Time spent walking and relaxing in a forest environment (“forest bathing” or “forest therapy”) has well demonstrated anti-stress effects in healthy adults, but benefits for ill or at-risk populations have not been reported. The present study assessed the physiological and psychological effects of forest therapy (relaxation and stress management activity in the forest) on middle-aged males with high-normal blood pressure. Blood pressure and several physiological and psychological indices of stress were measured the day before and approximately 2 h following forest therapy. Both pre- and post-treatment measures were conducted at the same time of day to avoid circadian influences. Systolic and diastolic blood pressure (BP), urinary adrenaline, and serum cortisol were all significantly lower than baseline following forest therapy (p < 0.05). Subjects reported feeling significantly more “relaxed” and “natural” according to the Semantic Differential (SD) method. Profile of Mood State (POMS) negative mood subscale scores for “tension-anxiety,” “confusion,” and “anger-hostility,” as well as the Total Mood Disturbance (TMD) score were significantly lower following forest therapy. These results highlight that forest is a promising treatment strategy to reduce blood pressure into the optimal range and possibly prevent progression to clinical hypertension in middle-aged males with high-normal blood pressure.

The natural environment is increasingly recognized as an effective counter to urban stress, and “Forest Therapy” has recently attracted attention as a relaxation and stress management activity with demonstrated clinical efficacy. The present study assessed the physiological and psychological effects of a forest therapy program on middle-aged females. Seventeen Japanese females (62.2 ± 9.4 years; mean ± standard deviation) participated in this experiment. Pulse rate, salivary cortisol level, and psychological indices were measured on the day before forest therapy and on the forest therapy day. Pulse rate and salivary cortisol were significantly lower than baseline following forest therapy, indicating that subjects were in a physiologically relaxed state. Subjects reported feeling significantly more “comfortable,” “relaxed,” and “natural” according to the semantic differential (SD) method. The Profile of Mood State (POMS) negative mood subscale score for “tension–anxiety” was significantly lower, while that for “vigor” was significantly higher following forest therapy. Our study revealed that forest therapy elicited a significant (1) decrease in pulse rate, (2) decrease in salivary cortisol levels, (3) increase in positive feelings, and (4) decrease in negative feelings. In conclusion, there are substantial physiological and psychological benefits of forest therapy on middle-aged females.

This study uses qualitative research methods of text mining to elucidate the potential and prospects for community-based learning opportunities for raising environmental awareness and bringing about healthy behaviour change among university students and local residents. In particular, we focus on the importance of community-based learning in raising environmental awareness and inspiring action to support healthy living and harmony with nature. The three groups were triangulated using semi-structured questionnaires to model the ways in which education for sustainable development (ESD) can contribute to the promotion of environmental education in local communities. In order to collect in-depth data, the authors themselves were present at the study sites and collected textual data based on semi-structured questionnaires in a participatory observation framework, where they had a common experience to understand the observations. Analysis was carried out using NVivo12. The two community learning initiatives studied were in Okayama and Tokyo, which are leading ESD policy areas. The two case studies are both university student-led projects that aim to raise environmental awareness in local communities through environmentally conscious behaviour change and the creation of a foundation for healthy living. This study focuses on “youth” and “community” among the five priority areas proposed in the 2015 ESD report and discusses the potential and prospects for community learning initiatives and the triggering of the nudge effect on environmentally conscious behaviour change and health behaviours. The results of the textual analysis with triangulation show that, while policymakers and teachers and leaders driving the initiative acknowledge the importance of ESD in a comprehensive way, their attention is more focused on the design of specific projects and curricula. In contrast, university students engaged in ESD activities rated the social education facilities (local community centres, community learning centres) as “lively” and “motivating”. It was found that there are high expectations for “public living rooms”, which are important as a base for learning to promote healthy and sustainable communities and environmentally conscious behaviour change.

Background: We previously found that a forest bathing (shinrin-yoku) program significantly reduced the scores for depression, anxiety, anger, fatigue, and confusion and increased the score for vigor in the profile of mood states (POMS) test and showed a potential preventive effect on the depressive status in both males and females. In the present study, we investigated the effects of a forest bathing program on the level of serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males.Methods: Twenty healthy male subjects aged 57.3 ± 8.4 years were selected after obtaining informed consent. These subjects took day trips to a forest park, the birthplace of forest bathing in Japan named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture (situated in central Japan), and to an urban area of Nagano Prefecture as a control in June 2019. On both trips, they walked 2.5 km for 2 hours each in the morning and afternoon on Saturday and Sunday, respectively. Blood was sampled in the afternoon before and after each trip. Concentrations of serotonin and lactic acid in serum were measured. The POMS test and a questionnaire for subjective sleep quality were conducted before and after the trips. Ambient temperature and humidity were monitoring during the trips. The Ethics Committees of the Nippon Medical School and Nagano Prefectural Kiso Hospital approved this study.Results: The forest bathing program significantly increased level of serotonin in serum, and significantly increased the score for vigor and decreased the score for fatigue in the POMS test. The forest bathing program also improved the sleepiness on rising and feeling refreshed (recovery from fatigue) in the Oguri-Shirakawa-Azumi sleep inventory MA version (OSA-MA).Conclusions: Taken together, the present study suggests that forest bathing may have potential preventive effects on depression (depressive status).

Nature therapy has been demonstrated to induce physiological relaxation. The psychophysiological effects of nature therapy (stimulation with bonsai trees) on adult male patients with spinal cord injury (SCI) were examined. Oxyhemoglobin concentration changes in the prefrontal cortex were measured using near-infrared spectroscopy, and heart rate variability was analyzed. Psychological responses were evaluated using the modified semantic differential method and Profile of Mood States (POMS) subscale scores. Visual stimulation of adult male patients with SCI elicited significantly decreased left prefrontal cortex activity, increased parasympathetic nervous activity, decreased sympathetic nervous activity, increased positive feelings, and resulted in lower negative POMS subscale scores. Nature therapy can lead to a state of physiological and psychological relaxation in patients with SCI.

Background: Capsular contracture is a common complication after breast augmentation surgery. This study pathologically evaluated the soft-tissue response to surface modifications in both smooth and textured tissue expander prostheses. Methods: Smooth tissue expanders and textured tissue expanders in 5 cases each were used for breast reconstruction after mastectomy. Histological samples were harvested from the capsules when the tissue expanders were replaced by silicone implants. Collagen orientation and cellular responses were assessed histologically. Capsular contracture was evaluated using the Baker classification 6 months and 2 years after the removal of the tissue expander. Results: The capsules surrounding the smooth tissue expanders tended to produce more contracture than those surrounding the textured tissue expanders. The collagen architecture of the capsules of the smooth tissue expanders showed random orientation with fragmentation. Conversely, the capsules of the textured tissue expanders showed parallel orientation with collagen bundles of almost normal structure. Significantly more fibrils of elastin and myofibroblasts were found in the capsules surrounding the smooth tissue than in those surrounding the textured ones. Conclusions: The collagen fibers surrounding the smooth tissue expanders could be cracked during expansion, which may lead to scarring and contracture. Conversely, the collagen orientation surrounding the textured tissue expanders was excellent. Moreover, the increase in elastic fibers and myofibroblasts in the capsules surrounding the smooth tissue expanders may be associated with in vivo contraction patterns. Therefore, the surface type of tissue expanders affects capsular contraction after replacement with definitive implants.