Environment driven changes in type 2 diabetes, overweight and obesity in an isolated Mixe community in the Valley of Oaxaca, southern Mexico.

BACKGROUND: This study focused on type 2 diabetes mellitus (T2DM) in a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. Mixe comprised an estimated 9.4% (n ≅ 90 000) of the Indigenous population in Oaxaca. Mexico. OBJECTIVE: This study focused on a group of adult Mixe, an Indigenous population from Oaxaca, Mexico. To compare the prevalence of T2DM, overweight (OW), obesity (OB), and hypertension (HTN) between 2007 and 2017 for a small, isolated Mixe community in the Valley of Oaxaca, Mexico. We test whether or not environmental changes have affected T2DM prevalence. METHODS AND MATERIALS: Demographic and medical record data were collected in the community in 2007 and 2017 from the medical clinic and the mayor's office. T2DM was medically diagnosed among adults (>34 years old), in 2007 (n = 730) and in 2017 (n = 829). RESULTS: T2DM crude prevalence increased from 6.7% to 12.1% (p < .001) from 2007 to 2017. The mean age of the sample analyzed was 60.6 (SD = 9.7). Age-adjusted T2DM prevalence increased from 6.7% to 10.8% (p < .002). T2DM was 5.7%-5.5% among males (p < .53) and 7.1%-13.6% among females (p < .001). Sex-specific OW and OB simulation studies indicate females had 7% less OW in 2007, and males were unchanged compared with 2017. OB among males and females was significantly higher in 2017 compared with 2007 (increased by 15.2% and 8.3%, males and females, respectively). Sexes combined OW + OB increased 12.7% among males but was unchanged in females (-0.5%). In the sexes combined analysis, OW prevalence increased 12.7% to 27.1% (p < .001) and OB prevalence increased 10.7%-27.9% (p < .001) from 2007 to 2017. HTN did not change significantly from 2007 to 2017 (15.4% and 14.6%, respectively) (p = .63) in adults. Among T2DM individuals, the frequency of HTN was not significantly different in 2007 and 2017 (57.1% and 37%, respectively) (p = .65). Transition to a Western diet consisting of high-carbohydrate foods occurred at the same time as increased T2DM from 2007 to 2017, with a higher prevalence of T2DM noted among females in 2017. CONCLUSIONS: An increased prevalence of T2DM, OW, and OB but not HTN was observed in the Mixe community from 2007 to 2017 and was associated with the adoption of a high-carbohydrate Western diet.

Physical Activity Supporting Connection to Nature, and Helping to Maintain Wellbeing during the Covid-19 Restrictions in England.

The Covid-19 pandemic and the restrictions put in place to prevent or reduce the spread of the disease led to anxiety, concern and stress for many people. In England restrictions varied at different times of the year, and throughout this time there was a lot of attention focused on the importance of exercise and on engaging with nature to maintain wellbeing. We undertook an online survey that ran for six weeks in June/July 2020 and gained a response from 2115 people, of which 25% were male and 74% female, with 35% aged 16-44 and 65% aged 45+. This survey focused on people who were already interested or engaged with nature. We explored whether being physically activity changed or not, if being active impacted people's wellbeing and whether those who were active benefited from connecting to nature. We found that those meeting the government recommended levels of physical activity in the previous week, of 150 min, were more likely to maintain their overall wellbeing through feeling that the things they did in their life were worthwhile (p < 0.0001) and reported an increase in feelings of connection to nature (p < 0.0001). While those who did less than 30 min of physical activity in the previous week were less happy (p < 0.0001) and more anxious than usual (p < 0.0001). The research highlights the importance of physical activity and contact with nature and how these can play important roles in maintaining people's everyday wellbeing under extremely difficult national circumstances.

Understanding how best to engage recreationists in biosecurity to reduce the impacts of tree diseases: a review.

Pests and diseases introduced from other countries are known to pose a threat to trees, woods and forests in many locations throughout the world. Once introduced they can be spread inadvertently by countryside visitors hiking, biking or riding along paths and trails through wooded areas. Engaging and communicating with these groups of countryside users to encourage and facilitate positive biosecurity behaviours is crucial for the future resilience of trees, woods and forests. This review draws on literature outlining principles for stakeholder engagement in forestry as well as evaluations of biosecurity campaigns from around the world. Key points are briefly presented for communicators aiming to encourage better biosecurity in the countryside. These include, the need to design campaigns based on the values and motivations of recreationists, using trusted information sources and understanding the importance of combining information with facilities so as to reduce the cost (in terms of effort and inconvenience) to hikers and other countryside users.

Carrying out Physical Activity as Part of the Active Forests Programme in England: What Encourages, Supports and Sustains Activity?-A Qualitative Study.

The Active Forests programme was developed through a partnership between Forestry England and Sport England. A three-year pilot programme focused on five forest sites ran from 2014. It was mainstreamed in April 2017 and is now running on eighteen forest sites in England in 2019. The aim of the programme is to encourage a physical activity habit, and participants can get involved in a wide range of activities from Nordic walking to mountain biking, Pilates, running, and Bootcamp in different scenic forests. The aim of the research was to identify the motivations, benefits and the overall experience participants had from their forest physical activity. As part of the programme, qualitative data was gathered through in-situ participant observation, and interviews or focus groups. One hundred and twenty people were involved in the research. The findings identify some of the key elements of the programme that encourage, support and in some instances help to sustain or change physical activity. These include participants gaining a wide range of wellbeing benefits; appropriate targeted activities; opportunities for progression; social connections; providing challenge; and a supportive atmosphere. There is evidence of participants sustaining and changing physical activity practices, however attribution of this to the Active Forests programme is not straightforward. The programme is also explored through the lens of social practice theory and its concepts of materials, competence, and meanings. The research highlights how a targeted physical activity programme can reach and involve a broad range of people from the already physically active to those who are less active.

[Mental health and wellbeing: The contribution of trees and forests to diverse populations in Britain]. / Santé mentale et bien-être : l'apport des arbres et des forêts au bénéfice de différentes populations en Grande-Bretagne.

This paper explores the potential contribution of trees and forest to the mental wellbeing of diverse populations in Britain. We use a conceptual framework that makes a distinction between three different levels of engagement: everyday life; green health promotion; and green therapeutic care. We then use researched and evaluated case studies in Britain to provide examples associated with these three levels of engagement. The case studies illustrate that practical approaches and interventions are developing rapidly in the Britain. Finally we discuss the main pathways and mechanisms that link mental health and wellbeing and trees and forests. We outline that there are limitations to the current international evidence base and call for consistent approaches within and between countries using a range of methodologies to capture the nuances of the complex relationships between trees, forests and mental health and wellbeing.

Engaging with and Shaping Nature: A Nature-Based Intervention for Those with Mental Health and Behavioural Problems at the Westonbirt Arboretum in England.

Mental health problems have become one of the leading causes of disease burden worldwide. This study used qualitative mixed methods including in-situ 'being and doing' activities with participants, interviews, and participant observations to explore participant's experiences of a multi-visit nature-based intervention at Westonbirt Arboretum in England. The research found that three engagement types: (1) social, (2) woodland craft, and (3) creative and sensory, provided a meaningful programme to engage those with mental health, addiction, autism and behavioural problems. These types of engagement conferred a wide range of well-being benefits on participants. The study highlights key elements of the programme that were effective including the importance of repeat visits to nature to enable familiarity, using creative, sensory and craft activities, creating a supportive environment, involving the volunteers, and understanding the needs of participants and the organisations that work with them. The research suggests that nature-based programmes can be designed to be flexible and adaptable to meet the needs of participants with mental health and behavioural problems. Small numbers of participants can be involved in an intensive and immersive way that encourages an emotional affinity with nature. Inclusive and supportive programmes are particularly important for those who are vulnerable, as they are less likely to engage with nature than the wider population.

A comparison of per sample global scaling and per gene normalization methods for differential expression analysis of RNA-seq data.

Normalization is an essential step with considerable impact on high-throughput RNA sequencing (RNA-seq) data analysis. Although there are numerous methods for read count normalization, it remains a challenge to choose an optimal method due to multiple factors contributing to read count variability that affects the overall sensitivity and specificity. In order to properly determine the most appropriate normalization methods, it is critical to compare the performance and shortcomings of a representative set of normalization routines based on different dataset characteristics. Therefore, we set out to evaluate the performance of the commonly used methods (DESeq, TMM-edgeR, FPKM-CuffDiff, TC, Med UQ and FQ) and two new methods we propose: Med-pgQ2 and UQ-pgQ2 (per-gene normalization after per-sample median or upper-quartile global scaling). Our per-gene normalization approach allows for comparisons between conditions based on similar count levels. Using the benchmark Microarray Quality Control Project (MAQC) and simulated datasets, we performed differential gene expression analysis to evaluate these methods. When evaluating MAQC2 with two replicates, we observed that Med-pgQ2 and UQ-pgQ2 achieved a slightly higher area under the Receiver Operating Characteristic Curve (AUC), a specificity rate > 85%, the detection power > 92% and an actual false discovery rate (FDR) under 0.06 given the nominal FDR (≤0.05). Although the top commonly used methods (DESeq and TMM-edgeR) yield a higher power (>93%) for MAQC2 data, they trade off with a reduced specificity (<70%) and a slightly higher actual FDR than our proposed methods. In addition, the results from an analysis based on the qualitative characteristics of sample distribution for MAQC2 and human breast cancer datasets show that only our gene-wise normalization methods corrected data skewed towards lower read counts. However, when we evaluated MAQC3 with less variation in five replicates, all methods performed similarly. Thus, our proposed Med-pgQ2 and UQ-pgQ2 methods perform slightly better for differential gene analysis of RNA-seq data skewed towards lowly expressed read counts with high variation by improving specificity while maintaining a good detection power with a control of the nominal FDR level.

Engaging with peri-urban woodlands in England: the contribution to people's health and well-being and implications for future management.

In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin's ideas of co-construction and Gibson's theory of affordances. We focus on peri-urban woodlands in England as important places where people can interact with nature for health and well-being. Qualitative data were collected in situ via walks in the woods, focus group discussions and photo elicitation, with a sample of 49 people. These methods provide rich data on the wide range of meanings associated with woodlands that can have a perceived impact on people's health and well-being. The findings link to contemporary debates about health, well-being and ecosystem services. We explore the inter-play between attributes of the physical environment and the range of facilities provided to enable access, social interactions and the benefits people attribute to their woodland experiences. We conclude that peri-urban woodlands can clearly contribute to self-reported health and well-being in multiple ways, and that organized activities can be important for those who face barriers to accessing woodlands. A strong message emerging from the research is the opportunity afforded by woodlands for social connections with others, as well as the provision of a range of sensory benefits and opportunities to observe and enjoy seasonal change in woodlands. Mental restoration via connection with nature also emerged as important, confirming previous research.

Use of ethnographic approaches to the study of health experiences in relation to natural landscapes.

AIMS: This paper discusses the use of ethnographic approaches to explore how engagement with natural landscapes might benefit people's health. METHODS: Drawing on a selected review of empirical research we identified 30 relevant research papers that utilised qualitative methods to explore health issues and engagement with nature. Three examples of 'alternative' - i.e. non-mainstream qualitative approaches - are used to illustrate how different methods can be used to explore people's experiences of engaging with nature for health. RESULTS: While quantitative methods are dominant in health research, qualitative approaches are becoming more widely used. Approaches such as autoethnography can add value to nature and health studies by providing opportunities for researchers to be self-critical of their role as a researcher. Accompanied visits and visual ethnography can afford the researcher rich data about bodily movement, facial expressions and journeys, as well as dialogues associated with the meanings of nature for health. CONCLUSIONS: The paper concludes by suggesting that ethnographic methods can provide useful and important insights into why people engage with the natural environment and the range of health benefits they may gain from contact with nature.

Frameworks for risk communication and disease management: the case of Lyme disease and countryside users.

Management of zoonotic disease is necessary if countryside users are to gain benefit rather than suffer harm from their activities, and to avoid disproportionate reaction to novel threats. We introduce a conceptual framework based on the pressure-state-response model with five broad responses to disease incidence. Influencing public behaviour is one response and requires risk communication based on an integration of knowledge about the disease with an understanding of how publics respond to precautionary advice. A second framework emphasizes how risk communication involves more than information provision and should address dimensions including points-of-intervention over time, place and audience. The frameworks are developed by reference to tick-borne Lyme borreliosis (also known as Lyme disease), for which informed precautionary behaviour is particularly relevant. Interventions to influence behaviour can be directed by knowledge of spatial and temporal variation of tick abundance, what constitutes risky behaviour, how people respond to information of varying content, and an understanding of the social practices related to countryside use. The frameworks clarify the response options and help identify who is responsible for risk communication. These aspects are not consistently understood, and may result in an underestimation of the role of land-based organizations in facilitating appropriate precautionary behaviour.

Volunteering in nature as a way of enabling people to reintegrate into society.

AIMS: Those who experience emotional and behavioural difficulties or mental health problems, are unemployed or bereaved, or have been in trouble with the law can be socially marginalized and can become isolated from their families, community and wider society. This paper explores the role of active hands-on contact with the environment through a general environmental volunteering programme and through a targeted therapeutic volunteer programme, highlighting how these two approaches can potentially aid some marginalized people to reintegrate into society. METHODS: This study draws on concepts from the well-being and social capital literatures and refers to two separate pieces of research: Study 1 was based on general environmental volunteering primarily in northern England and southern Scotland; and Study 2 focused on mental health participants at Meanwhile Wildlife Garden in London. Ethnographic and interview data were gathered from participants as a means to understand the benefits they gained from their voluntary involvement. The participants all volunteered to undertake the activities they were involved in and chose outdoor nature activity as opposed to other activities. RESULTS: There is self-reported and observed evidence from and of participants in these studies that contact with nature can be beneficial to a range of excluded groups; also the studies show that the learning and curative processes that take place in green spaces can provide benefits in terms of social reintegration of vulnerable young people and adults. Three key themes of particular relevance to the marginalized participants were identified as: (1) improving relations with others and nature; (2) working alongside others who are different; and (3) developing social and employable skills. Active hands-on engagement allows people to work at their own pace, since these approaches are not target focused, and skills and social networks can be developed slowly. Practical engagement in environmental conservation work is one approach that may provide people with a new role, identity, skills and social networks. This paper argues that volunteering in nature has the potential to provide a shared purpose for people, independent of gender, age, physical ability, mental functioning, socioeconomic status or knowledge of environmental management. However, it is recognized that particular people may and do experience barriers to engaging with and enjoying the natural environment. CONCLUSIONS: Volunteering in nature may be particularly effective for those who would like to be outdoors and have more contact with nature yet need specific encouragement and supported/led activities to participate.

The natural outdoors and health: assessing the value and potential contribution of secondary public data sets in the UK to current and future knowledge.

UK policy interest in the health effects of the outdoors has grown rapidly in recent years. In parallel, the research community's effort to strengthen the evidence base for the relationships between the outdoors and health has also increased. However, little has been done to explore quantitative secondary public data sets conducted by government departments and agencies to improve the evidence base on understanding such links. This paper aims to provide an overview of potentially valuable secondary public data sets and to assess their relevance for adding to the existing evidence base on the health effects of the natural outdoors. The search identified 41 data sets dealing with the outdoors/outdoor use, health or both. Review results indicated that, due to their large scale, extensive coverage, and continuous or longitudinal nature, knowledge included in secondary public data sets could be a valuable addition to the current evidence base and provide useful baseline information for future studies. This paper also identifies some aspects of secondary public data which could be improved, establishing a stronger knowledge base for the health effects of the natural outdoors.