Can Views and Contact with Nature at Home Help Combat Anxiety and Depression during the Pandemic? Results of the GreenCOVID study.

BACKGROUND: The COVID-19 pandemic and the lockdown measures have had important consequences on the mental health of the population, although little is known about the role played by nature and its benefits. OBJECTIVES: The present study aims to evaluate the risk of anxiety and depression during the first wave of the COVID-19 pandemic in Spain and to identify the factors most strongly associated with anxiety and depression, including sociodemographic, household characteristics, and access to or contact with natural environment. METHODS: GreenCOVID is an online cross-sectional study promoted by the Health & Territory Research (HTR) of the University of Seville in Spain, Maynooth University in Ireland, and the University of Winchester in the United Kingdom. This study includes only data from Spain which were collected between April 8, 2020 and April 27, 2020. Binary logistic regression was conducted to identify the factors associated with anxiety and depression through the HADS scale. RESULTS: Of the total of 2,464 adults who participated in GreenCOVID Spain, mean age was 38.1 years, 72.6% were female, 58.1% were at risk of anxiety, and 32.3% of depression. In the multivariable logistic regression, the factors associated with risk of anxiety were female: gender, being a student and problems at home. Regarding the risk of depression, the factors most associated were being a student, female gender, problems at home, worse evaluation of views from home and less help from outside views to cope with lockdown. CONCLUSIONS: Our findings show that during COVID-19 pandemic, in addition to sociodemographic factors female gender and being a student, problems at home, lack of natural elements in the home, and worse appreciation of views from home were associated with mental health problems. Thus, housing conditions and access to the natural environment were important for mental health during COVID-19 lockdown.

The importance for wellbeing of having views of nature from and in the home during the COVID-19 pandemic. Results from the GreenCOVID study.

Introduction: The COVID-19 pandemic has influenced the daily lives of people and may affect their well-being. The aim of the present study is to assess well-being and associated factors during the first wave of the COVID-19 pandemic in the general population in three European countries. Methods: GreenCOVID was an observational cross-sectional study using an online survey (7 April 2020 to 24 July 2020) promoted by the Health & Territory Research (HTR) of the University of Seville in Spain, Maynooth University in Ireland, and the University of Winchester in England, which included a sample of 3109 unselected adults. Well-being was measured using the World Health Organization-Five Well-Being Index (WHO-5) scale. Seven aspects, related to the natural environment of the home, were evaluated (role of outdoor views in coping with lockdown, importance of blue spaces during lockdown, importance of green spaces during lockdown, quality of view from home, use of outdoor spaces or window views, elements of nature in the home, and views of green or blue spaces from home). Binary logistic regression was conducted to identify the parameters associated with poor well-being. Results: Mean age was 39.7 years and 79.3% lived in Spain, the majority in urban areas (92.8%). 73.0% were female and 72.0% had undertaken university studies. Poor well-being was reported by 59.0%, while 26.6% indicated the possible presence of clinical depression. The factors most associated with poor well-being were students (OR = 1.541), those who had no engagement in physical activity (OR = 1.389), those who reported 'living in Spain' compared to Ireland (OR = 0.724), being female (OR = 1.256), poor quality views from home (OR = 0.887), less benefit from views of the natural environment to cope with lockdown (OR = 0.964), and those younger in age (OR = 0.990). Conclusions: More than half of participants reported poor well-being and one in four indicated the possible presence of clinical depression during the first wave of the COVID-19 pandemic. We identified that belonging to a younger age cohort, being a student, being female, not being able to continue with daily pursuits such as physical activity, and having poorer quality of views from home led to poor well-being among participants. Our study highlights the importance of continued physical activity and views of nature to improve the well-being of individuals during times of crisis such as the COVID-19 pandemic.

Association of sleep duration with mental health: results from a Spanish general population survey.

PURPOSE: The purpose of the present study was to evaluate the association of sleep duration and mental health among the general population. METHODS: A cross-sectional study was carried out with an adult Spanish population sample between 16 and 64 years old. The information was obtained from data provided by a randomly selected representative sample of 505 adults stratified by age, sex, and geographic area. Participants were interviewed face-to-face in their respective households with questions including sociodemographic characteristics, lifestyle, sleep duration, and the 12-item General Health Questionnaire to screen risk for poor mental health. The duration of sleep hours were grouped into the following categories: < 6 h, 6-7 h, and, > 7 h. Regression analysis was used to assess associations between sleep duration and risk of poor mental health. RESULTS: A percentage of respondents 13.1% reported sleeping less than 6 h. The analysis demonstrated a significant (p = 0.001) negative (B = - 0.512) relationship between hours of sleep and risk of poor mental health (GHQ-12), demonstrating that reduced sleep duration increases the risk of poor mental health. CONCLUSIONS: Sleep duration lower than 6 h is prevalent among the general population in Spain, especially among women and people who frequently use electronic devices. The results show that people who experience shorter sleep duration face a greater risk of poor mental health. These findings suggest that it is important to raise awareness of healthy sleeping habits, with emphasis on adequate sleep duration.

Perceptions of Change in the Natural Environment produced by the First Wave of the COVID-19 Pandemic across Three European countries. Results from the GreenCOVID study.

Although different studies have evaluated the positive impacts of the COVID-19 pandemic and lockdown measures on reducing noise pollution and traffic levels and improving air quality, how populations have perceived such changes in the natural environment has not been adequately evaluated. The present study provides a more in-depth exploration of human population perception of enhanced natural exposure (to animal life and nature sounds) and reduced harmful exposure (by improved air quality and reduced traffic volume) as a result of the COVID-19 pandemic lockdown. The data is drawn from 3,109 unselected adults who participated in the GreenCOVID survey from April to July 2020 in England, Ireland, and Spain. The findings suggest that the positive impacts to the natural environment as a result of the lockdown have been better received by the population in Spain and Ireland, in comparison to England. Participants who resided in urban areas had better perceived improvements in nature sounds, air quality, and traffic volume compared to those in rural areas. Older populations and those with lower smoking and alcohol consumption were found to perceive this improvement the most. Furthermore, the greater perception of improvements in environmental elements was also associated with better self-perceived health and improved wellbeing. In the binary logistic regression, living in Ireland or Spain, urban areas, female gender, older age, and good overall wellbeing were associated with a greater perception of improvements in the natural environment, while the factors most associated with a greater perception of reduced harmful exposure were living in Spain, had a good self-perceived health status and older age.

Social economic costs of ankylosing spondylitis in Spain.

OBJECTIVES: Ankylosing spondylitis (AS) is a disease associated with a high number of comorbidities, chronic pain, functional disability, and resource consumption. The aim of this study was to estimate the burden of AS in Spain. METHODS: A questionnaire, designed for the development of the "Atlas of Axial Spondyloarthritis in Spain 2017" cross-sectional study, was distributed to patients in 2016. This questionnaire was used to collect relevant sociodemographic and clinical information on patients with AS, as well as to identify resource consumption and patient work productivity losses related to AS within the previous 12 months of survey completion. Subsequently, direct costs were estimated with the bottom-up method and work productivity losses with the human capital method. Economic burden was estimated by subgroups, taking into account the degree of disease activity and the psychological status. RESULTS: The study sample comprised 578 patients with AS: mean age was 46.0±11.0 years, 52.9% were males, and 35.8% had a university-level education. Mean disease duration and diagnostic delay were 13.4±11.3 and 8.4±7.6 years, respectively, and mean Bath Ankylosing Spondylitis Disease Activity Index was 5.4±2.1. The estimated median annual cost per patient with AS was 5,402.4, with an average annual cost per patient of 11,462.3 euros, of which 61.1% (6,999.8 euros) were attributed to direct health care costs, 5.3% (611.3 euros) to direct non-health care costs, and 33.6% (3,851.2 euros) to work productivity losses. CONCLUSIONS: AS poses a significant burden for the Spanish National Health System and society.

Is a View of Green Spaces from Home Associated with a Lower Risk of Anxiety and Depression?

Although a large body of research supports the theory that exposure to nature results in mental health benefits, research evidence on the effects of having a view of green space from home is still scarce. The aim of the present study is to assess the impact that access to a green space view from home has on anxiety and depression. This is a cross-sectional study extracting data from the "2018 Green Spaces, Daily Habits and Urban Health Survey" conducted in Carmona (Spain). The study included variables on sociodemographic and lifestyle, view of green spaces from home, self-perceived health status, and risk of anxiety and depression measured using the Hospital Anxiety and Depression Scale (HADS). Chi-square tests were used to assess variable's associations and a multiple linear regression models used to identify the variables explaining the risk of anxiety and depression, taking into account sociodemographic characteristics, frequency of visits and view of green spaces from home. According to our results, adults who enjoy a view of green spaces from home have a lower risk of anxiety and depression.

Atlas of axial spondyloarthritis in Spain 2017: Study design and population / Atlas de Espondiloartritis Axial en España 2017: diseño del estudio y descripción de la muestra

Objective: Atlas of Axial Spondyloarthritis in Spain 2017 aims to better understand the reality of the patients suffering from this disease from an integrated approach. Methods: The Atlas 2017 based its results on an extensive cross-sectional patient survey conducted in Spain (2016), validated by a multidisciplinary group of experts on spondyloarthritis. Results: Data from 680 patients with axSpA were obtained, most of them suffered from AS, were HLA-B27 positive, older than 45 years, and live as part of a couple. A large percentage had university studies, were disabled and members of a patient association. Patients reported a diagnostic delay of 8.5 years, high disease activity (BASDAI 5.5±2.2), moderate-important stiffness (61.0%), medium-high functional limitation (74.9%), and psychological distress (GHQ 5.7±4.5). A total of 54.7% reported taking NSAIDs, 28.4% DMARDs, 36.3% biological therapy and 32.2% were not receiving pharmacological treatment. Conclusions: The Atlas survey data reveals still a long diagnostic delay, high disease activity, psychological distress, while an important proportion could be undertreated

Objetivo: El Atlas de Espondiloartritis Axial en España 2017 tiene como objetivo comprender mejor la realidad de los pacientes que padecen esta enfermedad desde un enfoque integrado. Métodos: El Atlas 2017 basó sus resultados en una amplia encuesta transversal de pacientes realizada en España (2016), validada por un grupo interdisciplinar de expertos en espondiloartritis. Resultados: Se obtuvieron datos de 680 pacientes con EspAax. La mayoría de ellos sufría EA, eran HLA-B27 positivo, mayores de 45 años y vivían en pareja. Un gran porcentaje tenía estudios universitarios, discapacidad reconocida y era miembro de una asociación de pacientes. Los pacientes declararon un retraso diagnóstico de 8,5 años, alta actividad de la enfermedad (BASDAI 5,5±2,2), rigidez moderada-importante (61,0%), limitación funcional moderada-alta (74,9%) y problemas psicológicos (GHQ 5,7±4,5). Un total del 54,7% declaró estar tomando AINE, el 28,4% FAME, el 36,3% terapia biológica, mientras que el 32,2% no recibía ningún tipo de tratamiento farmacológico. Conclusiones: Los datos de la encuesta Atlas revelan todavía un enorme retraso diagnóstico, alta actividad de la enfermedad, problemas psicológicos, mientras que una proporción importante de pacientes podrían estar infratratados

Atlas of axial spondyloarthritis in Spain 2017: Study design and population.

OBJECTIVE: Atlas of Axial Spondyloarthritis in Spain 2017 aims to better understand the reality of the patients suffering from this disease from an integrated approach. METHODS: The Atlas 2017 based its results on an extensive cross-sectional patient survey conducted in Spain (2016), validated by a multidisciplinary group of experts on spondyloarthritis. RESULTS: Data from 680 patients with axSpA were obtained, most of them suffered from AS, were HLA-B27 positive, older than 45 years, and live as part of a couple. A large percentage had university studies, were disabled and members of a patient association. Patients reported a diagnostic delay of 8.5 years, high disease activity (BASDAI 5.5±2.2), moderate-important stiffness (61.0%), medium-high functional limitation (74.9%), and psychological distress (GHQ 5.7±4.5). A total of 54.7% reported taking NSAIDs, 28.4% DMARDs, 36.3% biological therapy and 32.2% were not receiving pharmacological treatment. CONCLUSIONS: The Atlas survey data reveals still a long diagnostic delay, high disease activity, psychological distress, while an important proportion could be undertreated.

The convention on the rights of persons with disabilities UN: analysis of the implementation in Andalucía (Spain) of article 33 / La convención sobre los derechos de las personas con discapacidad de la ONU: análisis de la aplicación del artículo 33 en Andalucía (España)

The United Nations Convention on the Rights of Persons with Disabilities is a major human rights instrument of the United Nations with the goal of ensuring protection of rights of persons with disabilities. In Article 33, ‘National implementation and monitoring’ establishes, among other things, that States Parties shall implement the Convention and establish or designate a coordination mechanism at government level. This article aims to show the results of implementing Article 33 in Andalucía (Spain) in the context of the European project ‘Planning Inclusive Communities’ led by the University of Siegen (Germany). The methodology used in this study was based on a comparative analysis of data obtained through a series of surveys addressed to local governments in different European regions. This article shows the results obtained in Andalucía region where the Convention is disseminated in various formats, at local levels it shows a low presence, because ratification have neither led to a legal obligation at lower state levels. Local managers showed disregard for the principles of the Convention and its practical application. This lack of information at local level influences the methods that Spanish occupational therapists (OT) use with persons with disabilities in occupational centers (OC).

La Convención de las Naciones Unidas sobre los Derechos de las Personas con discapacidad es un importante instrumento de derechos humanos que tiene como objetivo garantizar la protección de los derechos de las personas con discapacidad. En el artículo 33, ‘Aplicación y seguimiento nacional‘ se establece, entre otras cosas, que los Estados deben aplicar los artículos de la Convención y establecer o designar un mecanismo de coordinación a nivel gubernamental. Este artículo tiene como objetivo mostrar los resultados obtenidos en Andalucía (España) de la aplicación del artículo 33 dentro del proyecto europeo `Planning Inclusive Communities‘ dirigido por la Universidad de Siegen (Alemania). La metodología seguida en este estudio se basó en un análisis comparativo de los datos obtenidos a través de una serie de encuestas dirigidas a gobiernos locales de diferentes regiones europeas. Este artículo muestra los resultados obtenidos en la región de Andalucía, en la cual la Convención se difunde en una gran variedad de formas. A nivel local, la Convención se muestra con una presencia baja debido a que la ratificación no ha conllevado una obligación legal en los niveles administrativos más bajos. Los gerentes locales mostraron un cierto desconocimiento de los principios de la Convención de las Naciones Unidas y su aplicación práctica. Esta falta de información a nivel local influye en los métodos que los terapeutas ocupacionales (TO) españoles utilizan con las personas con discapacidad en los centros ocupacionales (CO).