How do different types and characteristics of green space impact mental health? A scoping review

1. Green space matters for mental health but is under constant pressure in an increasingly urbanising world. Often there is little space available in cities for green areas, so it is vital to optimise the design and usage of these available green spaces. To achieve this, experts in planning, design and nature conservation need to know which types and characteristics of green spaces are most beneficial for residents' mental health. 2. A scoping review of studies that compare different green space types and characteristics on mental health was conducted. A total of 215 (experimental, observational and qualitative) papers were included in the scoping review. 3. This review highlights a high level of heterogeneity in study design, geographical locations, mental health outcomes and green space measures. Few of the included studies were specifically designed to enable direct comparisons between green space types and characteristics (e.g. between parks and forests). The included studies have predominantly experimental research designs looking at the effects of short-term exposure to green space on short-term mental health outcomes (e.g. affect and physiological stress). More studies enabled only indirect comparisons, either within the same study or between different studies. 4. Analysis of the direction of the mental health outcomes (positive, neutral, negative) from exposure to various types and characteristics of green space found positive (i.e. beneficial) effects across all green space types. However, green space characteristics did appear to render more diverse effects on mental health, which is especially the case for vegetation characteristics (e.g. higher vegetation density can be negative for mental health). 5. The scoping review reveals gaps in the present evidence base, with a specific need for more studies directly comparing green space types and characteristics within the same study. Proposed future research directions include the use of longitudinal research designs focusing on green space characteristics, considering actual exposure and systematically addressing heterogeneity in factors influencing the relation between green spaces and mental health (e.g. type of interaction, user experience)

The impact of open versus closed format ICU admission practices on the outcome of high risk surgical patients: a cohort analysis

<p>Abstract</p> <p>Background</p> <p>In the year 2000, the organizational structure of the ICU in the Zaandam Medical Centre (ZMC) changed from an open to a closed format ICU. The objective of this study was to evaluate the effect of this organizational change on outcome in high risk surgical patients.</p> <p>Methods</p> <p>The medical records of all consecutive high risk surgical patients admitted to the ICU from 1996 to 1998 (open format) and from 2003 to 2005 (closed format), were reviewed. High-risk patients were defined according to the Identification of Risk in Surgical patients (IRIS) score. Parameters studied were: mortality, morbidity, ICU length of stay (LOS) and hospital LOS.</p> <p>Results</p> <p>Mortality of ICU patients was 25.7% in the open format group and 15.8% in the closed format group (p = 0.01). Morbidity decreased from 48.6% to 46.1% (p = 0.6). The average length of hospital stay was 17 days in the open format group, and 21 days in the closed format group (p = 0.03).</p> <p>Conclusions</p> <p>High risk surgical patients in the ICU are patients that have undergone complex and often extensive surgery. These patients are in need of specialized treatment and careful monitoring for maximum safety and optimal care. Our results suggest that closed format is a more favourable setting than open format to minimize the effects of high risk surgery, and to warrant safe outcome in this patient group.</p

A microcosting study of microsurgery, LINAC radiosurgery, and gamma knife radiosurgery in meningioma patients

The aim of the present study is to determine and compare initial treatment costs of microsurgery, linear accelerator (LINAC) radiosurgery, and gamma knife radiosurgery in meningioma patients. Additionally, the follow-up costs in the first year after initial treatment were assessed. Cost analyses were performed at two neurosurgical departments in The Netherlands from the healthcare providers’ perspective. A total of 59 patients were included, of whom 18 underwent microsurgery, 15 underwent LINAC radiosurgery, and 26 underwent gamma knife radiosurgery. A standardized microcosting methodology was employed to ensure that the identified cost differences would reflect only actual cost differences. Initial treatment costs, using equipment costs per fraction, were €12,288 for microsurgery, €1,547 for LINAC radiosurgery, and €2,412 for gamma knife radiosurgery. Higher initial treatment costs for microsurgery were predominantly due to inpatient stay (€5,321) and indirect costs (€4,350). LINAC and gamma knife radiosurgery were equally expensive when equipment was valued per treatment (€2,198 and €2,412, respectively). Follow-up costs were slightly, but not significantly, higher for microsurgery compared with LINAC and gamma knife radiosurgery. Even though initial treatment costs were over five times higher for microsurgery compared with both radiosurgical treatments, our study gives indications that the relative cost difference may decrease when follow-up costs occurring during the first year after initial treatment are incorporated. This reinforces the need to consider follow-up costs after initial treatment when examining the relative costs of alternative treatments

Co-designing Urban Living Solutions to Improve Older People’s Mobility and Well-Being

Mobility is a key aspect of active ageing enabling participation and autonomy into later life. Remaining active brings multiple physical but also social benefits leading to higher levels of well-being. With globally increasing levels of urbanisation alongside demographic shifts meaning in many parts of the world this urban population will be older people, the challenge is how cities should evolve to enable so-called active ageing. This paper reports on a co-design study with 117 participants investigating the interaction of existing urban spaces and infrastructure on mobility and well-being for older residents (aged 55 + years) in three cities. A mixed method approach was trialled to identify locations beneficial to subjective well-being and participant-led solutions to urban mobility challenges. Spatial analysis was used to identify key underlying factors in locations and infrastructure that promoted or compromised mobility and well-being for participants. Co-designed solutions were assessed for acceptability or co-benefits amongst a wider cross-section of urban residents (n = 233) using online and face-to-face surveys in each conurbation. Our analysis identified three critical intersecting and interacting thematic problems for urban mobility amongst older people: The quality of physical infrastructure; issues around the delivery, governance and quality of urban systems and services; and the attitudes and behaviors of individuals that older people encounter. This identified complexity reinforces the need for policy responses that may not necessarily involve design or retrofit measures, but instead might challenge perceptions and behaviors of use and access to urban space. Our co-design results further highlight that solutions need to move beyond the generic and placeless, instead embedding specific locally relevant solutions in inherently geographical spaces, populations and processes to ensure they relate to the intricacies of place

Spatial and temporal evolution of distal 10q deletion, a prognostically unfavorable event in diffuse low-grade gliomas

Peer reviewe

Biodiversity and health in the urban environment

Biodiversity underpins urban ecosystem functions that are essential for human health and well-being. Understanding how biodiversity relates to human health is a developing frontier for science, policy and practice. This article describes the beneficial, as well as harmful, aspects of biodiversity to human health in urban environments. Recent research shows that contact with biodiversity of natural environments within towns and cities can be both positive and negative to human physical, mental and social health and well-being. For example, while viruses or pollen can be seriously harmful to human health, biodiverse ecosystems can promote positive health and well-being. On balance, these influences are positive. As biodiversity is declining at an unprecedented rate, research suggests that its loss could threaten the quality of life of all humans. A key research gap is to understand-and evidence-the specific causal pathways through which biodiversity affects human health. A mechanistic understanding of pathways linking biodiversity to human health can facilitate the application of nature-based solutions in public health and influence policy. Research integration as well as cross-sector urban policy and planning development should harness opportunities to better identify linkages between biodiversity, climate and human health. Given its importance for human health, urban biodiversity conservation should be considered as public health investment

Assessment protocol and effects of two dynamic light patterns on human well-being and performance in a simulated and operational office environment

Sophisticated electric lighting solutions like tuneable white-light LED-systems, varying in light amount and/or colour temperature, can help to supplement or mimic daylight. Today's office environments are increasingly being equipped with dynamic lighting solutions even though it is yet unknown what a dynamic pattern looks like to optimally support human performance and well-being. In a pilot study, a dual-experimental methodology was employed to examine the effects of a dynamic lighting pattern. Two opposite dynamic electric light patterns were applied both in a controlled laboratory study as well as in a quasi-controlled field study. A momentary questionnaire concerning different aspects of well-being was repeated multiple times during the duration of the experiment, complemented by two performance tasks. The current results were inconclusive and inconsistent between the two study types, carefully pointing at the need to test dynamic light patterns in the field before implementing it in a real office environment