Nature-Based Interventions for Improving Health and Wellbeing : The Purpose, the People and the Outcomes

Engagement with nature is an important part of many people's lives, and the health and wellbeing benefits of nature-based activities are becoming increasingly recognised across disciplines from city planning to medicine. Despite this, urbanisation, challenges of modern life and environmental degradation are leading to a reduction in both the quantity and the quality of nature experiences. Nature-based health interventions (NBIs) can facilitate behavioural change through a somewhat structured promotion of nature-based experiences and, in doing so, promote improved physical, mental and social health and wellbeing. We conducted a Delphi expert elicitation process with 19 experts from seven countries (all named authors on this paper) to identify the different forms that such interventions take, the potential health outcomes and the target beneficiaries. In total, 27 NBIs were identified, aiming to prevent illness, promote wellbeing and treat specific physical, mental or social health and wellbeing conditions. These interventions were broadly categorized into those that change the environment in which people live, work, learn, recreate or heal (for example, the provision of gardens in hospitals or parks in cities) and those that change behaviour (for example, engaging people through organized programmes or other activities). We also noted the range of factors (such as socioeconomic variation) that will inevitably influence the extent to which these interventions succeed. We conclude with a call for research to identify the drivers influencing the effectiveness of NBIs in enhancing health and wellbeing.Peer reviewe

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

A review of the benefits of nature experiences: more than meets the eye

Evidence that experiences of nature can benefit people has accumulated rapidly. Yet perhaps because of the domination of the visual sense in humans, most research has focused on the visual aspects of nature experiences. However, humans are multisensory, and it seems likely that many benefits are delivered through the non-visual senses and these are potentially avenues through which a physiological mechanism could occur. Here we review the evidence around these lesser studied sensory pathways—through sound, smell, taste, touch, and three non-sensory pathways. Natural sounds and smells underpin experiences of nature for many people, and this may well be rooted in evolutionary psychology. Tactile experiences of nature, particularly beyond animal petting, are understudied yet potentially fundamentally important. Tastes of nature, through growing and consuming natural foods, have been linked with a range of health and well-being benefits. Beyond the five senses, evidence is emerging for other non-visual pathways for nature experiences to be effective. These include ingestion or inhalation of phytoncides, negative air ions and microbes. We conclude that (i) these non-visual avenues are potentially important for delivering benefits from nature experiences; (ii) the evidence base is relatively weak and often based on correlational studies; and (iii) deeper exploration of these sensory and non-sensory avenues is needed

Working together to scale ecosystem restoration: collective approaches to community action in Aotearoa New Zealand

Community groups are key drivers of ecosystem restoration in many countries. However, there is increasingly recognition that small scale restoration efforts are often insufficient to reverse ongoing biodiversity declines, and questions have been raised regarding the sustainability and efficiency of community-based initiatives. In Aotearoa New Zealand, collectives that bring together multiple community groups and other actors have arisen as a mechanism to scale restoration activities and support community restoration efforts. This article examines the nature, role, and contribution of ecosystem restoration collectives in Aotearoa, based on a survey of 27 collectives in 2021. Collectives generally engage in governance activities like funding, administration, and advocacy, adding to the typically “hands on” work of community groups. Similarly, they improve ways of working by increasing connections and communication between groups, agencies, and the wider public. This study indicates that collectives contribute to scaling restoration by improving the efficiency and sustainability of community initiatives, increasing the spatial scale and social-ecological scope of restoration, and increasing the range of actors involved in restoration

Emerging issues in urban ecology: implications for research, social justice, human health, and well-being

Urbanization affects landscape structure and the overall human condition in numerous ways. Green spaces include vegetated land cover (e.g., urban forests, trees, riparian zones, parks) which play a distinctive role in urban ecology. This article reviews emergent literature on the linkages between urban green spaces, social justice, and human health. We explore this subject in the context of landscape structure, ecosystem services, and distributional equity as it relates to various health outcomes. Finally, we conclude by identifying gaps in the scholarship and potential areas of future research

The challenges of urban living

This chapter first discusses the challenges posed by the urban environment for bird populations. These include habitat loss, habitat fragmentation, alteration of resource flows, pollution, and species interactions. The chapter then turns to some of the ways in which urbanization filters bird communities. There are at least two approaches to tackling this question. First, one can measure how the species richness and abundance of birds changes in response to urbanization. Second, one can take a comparative approach to identify how urban-adapted species differ from those that are sensitive to urbanization. Finally, the chapter considers adaptive responses to urbanization and the impact of human behaviours for urban wildlife

The Benefits of Natural Environments for Physical Activity

Urbanisation has a profound effect on both people and the environment, as levels of physical activity decline and many natural ecosystems become lost or degraded. Here we draw on emerging research to examine the role of green spaces in providing a venue for outdoor physical activity, and in enhancing the benefit of a given amount of physical activity for urban residents. We identify critical knowledge gaps, including (1) whether (and for whom) levels of physical activity increase as new green spaces are introduced or old spaces reinvigorated; (2) which characteristics of nature promote physical activity; (3) the extent to which barriers to outdoor physical activity are environmental or social; and (4) whether the benefits of physical activity and experiences of nature accrue separately or synergistically. A clear understanding of these issues will help guide effective investment in green space provision, ecological enhancement and green exercise promotion

The health benefits of urban nature: how much do we need?

Over 30 years of research has shown that urban nature is a promising tool for enhancing the physical, psychological, and social well-being of the world's growing urban population. However, little is known about the type and amount of nature people require in order to receive different health benefits, preventing the development of recommendations for minimum levels of exposure and targeted city planning guidelines for public health outcomes. Dose–response modelling, when a dose of nature is modeled against a health response, could provide a key method for addressing this knowledge gap. In this overview, we explore how “nature dose” and health response have been conceptualized and examine the evidence for different shapes of dose–response curves. We highlight the crucial need to move beyond simplistic measures of nature dose to understand how urban nature can be manipulated to enhance human health