Impacts of nature deprivations during the COVID-19 pandemic: A pre-post comparison

Nature provides a myriad of intangible and non-material services to people. However, urbanites are increasingly disconnected from the natural world. The consequences of this progressive disconnection from nature remain difficult to measure as this process is slow and long-term monitoring or large-scale manipulation on nature experiences are scarce. Measures to contain the spread of the recent covid-19 pandemic (i.e., lockdowns) have potentially reduced or even suppressed nature experiences in cities. This situation provided an opportunity for conducting a longitudinal study that can serve as a sort of natural experiment to quantify the effects of nature deprivation on individuals' health, well-being and relationship to nature. We collected data on these variables from the same individuals inhabiting a large metropolis (Tel Aviv, Israel) twice, in 2018 (before) and during the lockdown in 2020. Our results confirmed that frequency, duration and quality of nature interactions dropped during the lockdown, while environmental attitudes and affinity towards nature remained similar. This was particularly true for people living in the least green neighborhoods, where a significant decrease in personal and social well-being was also found. Finally, affinity towards nature influenced well-being through nature experiences in 2018. The mediation effect was not significant in 2020, probably due to the decrease in nature experiences during the lockdown, but the direct relationship between affinity towards nature and well-being remained strong. These results provide insights into the means required to align the public health and conservation agendas to safeguard urbanites' health and well-being during a pandemic and mitigate the biodiversity crisis

How do habitat variability and management regime shape the spatial heterogeneity of birds within a large Mediterranean urban park?

Large urban parks can support a diverse bird community. However, the effects of variability among habitats and of park management on bird assemblages are poorly understood. We studied bird communities within the Yarkon Park, Tel Aviv, the largest urban park in Israel. We examined species richness, abundance and community composition across 20 locations that differ in levels of park management to identify habitat variables responsible for variation in bird richness and composition. Of 91 recorded bird species, 13 were aliens (14%), 4 were urban exploiters (4%), 54 were urban adapters (60%) and 20 were migrants (22%). Management had a significant effect on native bird richness and bird community structure varied among areas with different management regimes. Species richness of all the above species’ groups was lowest in intensively managed areas. Areas with intermediate levels of management had higher or equal richness compared to unmanaged areas. The majority of urban exploiters were found at all locations within the park reaching their highest abundances in intensively managed areas. Species richness of alien birds did not vary across levels of management. Bird species richness was negatively associated with lawn cover and with distance from nearest water source and was positively associated with the number of woody plant species. We suggest that urban parks should be designed such that the heterogeneity of native vegetation is preserved, if we aim to maintain native bird species diversity and minimize urban exploiter and alien species. When lightly managed or unmanaged, urban parks can retain large remnants of sub-natural habitats and can serve as important contributors to the conservation of native biodiversity within a large urban metropolis

A framework for understanding the human experience of nature through cognitive mapping

Human behavior is a key driver of the biodiversity crisis, and addressing it requires changing individual choices and actions. Yet, the same processes that imperil biodiversity (e.g., urbanization) also alienate people from the experience of nature, eroding care for the natural world. Although averting this extinction of experience is increasingly recognized as a major contemporary conservation challenge, understanding of what constitutes nature experience remains elusive and few empirical studies have explored it directly. Most researchers have used nature interactions as a stand-in for experience, even though experience extends beyond interactions. We aimed to determine what constitutes the experience of nature and to propose a holistic, empirically derived framework that incorporates the multiple dimensions and components of the experience of nature. Using a mixed-method approach across 3 countries (the United States, Switzerland, and Israel), we conducted a multistage, conceptual content, cognitive mapping (3CM) exercise with 106 participants. This methodology included developing a prompt to capture participants' perceptions of nature experiences and subsequently refining and organizing their input into distinct components and underlying dimensions through an iterative engagement process. Beyond multisensory interactions with nature, experience of nature consisted of 2 dimensions: the circumstances in which interactions occur and the internal responses that encompass various cognitive, affective, and restorative benefits associated with nature interactions. These 3 dimensions had 33 components that occurred consistently across participants in the 3 countries. Frequently mentioned components included seeing animals, landscapes, or scenery; lack of human influence; weather conditions; relaxing, recharging; feeling good; and awe for nature. Fear and nature experienced at home were the least mentioned components. Together, our results showed that nature experience is a combination of nature interactions, circumstances, and internal responses. The emphasized components underscore the significance of offering access to extensive, less human-influenced natural spaces. This in turn can foster a profound nature experience, cultivating feelings of connectedness and care for nature. [Abstract copyright: © 2024 The Authors. Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.

High hospital admission rates and inappropriate care

This study tests whether the rate of inappropriate hospital admissions is high in areas with high medical admission rates. Seventy small geographic areas were formed by grouping Massachusetts ZIP codes by similarity of hospital use. Appropriateness of hospital admission was measured both by applying the Appropriateness Evaluation Protocol and by applying physicians\u27 judgment to the medical records of patients age sixty-five and older who were admitted for treatment of a medical condition in 1990-1992. No relationship between hospital admission rate and inappropriate admission rate was found, which calls into question the common assumption that areas with higher hospital use have more inappropriate use of hospital care

The Self-Adapting Focused Review System. Probability sampling of medical records to monitor utilization and quality of care

Medical record review is increasing in importance as the need to identify and monitor utilization and quality of care problems grow. To conserve resources, reviews are usually performed on a subset of cases. If judgment is used to identify subgroups for review, this raises the following questions: How should subgroups be determined, particularly since the locus of problems can change over time? What standard of comparison should be used in interpreting rates of problems found in subgroups? How can population problem rates be estimated from observed subgroup rates? How can the bias be avoided that arises because reviewers know that selected cases are suspected of having problems? How can changes in problem rates over time be interpreted when evaluating intervention programs? Simple random sampling, an alternative to subgroup review, overcomes the problems implied by these questions but is inefficient. The Self-Adapting Focused Review System (SAFRS), introduced and described here, provides an adaptive approach to record selection that is based upon model-weighted probability sampling. It retains the desirable inferential properties of random sampling while allowing reviews to be concentrated on cases currently thought most likely to be problematic. Model development and evaluation are illustrated using hospital data to predict inappropriate admissions

Illness severity and costs of admissions at teaching and nonteaching hospitals

This research examined the hypothesis that greater severity of illness explains the higher costs of hospitalizations at teaching compared with nonteaching hospitals. Medical records of 4439 cases within eight common conditions were reviewed at five tertiary teaching, five other teaching, and five nonteaching hospitals in metropolitan Boston, Mass. We assessed acute physiologic status, severity of the principal diagnosis, comorbidities, and functional status. The principal diagnosis was more severe for teaching hospital patients in four conditions, but few significant differences were found for the other severity dimensions by condition. Across all conditions combined, except for functional status, severity was significantly higher at teaching hospitals, but the absolute differences were small. After adjusting for diagnosis related groups, costs were higher at tertiary teaching compared with other teaching and nonteaching hospitals. Further adjusting for severity and other patient characteristics explained 18% (90% confidence interval, 4 to 33) of the higher costs at tertiary compared with nonteaching hospitals

Using utilization review information to improve hospital efficiency

Hospitals are currently under great pressure to improve the efficiency of internal operations without sacrificing quality of care. In the rush to do this, they often overlook an extremely useful source of information that already exists--data routinely collected as part of the utilization review (UR) process. This article describes a system using UR data for management purposes that was developed in a large urban teaching hospital. The components described are: (1) data collected systematically by trained reviewers applying the Appropriateness Evaluation Protocol; (2) software for data collection using inexpensive, highly portable computers; and (3) formats for reporting UR findings to hospital administrators and physicians. Information derived from UR in the study hospital is discussed, as well as factors to be considered in adapting some or all of the system\u27s components in other hospitals

Small area variations in hospitalization rates: how much you see depends on how you look

This research investigates the degree that estimates of the magnitude of small area variations in hospitalization rates depend on both the estimation method and the number of years of data used. Hospital discharge abstracts for patients 65 and older from acute care hospitals in Massachusetts from 1982 to 1987 were analyzed. The SCV statistic, the approach used in many current small area variation studies, and empirical Bayes (EB), an approach that adjusts more fully for the effect of random variation, were compared. EB estimates based on 3 years of data were best able to predict future area-specific hospitalization rates. Compared to EB estimates using 3 years of data, the SCV statistic with 1 year of data overestimated the median amount of systematic variation by over 70% for the 68 conditions studied; with 3 years of data, the SCV overestimated the median by 55%. Regardless of method, the same conditions were identified as relatively more variable and the same geographic areas were found to have higher than expected hospitalization rates. The magnitude of differences in hospitalization rates depends on how the data are analyzed and how many years of data are used. Hospitalization rates across small geographic areas may vary substantially less than reported previously

Therapeutic Effect of Astroglia-like Mesenchymal Stem Cells Expressing Glutamate Transporter in a Genetic Rat Model of Depression

Recent studies have proposed that abnormal glutamatergic neurotransmission and glial pathology play an important role in the etiology and manifestation of depression. It was postulated that restoration of normal glutamatergic transmission, by enhancing glutamate uptake, may have a beneficial effect on depression. We examined this hypothesis using unique human glial-like mesenchymal stem cells (MSCs), which in addition to inherent properties of migration to regions of injury and secretion of neurotrophic factors, were differentiated to express high levels of functional glutamate transporters (excitatory amino acid transporters; EAAT). Additionally, gold nanoparticles (GNPs), which serve as contrast agents for CT imaging, were loaded into the cells for non-invasive, real-time imaging and tracking of MSC migration and final location within the brain. MSC-EAAT (2×105; 10 μl) were administered (i.c.v.) to Flinder Sensitive Line rats (FSLs), a genetic model for depression, and longitudinal behavioral and molecular changes were monitored. FSL rats treated with MSC-EAAT showed attenuated depressive-like behaviors (measured by the forced swim test, novelty exploration test and sucrose self-administration paradigm), as compared to controls. CT imaging, Flame Atomic Absorption Spectroscopy analysis and immunohistochemistry showed that the majority of MSCs homed specifically to the dentate gyrus of the hippocampus, a region showing structural brain changes in depression, including loss of glial cells. mRNA and protein levels of EAAT1 and BDNF were significantly elevated in the hippocampus of MSC-EAAT-treated FSLs. Our findings indicate that MSC-EAATs effectively improve depressive-like manifestations, possibly in part by increasing both glutamate uptake and neurotropic factor secretion in the hippocampus