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      Mental Health, Greenness, and Nature Related Behaviors in the Adult Population of Stockholm County during COVID-19-Related Restrictions

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          Abstract

          International data suggest that exposure to nature is beneficial for mental health and well-being. The restrictions related to the COVID-19 pandemic have created a setting that allows us to investigate the importance of greenness exposure on mental health during a period of increased isolation and worry. Based on 2060 responses from an online survey in Stockholm County, Sweden, we investigated: (1) whether the COVID-19 pandemic changed peoples’ lifestyle and nature-related habits, and (2) if peoples’ mental health differed depending on their exposure to greenness. Neighborhood greenness levels were quantified by using the average normalized difference vegetation index (NDVI) within 50 m, 100 m, 300 m, and 500 m buffers surrounding the participant’s place of residence. We found that the number of individuals that reported that they visited natural areas “often” was significantly higher during the pandemic than before the pandemic. Higher levels of greenness surrounding one’s location of residence were in general associated with higher mental health/well-being and vitality scores, and less symptoms of depression, anxiety, and perceived and cognitive stress, after adjustments for demographic variables and walkability. In conclusion, the results from the present study provided support to the suggestion that contact with nature may be important for mental health in extreme circumstances.

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          Mental Health and the Covid-19 Pandemic

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            Purposeful selection of variables in logistic regression

            Background The main problem in many model-building situations is to choose from a large set of covariates those that should be included in the "best" model. A decision to keep a variable in the model might be based on the clinical or statistical significance. There are several variable selection algorithms in existence. Those methods are mechanical and as such carry some limitations. Hosmer and Lemeshow describe a purposeful selection of covariates within which an analyst makes a variable selection decision at each step of the modeling process. Methods In this paper we introduce an algorithm which automates that process. We conduct a simulation study to compare the performance of this algorithm with three well documented variable selection procedures in SAS PROC LOGISTIC: FORWARD, BACKWARD, and STEPWISE. Results We show that the advantage of this approach is when the analyst is interested in risk factor modeling and not just prediction. In addition to significant covariates, this variable selection procedure has the capability of retaining important confounding variables, resulting potentially in a slightly richer model. Application of the macro is further illustrated with the Hosmer and Lemeshow Worchester Heart Attack Study (WHAS) data. Conclusion If an analyst is in need of an algorithm that will help guide the retention of significant covariates as well as confounding ones they should consider this macro as an alternative tool.
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              Nature and health.

              Urbanization, resource exploitation, and lifestyle changes have diminished possibilities for human contact with nature in urbanized societies. Concern about the loss has helped motivate research on the health benefits of contact with nature. Reviewing that research here, we focus on nature as represented by aspects of the physical environment relevant to planning, design, and policy measures that serve broad segments of urbanized societies. We discuss difficulties in defining "nature" and reasons for the current expansion of the research field, and we assess available reviews. We then consider research on pathways between nature and health involving air quality, physical activity, social cohesion, and stress reduction. Finally, we discuss methodological issues and priorities for future research. The extant research does describe an array of benefits of contact with nature, and evidence regarding some benefits is strong; however, some findings indicate caution is needed in applying beliefs about those benefits, and substantial gaps in knowledge remain.
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                Author and article information

                Contributors
                Role: Academic Editor
                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
                23 March 2021
                March 2021
                : 18
                : 6
                : 3303
                Affiliations
                [1 ]Center for Occupational and Environmental Medicine, Region Stockholm, 113 65 Stockholm, Sweden; tomas.lind@ 123456sll.se (T.L.); andre.lauber@ 123456sll.se (A.L.); antonios.georgelis@ 123456sll.se (A.G.)
                [2 ]Institute of Environmental Medicine, Karolinska Institute, Box 210, 171 77 Stockholm, Sweden
                [3 ]Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden; cecilia.stenfors@ 123456psychology.su.se
                [4 ]Aging Research Center, Department of Neurobiology, Care Science and Society, Karolinska Institute, 171 77 Stockholm, Sweden
                Author notes
                Author information
                https://orcid.org/0000-0002-6619-9679
                https://orcid.org/0000-0002-0657-1512
                Article
                ijerph-18-03303
                10.3390/ijerph18063303
                8004976
                33806787
                7f9444c0-cdaa-4287-8a10-8a4c58b0a497
                © 2021 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
                : 05 March 2021
                : 19 March 2021
                Categories
                Article

                Public health
                covid-19,greenness,mental health,societal change,social isolation,psychological factors,resilience

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