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The importance of the outdoors for supporting well-being is recognized, but less is known about the role of the outdoors in supporting people living with dementia. The aim of this study was to examine three stakeholder groups' understandings about outdoor-based support and care for people living with dementia to help understand what might be done to maximize the outdoors as a source of support for people living with dementia. Data were collected in Southern Ontario, Canada, between January and June 2023 via 1-1 interviews (n = 12); four focus groups (n = 17) with staff from organizations providing outdoor recreation or social programming; six in-person focus groups (n = 37); and 2 outdoor-based walking focus groups (n = 17) conducted with people living with dementia, care partners, and older adults. All interviews and focus groups, other than the walking focus groups where the field notes were used, were audio recorded and fully transcribed verbatim. Within and across data sets, thematic analysis was conducted. We report findings relating to the challenges of achieving full participation in outdoor-based activities; perceived physical, social, and mental health benefits of outdoor activities; stigma; and overcoming perceived risks. The importance of the outdoors for people living with dementia and their care partners is evident. There are implications for care policy and practice relating to the promotion of (social) health and well-being for people living with dementia.

Heart rate variability (HRV) is a psychophysiological variable that is often used in applied analysis techniques to indicate health status because it provides a window into the intrinsic regulation of the autonomic nervous system. However, HRV data analysis methods are varied and complex, which has led to different approaches to data collection, analysis, and interpretation of results. Our scoping review aimed to explore the diverse use of HRV methods in studies designed to assess health outcomes in outdoor free-living contexts. Four database indexes were searched, which resulted in the identification of 17,505 candidate studies. There were 34 studies and eight systematic reviews that met the inclusion criteria. Just over half of the papers referenced the 1996 task force paper that outlined the standards of measurement and physiological interpretation of HRV data, with even fewer adhering to recommended HRV recording and analysis procedures. Most authors reported an increase in parasympathetic (n = 23) and a decrease in systematic nervous system activity (n = 20). Few studies mentioned methods-related limitations and challenges, despite a wide diversity of recording devices and analysis software used. We conclude our review with five recommendations for future research using HRV methods in outdoor and health-related contexts.

Aging populations across the world are facing a number of challenges in the context of health and healthcare. These challenges are driven by the aging process and the illnesses associated with aging. Healthcare for older people has become a point of concern with most health organizations, and this is particularly the case with palliative care. In this instance, the movement of the patient may be restricted to a room with no or limited access to the outdoors. This research focuses on the active integration of immersive technologies with healthcare. By addressing the problem of providing patients with the experience of being present in an outdoors space, the associated psychological and physiological benefits can be identified. In this mixed methods research paper, the impact of a crossover study to discern technology preferences in relation to immersive technologies among a sample of older people is reported. In addition, the study highlights factors that contribute to a meaningful immersive experience that can improve psychological and physiological wellbeing. The study identifies that there are two significant categorical aspects that contribute to such immersive experiences, technological aspects (including, for example, the weight of headsets, visual impairment, pixelation, and gamification) and emotive aspects (for example, joy, anger, and fear). The study suggests that older people prefer immersive Virtual Reality (VR) environments rather than 360 video experiences. This can be attributed to the greater flexibility in the provision of interactivity in virtual reality systems.

Both physical activity (PA) and nature exposure are associated with several youth health benefits. However, the health outcomes when being physically active in nature, called Green Exercise (GE), are less clear. Thus, the purpose of this systematic review was to provide an overview of the psychosocial and physiological outcomes of GE in children and adolescents and to outline future GE research directions. The PRISMA statement guided the review. Web of Science, PubMed, ERIC, and APA PsychNET were systematically searched in February 2019, including studies between 2000 and 2019. Fourteen of 1175 identified publications were included, which reported 15 different psychosocial and six different physiological outcomes, with some studies reporting more than one outcome. For 16 outcomes, studies reported either similar or no effects for both GE and comparison groups. For six outcomes, studies reported stronger effects for GE, for three outcomes, studies reported stronger effects in the comparison group. Evidence was rated as weak, using the EPHPP tool. Thus, GE does not have deleterious effects for children and adolescents compared to PA in other settings. GE might be beneficial; however, due to the study's heterogeneity and quality, it is premature to make definite conclusions. Future research should build the quality of evidence for GE, use more rigorous research designs, and investigate the underlying effects and mechanisms of GE., Competing Interests: The authors declare no conflict of interest.

Mounting evidence supports health and well-being benefits associated with nature experiences, while also highlighting race- and class-based inequalities in access and exposure. We synthesized the literature on nature contact by Latinos in the United States to assess the state of knowledge and strategically identify research needs to improve outcomes and reduce health disparities for this rapidly growing ethnic group. Our systematic review revealed 108 articles with a notable increase in number of papers over the past 3 decades. We noted that the body of research is focused on certain demographic targets (adults in urban areas) with a relative dearth of knowledge for others (children, seniors, and rural areas). Our analysis also revealed strong compartmentalizing of studies into research “clusters” based on nonoverlapping topics and types of outcomes that are measured. Although one-third of studies explored health outcomes, these studies rarely examined other outcomes or research topics. Moreover, less than 7% of studies reported on interventions. Given the potential for nature contact to enhance health and well-being, there is substantial need for multidisciplinary research that explores interactions between social, cultural, and economic factors, and how those ultimately relate to nature contact and outcomes for Latinos in the United States.

Knowledge of human activity patterns is needed in air pollution exposure and health risk assessment. However, human activity patterns have never been evaluated in the Eastern Mediterranean societies. Therefore, we investigated the activity pattern of 285 subjects (17-63 years) in Amman, Jordan during October to November, 2015. The subjects spent >80% of their time indoors during weekend days and >85% on workdays. They spent ~4.8% and ~5.7% in transportation during weekend days and workdays, respectively. Males had a different activity pattern than females on weekend days, but both genders had similar activity patterns on workdays. On workdays, males spent less time indoors than females. The activity pattern found in this study is a bit different than that for North Americans and Europeans, who spend more time indoors and in transit. The activity pattern found in this study was very different than that observed for Koreans, who spent about 59% and 67% indoors on workdays and weekend, respectively. The main outcomes of this survey can be utilized in human exposure studies. This study and the upcoming future studies have been encouraged and supported by the regional WHO office in Amman., Competing Interests: The authors declare no conflict of interest.