differences were found in relation to specific modes of PA. After controlling for multiple sociodemographic characteristics, men, those with lower educational levels and, to a certain extent, older adults tended to perceive a more negative impact and be less physically active than their respective counterparts. Compared with those living in the most urbanized regions, a larger proportion of those living in less urbanized regions perceived a negative impact, though no differences were observed in terms of PA levels. The findings are discussed in light of acculturation, gender, and social gradient. The knowledge generated by this study sheds light on an important health-related behavior among Italians in Norway, which can inform initiatives that aim at promoting PA in this specific group as well as other similar contexts of intra-EEA migration.

Effects on sleep from group activity with a robotic seal for nursing home residents with dementia: a cluster randomized controlled trial.

OBJECTIVES: Sleep disturbances are common in people with dementia and increase with the severity of the disease. Sleep disturbances are complex and caused by several factors and are difficult to treat. There is a need for more robust and systematic studies dealing with sleep disturbances in older people with dementia. The aim of this study was to investigate effects from robot-assisted (Paro) group activity on sleep patterns in nursing home (NH) residents with dementia. DESIGN: A cluster randomized controlled trial. SETTING: Special care units in 10 NH in Norway. PARTICIPANTS: A total of 60 participants over 65 years with dementia were recruited. Thirty participants were recruited to the intervention group and 30 participants to the control group. INTERVENTION: Participants participated in group activity with Paro for 30 minutes twice a week over 12 weeks or in control group (treatment as usual). MEASUREMENTS: Sleep-wake patterns were assessed objectively by 7 days of wrist actigraphy before and after the intervention. Data were collected between March 2013 and September 2014. Data were analyzed using mixed models. RESULTS: Positive effects on change in sleep were found in the intervention group as compared with the control group. The intervention group increased percentage of sleep efficiency, increased the amount of total sleep time and reduced number of nocturnal awakenings. In addition, a significant effect was found in reduced awakenings after sleep onset. CONCLUSIONS: Social stimulation through engaging group activity could contribute to improved sleep in people with dementia in NH. Increased sleep efficiency and total sleep time, in addition to fewer night awakenings, affect central indicators of good sleep quality across the life span. Improved sleep quality will also affect quality of life and comorbidities in vulnerable groups. We believe group activity with Paro to be an accessible and feasible non-pharmacological treatment for those who enjoy Paro.

Proposing a Framework for the Restorative Effects of Nature through Conditioning: Conditioned Restoration Theory.

Natural environments have been shown to trigger psychological and physiological restoration in humans. A new framework regarding natural environments restorative properties is proposed. Conditioned restoration theory builds on a classical conditioning paradigm, postulating the occurrence of four stages: (i) unconditioned restoration, unconditioned positive affective responses reliably occur in a given environment (such as in a natural setting); (ii) restorative conditioning, the positive affective responses become conditioned to the environment; (iii) conditioned restoration, subsequent exposure to the environment, in the absence of the unconditioned stimulus, retrieves the same positive affective responses; and (iv) stimulus generalization, subsequent exposure to associated environmental cues retrieves the same positive affective responses. The process, hypothetically not unique to natural environments, involve the well-documented phenomenon of conditioning, retrieval, and association and relies on evaluative conditioning, classical conditioning, core affect, and conscious expectancy. Empirical findings showing that restoration can occur in non-natural environments and through various sensory stimuli, as well as findings demonstrating that previous negative experience with nature can subsequently lower restorative effects, are also presented in support of the theory. In integration with other existing theories, the theory should prove to be a valuable framework for future research.

The Effects of Workplace Nature-Based Interventions on the Mental Health and Well-Being of Employees: A Systematic Review.

Mental health in the workplace is a societal challenge with serious economical and human costs. Most prevalent mental disorders in the workforce (e.g., depression), however, are preventable. There is widespread agreement about the favorable effects of nature exposure and consequently, nature-based interventions (NBI) in the workplace have been proposed as a cost-effective approach to promote good health among employees. The objective of the present study was to systematically review scientific evidence on the effectiveness of NBI to promote mental health and well-being among actual employees in actual workplace settings. The review was conducted and presented in accordance with the PRISMA guidelines. The literature search was performed on five databases (PubMed, Embase, CENTRAL, CINHAL, and PsycINFO), hand-searching of field-specific journals, and the reference lists of retrieved papers over the past 5 years up to November (13th, 2018). Studies were eligible for inclusion if they (i) were randomized or nonrandomized controlled trials; (ii) comprised samples of actual employees; (iii) implemented a workplace-based intervention with exposure to nature; (iv) included comparison conditions that displayed a clear contrast to NBIs; and (v) investigated the quantitative effects on mental health or well-being. No restrictions on type of employees or workplace, publication period, or language of the publication were set. Risk of bias was assessed using the Cochrane's RoB2 tool. Narrative synthesis was performed due to large heterogeneity in outcome variables. Of the 510 articles identified, 10 NBIs (nine papers) met the eligibility criteria. The outcomes were grouped in five categories: (i) mental health indices, (ii) cognitive ability, (iii) recovery and restoration, (iv) work and life satisfaction, and (v) psychophysiological indicators. Narrative synthesis indicates consistently positive effects on mental health indices and cognitive ability, while mixed results were found for the other outcome categories. Caution must be given when interpreting the current evidence in this emerging research field because of the diversity of NBIs and the overall high risk of bias in the individual studies. Although in this field often researchers have to balance scientific rigor and ecological validity, there is a need for large, well-designed and rigorously conducted trials grounded in contemporary theories.

Enable, Reconnect and Augment: A New ERA of Virtual Nature Research and Application.

Being exposed to natural environments is associated with improved health and well-being, as these environments are believed to promote feelings of "being away" from everyday struggles, positive emotional reactions and stress reduction. Despite these positive effects, humanity is becoming increasingly more distanced from nature due to societal changes, such as increased urbanization and the reduced accessibility of natural environments. Technology is also partly to blame, as research suggests that people replace nature contact with increased screen time. In this cross-section between nature and technology, we find technological nature which is progressing towards a point where we may be capable of simulating exposure to real nature. Concerns have been raised regarding this technology, as it is feared it will replace real nature. However, research suggests that virtual nature may have a more positive impact on society than a mere replacement of real nature, and this review propose several areas where virtual nature may be a beneficial addition to actual nature (Enable), help people reconnect with the real natural world (Reconnect) and "boost" human-nature interactions (Augment). Based on the current research and theoretical framework, this review proposes guidelines for future research within these areas, with the aim of advancing the field by producing high quality research.

Do "Girls Just Wanna Have Fun?" Participation Trends and Motivational Profiles of Women in the Birkebeiner Races, Norway's Ultimate Mass Participation Ski Event.

Mass participation sporting events (MPSEs) are viewed as encouraging regular exercise in the population, but concerns have been expressed about the extent to which they are inclusive for women. This study focuses on an iconic cross-country skiing MPSE in Norway, the Birkebeiner race (BR), which includes different variants (main, Friday, half-distance, and women-only races). In order to shed light on women's participation in this specific MPSE, as well as add to the understanding of women's MPSEs participation in general, this study was set up to: (i) analyze trends in women's participation, (ii) examine the characteristics, and (iii) identify key factors characterizing the motivational profile of women in different BR races, with emphasis on the full-distance vs. the women-only races. Entries in the different races throughout the period 1996-2018 were analyzed using an autoregressive model. Information on women's sociodemographic characteristics, sport and exercise participation, and a range of psychological variables (motives, perceptions, overall satisfaction, and future participation intention) were extracted from a market survey and analyzed using a machine learning (ML) approach (n = 1,149). Additionally, qualitative information generated through open-ended questions was analyzed thematically (n = 116). The relative prevalence of women in the main BR was generally low (< 20%). While the other variants contributed to boosting women's participation in the overall event, a future increment of women in the main BR was predicted, with women's ratings possibly matching the men's by the year 2034. Across all races, most of the women were physically active, of medium-high income, and living in the most urbanized region of Norway. Satisfaction and future participation intention were relatively high, especially among the participants in the women-only races. "Exercise goal" was the predominant participation motive. The participants in women-only races assigned greater importance to social aspects, and perceived the race as a tradition, whereas those in the full-distance races were younger and gave more importance to performance aspects. These findings corroborate known trends and challenges in MPSE participation, but also contribute to greater understanding in this under-researched field. Further research is needed in order to gain more knowledge on how to foster women's participation in MPSEs.

Camera Stabilization in 360° Videos and Its Impact on Cyber Sickness, Environmental Perceptions, and Psychophysiological Responses to a Simulated Nature Walk: A Single-Blinded Randomized Trial.

Immersive virtual environments (IVEs) technology has emerged as a valuable tool to environmental psychology research in general, and specifically to studies of human-nature interactions. However, virtual reality is known to induce cyber sickness, which limits its application and highlights the need for scientific strategies to optimize virtual experiences. In this study, we assessed the impact of improved camera stability on cyber sickness, presence, and psychophysiological responses to a simulated nature walk. In a single-blinded trial, 50 participants were assigned to watch, using a head-mounted display, one of two 10-min 360° videos showing a first-person nature walk: one video contained small-magnitude scene oscillations associated with cameraman locomotion, while in the other video, the oscillations were drastically reduced thanks to an electric stabilizer and a dolly. Measurements of cyber sickness (in terms of both occurrence and severity of symptoms), perceptions of the IVE (presence and perceived environmental restorativeness), and indicators of psychophysiological responses [affect, enjoyment, and heart rate (HR)] were collected before and/or after the exposure. Compared to the low-stability (LS) condition, in the high-stability (HS) condition, participants reported lower severity of cyber sickness symptoms. The delta values for pre-post changes in affect for the LS video revealed a deterioration of participants' affect profile with a significant increase in ratings of negative affect and fatigue, and decrease in ratings of positive affect. In contrast, there were no pre-post changes in affect for the HS video. No differences were found between the HS and LS conditions with respect to presence, perceived environmental restorativeness, enjoyment, and HR. Cyber sickness was significantly correlated with all components of affect and enjoyment, but not with presence, perceived environmental restorativeness, or HR. These findings demonstrate that improved camera stability in 360° videos is crucial to reduce cyber sickness symptoms and negative affective responses in IVE users. The lack of associations between improved stability and presence, perceived environmental restorativeness, and HR suggests that other aspects of IVE technology must be taken into account in order to improve virtual experiences of nature.

A cross-sectional and 6-year follow-up study of associations between leisure time physical activity and vertebral fracture in adults.

INTRODUCTION: Vertebral fractures are common osteoporotic fractures, affecting 2-46% of the population, causing morbidity and increased risk of mortality. Physical activity has beneficial effects for bone health, including increased bone mineral density and reduced hip fractures. However, evidence concerning prevention of vertebral fractures is scarce. Therefore, the aim of this study was to investigate the association between leisure time physical activity and vertebral fracture risk. METHODS: The data were retrieved from the 2001 and 2007-2008 surveys of the Tromsø Study, a longitudinal population study in Norway. A total of 1904 participants (1030 women and 874 men, age 38-87 yr and 40-87 yr respectively) were included in the cross-sectional analysis (2007-2008). Prospective follow-up data (2001 to 2007) on physical activity were available for 1131 participants (636 women and 495 men, age 32-69 yr and 33-69 yr respectively). Physical activity was assessed by a questionnaire and vertebral fracture by lateral vertebral fracture assessment from dual-energy x-ray absorptiometry scans. Logistic regression was used to examine associations between physical activity and vertebral fracture. RESULTS: After controlling for confounders (age, height, weight, smoking, osteoporosis, osteoporosis medication, left hip total bone mineral density, and use of hormones in women only), no cross-sectional associations between physical activity levels and vertebral fracture were observed, OR 1.13 (95% CI: 0.59-2.13), for moderately active women and 1.44 (0.61-3.42) for highly active women, compared with sedentary women. In men, the respective ORs were 1.74 (95% CI: 0.91-3.35) and 1.64 (0.78-3.41). In the prospective analyses, OR for vertebral fracture in women with reduced physical activity was 0.81 (95% CI: 0.18-3.62), 1.24 (95% CI: 0.29-5.26) for increased physical activity and 1.54 (95% CI: 0.43-5.50) for active unchanged physical activity pattern, compared with sedentary unchanged physical activity. In men, the respective ORs were 2.05 (95% CI: 0.57-7.42), 2.23 (95% CI: 0.63-7.87), and 1.81 (95% CI: 0.54-6.02). Subanalyses of women and men ≥50 yr showed similar results. CONCLUSIONS: Our findings suggest that physical activity does not play a major role in preventing vertebral fractures in Norwegian adults. Future studies may benefit from data on incident vertebral fracture, and objectively measured physical activity.