Short- and long-term reproducibility of body surface gastric mapping using the Gastric Alimetry® system.

BACKGROUND: Many diagnostic tests for gastroduodenal symptoms, such as gastric emptying scintigraphy (GES), gastric emptying breath tests (GEBT), and electrogastrography (EGG) show variable intra-individual reproducibility over time. This study investigated the short- and long-term reproducibility of body surface gastric mapping (BSGM), a non-invasive test for assessing gastric function, in controls and patients with chronic gastroduodenal disorders. METHODS: Participants completed three standardized BSGM tests using Gastric Alimetry® (Alimetry, New Zealand). The test encompassed a fasting baseline (30 min), a 482 kCal standard meal, and a 4 h postprandial recording. The first two tests were >6 months apart and the last occurred ~1 week after the second test, to evaluate long and short-term reproducibility. RESULTS: Fourteen patients with upper gastrointestinal symptoms and 14 healthy controls were recruited. There were no significant differences in any BSGM metrics between the tests at short and long term (all p > 0.180). Lin's concordance correlation coefficients (CCC) for the primary metrics were high, ranging from 0.58 to 0.96, with intra-individual coefficients of variance (CVintra) ranging from 0.2% to 1.9%. Reproducibility was higher, and intra-individual variation lower, than in previous studies of GES (CCC = 0.54-0.83, CVintra = 3%-77%), GEBT (CVintra = 8%-11%), and EGG (CVintra = 3%-78%). CONCLUSIONS: BSGM spectral metrics demonstrate high reproducibility and low intra-individual variation at both short and long term, with superior results to comparable tests. The high reproducibility of Gastric Alimetry supports its role as a diagnostic aid for gastric dysfunction and a reliable tool for evaluating treatment outcomes and disease progression over time.

Changes in hair cortisol in a New Zealand community sample during the Covid-19 pandemic.

Background: Evidence suggests that countries with higher Covid-19 infection rates experienced poorer mental health. This study examined whether hair cortisol reduced over time in New Zealand, a country that managed to eliminate the virus in the first year of the pandemic due to an initial strict lockdown. Methods: A longitudinal cohort study assessed self-reported stress, anxiety and depression and collected hair samples that were analyzed for cortisol, across two waves in 2020. The sample consisted of 44 adults who each returned two 3 cm hair samples and completed self-reports. Hair cortisol was assessed per centimetre. Results: Hair cortisol reduced over time (F (5, 99.126) = 10.15, p < .001, partial eta squared = 0.19), as did anxiety and depression. Higher hair cortisol was significantly associated with more negative life events reported at wave two (r = 0.30 segment 1, r = 0.34 segment 2, p < .05), but not anxiety or depression. Conclusions: Strict virus control measures may not only reduce infection rates, but also reduce psychological distress, and hair cortisol over time.

Longitudinal outcome monitoring in patients with chronic gastroduodenal symptoms investigated using the Gastric Alimetry system: study protocol.

INTRODUCTION: The Gastric Alimetry platform offers a multimodal assessment of gastric function through body surface gastric mapping (BSGM) and concurrent symptom-tracking via a validated App. We aim to perform a longitudinal cohort study to examine the impact of Gastric Alimetry, and changes in clinical management on patient symptoms, quality of life and psychological health. METHODS AND ANALYSIS: This is a prospective multicentre longitudinal observational cohort study of participants with chronic gastroduodenal symptoms. Consecutive participants undergoing Gastric Alimetry will be invited to participate. Quality of life will be assessed via EuroQol-5D and the Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life score. Gastrointestinal symptoms will be assessed via the Patient Assessment of Upper Gastrointestinal Symptom Severity index, and the Gastroparesis Cardinal Symptom Index. Psychometrics will be assessed, including anxiety via the General Anxiety Disorder-7, perceived stress using the Perceived Stress Scale 4, and depression via the Patient Health Questionnaire 9. Clinical parameters including diagnoses, investigations and treatments (medication and procedures) will also be captured. Assessments will be made the week after the BSGM test, at 30 days, 90 days, 180 days and 360 days thereafter. The primary outcome is feasibility of longitudinal follow-up of a cohort that have undergone Gastric Alimetry testing; from which patients' continuum of care can be characterised. Secondary outcomes include changes in patient-reported symptoms, quality of life and psychometrics (anxiety, stress and depression). Inferential causal analyses will be performed at the within patient level to explore causal associations between treatment changes and clinical outcomes. The impact of Gastric Alimetry on clinical management will also be captured. ETHICS AND DISSEMINATION: The protocol has been approved in Aotearoa New Zealand by the Auckland Health Research Ethics Committee. Results will be submitted for conference presentation and peer-reviewed publication.

Cognitive behavioural therapy-based interventions for gastroduodenal disorders of gut-brain interaction: A systematic review.

OBJECTIVE: Cognitive behavioural therapy (CBT) is increasingly used to manage Disorders of Gut-Brain Interaction (DGBIs). This systematic review aimed to review the evidence for the effectiveness of CBT-based interventions for patients with gastroduodenal DGBIs. METHODS: Medline, Embase, PubMed, Cochrane Central, and Scopus were searched in July 2022. Studies were included if they investigated the effects of a CBT-based intervention on gastrointestinal symptoms and/or psychological outcomes pre- and post-intervention in patients with gastroduodenal DGBIs. Case studies, studies not in English, and studies with patients under 18 years were excluded. Results were synthesised narratively, and standardised effect sizes were calculated where possible. RESULTS: Nine studies (seven RCTs and two pre/post studies) were identified, with data reported in 10 articles (total N = 602). The studies investigated patients with functional dyspepsia (n = 7), rumination syndrome (n = 1), and supragastric belching (n = 1). The studies had heterogeneous interventions, methodologies, and outcomes, precluding meta-analysis, as well as a moderate-high risk of bias and high drop-outs rates. Findings demonstrated decreased gastrointestinal symptoms and improved anxiety, depression, and quality of life, from pre- to post-intervention, with medium to large effect sizes for symptoms and small to large effect sizes for psychological outcomes. Efficacy was maintained at follow-up, up to one year later. CONCLUSIONS: This review suggests promising evidence that CBT effectively improves gastrointestinal symptoms and psychological outcomes in patients with gastroduodenal DGBIs. However, heterogeneity, risk of bias, and lack of statistical reporting were noted, indicating the need for more robust research and standardisation.

It's a helluva journey: a qualitative study of patient and clinician experiences of nausea and vomiting syndromes.

Background: Chronic gastroduodenal disorders including, chronic nausea and vomiting syndrome, gastroparesis, and functional dyspepsia, are challenging to diagnose and manage. The diagnostic and treatment pathways for these disorders are complex, costly and overlap substantially; however, experiences of this pathway have not been thoroughly investigated. This study therefore aimed to explore clinician and patient perspectives on the current clinical pathway. Methods: Semi-structured interviews were conducted between June 2020 and June 2022 with 11 patients with chronic nausea and vomiting syndrome alone (based on Rome IV criteria) and nine gastroenterologists who treat these conditions. Interviews were recorded, transcribed, and thematically analyzed using a reflexive, iterative, inductive approach. Five key patient themes were identified: (1) the impacts of their chronic gastroduodenal symptoms, (2) the complexity of the clinical journey, (3) their interactions with healthcare providers, (4) the need for advocacy, and (5) their experience of treatments. Five key clinician themes were also identified: (1) these conditions were seen as clinically complex, (2) there is an uncertain and variable clinical pathway, (3) the nuance of investigations, (4) these conditions were difficult to therapeutically manage, and (5) there are barriers to developing a therapeutic relationship. Conclusion: Findings indicate that both patients and clinicians are dissatisfied with the current clinical care pathways for nausea and vomiting syndromes. Recommendations included the development of more clinically relevant and discriminant tests, standardization of the diagnostic journey, and the adoption of a multidisciplinary approach to diagnosis and treatment.

Illness perceptions and diabetes self-care behaviours in Maori and New Zealand Europeans with type 2 diabetes mellitus: a cross-sectional study.

AIMS: This study investigated differences in illness perceptions and self-care behaviours between Maori and New Zealand (NZ) Europeans with type 2 diabetes mellitus (T2DM), and how these perceptions were related to clinical outcomes. METHODS: Participants were 85 Maori and 85 NZ European adults, recruited from outpatient clinics, who completed a cross-sectional questionnaire on illness perceptions and self-care behaviours. Clinical data, including HbA1c, retinopathy, neuropathy and nephropathy, were collected from medical records. RESULTS: Compared to NZ Europeans, Maori had higher HbA1c, lower adherence to medication and a healthy diet, and were more likely to smoke. Maori reported greater perceived consequences of diabetes on their lives, and more severe symptoms than NZ Europeans did. Maori were more likely to attribute T2DM to food and drink, whereas NZ Europeans were more likely to attribute T2DM to weight. Perceiving that treatment could help control diabetes was associated with lower HbA1c and higher medication adherence in Maori and NZ Europeans independently. CONCLUSIONS: Maori experienced and perceived worse T2DM outcomes than NZ Europeans did. Research is needed to develop and test clinical interventions to address these inequities and improve outcomes, possibly by asking patients about their perceptions, providing tailored and culturally appropriate education, and discussing patients' concerns.

Cultural Differences in Psychological Distress and Illness Perceptions Amongst People Living With Cardiac Inherited Diseases.

Cardiac Inherited diseases (CID) and minority ethnic status are both associated with anxiety and depression. This study aimed to investigate differences in patient experiences of CID between ethnic groups in New Zealand (NZ) in order to inform psychosocial interventions and promote health equity. A cross-sectional survey was administered to a NZ CID database. One-hundred and fifty-two (152) NZ Europeans, 19 Maori, and two Pasifika participated. Maori and Pasifika peoples reported significantly greater symptom perceptions, shorter timeline perceptions, higher perceived risk of severe symptoms, and were less likely to attribute the cause of their CID to hereditary factors than NZ Europeans. Maori and Pasifika also reported more anxiety and distress, although both groups reported beneficial medication perceptions and high medication adherence. Differences could not be attributed to clinical or other demographic variables. The use of screening tools and development of culturally appropriate interventions may help reduce both distress and health inequities.

Perspectives and experiences of Maori and Pasifika peoples living with cardiac inherited disease: a qualitative study.

OBJECTIVE: Cardiac inherited diseases can have considerable psychosocial effects, including lifestyle limitations, anxiety and depression. Most research to date on patient experiences of CID has been conducted with people from Western cultures, yet culture can shape patient views and experiences of health. The aim of this research was to explore the experiences and perspectives of Maori and Pasifika living with a cardiac inherited disease (CID). METHODS AND MEASURES: Semi-structured interviews were conducted with 14 Maori and 14 Pasifika patients living with a cardiac inherited disease and seven of their family members, using Talanoa and Kaupapa Maori methodologies. Themes from the interviews were identified using interpretative phenomenological analysis. RESULTS: Three common themes were identified as important in shaping participants' perceptions and experiences of CID: (1) difficulty in understanding the disease as separate from symptoms, (2) considering ancestors and future generations and (3) the role of spirituality and religion. CONCLUSION: This study highlights a gap between indigenous patients' understanding of CID and the western biomedical approach. Patients' understanding and treatment behaviours depend on symptoms, familial ties and spirituality. The findings support the need for transparency and culturally appropriate practices in healthcare. Considering these aspects may help to reduce health inequities for these populations.

The effect of expressive writing on wound healing: Immunohistochemistry analysis of skin tissue two weeks after punch biopsy wounding.

OBJECTIVE: To investigate the effects of expressive writing and its timing (pre or post wounding) on re-epithelialisation and leucocyte subsets within healing tissue. We previously showed expressive writing pre-wounding improved re-epithelialisation. Here we investigate cellular processes in the wound. METHODS: In a 2(writing content) x 2(writing timing) randomized trial, 122 participants were randomized to perform either expressive or control writing, before or after a 4 mm punch biopsy wound. On day 14 post-wounding, participants had a 5 mm punch biopsy of the initial wound. Seven of 16 primary registered outcomes were analysed, including re-epithelialisation from two photographs of the 4 mm biopsy (previously reported). This paper reports immunohistochemistry analysis of five primary outcomes - Langerhans cells, immune cell activation (HLA and CD3+), and macrophages (CD68 and MPO) - in the 5 mm biopsies in a random sample of 96 participants. RESULTS: Participants who performed either writing task pre-wounding had greater Langerhans cell infiltration, than those who wrote post-wounding (F(1,85) = 7.86, p = .006, ηp2 = 0.08). Those who performed expressive writing also had greater Langerhans cell infiltration than those who performed control writing (F(1,85) = 4.00, p = .049, ηp2 = 0.04). There were no significant group or interaction effects on immune cell activation or macrophages. Healed wounds on day 10 had lower levels of macrophages (z = -1.96, p = .050), and CD3+ cells (z = -1.99, p = .046) than non-healed wounds. CONCLUSION: Langerhans cells in the healing skin are affected by the timing and topic of writing. More research is needed to further explore timing and corroborate these results. CLINICAL TRIALS REGISTRATION: Registered at https://www.anzctr.org.au/ (Trial ID: ACTRN12614000971639).

Utility and Acceptability of a Brief Type 2 Diabetes Visual Animation: Mixed Methods Feasibility Study.

BACKGROUND: Visualizations of illness and treatment processes are promising interventions for changing unhelpful perceptions and improving health outcomes. However, these are yet to be tested in patients with type 2 diabetes mellitus (T2DM). OBJECTIVE: This study assesses the cross-cultural acceptability and potential effectiveness of a brief visual animation of T2DM at changing unhelpful illness and treatment perceptions and self-efficacy among patients and family members in 2 countries, New Zealand and Saudi Arabia. Health care professionals' views on visualization are also explored. METHODS: A total of 52 participants (n=39, 75% patients and family members and n=13, 25% health care professionals) were shown a 7-minute T2DM visual animation. Patients and family members completed a questionnaire on illness and treatment perceptions and self-efficacy before and immediately after the intervention and completed semistructured interviews. Health care professionals completed written open-ended questions. Means and 95% CIs are reported to estimate potential effectiveness. Inductive thematic analysis was conducted on qualitative data. RESULTS: All participants rated the visual animation as acceptable and engaging. Four main themes were identified: animation-related factors, impact of the animation, animation as an effective format for delivering information, and management-related factors. Effect sizes (ranged from 0.10 to 0.56) suggested potential effectiveness for changing illness and treatment perceptions and self-efficacy among patients and family members. CONCLUSIONS: Visualizations are acceptable and may improve the perceptions of patients' with diabetes in a short time frame. This brief visual animation has the potential to improve current T2DM education. A subsequent randomized controlled trial to investigate the effects on illness and treatment perceptions, adherence, glycemic control, and unplanned hospital admission is being prepared.

The Effects of Interacting With a Paro Robot After a Stressor in Patients With Psoriasis: A Randomised Pilot Study.

Objective: Stress can play a role in the onset and exacerbation of psoriasis. Psychological interventions to reduce stress have been shown to improve psychological and psoriasis-related outcomes. This pilot randomised study investigated the feasibility of a brief interaction with a Paro robot to reduce stress and improve skin parameters, after a stressor, in patients with psoriasis. Methods: Around 25 patients with psoriasis participated in a laboratory stress task, before being randomised to either interact with a Paro robot or sit quietly (control condition) for 30 min. Raman spectroscopy and trans-epidermal water loss were measured at baseline, after the stressor and after the intervention as indexes of acute skin changes. Psychological variables, including self-reported stress and affect, were also measured at the three time-points. Results: No statistically significant differences between the two conditions were found for any of the outcomes measured. However, effect sizes suggest significance could be possible with a larger sample size. Changes in the psychological and Raman spectroscopy outcomes across the experimental session were found, indicating the feasibility of the procedures. Conclusion: This pilot study showed that a brief interaction with a Paro robot was a feasible intervention for patients with psoriasis, but future trials should broaden the inclusion criteria to try to increase recruitment rates. Studying people who are highly stressed, depressed or who are stress-responders may increase the power of the intervention to show effects using a longer-term intervention.

Evidence for the effects of viewing visual artworks on stress outcomes: a scoping review.

OBJECTIVE: To review the existing evidence on the effects of viewing visual artworks on stress outcomes and outline any gaps in the research. DESIGN: A scoping review was conducted based on the Joanna Briggs Institute methodology for scoping reviews and using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Two independent reviewers performed the screening and data extraction. DATA SOURCES: Medline, Embase, APA PsycINFO, Cochrane CENTRAL, Scopus, Google Scholar, Google, ProQuest Theses and Dissertations Database, APA PsycExtra and Opengrey.eu were searched in May 2020. ELIGIBILITY CRITERIA: Studies were included if they investigated the effects of viewing at least one visual artwork on at least one stress outcome measure. Studies involving active engagement with art, review papers or qualitative studies were excluded. There were no limits in terms of year of publication, contexts or population types; however, only studies published in the English language were considered. DATA EXTRACTION AND SYNTHESIS: Information extracted from manuscripts included: study methodologies, population and setting characteristics, details of the artwork interventions and key findings. RESULTS: 14 primary studies were identified, with heterogeneous study designs, methodologies and artwork interventions. Many studies lacked important methodological details and only four studies were randomised controlled trials. 13 of the 14 studies on self-reported stress reported reductions after viewing artworks, and all of the four studies that examined systolic blood pressure reported reductions. Fewer studies examined heart rate, heart rate variability, cortisol, respiration or other physiological outcomes. CONCLUSIONS: There is promising evidence for effects of viewing artwork on reducing stress. Moderating factors may include setting, individual characteristics, artwork content and viewing instructions. More robust research, using more standardised methods and randomised controlled trial designs, is needed. REGISTRATION DETAILS: A protocol for this review is registered with the Open Science Framework (osf.io/gq5d8).

Friends from the Future: A Scoping Review of Research into Robots and Computer Agents to Combat Loneliness in Older People.

BACKGROUND AND AIM: Loneliness is a common problem in older adults and contributes to poor health. This scoping review aimed to synthesize and report evidence on the effectiveness of interventions using social robots or computer agents to reduce loneliness in older adults and to explore intervention strategies. METHODS: The review adhered to the Arksey and O'Malley process for conducting scoping reviews. The SCOPUS, PUBMED, Web of Science, EMBASE, CINAHL, PsycINFO, ACM Digital Library and IEEE Xplore databases were searched in November, 2020. A two-step selection process identified eligible research. Information was extracted from papers and entered into an Excel coding sheet and summarised. Quality assessments were conducted using the Mixed Methods Appraisal Tool. RESULTS: Twenty-nine studies were included, of which most were of moderate to high quality. Eighteen were observational and 11 were experimental. Twenty-four used robots, four used computer agents and one study used both. The majority of results showed that robots or computer agents positively impacted at least one loneliness outcome measure. Some unintended negative consequences on social outcomes were reported, such as sadness when the robot was removed. Overall, the interventions helped to combat loneliness by acting as a direct companion (69%), a catalyst for social interaction (41%), facilitating remote communication with others (10%) and reminding users of upcoming social engagements (3%). CONCLUSION: Evidence to date suggests that robots can help combat loneliness in older adults, but there is insufficient research on computer agents. Common strategies for reducing loneliness include direct companionship and enabling social interactions. Future research could investigate other strategies used in human interventions (eg, addressing maladaptive social cognition and improving social skills), and the effects of design features on efficacy. It is recommended that more robust experimental and mixed methods research be conducted, using a combination of validated self-report, observational, and interview measures of loneliness.

Perceptions of community pharmacists to implementing technologies in the workplace: an exploratory study.

Background The proliferation of different technologies in pharmacies has begun to change the role and work of pharmacists; however, while workplace integration of technologies has been shown to be beneficial, there are still barriers to their implementation. Few studies have investigated pharmacists' perceptions of these technologies. Objective To investigate the views of community pharmacists on the implementation of technologies in pharmacy practice. Setting Community pharmacies in Auckland, New Zealand. Methods Semi-structured interviews were conducted June-September 2018 with a convenience sample of 20 pharmacists. Interviews explored current medication management and technologies used to support this service, experiences with technologies, confidence in learning new technologies, and whether the introduction of technologies could solve any needs in pharmacy practice. Data were analysed using inductive thematic analysis. Main outcome measure Community pharmacists views on pharmacy technologies. Results Four key themes were identified: attitudes to existing medication management technologies, adapting to new technologies, acceptance of technology, and barriers to implementing technology in pharmacies. Pharmacists were accepting of technology to help with medication management and allowing them to provide more patient-centered care. Most pharmacists expressed confidence in using new technologies and viewed technology as a tool to address current limitations in their practice. Barriers to technology were cost, consequences of medication error, fear that technology may replace people, and an over-reliance on technology. Conclusion Community pharmacists made use of several types of technologies to promote medication management, including robotics. While mostly accepting of new technologies to streamline tasks and reduce error, pharmacists highlighted the importance of addressing barriers to technology implementation prior to workplace implementation.

The Effects of Sensory Enrichment After a Laboratory Stressor on Human Skin Barrier Recovery in a Randomized Trial.

OBJECTIVE: Environmental enrichment (EE) can reduce stress, alter immunity, and speed wound healing in animals. However, it is not known whether these effects translate to humans. This study aimed to investigate whether sensory EE could improve wound healing after a stressor in humans. METHODS: A total of 105 participants underwent a tape-stripping procedure and were then stressed using a laboratory stress paradigm. After this, they were randomized to interact for 30 minutes with one of two possible sensory EE interventions (music as auditory enrichment or a Paro robot as multisensory enrichment) or to a control condition. Skin barrier recovery was measured using transepidermal water loss at baseline, after the stressor, and after the intervention. Stress was measured using self-report, heart rate, blood pressure, and salivary stress-related biological measures. Enjoyment during the intervention was measured by self-report as a possible mediator. RESULTS: The Paro condition had significantly improved skin barrier recovery (mean [M] = 44%, standard error [SE] = 1.92) compared with the control condition (M = 37% SE = 2.01, F(2,88) = 3.25, p = .043), both with and without controlling for covariates. The music condition did not significantly differ from the other conditions (M = 42%, SE = 1.95, p values > .05). Both objective and subjective stress measures did not significantly differ between conditions. Mediational analysis showed that enjoyment levels during the intervention period significantly mediated the relationship between condition and skin barrier recovery (z = 2.00, p = .046). CONCLUSIONS: Paro, or other companion robots, may be an effective form of enrichment to improve skin barrier recovery in humans after a laboratory stressor, and this effect may be due to enjoyment. Further research with patient groups is required to investigate whether Paro can help heal clinical wounds. TRIAL REGISTRATION: ACTRN12618000953235, registered at https://anzctr.org.au.

The effects of environmental enrichment on skin barrier recovery in humans: a randomised trial.

This study investigated whether environmental enrichment (EE) could reduce stress and improve wound healing in humans. 120 participants underwent a standardised tape-stripping procedure and were then randomised to interact for 30 minutes with one of three EE interventions (comfort blankets as tactile enrichment, music as auditory enrichment or a Paro robot as multi-sensory enrichment) or to a control group. Skin barrier recovery (SBR) was measured using transepidermal water loss at baseline, after tape-stripping and after the intervention. Psychological variables, cortisol and alpha-amylase were measured at the three time-points. SBR did not significantly differ between the EE conditions and the control condition. The music condition had higher stimulation levels than the control condition, and the comfort condition had significantly lower relaxation levels than the control condition after the intervention. The EE interventions tested were not beneficial for wound healing compared to a control group. Limitations were that the sample were not stressed and an active control condition was used.

Developing assistive robots for people with mild cognitive impairment and mild dementia: a qualitative study with older adults and experts in aged care.

OBJECTIVES: This research is part of an international project to design and test a home-based healthcare robot to help older adults with mild cognitive impairment (MCI) or early dementia. The aim was to investigate the perceived usefulness of different daily-care activities for the robot, developed from previous research on needs. DESIGN: Qualitative descriptive analysis using semistructured interviews. Two studies were conducted. In the first study, participants watched videos of a prototype robot performing daily-care activities; in the second study, participants interacted with the robot itself. SETTING: Interviews were conducted at a university and a retirement village. PARTICIPANTS: In study 1, participants were nine experts in aged care and nine older adults living in an aged care facility. In study 2, participants were 10 experts in aged care. RESULTS: The themes that emerged included aspects of the robot's interactions, potential benefits, the appearance, actions and humanness of the robot, ways to improve its functionality and technical issues. Overall, the activities were perceived as useful, especially the reminders and safety checks, with possible benefits of companionship, reassurance and reduced caregiver burden. Suggestions included personalising the robot to each individual, simplifying the language and adding more activities. Technical issues still need to be fixed. CONCLUSION: This study adds to knowledge about healthcare robots for people with MCI by developing and testing a new robot with daily-care activities including safety checks. The robot was seen to be potentially useful but needs to be tested with people with MCI.

Viewing Landscapes Is More Stimulating Than Scrambled Images After a Stressor: A Cross-disciplinary Approach.

Research has demonstrated that nature is beneficial for many aspects of one's health. This pilot study aimed to investigate whether viewing landscape artworks, as a form of representational nature, could improve psychological and physiological recovery from a laboratory stressor. A sample of 30 participants was randomized to one of two conditions: landscape and scrambled. After a laboratory stress task, participants in the landscape condition viewed a series of landscape paintings for 30 min; participants in the scrambled condition viewed digitally scrambled versions of these artworks as a control condition. Pupil size was measured while viewing the images using an eye tracker. Affect, drowsiness and fatigue, and the salivary stress biomarkers, cortisol, and alpha-amylase were measured at baseline, after the stressor, and after the artwork viewing period. After the viewing period, the scrambled condition had increased reports of low negative affect (which contains the variables of sleepy, dull, and sluggish) (p = 0.045, η p 2 = 0.12) and increased reports of drowsiness (p = 0.038, η p 2 = 0.12). Salivary cortisol levels decreased more rapidly while viewing the scrambled images compared to the landscape artworks (p = 0.027, η p 2 = 0.62). Lastly, pupil size while viewing the landscape artworks was larger than when viewing a blank screen (p = 0.025, η p 2 = 0.33), an effect not seen in the scrambled condition. This pilot study suggests that viewing landscape artworks was more stimulating and reduced drowsiness after stress when compared to viewing scrambled images.

A comparison of the cardiovascular effects of simulated and spontaneous laughter.

OBJECTIVES: Laughter has long been regarded as beneficial for health, but the mechanisms are not clearly understood. The current study aimed to compare the acute cardiovascular effects of spontaneous and simulated laughter. DESIGN: A mixed factorial experiment was performed to examine changes in cardiovascular variables in response to experimental tasks across conditions. INTERVENTIONS: A sample of 72 participants were randomised to one of three 6 min interventions. Participants in the simulated laughter condition were asked to generate fake laughter, the spontaneous laughter condition viewed a humorous video, and the control condition watched a non-humorous documentary. This was followed by a laboratory stress task. MAIN OUTCOMES MEASURES: Heart rate and heart rate variability (as indexed by rMSSD) were monitored continuously throughout the experiment using ECG. RESULTS: The simulated laughter condition had a significantly higher heart rate (p < .001, ηp2 = .26) and lower rMSSD (p < .001, ηp2 = .13) during the laughter task compared to the other two conditions. Follow-up hierarchical regressions indicated that the difference in heart rate was due to the fact that the simulated condition produced more laughter. The difference in rMSSD, however, was unique to the simulated condition even when controlling for the amount of laughter. The simulated laughter condition had a significantly lower mean HR during the stress task but this was not significant after controlling amount of laughter produced. CONCLUSIONS: Laughter leads to increased heart rate and reduced heart rate variability, which is similar to the effects of exercise. This finding is more pronounced in simulated laughter.