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      Wetlands for Wellbeing: Piloting a Nature-Based Health Intervention for the Management of Anxiety and Depression

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          Abstract

          Nature-based health interventions (NBIs) for the treatment of poor mental health are becoming increasingly common, yet evidence to support their effectiveness is lacking. We conduct a pilot study of a six-week intervention, aiming to engage individuals with wetland nature for the treatment of anxiety and/or depression. We employed a mixed methods design, using questionnaires, focus groups and semi-structured interviews to evaluate the intervention from the perspective of participants (n = 16) and healthcare professionals (n = 2). Results demonstrate significant improvements in mental health across a range of indicators, including mental wellbeing (Warwick and Edinburgh Mental Wellbeing Scale), anxiety (Generalised Anxiety Disorder-7), stress (Perceived Stress Scale) and emotional wellbeing (Positive and Negative Affect Schedule). Participants and healthcare professionals cited additional outcomes including improved physical health and reduced social isolation. The wetland site provided a sense of escape from participants’ everyday environments, facilitating relaxation and reductions in stress. Wetland staff knowledge of the natural world, transportation and group organisation also played a considerable role in the intervention’s success. These aspects should be considered in future and existing NBIs to maximise benefits to participants. We propose NBIs based in wetlands are an effective therapy option for individuals diagnosed with anxiety and/or depression.

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          Most cited references52

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          Green spaces and cognitive development in primary schoolchildren.

          Exposure to green space has been associated with better physical and mental health. Although this exposure could also influence cognitive development in children, available epidemiological evidence on such an impact is scarce. This study aimed to assess the association between exposure to green space and measures of cognitive development in primary schoolchildren. This study was based on 2,593 schoolchildren in the second to fourth grades (7-10 y) of 36 primary schools in Barcelona, Spain (2012-2013). Cognitive development was assessed as 12-mo change in developmental trajectory of working memory, superior working memory, and inattentiveness by using four repeated (every 3 mo) computerized cognitive tests for each outcome. We assessed exposure to green space by characterizing outdoor surrounding greenness at home and school and during commuting by using high-resolution (5 m × 5 m) satellite data on greenness (normalized difference vegetation index). Multilevel modeling was used to estimate the associations between green spaces and cognitive development. We observed an enhanced 12-mo progress in working memory and superior working memory and a greater 12-mo reduction in inattentiveness associated with greenness within and surrounding school boundaries and with total surrounding greenness index (including greenness surrounding home, commuting route, and school). Adding a traffic-related air pollutant (elemental carbon) to models explained 20-65% of our estimated associations between school greenness and 12-mo cognitive development. Our study showed a beneficial association between exposure to green space and cognitive development among schoolchildren that was partly mediated by reduction in exposure to air pollution.
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            Exposure to Neighborhood Green Space and Mental Health: Evidence from the Survey of the Health of Wisconsin

            Green space is now widely viewed as a health-promoting characteristic of residential environments, and has been linked to mental health benefits such as recovery from mental fatigue and reduced stress, particularly through experimental work in environmental psychology. Few population level studies have examined the relationships between green space and mental health. Further, few studies have considered the role of green space in non-urban settings. This study contributes a population-level perspective from the United States to examine the relationship between environmental green space and mental health outcomes in a study area that includes a spectrum of urban to rural environments. Multivariate survey regression analyses examine the association between green space and mental health using the unique, population-based Survey of the Health of Wisconsin database. Analyses were adjusted for length of residence in the neighborhood to reduce the impact of neighborhood selection bias. Higher levels of neighborhood green space were associated with significantly lower levels of symptomology for depression, anxiety and stress, after controlling for a wide range of confounding factors. Results suggest that “greening” could be a potential population mental health improvement strategy in the United States.
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              Directed Attention as a Common Resource for Executive Functioning and Self-Regulation.

              Research on executive functioning and on self-regulation have each identified a critical resource that is central to that domain and is susceptible to depletion. In addition, studies have shown that self-regulation tasks and executive-functioning tasks interact with each other, suggesting that they may share resources. Other research has focused specifically on restoring what we propose is the shared resource between self-regulation and executive functioning. Utilizing a theory-based natural environment intervention, these studies have found improvements in executive-functioning performance and self-regulation effectiveness, suggesting that the natural environment intervention restores this shared resource.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                11 November 2019
                November 2019
                : 16
                : 22
                : 4413
                Affiliations
                [1 ]The Wildfowl & Wetlands Trust, Slimbridge, Gloucester GL2 7BT, UK; jonathan.reeves@ 123456wwt.org.uk (J.R.); emily.strong@ 123456wwt.org.uk (E.S.); ruth.cromie@ 123456wwt.org.uk (R.C.)
                [2 ]Durrell Institute of Conservation and Ecology (DICE), School of Anthropology and Conservation, University of Kent, Canterbury CT2 8NR, UK; z.g.davies@ 123456kent.ac.uk
                [3 ]Social, Economic and Geographic Sciences, James Hutton Institute, Craigiebuckler, Aberdeen AB15 8QH, UK; Kate.Irvine@ 123456hutton.ac.uk
                [4 ]Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds LS9 2JT, UK; M.Dallimer@ 123456leeds.ac.uk
                Author notes
                Article
                ijerph-16-04413
                10.3390/ijerph16224413
                6887757
                31718035
                4cf8fc0b-fa89-431d-aef9-11744e467aac
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 14 October 2019
                : 08 November 2019
                Categories
                Article

                Public health
                attention restoration theory,biodiversity,blue space,ecosystem services,green space,mental health,mixed methods,nature-based therapy,social prescribing,stress

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