What evidence is there to support the impact of gardens on health outcomes? A systematic scoping review of the evidence

According to the World Health Organisation Global Health Observatory (2017), non-communicable diseases (NCD’s) present a significant cause of death through cardiovascular disease, respiratory conditions and type 2 diabetes. The impact of NCDs on health and social care is estimated to outstrip service provision and the drive to promote health and well-being to tackle the key causes of NCD’s is at the vanguard of UK, European and global health care policy. There is a need for health and social care commissioners to examine and commission new treatment interventions that can offer multipurpose interventions for people in the community with LTC and co-morbid conditions. It is claimed that nature based activities, such as therapeutic horticulture or gardening activity, can improve health and wellbeing for a range of people with long-term conditions. Nature Based Activities have been defined as ‘an intervention with the aim to treat, hasten recovery, and/or rehabilitate patients with a disease or a condition of ill health, with the fundamental principle that the therapy involves plants, natural materials, and/or outdoor environment, without any therapeutic involvement of extra human mammals or other living creatures’ (Annerstedt & Währborg 2011). This includes, amongst other activities, gardens as a nature based activity that encourages individuals to engage with, observe or access. This review has located and described research evidence that has reported on the impact of gardens on physical, mental, health and well being. A systematic approach was used to scope the evidence base across a range of data bases and external sources. The review reports on the following: - How gardens can improve physical, mental, health and wellbeing outcomes - A ‘map’ of the literature in relation to the benefits for particular conditions , types of garden, and health outcomes - The gaps in the literature in relation to particular conditions, garden types and health outcomes - Gardens as an intervention within the social prescribing movement - Infographics and a logic models, which capture the data in a simple way. These can be used to inform the future development of the RHS therapeutic garden and for organisations interested in green care or nature-based activities This report has provided an overview of the evidence for gardens as an intervention that could promote health and wellbeing in a range of populations. This has significance for public health and health care as there is a precedence to explore alternative methods of service provision. The findings from this review report on the impact of gardens and gardening on four key areas: Mental Health, Dementia, Wellbeing, Specific Conditions using Physiological Outcome Measures and Nutrition. The review evidence indicated that nature based activities such as gardens (in the range of formats) can help social inclusion, self-esteem and perceived wellbeing. Although the methodologies and interventions varied, the evidence base overwhelming supported the use of gardens as an activity that could promote wellbeing. Moreover, these activities were reflected in the Bragg et al (2016) Green Framework which suggests that gardens positively impact on people through everyday life such as home gardening, health promotion through nature based activates such as digging and community gardening through to and green care that uses more structured approaches for people with defined needs

What is the evidence for the impact of gardens and gardening on health and well-being : a scoping review and evidence-based logic model to guide healthcare strategy decision making on the use of gardening approaches as a social prescription

Objective: To systematically identify and describe studies that have evaluated the impact of gardens and gardening on health and wellbeing. A secondary objective was to use this evidence to build evidence-based logic models to guide health strategy decision making about gardens and gardening as a non-medical, social prescription. Design: Scoping review of the impact of gardens and gardening on health and wellbeing. Gardens include private spaces and those open to the public or part of hospitals, care homes, hospices or third sector organisations. Data Sources: A range of biomedical and health management journals were searched including Medline, CINAHL, Psychinfo, Web of Knowledge, ASSIA, Cochrane, Joanna Briggs, Greenfile, Environment Complete and a number of indicative websites were searched to locate context specific data and grey literature. We searched from 1990 – November 2019. Eligibility Criteria: We included research studies (including systematic reviews) that assessed the effect, value or impact of any garden that met the gardening definition. Data Extraction and Synthesis: Three reviewers jointly screened 50 records by titles and abstracts to ensure calibration. Each record title was screened independently by 2 out of 3 members of the project team and each abstract was screened by 1 member of a team of 3. Random checks on abstract and full text screening were conducted by a fourth member of the team and any discrepancies were resolved through double-checking and discussion. Results: From the 8896 papers located, a total of 77* studies were included. Over 35 validated health, wellbeing and functional biometric outcome measures were reported. Interventions ranged from viewing gardens, taking part in gardening or undertaking therapeutic activities. The findings demonstrated links between gardens and improved mental wellbeing, increased physical activity and a reduction in social isolation enabling the development of 2 logic models. Conclusions: Gardens and gardening can improve the health and wellbeing for people with a range of health and social needs. The benefits of gardens and gardening could be used as a ‘social prescription’ globally, for people with Long Terms Conditions (LTC). Our logic models provide an evidence-based illustration that can guide health strategy decision making about the referral of people with LTC to socially prescribed, non-medical interventions involving gardens and gardenin

Care farming and green care in Salford

This report presents a University of Salford (UoS) investigation into the potential for care farming in Salford as part of the University’s teaching, research and enterprise activities. The work has critically engaged with the notion of care farming with a view to better understand how this approach can contribute to helping communities with diverse needs in terms of physical and mental health as well as wider determinants of health such as social inclusion and employability. Through the establishment of, and engagement with a network of key local stakeholders, the work developed a model that has explored the potential of a care farm. What has emerged is a first step towards the design and establishment of an urban care farm that that could serve as a centre for learning and research as well as integrate existing activities as part of a green and blue network identified through the stakeholder engagement work. This report provides a direction for future work on care farming in Salford in general, and in terms of the University’s teaching and learning activities in particular

Consumption of an omega-3 fatty acids product, INCELL AAFA™, reduced side-effects of CPT-11 (irinotecan) in mice

INCELL AAFA™, an omega-3 polyunsaturated fatty acid product containing a high concentration of long chain fatty acids, was tested for its ability to ameliorate the harmful side effects of CPT-11 chemotherapy including: leukopenia, anaemia, asthenia, weight loss and liver involvement. Four groups of mice were fed an AIN-76 diet modified to contain: 10% w/w corn oil (CO), 0% AAFA™; 9% CO, 1% AAFA™; 8% CO, 2% AAFA™; or 7% CO, 3% AAFA™. After 2 weeks on the diets, half of the mice received CPT-11 chemotherapy (60 mg kg−1 q 4 days, i.v.) the rest of the mice received vehicle for 2 weeks. It was found that 2% AAFA™ in the diet of the CPT-11 treated mice: decreased apoptotic figures in the duodenal crypts; markedly suppressed the inflammatory eicosanoid, prostaglandin E2 in the liver; prevented liver hypertrophy; improved white blood cell counts; significantly increased red blood cell counts; decreased numbers of CPT-11 induced immature red blood cell and micronuclei in red blood cells of the peripheral blood; increased eicosapentaenoic acid and docosahexaenoic acid in liver cell membranes and maintained normal grooming behaviour. Thus 2% AAFA™ in the diet reduced the side effects of CPT-11 treatment in mice

Thyrotropin-releasing hormone (TRH) promotes wound re-epithelialisation in frog and human skin

There remains a critical need for new therapeutics that promote wound healing in patients suffering from chronic skin wounds. This is, in part, due to a shortage of simple, physiologically and clinically relevant test systems for investigating candidate agents. The skin of amphibians possesses a remarkable regenerative capacity, which remains insufficiently explored for clinical purposes. Combining comparative biology with a translational medicine approach, we report the development and application of a simple ex vivo frog (Xenopus tropicalis) skin organ culture system that permits exploration of the effects of amphibian skin-derived agents on re-epithelialisation in both frog and human skin. Using this amphibian model, we identify thyrotropin-releasing hormone (TRH) as a novel stimulant of epidermal regeneration. Moving to a complementary human ex vivo wounded skin assay, we demonstrate that the effects of TRH are conserved across the amphibian-mammalian divide: TRH stimulates wound closure and formation of neo-epidermis in organ-cultured human skin, accompanied by increased keratinocyte proliferation and wound healing-associated differentiation (cytokeratin 6 expression). Thus, TRH represents a novel, clinically relevant neuroendocrine wound repair promoter that deserves further exploration. These complementary frog and human skin ex vivo assays encourage a comparative biology approach in future wound healing research so as to facilitate the rapid identification and preclinical testing of novel, evolutionarily conserved, and clinically relevant wound healing promoters

Socio-economic inequalities in physical activity practice among Italian children and adolescents: a cross-sectional study

Aim: The aim of the study was to evaluate whether socio-economic inequalities in the practice of physical activity existed among children and adolescents, using different indicators of socio-economic status (SES). Subjects and methods: Data were derived from the Italian National Health Interview Survey carried out in 2004–2005, which examined a large random sample of the Italian population using both an interviewer-administered and a self-compiled questionnaire. This study was based on a sample of 15,216 individuals aged 6–17 years. The practice of physical activity was measured on the basis of questions regarding frequency and intensity of activity during leisure time over the past 12 months. Parents’ educational and occupational level, as well as family’s availability of material resource, were used as indicators of SES. Multivariable logistic regression analyses were performed to estimate the contribution of each SES indicator to the practice of physical activity, adjusting for potential confounding factors. The results of the regression models are expressed as odds ratio (OR) with 95% confidence intervals (95% CI). Results: About 64% of children and adolescents in the sample declared that they participated in moderate or vigorous physical activity at least once a week. After adjustment for gender, age, parental attitudes towards physical activity and geographical area, the practice of physical activity increased with higher parental educational and occupational level and greater availability of material resources. Children and adolescents whose parents held a middle or high educational title were 80% more likely to practice moderate or vigorous physical activity than subjects whose parents had a lower level of education (OR = 1.80, 95% CI: 1.40–2.33), while subjects with unemployed parents had an odds of practicing moderate or vigorous physical activity 0.43 times that of those children whose parents belonged to the top job occupation category (administrative/professionals). Socio-economic differences were about the same when the practice of vigorous physical activity only was considered instead of that of moderate or vigorous physical activity. Conclusion: Interventions that promote the practice of physical activity, and especially those aimed at the wider physical and social environment, are strongly needed to contrast socio-economic differences in physical activity among children and adolescents

Three-dimensional echocardiography using single-heartbeat modality decreases variability in measuring left ventricular volumes and function in comparison to four-beat technique in atrial fibrillation

BACKGROUND: Three dimensional echocardiography (3DE) approaches the accuracy of cardiac magnetic resonance in measuring left ventricular (LV) volumes and ejection fraction (EF). The multibeat modality in comparison to single-beat (SB) requires breath-hold technique and regular heart rhythm which could limit the use of this technique in patients with atrial fibrillation (AF) due to stitching artifact. The study aimed to investigate whether SB full volume 3DE acquisition reduces inter- and intraobserver variability in assessment of LV volumes and EF in comparison to four-beat (4B) ECG-gated full volume 3DE recording in patients with AF. METHODS: A total of 78 patients were included in this study. Fifty-five with sinus rhythm (group A) and 23 having AF (group B). 4B and SB 3DE was performed in all patients. LV volumes and EF was determined by these two modalities and inter- and intraobserver variability was analyzed. RESULTS: SB modality showed significantly lower inter- and intraobserver variability in group B in comparison to 4B when measuring LV volumes and EF, except for end-systolic volume (ESV) in intraobserver analysis. There were significant differences when calculating the LV volumes (p<0.001) and EF (p<0.05) with SB in comparison to 4B in group B. CONCLUSION: Single-beat three-dimensional full volume acquisition seems to be superior to four-beat ECG-gated acquisition in measuring left ventricular volumes and ejection fraction in patients having atrial fibrillation. The variability is significantly lower both for ejection fraction and left ventricular volumes

Dermatitis and Aging-Related Barrier Dysfunction in Transgenic Mice Overexpressing an Epidermal-Targeted Claudin 6 Tail Deletion Mutant

The barrier function of the skin protects the mammalian body against infection, dehydration, UV irradiation and temperature fluctuation. Barrier function is reduced with the skin's intrinsic aging process, however the molecular mechanisms involved are unknown. We previously demonstrated that Claudin (Cldn)-containing tight junctions (TJs) are essential in the development of the epidermis and that transgenic mice overexpressing Cldn6 in the suprabasal layers of the epidermis undergo a perturbed terminal differentiation program characterized in part by reduced barrier function. To dissect further the mechanisms by which Cldn6 acts during epithelial differentiation, we overexpressed a Cldn6 cytoplasmic tail deletion mutant in the suprabasal compartment of the transgenic mouse epidermis. Although there were no gross phenotypic abnormalities at birth, subtle epidermal anomalies were present that disappeared by one month of age, indicative of a robust injury response. However, with aging, epidermal changes with eventual chronic dermatitis appeared with a concomitant barrier dysfunction manifested in increased trans-epidermal water loss. Immunohistochemical analysis revealed aberrant suprabasal Cldn localization with marked down-regulation of Cldn1. Both the proliferative and terminal differentiation compartments were perturbed as evidenced by mislocalization of multiple epidermal markers. These results suggest that the normally robust injury response mechanism of the epidermis is lost in the aging Involucrin-Cldn6-CΔ196 transgenic epidermis, and provide a model for evaluation of aging-related skin changes

Search for a Technicolor omega_T Particle in Events with a Photon and a b-quark Jet at CDF

If the Technicolor omega_T particle exists, a likely decay mode is omega_T -> gamma pi_T, followed by pi_T -> bb-bar, yielding the signature gamma bb-bar. We have searched 85 pb^-1 of data collected by the CDF experiment at the Fermilab Tevatron for events with a photon and two jets, where one of the jets must contain a secondary vertex implying the presence of a b quark. We find no excess of events above standard model expectations. We express the result of an exclusion region in the M_omega_T - M_pi_T mass plane.Comment: 14 pages, 2 figures. Available from the CDF server (PS with figs): http://www-cdf.fnal.gov/physics/pub98/cdf4674_omega_t_prl_4.ps FERMILAB-PUB-98/321-