Anthropogenic impacts on urban blue space and its reciprocal effect on human and socio-ecological health.

Quantifying anthropogenic impacts on blue space (BS) and its effect on human and socio-ecological health was least explored. The present study aimed to do this in reference to the urban BS transformation scenario of Eastern India. To measure BS transformation, Landsat image-based water indices were run from 1990 to 2021. Anthropogenic impact score (AIS) and 7 components scores of 78 selected BS on 70 parameters related data driven from the field. Total 345 respondents were taken for human and socio-ecological health assessment. For this, depression (DEP), anxiety (ANX), stress (STR), physical activities (PA), social capital (SC), therapeutic landscape (TL) and environment building (EB) parameters were taken. The result exhibited that BS was reduced. About 50% of urban core BS was reported highly impacted. Human and socio-ecological health was identified as good in proximity to BS, but it was observed better in the cases of larger peripheral BS. AIS on BS was found to be positively associated with mental health (0.47-0.63) and negatively associated with PA, SC, TL and EB (-0.50 to -0.90). Standard residual in ordinary least square was reported low (-1.5 to 1.5) in 95% BS. Therefore, BS health restoration and management is crucial for sustaining the living environment.

Community environmental healing benefits: A systematic review comparing intervening variables, environments, and outcomes.

As the smallest spatial unit in the city, the community should be an important space for healing the urban population. This paper presents a systematic review summarizing studies on community healing environments. The study identified 75 publications. The research findings are as follows: the main intervening variables include restorativeness, emotions and mood, stress, and well-being. Little attention has been paid to the intervening variables including social support, environmental preferences and satisfaction, place attachment, behavior types that respond to personal will, self-fulfillment, and the spirit of personal culture. The various types of natural environments in communities have been given focused attention for a long time. However, the superiority of the natural environment should not be a reason to underestimate the healing benefits of community spaces. The mechanisms by which environmental characteristics are transformed into positive individual influences through intervening variables should be explored.

[Spatial turn : Opportunity, challenge and methodological momentum for geographical health research]. / "Spatial turn" : Chance, Herausforderung und Methodenimpuls für die geographische Gesundheitsforschung.

The (re)-discovery of the spatial dimension in many sciences has been guided for some time under the designation "spatial turn". Immense progress in geographic information sciences (GIS), global positioning systems (GPS), remote sensing and computer-aided cartography, in addition to geostatistical methods such as spatial distribution analysis and trend analysis, multi-level analysis, spatial data-mining and agent-based modelling, has created entirely new opportunities for spatial analysis and the modelling of spatial, health-relevant processes. These methods are increasingly being employed in epidemiology, public health and healthcare research.In the fields of cultural and social sciences, "spatial turn" refers to a paradigm shift that recognizes that geographical space also has a social and cultural meaning. This spatial conception considers space not only as an empty container, but also as a result of social processes. The Euclidean space is extended by socially and culturally shaped spatial perceptions and constructions. The "spatial turn" as a paradigm shift is not limited to the fact that space itself becomes an object of advanced investigation methods. It is instead about approaching objects of research with spatial categories.In light of the "spatial turn", geographical health research is currently facing great opportunities, but also a double challenge: on the one hand, recognizing, mediating and making meaningful use of the new methodological possibilities. On the other hand, and in line with its self-conception as a part of the medical humanities, it is challenged to implement the "spatial turn" in its social and cultural-scientific dimension, to go beyond stereotypical reception and to meet the paradigmatic significance of "spatial turn".

"It is like post-traumatic stress disorder, but in a positive sense!": New territories of the self as inner therapeutic landscapes for youth experiencing mental ill-health.

The manuscript reports on a study conducted on a youth mental health intervention, proposing a novel framework to look at the therapeutic potential of viticultural landscapes. Drawing on care studies applied to agricultural contexts, the work explores how the attention-based practice of manual grape harvest in a specific natural and social environment can produce a "therapeutic landscape of the mind". Through ethnographic research, we investigate how the spatial and social context of the viticultural environment influences the experience of a group of young people with mental-ill health, eventually supporting their process of recovery. Findings describe how the lived experience of caring for the vines while interacting with professional winegrowers in a one-to-one relationship allows participants to explore new territories of the self. It is argued that this powerful experience is not only beneficial as it unfolds, but also at a later time. Its therapeutic potential resides in the fact that the "landscape of the mind" can be recalled by the person, while positive identities associated with it and newly discovered "ways of being" can be re-enacted. The paper furthers the reflection on place-making practices of public health services and the way they can support the identification and cultivation of enabling places, particularly for vulnerable populations (e.g. young people) that can benefit from interventions conducted in non-medical, non-stigmatizing environments. The work is the result of an interdisciplinary collaboration between a psychiatrist (designing and coordinating the intervention) and a sociologist (designing and conducting the ethnographic study).

Exploring predictors of substance use disorder treatment engagement with machine learning: The impact of social determinants of health in the therapeutic landscape.

BACKGROUND: Improved knowledge of factors that influence treatment engagement could help treatment providers and systems better engage patients. The present study used machine learning to explore associations between individual- and neighborhood-level factors, and SUD treatment engagement. METHODS: This was a secondary analysis of the Global Appraisal of Individual Needs (GAIN) dataset and United States Census Bureau data utilizing random forest machine learning and generalized linear mixed modelling. Our sample (N = 15,873) included all people entering SUD treatment at GAIN sites from 2006 to 2012. Predictors included an array of demographic, psychosocial, treatment-specific, and clinical measures, as well as environment-level measures for the neighborhood in which patients received treatment. RESULTS: Greater odds of treatment engagement were predicted by adolescent age and psychiatric comorbidity, and at the neighborhood-level, by low unemployment and high population density. Lower odds of treatment engagement were predicted by Black/African American race, and at the neighborhood-level by high rate of public assistance and high income inequality. Regardless of the degree of treatment engagement, individuals receiving treatment in areas with high unemployment, alcohol sale outlet concentration, and poverty had greater substance use and related problems at baseline. Although these differences reduced with treatment and over time, disparities remained. CONCLUSIONS: Neighborhood-level factors appear to play an important role in SUD treatment engagement. Regardless of whether individuals engage with treatment, greater loading on social determinants of health such as unemployment, alcohol sale outlet density, and poverty in the therapeutic landscape are associated with worse SUD treatment outcomes.

Analysis of the Dong bao Ye as sacred landscape and its Putative therapeutic mechanisms.

Humans have innately established close and profound ties with the, and through these relationships shaped many kinds of landscapes. Among these are sacred landscapes, which have drawn the attention of researchers due to their cultural significance. In the field of health geography, large-sized sacred regional landscapes are now the focus of studies for their therapeutic properties. However, few scholars have focused on small sacred landscape systems at the community level (constructed by local communities) or the physical and psycological health benefits that these landscapes offer to the local residents. These small-sized and widespread, but often hidden, sacred landscapes are closely tied to people's daily lives and work. They have evolved and grown over millennia to become critical sociocultural phenomena. This study takes the sacred bao ye landscape of the Dong people of China as the research subject. By adopting the case study approach, field research, semi-structured interviews, and textual analysis, it summarizes the types, geographical distribution, rituals and processes of bao ye as a sacred landscape of the Huanggang village in Guizhou Province, and concludes with an analysis of motivation and health benefits to the bao ye worship. In this paper we argue that bao ye is a sacred landscape system focusing on the healthy development of children, and constitutes a local belief developed in an isolated environment lacking medical resources, which remains in practice. The sacred landscape of bao ye offers a therapeutic environment, providing children with increased opportunities to engage with and build deep connections to nature. Thruogh this process children may develop a bond with nature that inspires them to protect nature on their own accord. We argue that bao ye offers an important case study for understanding the landscape-people-healing interactivity at the community level.

Immunotherapy with Monoclonal Antibodies for Acute Myeloid Leukemia: A Work in Progress.

In the last few years, molecularly targeted agents and immune-based treatments (ITs) have significantly changed the landscape of anti-cancer therapy. Indeed, ITs have been proven to be very effective when used against metastatic solid tumors, for which outcomes are extremely poor when using standard approaches. Such a scenario has only been partially reproduced in hematologic malignancies. In the context of acute myeloid leukemia (AML), as innovative drugs are eagerly awaited in the relapsed/refractory setting, different ITs have been explored, but the results are still unsatisfactory. In this work, we will discuss the most important clinical studies to date that adopt ITs in AML, providing the basis to understand how this approach, although still in its infancy, may represent a promising therapeutic tool for the future treatment of AML patients.

Spending time in the forest or the field: qualitative semi-structured interviews in a randomized controlled cross-over trial with highly sensitive persons.

Introduction: The effects of spending time in forests have been subject to investigations in various countries around the world. Qualitative comparisons have been rarely done so far. Methods: Sixteen healthy highly sensitive persons (SV12 score ≥ 18) aged between 18 and 70 years were randomly assigned to groups spending 1 h in the forest and in the field at intervals of one week. Semi-structured interviews were conducted after each intervention and analyzed using a mixed-methods approach of content analysis and grounded theory. Results: Both natural environments induced feelings of inner calmness, inner cleansing, joy, freedom, connectedness, strengthening qualities, and heightened body awareness. The forest environment additionally offered emotional shelter, and showed advantages in promoting inner strength and self-concentration. Discussion: People with previous negative experiences in the forest may feel safer in fields because of the wider view and better overview. Important preconditions are enough time and the absence of a judgmental authority. The two environments induced in part different but also similar emotions which might be useful to promote psychological well-being differentially.

Research on patient-centered design for post-stroke depression patients based on SEM and comprehensive evaluation.

Introduction: Since COVID-19, medical resources have been tight, making it inconvenient to go offline for the sequelae of diseases such as post-stroke depression (PSD) that require long-term follow-up. As a new digital therapy, VRTL began to gain popularity. Method: The research is divided into two parts: pre-test and post-test. In the pre-test, an evaluation method integrating reality-based interaction (RBI), structural equation model (SEM), analytic hierarchy process (AHP), and entropy weight method is proposed. In the post-test the patients' physiological indicators (Diastolic blood pressure, systolic blood pressure and heart rate) are measured to verify the effectiveness of RBI-SEM model using T-test method. Results: In the pre-test, using SEM, it was confirmed that Pi physical awareness, Bi body awareness, Ei environmental awareness, and Si social awareness were significantly correlated and positively affected VRTL satisfaction (p >> F 0.217; B >> F 0.130; E >> F 0.243; S >> F 0.122). The comprehensive weight ranking based on RBI-SEM considered light environment (0.665), vegetation diversity (0.667), accessible roaming space (0.550) et al. relatively of importance. And T-tset in the post-test experiment considered that the data of the two measurements before and after the VRTL experience, systolic blood pressure (p < 0.01), diastolic blood pressure (p < 0.01), and blood pressure (p < 0.01) were significantly decreased; one-way ANOVA concluded that there was no significant difference in the changes of blood pressure and heart rate among participants of different ages and genders (p > 0.01). Conclusion: This research validated the effectiveness of RBI theory for VRTL design guidelines, established an RBI-SEM based VRTL evaluation model, and the output VRTL for PSD in the older adults was confirmed to have significant therapeutic benefits. This lays the foundation for designers to decompose design tasks and integrate VRTL into traditional clinical treatment systems. Contribution from the public or patients: Four public health department employees helped to improve the research's content.

Health perception and restorative experience in the therapeutic landscape of urban wetland parks during the COVID-19 pandemic.

Introduction: The effects of restoration and inspiration in the therapeutic landscape of natural environments on visitors during the COVID-19 pandemic have been well-documented. However, less attention has been paid to the heterogeneity of visitor perceptions of health and the potential impacts of experiences in wetland parks with green and blue spaces on visitors' overall perceived health. In this study, we investigate the impact of the restorative landscapes of wetland parks on visitors' health perceptions in the context of the COVID-19 pandemic. Methods: In our survey, 582 respondents participated in an online questionnaire. We analyzed the respondents' health perceptions in terms of latent class analysis, used multinomial logistic regression to determine the factors influencing the potential categorization of health perceptions, and used structural equation modeling to validate the relationships between health perceptions of different groups and landscape perceptions of wetland parks, restorative experiences, and personality optimistic tendencies. Results: The results identified three latent classes of health perceptions. Gender, marital status, education, occupation, income, distance, frequency of activities, and intensity of activities were significant predictors of potential classes of perceived health impacts among wetland park visitors. Discussion: This study revealed the nature and strength of the relationships between health perception and landscape perception, restorative experience, and dispositional optimism tendencies in wetland parks. These findings can be targeted not only to improve visitor health recovery but also to provide effective references and recommendations for wetland park design, planning, and management practices during and after an epidemic.

What makes a space safe? Consumers' perspectives on a mental health safe space.

The provision of community-based space for people experiencing a mental health crisis is regarded as a favourable alternative to the emergency department. However, the only non-emergency department safe spaces in Western Australia are located within hospitals or hospital grounds. This qualitative study asked mental health consumers in Western Australia with experience of presentation at the emergency department during a mental health crisis to describe what a safe space would look and feel like. Data were collected through focus groups and thematically analysed. The findings present the voices of mental health consumers through the framework of health geography and the therapeutic landscape. These participants articulated important physical and social features of a therapeutic safe space and their symbolism as inclusive, accessible places where they would experience a sense of agency and belonging. Participants also expressed a need for trained peer support within the space to complement the skilled professional mental health team. Participants' experiences of the emergency department during mental health crises were described as contrary to their recovery needs. The research reinforces the need for an alternative to the emergency department for adults who experience mental health crises and provides consumer-led evidence to inform the design and development of a recovery-focused safe space.

Retinitis Pigmentosa: Pathogenesis, Diagnostic Findings, and Treatment.

Retinitis Pigmentosa (RP) is an inherited retinal dystrophy (IRD) that causes progressive visual loss. Patients suffering from RP have a substantial influence on their everyday activities, social contacts, and jobs, lowering their quality of life. Frequent referral delays, as well as the lack of a standard therapy for the majority of patients, contribute to the significant unmet demand for RP. Any retinal injury has the potential to result in total blindness and visual impairment. Despite the fact that there is no cure for RP, people can manage it using rehabilitation programs and low-vision gadgets. The purpose of this research is to characterize the expanding treatment landscape for RP, as well as the justification for advanced therapy medicinal products (ATMPs). Vitamin A supplements can help prevent the sluggish visual loss caused by a prevalent kind of RP. The presence of visual purple in the rods and the underlying vascular choroid causes the retina to look purplish red. The major portion of the retina damaged is the rod photoreceptor electric cell; the development of diverse diseases is progressive. Because of the retina's accessibility, immunological privilege, and compartmentalization, hereditary retinal diseases are amenable to cell and gene therapy. Therapeutic techniques that attempt to rescue photoreceptors (gene therapies) require the existence of non-functional target cells, but other therapies (cell therapies) do not require the presence of live photoreceptors. To provide successful therapy choices for RP patients at all disease phases, the development pipeline must be continually diversified and advanced, as well as ongoing efforts to encourage early patient identification and quick diagnosis. Future research will focus on avoiding vision loss in genetic eye illnesses and assisting patients in regaining their eyesight. Retinal implants, cell therapies, supplementary medications, and gene therapies may become common treatments for reducing vision loss in the future.

Urban Blue Spaces as Therapeutic Landscapes: "A Slice of Nature in the City".

Urban blue spaces are defined as all natural and manmade surface water in urban environments. This paper draws on how the concepts of experienced, symbolic, social, and activity space combine to position urban blue spaces as therapeutic landscapes. We conducted 203 intercept interviews between 12 October 2019 and 10 November 2019. Although safety concerns had health-limiting impacts, interacting with the Glasgow Canal and surrounding landscape was predominantly perceived as health-enhancing. Our findings build on current evidence, which has suggested that urban blue spaces, particularly canals, may foster therapeutic properties, contributing to healthier city environments. Further research is required to understand better the interconnectedness of urban blue spaces and health and how such spaces can be best developed and managed to improve the health outcomes of local populations.

Current and Future Treatment of Retinitis Pigmentosa.

Retinitis Pigmentosa (RP) is a group of inherited retinal dystrophies (IRDs) characterised by progressive vision loss. Patients with RP experience a significant impact on daily activities, social interactions, and employment, reducing their quality of life. Frequent delays in referrals and no standard treatment for most patients also contribute to the high unmet need for RP. This paper aims to describe the evolving therapeutic landscape for RP including the rationale for advanced therapy medicinal products (ATMPs). A review of available data was conducted in three stages: (1) a search of publicly available literature; (2) qualitative research with physicians treating RP patients in France, Germany, Italy, Spain, and the UK; and (3) a review of leading candidates in the RP pipeline. Globally, there are currently over 100 drugs in development for RP; 50% of which are ATMPs. Amongst the 15 cell and gene therapies in late-stage development, 5 leading candidates have been selected to profile based on the development stage, drug target and geography: gene therapies AGN-151597, GS-030 and VMCO-1 and human stem cell therapies jCell and ReN-003. Hereditary retinal diseases are suitable for treatment with cell and gene therapies due to the accessibility of the retina and its immune privilege and compartmentalisation. Therapeutic approaches that aim to rescue photoreceptors (eg gene therapies) require that non-functional target cells are still present, whereas other therapies (eg cell therapies) are not reliant on the presence of viable photoreceptors. Gene therapies may be attractive as their fundamental goal is to restore vision; however, cell therapies will likely have a broader application and do not rely on genetic testing, which can delay treatment. Ensuring effective therapeutic options for RP patients across disease stages requires the continued diversification and advancement of the development pipeline, and sustained efforts to promote early patient identification and timely diagnosis.

Spending Time in the Forest or the Field: Investigations on Stress Perception and Psychological Well-Being-A Randomized Cross-Over Trial in Highly Sensitive Persons.

Research suggests that stays in a forest promote relaxation and reduce stress compared to spending time in a city. The aim of this study was to compare stays in a forest with another natural environment, a cultivated field. Healthy, highly sensitive persons (HSP, SV12 score > 18) aged between 18 and 70 years spent one hour in the forest and in the field at intervals of one week. The primary outcome was measured using the Change in Subjective Self-Perception (CSP-14) questionnaire. Secondary outcomes were measured using the Profile Of Mood States (POMS) questionnaire and by analyzing salivary cortisol. We randomized 43 participants. Thirty-nine were allocated and included in the intention-to-treat analysis (90% female, mean age 45 years). CSP-14 in part showed significant differences-total score (p = 0.054, Cohen's d = 0.319), item "integration" (p = 0.028, Cohen's d = 0.365)-favoring the effects of the forest. These effects were more pronounced in summer (August). In October, during rainfall, we detected no relevant differences. POMS only showed a significant difference in the subcategory "depression/anxiety" in favor of the field. The amount of cortisol in saliva was not different between the groups. A short-term stay in a forest in summer caused a greater improvement in mood and well-being in HSP than in a field. This effect was not detectable during bad weather in the fall.

Photovoice accounts of third places: Refugee and asylum seeker populations' experiences of therapeutic space.

This article draws on a photo-voice project carried out in the North West, UK, with 30 members of the asylum seeker and refugee population. The findings explore participants' experiences of 'third places' (for example, public green space and libraries), that were distinctly set apart from the domestic dwelling (first places), and institutional sites of exclusion, for example, immigration reporting centres (second places). These third places became affective sanctuaries that allowed for emotional retreat in the midst of the UK's exclusionary and repressive asylum regime. Moreover, for this group third places were places where participants could (re)connect with identities beyond the refugee label, and where cultural and transnational ties could be fostered. It is important that policy makers do not overlook the significance of third places for the wellbeing of community members, particularly asylum seeker and refugee populations.

The therapeutic landscape of hepatocellular carcinoma.

The liver is endowed with an amazing regenerative capacity that allows it to withstand an enormous amount of damage. Nevertheless, it is precisely this highly regenerative capacity that renders it susceptible to dysplasia and liver cancer. Liver cancer is not only one of the most common cancers but also one of the deadliest. Hepatocellular carcinoma (HCC) is the most common form of liver cancer, accounting for up to 70%-90% of all cases, but treatment options for advanced stages remain scarce. Therefore, a great deal of effort has gone into identifying early diagnostic markers as well as novel therapies, both local and systemic, for the treatment of this deadly disease. In this review, we aim to shed light into the current therapeutic landscape of HCC with an emphasis on the available treatments, ranging from surgical and local-ablative therapy for early and intermediate stages of the disease to systemic therapies for advanced cancer treatments. We will also address the molecular mechanisms and limitations of currently available systemic therapies and the causes of treatment resistance and finally summarize the emerging future avenues and novel concepts that are promising.

Health tourism destinations as therapeutic landscapes: Understanding the health perceptions of senior seasonal migrants.

Health-driven seasonal tourism has become a new way of providing for the aged, which demonstrates a profound relationship between place and health. Therapeutic landscapes strongly suggest a causal relationship between health tourism destination and individual health. However, the quantitative validation of such relationship remains neglected and possible mechanisms underlying the relationship lack a strong theoretical basis. Based on therapeutic landscape theory and the REPLACE framework, this study quantitatively examines health promotion mechanisms of health tourism destinations by using data collected in Sanya, China, in January 2019. The effect of personal traits of dispositional optimism on health perceptions is also considered. The results show that physical, social, and symbolic landscapes positively influence health perceptions through restorative experiences. Social landscapes, symbolic landscapes and dispositional optimism positively affect health perception, while physical landscapes do not directly have a significant impact on health perception. It is expected that this study will fill the knowledge gap and advance our knowledge of therapeutic landscapes by exploring how they can influence health.

Influence of Nature at the Time of the Pandemic: An Experience-Based Survey at the Time of SARS-CoV-2 to Demonstrate How Even a Short Break in Nature Can Reduce Stress for Healthcare Staff.

AIM: The current COVID-19 pandemic has been causing significant upheavals in the daily lives of citizens and consequently also their mood (stress, distraction, anxiety, etc.), especially during the lockdown phase. The aim of the investigation is to evaluate the benefits of 20-30 minutes in contact with nature. BACKGROUND: The Scientific Community, also through the evidence-based design approach, has already demonstrated the importance of greenery and nature on the psychophysical well-being of people and, in a moment of emergency, contact with the nature can be therapeutic and quite influential on the mental health of staff subject to stress. METHOD: During the lockdown, an Italian multidisciplinary working group promoted an experience-based survey, based on the Profile of Mood States methodology, for measuring the psychophysical well-being of hospital staff. RESULTS: The author collected 77 questionnaires. The benefits that users have obtained from the experience in nature have been investigated by comparing the type of stresses they were subjected to and highlighting various peculiarities in the data analysis associated with the type of green in which they carried out the survey, the healthcare areas in which they worked during the pandemic emergency, and the moment in which the survey was conducted. CONCLUSIONS: The study has highlighted that a short break in green spaces strongly influenced the mental and psychophysical well-being of hospital staff, emphasizing the importance of nearby green spaces in architectures for health. Even a brief break in nature can regenerate users, especially in times of a stressful health emergency.

The co-evolution of therapeutic landscape and health tourism in bama longevity villages, China: An actor-network perspective.

Many locales featuring therapeutic landscapes have seen a rise in health tourism recent years. This study introduces an actor-network perspective to examine the co-evolution of therapeutic landscapes and health tourism, and its inherent dynamism. We argue that therapeutic landscapes and health tourism are emerging out of an integrated actor-network, and thus are in continuous processes of (re)ordering and co-evolution. We also propose a typology of dynamics for the study of such an actor-network, substantiated with an empirical study of the Bama longevity villages in China, in which four interrelated and cascaded dynamics are closely scrutinized: tourists as part of the therapeutic landscape; tourism's impact on the landscape; the heterogeneous therapeutic perceptions of tourists; and the extension of the therapeutic network by health tourism. This study contributes to the relational thinking of therapeutic landscapes and health tourism, and enriches the understanding of their interlacing dynamics from the vantage point of the tourismscape.