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1. Nature-based social prescribing programmes: opportunities, challenges, and facilitators for implementation

Author

de Bell, S, Alejandre, J.C., Menzel, C, Sousa-Silva, R, Straka, T, Berzborn, S, Bürck-Gemassmer, M, Dallimer, Martin, Dayson, C, Fisher, Jessica C., Haywood, A, Herrmann, A, Immich, G, Keßler, C.S., Köhler, K, Lynch, M, Marx, V, Michalsen, A, Mudu, P, Napierala, H, Nawrath, M, Pfleger, S, Quitmann, C, Reeves, J.P., Rozario, K, Straff, W, Straff, K, Wendelboe-Nelson, C, Marselle, M., Oh, R.R.Y., Bonn, A, de Bell, S, Alejandre, J.C., Menzel, C, Sousa-Silva, R, Straka, T, Berzborn, S, Bürck-Gemassmer, M, Dallimer, Martin, Dayson, C, Fisher, Jessica C., Haywood, A, Herrmann, A, Immich, G, Keßler, C.S., Köhler, K, Lynch, M, Marx, V, Michalsen, A, Mudu, P, Napierala, H, Nawrath, M, Pfleger, S, Quitmann, C, Reeves, J.P., Rozario, K, Straff, W, Straff, K, Wendelboe-Nelson, C, Marselle, M., Oh, R.R.Y., and Bonn, A

Abstract

Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems. This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany's health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP. We identified five overarching themes for developing, implementing, and evaluating NBSP: Capacity Building; Accessibility and Acceptability; Networks and Collaborations; Standardised Implementation and Evaluation; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation. NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to different contexts. This research could

Published
2024

2. Nature-based social prescribing programmes: opportunities, challenges, and facilitators for implementation

Author

de Bell, S., Alejandre, J.C., Menzel, C., Sousa-Silva, R., Straka, T.M., Berzborn, S., Bürck-Gemassmer, M., Dallimer, M., Dayson, C., Fisher, J.C., Haywood, A., Herrmann, A., Immich, G., Keßler, C.S., Köhler, K., Lynch, M., Marx, V., Michalsen, A., Mudu, P., Napierala, H., Nawrath, M., Pfleger, S., Quitmann, C., Reeves, J.P., Rozario, Kevin, Straff, W., Walter, K., Wendelboe-Nelson, C., Marselle, M.R., Oh, Rui Ying Rachel, Bonn, Aletta, de Bell, S., Alejandre, J.C., Menzel, C., Sousa-Silva, R., Straka, T.M., Berzborn, S., Bürck-Gemassmer, M., Dallimer, M., Dayson, C., Fisher, J.C., Haywood, A., Herrmann, A., Immich, G., Keßler, C.S., Köhler, K., Lynch, M., Marx, V., Michalsen, A., Mudu, P., Napierala, H., Nawrath, M., Pfleger, S., Quitmann, C., Reeves, J.P., Rozario, Kevin, Straff, W., Walter, K., Wendelboe-Nelson, C., Marselle, M.R., Oh, Rui Ying Rachel, and Bonn, Aletta

Abstract

Background:Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems.Methods:This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany’s health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP.Results:We identified five overarching themes for developing, implementing, and evaluating NBSPCapacity Building; Accessibility and Acceptability; Networks and Collaborations; Standardised Implementation and Evaluation; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation.Conclusions:NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to diffe

Published
2024

3. Genome-wide DNA methylation sequencing identifies epigenetic perturbations in the upper airways under long-term exposure to moderate levels of ambient air pollution.

Author

Messingschlager M, Bartel-Steinbach M, Mackowiak SD, Denkena J, Bieg M, Klös M, Seegebarth A, Straff W, Süring K, Ishaque N, Eils R, Lehmann I, Lermen D, and Trump S

Subjects
Adult, Humans, DNA Methylation, Environmental Exposure analysis, Particulate Matter toxicity, Particulate Matter analysis, Epigenesis, Genetic, Air Pollutants toxicity, Air Pollutants analysis, Air Pollution adverse effects, Air Pollution analysis
Abstract

While the link between exposure to high levels of ambient particulate matter (PM) and increased incidences of respiratory and cardiovascular diseases is widely recognized, recent epidemiological studies have shown that low PM concentrations are equally associated with adverse health effects. As DNA methylation is one of the main mechanisms by which cells regulate and stabilize gene expression, changes in the methylome could constitute early indicators of dysregulated signaling pathways. So far, little is known about PM-associated DNA methylation changes in the upper airways, the first point of contact between airborne pollutants and the human body. Here, we focused on cells of the upper respiratory tract and assessed their genome-wide DNA methylation pattern to explore exposure-associated early regulatory changes. Using a mobile epidemiological laboratory, nasal lavage samples were collected from a cohort of 60 adults that lived in districts with records of low (Simmerath) or moderate (Stuttgart) PM 10 levels in Germany. PM 10 concentrations were verified by particle measurements on the days of the sample collection and genome-wide DNA methylation was determined by enzymatic methyl sequencing at single-base resolution. We identified 231 differentially methylated regions (DMRs) between moderately and lowly PM 10 exposed individuals. A high proportion of DMRs overlapped with regulatory elements, and DMR target genes were involved in pathways regulating cellular redox homeostasis and immune response. In addition, we found distinct changes in DNA methylation of the HOXA gene cluster whose methylation levels have previously been linked to air pollution exposure but also to carcinogenesis in several instances. The findings of this study suggest that regulatory changes in upper airway cells occur at PM 10 levels below current European thresholds, some of which may be involved in the development of air pollution-related diseases., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2023
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4. Road traffic noise and hypertension--accounting for the location of rooms.

Author

Babisch W, Wölke G, Heinrich J, and Straff W

Subjects
Adult, Aged, Berlin epidemiology, Cross-Sectional Studies, Female, Humans, Hypertension epidemiology, Male, Middle Aged, Housing, Hypertension etiology, Noise adverse effects
Abstract

Objective: The association between the exposure to road traffic noise and the prevalence of hypertension was assessed accounting for background air pollution and the location of rooms with respect to the road., Methods: A cross-sectional study was carried out inviting all subjects aged 35-74 years for participation that lived on 7 major trunk roads in 3-4 storey terraced apartment buildings and in parallel side streets that were completely shielded from noise due to the rows of houses along the major roads. The study was performed on 1770 subjects that did not have a self-reported medical doctor diagnosis of hypertension before they moved into their current residence. Noise levels at the facade of the front and the rear side of the houses were drawn from available noise maps of the area. A large set of covariates were considered to adjust the results for confounding., Results: Significant increases between road traffic noise and hypertension were found with respect to the 24h A-weighted average noise indicator L(DEN). The adjusted odds ratio (OR) per noise level increment of 10 dB(A) was 1.11 (95% confidence interval (CI): 1.00-1.23). Stronger significant estimates of the noise effect were found in subjects with long residence time (OR=1.20, CI=1.05-1.37), and with respect to the exposure of the living room during daytime (OR=1.24, CI=1.08-1.41) compared with the exposure of the bedroom during night-time (OR=0.91, CI=0.78-1.06)., Conclusion: Chronic exposure to road traffic noise is associated with an increased risk of high blood pressure. Daytime noise exposure of the living room had a stronger impact on the association than night-time exposure of the bedroom., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Published
2014
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