Date: 9/1/19 12:57 pm
From: Larry Nooden <ldnum...>
Subject: Re: [birders] Medical prescriptions for nature exposure
Fred has raised an interesting question about the data on the pyscho-social
effects of our environment, and I think that most on this list can realize
that the answer is complex, interdisciplinary and highly political, because
there are many facets and approaches to the question.

Even before President Trump, this became a partisan issue with one side
favoring maximal short-term profits dismissing other aspects as
nonquantitative/nonmonetary, but I think that those who are are interested
in the data/facts will see that there are measurable short-term as well as
long-term costs/gains in addition to subjective quality of life
components. This partisan divide did not exist in the times of Eisenhower
and Nixon.

In some ways, present day birds and endangered species are measures of what
is being done to our habitat much like the canaries once did in the coal
mines. Are the lessons for coal-mine canaries or the bald eagle-DDT
episode being utilized? Although environmental degradation by chemical
pollution is important, there can be psycho-social problems, and the gains
from dealing with them are for the greater good. Are we witnessing another
facet of human habitat destruction?

Below is a scattering of diverse reports from a very large scientific
literature. *For those only interested in the key points, some key phrases
marked in bold*. The abstracts provide glimpses of the methods used and
the data obtained. I have also listed links to the original sources for
several reports. Some of these are open-access; others would to be
accessed through a special source such as the UM Library system.

I have included some local pioneers, i.e.. Cimprich and the Kaplans.

Cimprich, B. and D. L. Ronis (2003). "*An environmental intervention to
restore attention in women with newly diagnosed breast cancer*." Cancer
Nurs 26(4): 284-292; quiz 293-284.
*Earlier research indicated that attentional fatigue with reduced capacity
to direct attention in women treated for breast cancer may be ameliorated
by a theoretically based intervention involving regular exposure to the
natural environment.* This study tested the efficacy of a natural
environment intervention aimed at restoring attention in 157 women with
newly diagnosed breast cancer. Capacity to direct attention was assessed
with a brief battery of objective measures at two time points:
approximately 17 days before surgery (time 1) and 19 days after surgery
(time 2). A randomly assigned intervention protocol was initiated after the
first assessment and before any treatment. The intervention comprised a
home-based program involving 120 minutes of exposure to the natural
environment per week. The intervention group (n = 83) showed greater
recovery of capacity to direct attention from the pretreatment (time 1) to
the preadjuvant therapy period (time 2), as compared with the
nonintervention group (n = 74). *A significant effect of the natural
environment intervention was observed* even after control was used for the
effects of age, education, attention scores at time 1, other health
problems, symptom distress, and extent of surgery. The findings suggest
therapeutic benefits for capacity to direct attention from early
intervention aimed at restoring attention in women with newly diagnosed
breast cancer.

Cimprich, B., et al. (2005). "Assessing cognitive function in women with
and without breast cancer using functional magnetic resonance imaging
(fMRI)." Oncology Nursing Forum 32(1): 180-181.

Kim, G. W., et al. (2010). "*Functional neuroanatomy associated with
natural and urban scenic views in the human brain: 3.0T functional MR
imaging*." Korean J Radiol 11(5): 507-513.
OBJECTIVE: *By using a functional magnetic resonance imaging (fMRI)
technique we assessed brain activation patterns while subjects were viewing
the living environments representing natural and urban scenery. *MATERIALS
AND METHODS: A total of 28 healthy right-handed subjects underwent an fMRI
on a 3.0 Tesla MRI scanner. The stimulation paradigm consisted of three
times the rest condition and two times the activation condition, each of
which lasted for 30 and 120 seconds, respectively. During the activation
period, each subject viewed natural and urban scenery, respectively.
RESULTS: The predominant brain activation areas observed following exposure
to natural scenic views in contrast with urban views included the superior
and middle frontal gyri, superior parietal gyrus, precuneus, basal ganglia,
superior occipital gyrus, anterior cingulate gyrus, superior temporal
gyrus, and insula. On the other hand, t
CONCLUSION: Our findings support the idea that the differential functional
neuroanatomies for each scenic view are presumably related with subjects'
emotional responses to the natural and urban environment, and thus the
functional neuroanatomy can be utilized as a neural index for the
evaluation of friendliness in ecological housing*.

Berman, M. G., et al. (2008). "*The cognitive benefits of interacting with
nature*." Psychol Sci 19(12): 1207-1212.
We *compare the restorative effects on cognitive functioning of
interactions with natural versus urban environment*s. Attention restoration
theory (ART) provides an analysis of the kinds of environments that lead to
improvements in directed-attention abilities. Nature, which is filled with
intriguing stimuli, modestly grabs attention in a bottom-up fashion,
allowing top-down directed-attention abilities a chance to replenish.
Unlike natural environments, urban environments are filled with stimulation
that captures attention dramatically and additionally requires directed
attention (e.g., to avoid being hit by a car), making them less
restorative. We present two experiments that show that *walking in nature
or viewing pictures of nature can improve directed-attention abilities as
measured with* a backwards digit-span task and the Attention Network Task,
thus validating attention restoration theory.

Kaplan, R. and S. Kaplan (2008). "Bringing out the best in people: A
psychological perspective." Conservation Biology 22(4): 826-829.

Kondo, M. C., et al. (2018). "Does spending time outdoors reduce stress? A
review of real-time stress response to outdoor environments." Health &
Place 51: 136-150.
*Everyday environmental conditions impact human health. One mechanism
underlying this relationship is the experience of stress. Through
systematic review of published literature, we explore how stress has been
measured in real-time non-laboratory studies of stress responses to
deliberate exposure to outdoor environments*. The types of exposures
evaluated in this review include: nature viewing, outdoor walks, outdoor
exercise and gardening. We characterize study design, modalities of stress
measurements, and statistical estimates of effect and significance. *Heart
rate, blood pressure, and self-report measures provide the most convincing
evidence that spending time in outdoor environments, particularly those
with green space, may reduce the experience of stress, and ultimately
improve health.* More work is needed to understand effects of in situ
modifications to outdoor environments on residents' stress response.

South, E. C., et al. (2018). "*Effect of Greening Vacant Land on Mental
Health of Community-Dwelling Adults: A Cluster Randomized Trial Effect of
Greening Vacant Land on Mental Health Among Urban ResidentsEffect of
Greening Vacant Land on Mental Health Among Urban Residents*." JAMA Network
Open 1(3): e180298-e180298.
Neighborhood physical conditions have been associated with mental illness
and may partially explain persistent socioeconomic disparities in the
prevalence of poor mental health.To evaluate whether interventions to green
vacant urban land can improve self-reported mental health.*This citywide
cluster randomized trial examined 442 community-dwelling sampled adults
living in Philadelphia, Pennsylvania, within 110 vacant lot clusters
randomly assigned to 3 study groups. Participants were followed up for 18
months preintervention and postintervention.* This trial was conducted from
October 1, 2011, to November 30, 2014. Data were analyzed from July 1,
2015, to April 16, 2017.The greening intervention involved removing trash,
grading the land, planting new grass and a small number of trees,
installing a low wooden perimeter fence, and performing regular monthly
maintenance. The trash cleanup intervention involved removal of trash,
limited grass mowing where possible, and regular monthly maintenance. The
control group received no intervention.Self-reported mental health measured
by the Kessler-6 Psychological Distress Scale and the components of this
scale.A total of 110 clusters containing 541 vacant lots were enrolled in
the trial and randomly allocated to the following 1 of 3 study groups: the
greening intervention (37 clusters [33.6%]), the trash cleanup intervention
(36 clusters [32.7%]), or no intervention (37 clusters [33.6%]). Of the 442
participants, the mean (SD) age was 44.6 (15.1) years, 264 (59.7%) were
female, and 194 (43.9%) had a family income less than $25 000. A total of
342 participants (77.4%) had follow-up data and were included in the
analysis. Of these, 117 (34.2%) received the greening intervention, 107
(31.3%) the trash cleanup intervention, and 118 (34.5%) no intervention.
Intention-to-treat analysis of the greening intervention compared with no
intervention demonstrated a significant decrease in participants who were
feeling depressed (−41.5%; 95% CI, −63.6% to −5.9%; P = .03) and worthless
(−50.9%; 95% CI, −74.7% to −4.7%; P = .04), as well as a nonsignificant
reduction in overall self-reported poor mental health (−62.8%; 95% CI,
−86.2% to 0.4%; P = .051). For participants living in neighborhoods below
the poverty line, the greening intervention demonstrated a significant
decrease in feeling depressed (−68.7%; 95% CI, −86.5% to −27.5%; P = .007).
Intention-to-treat analysis of those living near the trash cleanup
intervention compared with no intervention showed no significant changes in
self-reported poor mental health.*Among community-dwelling adults,
self-reported feelings of depression and worthlessness were significantly
decreased*, and self-reported poor mental health was nonsignificantly
reduced *for those living near greened vacant land*. The treatment of
blighted physical environments, particularly in resource-limited urban
settings, can be an important treatment for mental health problems
alongside other patient-level Identifier:

On Thu, Aug 29, 2019 at 2:00 PM Fred Kaluza <fkaluza...> wrote:

> If anyone here has access to any associated statistics, I’d love to see
> survey results for area physicians in terms of how many local doctors do
> this, how often they do it and where they are sending people locally to
> “get their fix” of nature.
> On Thu, Aug 29, 2019 at 12:06 PM -0400, "Larry Nooden" <ldnum...>
> wrote:
> These prescriptions apply to birding, botanizing and just enjoying the
>> peace/aesthetics (e.g., forest bathing).
>> Most of you already know this intuitively, but I think that it is nice to
>> see it being recognized scientifically and being utilized in health
>> treatments.
>> Why doctors are increasingly prescribing nature | PBS NewsHour
>> - As rates of chronic disease among children have skyrocketed over the
>> past few decades, pediatricians have increasingly looked for solutions
>> beyond the clinic. ... Special correspondent Cat Wise reports from Oakland
>> on the medical evidence that indicates escaping modern urban life ...
>> UK doctors are prescribing nature to patients - CNN -
>> › health › nature-prescriptions-shetland-intl
>> Oct 5, 2018 - Doctors in Scotland's Shetland Islands are now *prescribing
>> nature* ... Now all 10 of the Shetland Islands' *public* surgeries will
>> now have a calendar and leaflet listing walks and activities. ... can hand
>> out to patients, according to an RSPB *news* release. .... Turner
>> *Broadcasting* System, Inc.All Rights Reserved.
>> A dose of nature: doctors prescribe a day in the park for anxiety
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