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Objectives: Arts on Prescription (AoP) interventions are part of mainstream social prescribing provision in primary health care. Whilst the body of evidence for AoP interventions has been developing, this has primarily focused on wellbeing. \ud Study Design: The present work is an observational longitudinal study on a community-based AoP social prescribing intervention in the South West UK. \ud Method: The present study assessed changes in anxiety, depression, and wellbeing in a cohort of patients participating in up to two eight-week cycles of AoP. The sample consisted of 245 individuals referred into the programme from 2017 to 2019, with a sub-sample of participants (N=110) with identifiable multimorbidity. Outcomes were measured pre- and post-intervention at both initial and re-referral. \ud Results: Anxiety, depression, and wellbeing were all significantly improved after initial referral, re-referral, and overall from initial to post re-referral for this intervention in the whole sample and multimorbid sub-sample. Multivariate analyses revealed that no participant variables appeared to account for the variance in outcome change scores. \ud Conclusion: The research provides further support for AoP interventions, finding associations with reduced anxiety and depression and increased wellbeing. Additionally, these outcomes are evidenced in those with multi-morbidity, as well as across initial- and re-referral cycles.

The literature addressing the potential for nature and natural environments to reduce stress and improve health outcomes has a relative paucity of work regarding interactions with animals, particularly those that are not domestic pets. The present observational study sought to understand whether a brief encounter with non‐domestic animals might reduce stress and improve well‐being of participants, and whether participants' nature relatedness, and their appraisals of the interaction might influence these changes. Participants (N = 86, mean age = 20.8 years, 81.8% women) took part in a brief wildlife encounter at a UK safari park, walking for approximately 11 min around an enclosure with free‐roaming lemurs. Heart rate, cortisol and measures of mood were taken before and after the encounter to understand whether this activity could reduce biological levels of stress and improve psychological well‐being. There was no decrease in participants’ heart rate after their encounter but there was a statistically significant decrease in salivary cortisol. Measures of mood significantly improved immediately after the encounter. Reductions in cortisol were associated with dimensions of an individual's nature relatedness, as well as aspects of the animal encounter (number of lemurs and lemur proximity). The findings contribute to parallel literature on nature–health relationships, with the addition of factors seemingly driving the interaction (individuals' nature relatedness, and the number and proximity of the animals) providing important contributory information. The present study provides new information on how encounters with nature, particularly those involving animals, may be beneficial for health and well‐being. Critically, this study was carried out in a setting where potential impact of visitors on animals is negligible, thereby demonstrating the potential for creating environments where both human and animal well‐being are maximised. A free Plain Language Summary can be found within the Supporting Information of this article.

Whilst the Covid-19 pandemic moves into a new phase with the successful roll out of vaccines in adults in the UK, there is an opportunity to reflect, re-evaluate, and reconfigure public health responses. Of importance is the need to defend and protect the frontline workforce who have sacrificed so much over the last 18 months. The present essay summarises key recommendations from frontline workers to policymakers with specific reference to the preparation needed for the Autumn and Winter to come. The participants from the CV19 Heroes Project give voice to concerns over the unique challenges posed by the coming months, and speak of the need to embed evidence into future policy to both compensate existing, and prevent future, occupational exposure to Covid-19, the experience of Long Covid, and the overall psychological and physical scars experienced from what has been a traumatic period of their working lives.

A mixed methods evaluation of the See with Fresh Eyes\ud programme delivered by Look Again in partnership with\ud Create Gloucestershire.

The Mindful Photography course offered by Look Again was established to support individuals to increase their wellbeing and mental health. Mindful Photography is defined as “using our sight and a camera as an anchor to help us become more consciously aware of the present moment. It is experiencing the process of creating photographs in a non-judgmental, compassionate way” (Ruth Davey, 2017). The mindful photography course involved six half-day sessions to develop photography skills and improve mental health and wellbeing through mindfulness techniques. The present evaluation was commissioned to evaluate this intervention for its efficacy in improving participants’ health and wellbeing.

Background: Arts on Prescription programmes are designed to support mental health and well-being of patients with a variety of clinical needs within the community. Despite a number of studies reporting benefits, there are some patients that do not see improvements in well-being. Yet, there is limited research investigating the reasons for this. Methods: Using a sequential mixed-methods design the present study sought to understand why some participants (N=312) experienced an increase in well-being and others did not (N=95) after attending an Arts on Prescription intervention based in the South West of England between 2009 and 2016. Results: Quantitative comparisons between the two groups identified little differences, aside from age and baseline well-being (WEMWBS scores), with those that improved being slightly younger, and having lower well-being at the outset compared with those that did not improve. A process model depicting the perceived facilitative and inhibitive factors of attending the programme was developed from the qualitative findings. This model suggests that the social aspect of the course may be implicated in the participants differential outcomes; with those that showed a decrease in well-being reporting difficulties in interacting with others during the intervention. Further, the participants who reported an increase in well-being felt vulnerable to “relapse” when finishing the course due to uncertainties regarding future support and at their ability to maintain their well-being without the provision of the programme. Conclusions: This research suggests a need to promote communication amongst groups in such interventions with the hope that this will provide a more facilitative environment for all participants to benefit. Also, such programmes should consider follow-on options to ensure the participants feel supported and confident in managing their well-being once the course comes to an end. Findings will be pertinent to those commissioning primary care art interventions, ensuring that referral policies and pathways are designed for optimal effectiveness and for potentially tailoring social prescribing programmes to suit the participants specific needs.

This report represents UNFPA’s contribution to a global stocktaking exercise to mark the 15th anniversary of the Madrid International Plan of Action on Ageing (MIPAA) which was adopted at the Second World Assembly on Ageing in April 2002. This report is one of six that are are being prepared by UNFPA and which complement the regional review reports prepared by respective UN Regional Commissions. It contributes to the cooperation programme on ageing that exists between the UN Economic Commission for Europe (UNECE) and the UNFPA Regional Office for Eastern Europe and Central Asia (EECARO). It is a technical, analytical report that reflects demographic analysis, direct experiences, literature review and policy and programme assessments. In addition, it focuses on a specific subset of countries: in this case the UNFPA programme countries in the Eastern Europe and Central Asia (EECA) region.\ud \ud It is hoped that this analytical UNFPA report will contribute to a comprehensive understanding of the implementation and challenges ahead of the Madrid International Plan of Action and inspire governments and non-governmental actors to share good practices and learn from successful examples.