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Introduction: Diagnosing behavioral problems in children and adolescents, which include conduct symptoms, anxiety, or somatic complaints, is frequently based on subjective perceptions and interviews with family or caregivers. However, current theoreticians and practitioners of systemic theory are increasingly emphasizing that there are multiple subjective narratives about oneself, the world, and one's symptoms. The question is whether these narratives are equivalent, and if not, under what circumstances do they diverge? Objectives: The study aimed to investigate whether the perception of behavioral problems among young adolescents with ADHD aligns with their parents' perspective, and whether family bonding is a factor in this association. Methods: The analytic sample comprised about 200 children, aged 10-14 years, and their parents, mostly coming from well-situated families. The data were collected as a part of the NeuroSmog project. The variables were measured by the Child Behaviour Checklist (CBCL), the Youth Self Report (YSR), the Family Adaptation and Cohesion Evaluation Scales (FACES-IV). The structural equation modelling (SEM) to analyse data was used. The models were also stratified by age, sex, and social status. Results: There is a significant difference between the perspectives of parents and children regarding the level of behavioral problems. Family bonding is associated with behavioral problems among children, but this relationship is only evident from their perspective. Conclusions: The perception referring to family narratives has the most significant impact on individual functioning. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Abstract: Background: The highly consistent association of growing up on a farm with a reduced asthma risk has so far been attributed to direct farm exposure. In contrast, geographic determinants of the larger environment have never been assessed. In this study, the effects of proximity to farms and environmental variables in relation to the residential address on asthma and atopy were assessed. Methods: Addresses of 2265 children of the Bavarian arm of the GABRIELA study were converted into geocodes. Proximity to the nearest cow farm was calculated, and environmental characteristics were derived from satellite data or terrestrial monitoring. Bacterial diversity in mattress dust samples was assessed in 501 children by sequencing of the 16S rRNA amplicons. Logistic regression models were used to calculate associations between outcomes and exposure variables. Results: Asthma and atopy were inversely associated with the presence of a farm within a radius of maximum 100 m. The environmental variables greenness, tree cover, soil sealing, altitude, air pollution differed not only between farm and non‐farm children but also between farm children with and without another farm nearby. The latter distinction revealed strong associations with characteristics of traditional farms including a broader diversity of microbial exposure, which mainly contributed to the protective effect on asthma. In non‐farm children, the protective effect of a farm nearby was completely explained by consumption of farm milk. Conclusions: Clustering of farms within a neighborhood of 100 m is strongly associated with the protective effect on asthma and may represent a more traditional style of farming with broader microbial exposure. [ABSTRACT FROM AUTHOR]

Background: Noise, one of the major environmental nuisances, affects the learning ability of children negatively. Objective: With the assumption that in the existing German 4-type school system children are exposed to various noise levels in each type of school, we investigated the association between children's school type and environmental noise level. Methods: In this cross-sectional study, we included 550 children—primary and secondary school students—aged 8–12 years, and who lived in 4 Bavarian cities. The environmental noise level was assessed by personal 24-h dosimeter measurements. The associations of interest were assessed by linear regression. Results: The average day noise level of 80.0 dB(A) was relatively high, exceeding the threshold level of 60 dB(A). In the model adjusted for sex, socioeconomic status (SES), and place of residence, noise level was significantly higher for primary schools by almost 2.3 dB(A); however, after additional adjustments for age, this association was distorted. The mean night noise level of 43.7 dB(A) was not associated with the school level. We could not find any significant differences in the noise level between different types of secondary schools. Conclusion: We found evidence that in Germany, children, especially of a younger age from primary school, are exposed to high noise levels during day in and outside the school environment. School administration and parents should work to make schools less noisy and more accomplished for learning to achieve a bright future for the children. [ABSTRACT FROM AUTHOR]

Background: Previous research suggests an association between exposure to nature and improved attention. However, no observational studies explored the underlying mechanisms or considered bluespace, and none used Polish data. We investigated the association between exposure to nature and attention, and whether it was mediated by nature perception, physical activity and sleep duration., Methods: Data derived from the case-control NeuroSmog study comprised 195 participants with attention deficit hyperactivity disorder (ADHD) and 457 participants without ADHD, all aged 10 to 13. Attention was evaluated using the computerized attention network test and the continuous performance test. Lifelong and current exposure to nature, determined by percentage of grass and tree cover and water presence within 500m buffer around residences, as well as domestic garden, were examined through linear, log-linear and negative binomial regressions. Potential pathways were explored using structural equation modelling., Results: Participants with ADHD with higher exposure to tree cover tended to have improved orienting ability, shorter reaction time and fewer correct rejections, while participants without ADHD tended to show decreased alertness and improved orienting ability. Participants with ADHD with higher exposure to grass cover tended to have longer reaction time, decreased alertness, improved orienting ability, reduced target discrimination ability, fewer correct rejections and less risky response style, while participants without ADHD tended to show decreased orienting ability, more mistakes, longer reaction time, better hit rate and more risky response style. Participants without ADHD with water in their neighbourhood tended to have improved orienting ability, fewer mistakes and better hit rate. Participants without ADHD with a garden tended to show improved target discrimination ability, better hit rate and more risky response style. No mediating pathways were revealed., Conclusion: Tree cover and presence of garden and water tended to be associated with improved attention in Polish adolescents while grass tended to have negative impact., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Nighttime light is a growing anthropogenic health threat, particularly in urban areas. Limited evidence suggests that exposure to outdoor artificial light at night (ALAN) may be associated with people's mental health by disrupting sleep-wake cycles., Aims: We assessed 1) the association between ALAN exposure and adults' symptoms of depression and anxiety, 2) whether the association was modified by sex, age, and income, and 3) the mediating role of sleep problems., Methods: We obtained cross-sectional data from 4,068 adults from the five largest Bulgarian cities. Depression and anxiety symptoms were measured using the 4-item Patient Health Questionnaire (PHQ-4). Sleep problems were self-reported based on three items. Outdoor ALAN at residential addresses was assessed using annual radiance levels obtained from satellite imagery. Regression models were adjusted for person-level characteristics, green space, and nitrogen dioxide (NO 2 ). We also assessed effect modification by sex, age, and income. Using mediation analyses, we tested sleep problems as a mediator of the ALAN-PHQ-4 association., Results: Greater ALAN exposure in the fully adjusted model was marginally associated with higher PHQ-4 scores. We observed no effect modification. The mediator, sleep problems, was also positively associated with ALAN. The mediation of sleep problems was significantly positive. While the direct association was null, the total ALAN association was marginally and positively associated with PHQ-4 scores., Conclusions: Our findings suggest a positive association between outdoor nighttime light pollution and mental health. Poor sleep quality is a possible pathway relating ALAN exposure to mental health. Considering the increasing ubiquity and intensity of urban nighttime illumination, light pollution-reducing policies may provide significant health benefits for urban populations., 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 © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Outdoor nighttime light (NTL) is a potential anthropogenic stressor in urban settings. While ecological studies have identified outdoor NTL exposure disparities, uncertainties remain about disparities in individual exposure levels, particularly in Europe., Aim: To assess whether some populations are disproportionately affected by outdoor NTL at their residences in urban Bulgaria., Methods: We analyzed 2023 data from a representative cross-sectional survey of 4,270 adults from the five largest Bulgarian cities. Respondents' annual exposures to outdoor artificial nighttime luminance were measured using satellite imagery and assigned at their places of residence. We calculated the Gini coefficient as a descriptive NTL inequality measure. Associations between respondents' NTL exposure levels and sociodemographic characteristics were assessed by estimating quantile mixed regression models. Stratified regressions were fitted by gender and for each city., Results: We found moderate distributive NTL inequalities, as indicated by a Gini coefficient of 0.214. Regression analyses showed associations between greater NTL exposure and higher educational attainment. Respondents with incomes perceived as moderate experienced less NTL exposure at the 0.5 and 0.8 quantiles, while unemployed respondents experienced lower exposure at the 0.2 and 0.5 quantiles. We observed null associations for the elderly and non-Bulgarian ethnicities. Regardless of the quantile, greater population density was associated with higher NTL levels. Stratification by sex did not yield substantial differences in the associations. We observed notable city-specific heterogeneities in the associations, with differences in the magnitudes and directions of the associations and the NTL quantiles., Conclusions: NTL exposures appeared to embody an environmental injustice dimension in Bulgaria. Our findings suggest that some sociodemographic populations experience higher exposure levels to NTL; however, those are not necessarily the underprivileged or marginalized. Identifying populations with high exposure levels is critical to influencing lighting policies to ease related health implications., 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 © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Prolonged exposure to air pollution has been linked to adverse respiratory health, yet the evidence concerning its association with chronic obstructive pulmonary disease (COPD) is inconsistent. The evidence of a greenness effect on chronic respiratory diseases is limited., Objective: This study aimed to investigate the association between long-term exposure to particulate matter (PM 2.5 and PM 10 ), black carbon (BC), nitrogen dioxide (NO 2 ), ozone (O 3 ) and greenness (as measured by the normalized difference vegetation index - NDVI) and incidence of self-reported chronic bronchitis or COPD (CB/COPD)., Methods: We analyzed data from 5355 adults from 7 centers participating in the Respiratory Health in Northern Europe (RHINE) study. Mean exposures to air pollution and greenness were assessed at available residential addresses in 1990, 2000 and 2010 using air dispersion models and satellite data, respectively. Poisson regression with log person-time as an offset was employed to analyze the association between air pollution, greenness, and CB/COPD incidence, adjusting for confounders., Results: Overall, there were 328 incident cases of CB/COPD during 2010-2023. Despite wide statistical uncertainty, we found a trend for a positive association between NO 2 exposure and CB/COPD incidence, with incidence rate ratios (IRRs) per 10 μg/m³ difference ranging between 1.13 (95% CI: 0.90-1.41) in 1990 and 1.18 (95% CI: 0.96-1.45) in 2000. O 3 showed a tendency for inverse association with CB/COPD incidence (IRR from 0.84 (95% CI: 0.66-1.07) in 2000 to 0.88 (95% CI: 0.69-1.14) in 2010. No consistent association was found between PM, BC and greenness with CB/COPD incidence across different exposure time windows., Conclusion: Consistent with prior research, our study suggests that individuals exposed to higher concentrations of NO 2 may face an elevated risk of developing COPD, although evidence remains inconclusive. Greenness was not associated with CB/COPD incidence, while O 3 showed a tendency for an inverse association with the outcome., 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 © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Lower birth weight and preterm birth may increase the risk of adverse health outcomes later in life. We examined whether maternal exposure to air pollution and greenness during pregnancy is associated with offspring birth weight and preterm birth., Methods: We analyzed data on 4286 singleton births from 2358 mothers from Respiratory Health in Northern Europe, a prospective questionnaire-based cohort study (1990-2010). Mixed-effects regression models with random intercepts for mothers and centers were used to estimate the association of exposures to particulate matter (PM 2.5 and PM 10 ), nitrogen dioxide (NO 2 ), ozone (O 3 ), black carbon (BC), and greenness (Normalized Difference Vegetation Index in 300m-buffers [NDVI 300m ]) with birth outcomes, adjusting for potential confounders., Results: Median (interquartile range [IQR]) exposures to PM 2.5 , PM 10 , NO 2 , O 3 , BC, and NDVI 300m during pregnancy were 8.4(5.0) µg/m 3 , 14.4(8.3) µg/m 3 , 14.0(11.0) µg/m 3 , 54.7(10.2) µg/m 3 , 0.47(0.41) µg/m 3 , and 0.31(0.20), respectively. IQR increases in air pollution exposures during pregnancy were associated with decreased birth weight and the strongest association was seen for PM 2.5 (-49g; 95% confidence interval [CI] = -83, -16). However, O 3 showed an opposite association. IQR increase in NDVI 300m was associated with an increase in birth weight of 25 g (95% CI = 7, 44). Preterm birth was not associated with the exposures., Conclusion: Increased greenness and decreased air pollution may contribute to healthier pregnancies and improve overall health in the next generation. This emphasizes the need to adopt policies that target the reduction of air pollution emissions and exposure of the population., Competing Interests: The authors declare that they have no conflicts of interest with regards to the content of this report., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Environmental Epidemiology. All rights reserved.)

Background: Previous cross-sectional studies have found a beneficial relationship between greenspace and children's behaviour. Nevertheless, evidence on the mechanisms underlying this association remains scant. We examined whether the availability of greenspace was related to fewer behavioural problems in Polish children and investigated potential mechanisms., Methods: Data were obtained from the case-control NeuroSmog study, in which children with and without attention deficit hyperactivity disorder (ADHD) were tested from October 2020 to September 2022. The analytic sample comprised 679 children aged 10-13 years. Parents reported internalizing, externalizing, and total behavioural problems using the Child Behaviour Check List (CBCL), as well as information about the presence of a domestic garden and potential mediators: greenspace perception, neighbourhood social cohesion, and physical activity. Tree and grass covers were extracted in 500 m and 1 km buffers around lifelong residences. Structural equation modelling (SEM) was used to examine the psychosocial pathways linking the greenspace metrics to behavioural problems., Results: Greenspace was only indirectly related to fewer behavioural problems. Specifically, tree cover was related to greater levels of physical activity which, in turn, was related to fewer internalizing and total behavioural problems. Tree cover and presence of garden were related to greenspace perception which, in turn, was associated with higher neighbourhood social cohesion which, in turn, was linked to fewer behavioural problems. The patterns of associations in children without ADHD were very similar to those in the full sample except that the associations from garden to greenspace perception and from physical activity to total behavioural problems were no longer significant. The only association persisted among girls was from neighbourhood social cohesion to behavioural problems and among boys were from tree cover to physical activity and tree cover and garden to greenspace perception., Conclusion: Trees and garden, but not grass, are linked to fewer behavioural problems through greenspace perception, neighbourhood social cohesion, and physical activity in Polish children., Competing Interests: 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., (© 2024 The Authors. Published by Elsevier Ltd.)

Background: Potential effect of greenspace exposure on human microbiota have been explored by a number of observational and interventional studies, but the results remained mixed. We comprehensively synthesized these studies by performing a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines., Methods: Comprehensive literature searches in three international databases (PubMed, Embase, and Web of Science) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Biology Medicine disc) were conducted from inception to November 1, 2023. Observational and interventional studies that evaluated associations between greenspace exposure and human microbiota at different anatomical sites were included. Studies were assessed using the National Toxicology Program's office of Health Assessment and Translation risk of bias tool and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation framework. Two authors independently performed study selection, data extraction, and risk of bias assessment, and evidence grading. Study results were synthesized descriptively., Results: Twenty studies, including 11 observational studies and 9 interventional studies, were finally included into the systematic review. The microbiota of the included studies was from gut (n = 13), skin (n = 10), oral cavity (n = 5), nasal cavity (n = 5) and eyes (n = 1). The majority of studies reported the associations of greenspace exposure with increased diversity (e.g., richness and Shannon index) and/or altered overall composition of human gut (n = 12) and skin microbiota (n = 8), with increases in the relative abundance of probiotics (e.g., Ruminococcaceae) and decreases in the relative abundance of pathogens (e.g., Streptococcus and Escherichia/Shigella). Due to limited number of studies, evidence concerning greenspace and oral, nasal, and ocular microbiota were still inconclusive., Conclusion: The current evidence suggests that greenspace exposure may diversify gut and skin microbiota and alter their composition to healthier profiles. These findings would be helpful in uncovering the potential mechanisms underlying greenspace and human health and in promoting a healthier profile of human microbiota., 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 © 2024. Published by Elsevier Ltd.)

Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures., Competing Interests: Declaration of competing interest No other authors have conflicts of interest to report., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory., Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM 2.5 and PM 10 ), black carbon (BC), nitrogen dioxide (NO 2 ), ozone (O 3 ) and greenness (normalized difference vegetation index - NDVI) across different exposure time windows., Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40-65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders., Results: Altogether, 327 (3.6 %) persons died in the period 2010-2021. Increased exposures in 1990 of PM 2.5 , PM 10 , BC and NO 2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04-1.87 per 5 μg/m 3 ), 1.33 (95 % CI: 1.02-1.74 per 10 μg/m 3 ), 1.16 (95 % CI: 0.98-1.38 per 0.4 μg/m 3 ) and 1.17 (95 % CI: 0.92-1.50 per 10 μg/m 3 ), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O 3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM 2.5 , PM 10 , BC and NO 2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics., Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated., 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 Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Development and functioning of attention-a key component of human cognition-can be affected by environmental factors. We investigated whether long- and short-term exposure to particulate matter with aerodynamic diameter < 10 μm (PM 10 ) and nitrogen dioxide (NO 2 ) are related to attention in 10- to 13-year-old children living in Polish towns recruited in the NeuroSmog case-control study., Methods: We investigated associations between air pollution and attention separately in children with attention deficit hyperactivity disorder (ADHD, n = 187), a sensitive, at-risk population with impaired attention and in population-based typically developing children (TD, n = 465). Alerting, orienting, and executive aspects of attention were measured using the attention network test (ANT), while inhibitory control was measured with the continuous performance test (CPT). We assessed long-term exposure to NO 2 and PM 10 using novel hybrid land use regression (LUR) models. Short-term exposures to NO 2 and PM 10 were assigned to each subject using measurements taken at the air pollution monitoring station nearest to their home address. We tested associations for each exposure-outcome pair using adjusted linear and negative binomial regressions., Results: We found that long-term exposures to both NO 2 and PM 10 were associated with worse visual attention in children with ADHD. Short-term exposure to NO 2 was associated with less efficient executive attention in TD children and more errors in children with ADHD. It was also associated with shorter CPT response times in TD children; however, this effect was accompanied by a trend towards more CPT commission errors, suggestive of more impulsive performance in these subjects. Finally, we found that short-term PM 10 exposure was associated with fewer omission errors in CPT in TD children., Conclusions: Exposure to air pollution, especially short-term exposure to NO 2 , may have a negative impact on attention in children. In sensitive populations, this impact might be different than in the general population., 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 B.V. All rights reserved.)

Background: While the adverse effects of short-term ambient ozone exposure on lung function are well-documented, the impact of long-term exposure remains poorly understood, especially in adults., Methods: We aimed to investigate the association between long-term ozone exposure and lung function decline. The 3014 participants were drawn from 17 centers across eight countries, all of which were from the European Community Respiratory Health Survey (ECRHS). Spirometry was conducted to measure pre-bronchodilation forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC) at approximately 35, 44, and 55 years of age. We assigned annual mean values of daily maximum running 8-h average ozone concentrations to individual residential addresses. Adjustments were made for PM 2.5 , NO 2 , and greenness. To capture the ozone-related change in spirometric parameters, our linear mixed effects regression models included an interaction term between long-term ozone exposure and age., Findings: Mean ambient ozone concentrations were approximately 65 μg/m³. A one interquartile range increase of 7 μg/m³ in ozone was associated with a faster decline in FEV 1 of -2.08 mL/year (95% confidence interval: -2.79, -1.36) and in FVC of -2.86 mL/year (-3.73, -1.99) mL/year over the study period. Associations were robust after adjusting for PM 2.5 , NO 2 , and greenness. The associations were more pronounced in residents of northern Europe and individuals who were older at baseline. No consistent associations were detected with the FEV 1 /FVC ratio., Interpretation: Long-term exposure to elevated ambient ozone concentrations was associated with a faster decline of spirometric lung function among middle-aged European adults over a 20-year period., Funding: German Research Foundation., Competing Interests: Marco Gnesi is currently an employee at AstraZeneca SpA; however, the research presented here has been conducted previously and AstraZeneca had no role in any phase of the research project. The authors have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: The few studies that have examined associations between greenspace and lung function in adulthood have yielded conflicting results and none have examined whether the rate of lung function decline is affected., Objective: We explored the association between residential greenspace and change in lung function over 20 years in 5559 adults from 22 centers in 11 countries participating in the population-based, international European Community Respiratory Health Survey., Methods: Forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC) were measured by spirometry when participants were approximately 35 (1990-1994), 44 (1999-2003), and 55 (2010-2014) years old. Greenness was assessed as the mean Normalized Difference Vegetation Index (NDVI) in 500 m, 300 m, and 100 m circular buffers around the residential addresses at the time of lung function measurement. Green spaces were defined as the presence of agricultural, natural, or urban green spaces in a circular 300 m buffer. Associations of these greenspace parameters with the rate of lung function change were assessed using adjusted linear mixed effects regression models with random intercepts for subjects nested within centers. Sensitivity analyses considered air pollution exposures., Results: A 0.2-increase (average interquartile range) in NDVI in the 500 m buffer was consistently associated with a faster decline in FVC (-1.25 mL/year [95% confidence interval: -2.18 to -0.33]). These associations were especially pronounced in females and those living in areas with low PM 10 levels. We found no consistent associations with FEV 1 and the FEV 1 /FVC ratio. Residing near forests or urban green spaces was associated with a faster decline in FEV 1 , while agricultural land and forests were related to a greater decline in FVC., Conclusions: More residential greenspace was not associated with better lung function in middle-aged European adults. Instead, we observed slight but consistent declines in lung function parameters. The potentially detrimental association requires verification in future studies., 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. SCD holds investigator initiated grants from Sanofi, GSK, and Astra Zenica for unrelated research. RJ reports grants from Estonian Research Council Personal Research Grant No. 562, during the conduct of the study; personal fees from Consultancy, grants from Grants/grants pending, personal fees from Payment for lectures, personal fees from Travel/accommodations/meeting expenses, outside the submitted work., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Previous studies have shown that exposure to nature and physical activity (PA) may be associated with higher intelligence in children. We examined whether there is an association between lifelong exposure to greenspace and bluespace and intelligence in children aged 10-13 with and without attention deficit hyperactivity disorder (ADHD), and whether PA mediates this association. The sample (N = 714) was collected within the NeuroSmog case-control study, where children with (N = 206) and without ADHD (N = 508) were recruited from 18 towns in Southern Poland. Nature exposure was estimated as the sum of the z-scores of the objective and perceived measures. Objective greenspace exposure was defined as the percentage of grass and tree cover in 500 m and 1 km buffers around lifelong residential addresses, respectively. Objective bluespace exposure was defined as the percentage of water cover in 500 m and 1 km buffers. Perceived greenspace/bluespace was measured as the parent-rated availability, quality, and use of greenspace/bluespace. Intelligence was assessed using the Polish version of the Stanford-Binet Intelligence Scales, 5th edition (SB5). SB5 Full Scale Intelligence Quotient (IQ), Nonverbal IQ, Verbal IQ, five factor and ten subtest scores were analysed as outcomes. The associations between nature and IQ scores were assessed by linear regressions separately for cases and controls, adjusting the models for sex, parental education, and urbanicity. Structural equation modeling was implemented to test whether PA mediated the association between nature and intelligence. None of the greenspace or bluespace measures were consistently associated with intelligence. PA was not found to be a mediator. We did not find evidence that higher lifelong nature exposure is associated with higher intelligence in Polish schoolchildren with or without ADHD. This casts doubts on whether exposure to nature has relevant influence on IQ., (Copyright © 2023 The Authors. Published by Elsevier GmbH.. All rights reserved.)

There is increasing awareness for beneficial health effects of green space surrounding the home, but the underlying mechanisms are not yet fully understood and challenging to study given the correlation with other exposures. Here, the association of residential greenness and vitamin D including a gene-environment interaction is investigated. 25-hydroxyvitamin D (25(OH)D) was measured by electrochemiluminescence at ages 10 and 15 years in participants of two German birth cohorts GINIplus and LISA. Greenness was measured using the Landsat-derived Normalized Difference Vegetation Index (NDVI) in a 500 m buffer surrounding the home. Linear and logistic regression models were applied at both time points adjusted for several covariates (N 10Y  = 2,504, N 15Y  = 2,613). In additional analyses vitamin D-related genes, physical activity, time spent outdoors, supplements, and measurement season were investigated as potential confounders or effect modifiers. A 1.5-SD increase in NDVI was significantly associated with increased 25(OH)D values at ages 10 and 15 years (β 10y  = 2.41 nmol/l, p=<0.01; β 15y  = 2.03 nmol/l, p = 0.02). In stratified analyses, the associations were not seen in participants spending more than 5 h/day outside in summer, having a high physical activity level, taking supplements, or being examined during the winter season. In a subset (n = 1,732) with genetic data, a significant gene-environment interaction of NDVI with CYP2R1, an upstream gene in 25(OH)D synthesis, was observed at age 10 years. When investigating 25(OH)D sufficiency, defined as values above 50 nmol/l, a 1.5-SD increase in NDVI was associated with significantly higher odds of having sufficient 25 (OH)D levels at age 10 years (OR = 1.48, 1.19-1.83). In conclusion, robust associations between residential greenness and 25 (OH)D levels were observed in children and adolescents independent of other confounders and additionally supported by the presence of a gene-environment interaction. Effects of NDVI were stronger in those having lower vitamin D levels at age 10 years due to their covariate profile or genetically lower 25(OH)D synthesis., 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 Elsevier Ltd. All rights reserved.)

Objective: This study aimed to specify whether family communication and satisfaction are predictors of a child's executive functions and whether attention deficit hyperactivity disorder (ADHD) severity lies in the pathway between these variables., Method: Two hundred Polish children with ADHD, aged 10 to 13, were tested using Conners 3, the PU1 Battery of Cognitive Tests and Stanford-Binet Intelligence Scale, Fifth Edition (SB5). Parents filled out the FACES IV-SOR questionnaire. Structural equation modeling (SEM) was used to test the hypotheses., Results: The quality of family communication and satisfaction did not predict executive functioning in children with ADHD, and ADHD severity did not play a mediating role neither in boys or in girls. Intelligent quotient was the only predictor of executive functioning in the group of boys., Conclusion: These results contrast with those of previous studies that have shown the existence of similar associations in other cultural contexts.

Background: The field of greenspace and bluespace research in relation to cognitive outcomes is rapidly growing. Several systematic reviews have already been published on this topic but none of them are specific to cognitive outcomes in the entire age range of children. Moreover, only a few of them have examined the effects of bluespace in addition to greenspace. Also, theses reviews are focused either only on observational studies or experimental studies. Our systematic review focuses on cognitive outcomes in relation to greenspace and bluespace in children and adolescents aged 0-18; it captures both observational and experimental studies. Cognitive outcomes are presented according to an evidence-based taxonomy of human cognitive abilities: the Cattell-Horn-Carroll (CHC) theory., Methods: We conducted searches in the PubMed and PsychInfo databases, from their inception dates to 17 December 2021. We used three-text terms related to outcome, exposure, and population as well as MeSH terms for outcome and population. Further, the reference lists and existing reviews were searched ("snowball" search) until 21 April 2022 to detect additional studies. For the results reporting, we followed the updated guidelines of the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA). We included observational and experimental studies on greenspace or bluespace exposure in relation to cognitive functioning, published in English, German, or Polish. Two reviewers independently checked study eligibility and extracted data. Two reviewers evaluated the risk of bias according to the Office of Health Assessment and Translation (OHAT) tool. At all stages, discrepancies between the two reviewers were solved via discussion with a third reviewer., Results: Records identified from PubMed (n = 2030) and PsycINFO (n = 1168) were deduplicated and screened. Twenty one reports were first selected. The "snowball" search revealed 16 additional reports. Altogether, 39 studies (17 experimental and 22 observational) published in 37 reports were qualified. The data extraction showed that the methodology used in the studies was heterogenous and the findings were inconsistent. The majority of the studies investigated attentional functioning, which we subdivided into two categories according to the CHC theory: attentional control and reaction and decision speed (12 studies) and attentional control and processing speed (10 studies). Eleven studies investigated working memory and/or short-term memory that we categorized as CHC working memory capacity. Nine studies investigated intellectual functioning, which we categorized as CHC general ability, fluid reasoning, and comprehension-knowledge. Two studies investigated visual-spatial skills, which we categorized as CHC visual processing and psychomotor speed. One study measured parent-reported attention; two studies examined early childhood/cognitive development; three studies examined decision-making and self-regulation, which can be categorized as several CHC theory abilities., Discussion: The heterogeneity of the included studies does not permit clear conclusions for our review. In accordance with previous systematic reviews, greenspace and bluespace were not more strongly related to a particular domain of cognitive functioning than other cognitive domains, and no effects of age or type of exposure assessment on the association between nature and cognition were detected. Further research is needed, including state-of-the-art of assessment of cognitive outcomes and diverse exposure assessment methods within both observational and experimental approaches. Expertise will be required in several domains, such as environmental epidemiology, cognitive psychology, and neuropsychology. Systematic review registration number (INPLASY): 202220018., 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.)