Shinrin-Yoku (Forest Bathing): A Scoping Review of the Global Research on the Effects of Spending Time in Nature.

Background: This Scoping review (ScR) builds upon the 2017 review conducted by Hansen et al which contributed to evidence base shinrin-yoku (SY), also known as forest bathing (FB), has many positive health effects and is becoming a prescribed dose (specific time spent in nature) by health care providers. Practice and research regarding SY, has been historically based in Asian countries with a recent increase in Europe. The need and call for more research worldwide continues to further the evidence of SY as a health promotion modality. Through this ScR the authors identified programmatic components, health information monitored and screened, time spent in nature, geographical regions, trends, and themes in SY research worldwide. Methods: Following PRISMA-ScR guidelines we searched across 7 electronic databases for SY or FB research articles from 2017 through 2022. PubMed, CINAHL, PsycInfo, ScienceDirect, SCOPUS, Embase, JSTOR were included due to the interdisciplinary nature of SY or FB research. Each database provided unique strengths ensuring a capture of a wide range of articles. The resulting articles were screened and extracted through Covidence. Results: Database searches returned 241 results, with 110 references removed during the deduplication process, 131 were initially screened in the title and abstract review stage. Resulting in 82 unique results deemed relevant and screened in full text. During the final stage of the review, 63 articles met all inclusion criteria and were extracted for data. Conclusions: The practice of SY has physiological (PHYS) and psychological (PSYCH) benefits across age groups. Research findings indicate either the natural or the virtual environment (VW) has significant health benefits. Continued research is encouraged globally for short- and long-term health outcomes for all individuals. The connection with nature benefits the mind, body and soul and is supported by Henry David Thoreau's philosophy: "Our livesneed the relief of where the pine flourishes and the jay still scream."

Facilitating an Interprofessional Course on Climate Change and Public Health Preparedness.

In this paper, we share the theories that guided the design of an interprofessional education course on Climate Change and Public Health Preparedness and how the course supported students' professional interest and action competence as they move through their education and into their professional work in the context of our unfolding climate crisis. The course was guided by the public health emergency preparedness domains and was built to allow for students to explore applications of the content for themselves and their own profession. We designed the learning activities to support personal and professional interest development and help students move into perceived and demonstrated action competence. For the evaluation of our course, we asked the following research questions: What kinds of personal and professional commitments to action did students propose by the end of the course? Did these vary in depth and specificity and by the number of credits they enrolled in? In what ways did students develop personal and professional action competence over the course? Finally, how did they show personal, professional, and collective agency related to the course content on adaptation, preparedness, and mitigation of the health impacts from climate change? Using qualitative analysis guided by action competence and interest development theories, we coded student writing from course assignments. We also conducted comparative statistical analysis to assess differential impacts for students who enrolled for one versus three credits. The results show that this course design supported students' progression of knowledge and perceived ability in specific individual and professional collective actions to reduce the health impacts of climate change.

Mechanisms underlying food insecurity in the aftermath of climate-related shocks: a systematic review.

Food insecurity is prevalent, affecting 1·2 billion people globally in 2021. However, the effects of food insecurity are unequally distributed across populations and climate-related shocks threaten to exacerbate food insecurity and associated health consequences. The mechanisms underlying this exacerbation at the household level are largely unknown. We aimed to synthesise the available evidence on the mechanisms connecting extreme climate events to household-level food insecurity and highlight the research gaps that must be addressed to inform better food security and health policy. For this systematic review, a comprehensive literature search was done by a medical librarian in February, 2021 for articles about food security and climate-related shocks. Relevant publications were identified by searching the following databases with a combination of standardised index terms and keywords: MEDLINE, Embase, CINAHL, GreenFILE, Environment Complete, Web of Science Core Collection, and Global Health. Searches were limited to human studies published in English. Included studies measured food security outcomes using indicators developed by the UN Food and Agricultural Organization (ie, consumption patterns, livelihood change, malnutrition, and mortality) and explained the mechanism behind the household-level or population-level food insecurity. Purely theoretical, modelling, and review studies were excluded. Quality assessment was conducted using the appropriate Joanna Briggs Institute Critical Appraisal Tool. Data were analysed using thematic analysis of the categories of mechanism (interpreted using internationally accepted frameworks), risk and resilience factors, and author policy recommendations. We found a paucity of data with only 18 studies meeting criteria for inclusion out of 337 studies identified for full-text review. All the studies that were included in our analysis showed worse food security outcomes after climate-related shocks. Food availability was the most common mechanism cited (17 studies), although most studies addressed at least one additional mechanism (15 studies). Studies were of mixed methodologies with nuanced discussions of risk and resilience factors, and of policy recommendations. This systematic review shows that there is an incomplete assessment of food security at the household and community level after climate-related shocks in the literature and finds that food availability is the primary mechanism studied. The low number of studies on this topic limits subgroup analysis and generalisability; however, the good quality of the studies allows for important policy recommendations around improving resilience to climate shocks and suggestions for future research including the need for a more granular understanding of mechanisms and feasible adaptation solutions.

Assessing the Impact of a Shinrin-Yoku (Forest Bathing) Intervention on Physician/Healthcare Professional Burnout: A Randomized, Controlled Trial.

Professional healthcare worker burnout is a crisis in the United States healthcare system. This crisis can be viewed at any level, from the national to local communities, but ultimately, must be understood at the level of the individual who is caring for patients. Thus, interventions to reduce burnout symptoms must prioritize the mental health of these individuals by alleviating some of the symptoms of depression, grief, and anxiety that accompany burnout. The practice of Shinrin-Yoku (Forest Bathing) is a specific evidence-based practice which research has shown can improve an individual's mental health and, when performed in a group, can support a sense of social connection. We investigated the impact of a three-hour, guided Shinrin-Yoku (Forest Bathing) nature-based intervention on burnout symptoms among physicians and other healthcare workers by using a randomized, controlled trial. The Oldenburg Burnout Inventory (OLBI) and Mini-Z assessments were used to collect baseline burnout scores and participants were randomized into the intervention group, which completed the assessment again after the Shinrin-Yoku walk, or into a control group, which completed the assessments again after a day off from any clinical duties. A total of 34 participants were enrolled in the intervention group and a total of 22 participants were enrolled in the control group. Ultimately, no statistically significant differences were detected between the pre-test and post-test scores for the intervention group or between the post-test scores of the intervention group compared to the control group. However, the subjective responses collected from participants after participating in the Shinrin-Yoku walk overwhelmingly reported decreased feelings of stress and increased mental wellbeing. This raises important questions about the difference between symptoms of burnout and other aspects of mental health, as well as the limitations of a one-time nature-based intervention on levels of chronic burnout symptoms. Thus, further research on the effects of engaging healthcare providers in an ongoing practice of Shinrin-Yoku is warranted.

A Daily Practice for Planetary Health.

The field of Planetary Health offers a theoretical framework to inspire and guide nurses as we work with individuals, families, and communities to improve health and well-being. As professionals, a daily practice of planetary health can help us flourish through connecting with nature, centering justice and equity, slowing down, savoring connection, and becoming stewards of our environments. Nurses are positioned to lead us into a future where health and well-being are built into our societies through endeavors that understand how our collective flourishing is dependent on realizing that human health is interconnected with the health of our planet and all beings.