Rediscovering Nature in Everyday Settings: Or How to Create Healthy Environments and Healthy People

It is estimated that half of the world’s population now live in urban environments. Urban living necessitates a removal from nature, yet evidence indicates that contact with nature is beneficial for human health. In fact, everyday urban places, such as where people live, study, and work, provide opportunities to bring nature back into cities to contribute to positive, healthy environments for people and to foster the human–nature connection. The inclusion of more nature in cities could have additional environmental benefits, such as habitat provision and improving the environmental performance of built environments. In the context of climate change, outcomes such as these assume further importance. This article explores how common urban places can foster links between people and nature, and generate positive health and well-being outcomes. We achieve this by exploring nature in the everyday settings of schools and residential housing.     

Examining associations between civic engagement and depressive symptoms from adolescence to young adulthood in a national U.S. sample

Many scholars posit that engaging in civic actions enhances mental health, yet existing evidence is limited. To address gaps in the literature and advance understanding of benefits of civic engagement from adolescence to young adulthood, we estimated a longitudinal structural model to test bidirectional associations between civic engagement (i.e., voting, community engagement, political behaviors) and depressive symptoms using nationally representative longitudinal U.S. data. Adolescent and early young adulthood (EYA) depressive symptoms predicted decreases in later voting. Adolescent and EYA community engagement predicted decreases in later depressive symptoms. Analyses suggested that findings generalized across gender, age, socioeconomic status, race/ethnicity, and EYA social roles. Despite key limitations in measurement of civic engagement over time, results provide some support the notion that community engagement may have mental health benefits for youth, and that depression may reduce later civic engagement.     

Treatment engagement of individuals experiencing mental illness: review and update

Individuals living with serious mental illness are often difficult to engage in ongoing treatment, with high dropout rates. Poor engagement may lead to worse clinical outcomes, with symptom relapse and rehospitalization. Numerous variables may affect level of treatment engagement, including therapeutic alliance, accessibility of care, and a client's trust that the treatment will address his/her own unique goals. As such, we have found that the concept of recovery‐oriented care, which prioritizes autonomy, empowerment and respect for the person receiving services, is a helpful framework in which to view tools and techniques to enhance treatment engagement. Specifically, person‐centered care, including shared decision making, is a treatment approach that focuses on an individual's unique goals and life circumstances. Use of person‐centered care in mental health treatment models has promising outcomes for engagement. Particular populations of people have historically been difficult to engage, such as young adults experiencing a first episode of psychosis, individuals with coexisting psychotic and substance use disorders, and those who are homeless. We review these populations and outline how various evidence‐based, recovery‐oriented treatment techniques have been shown to enhance engagement. Our review then turns to emerging treatment strategies that may improve engagement. We focus on use of electronics and Internet, involvement of peer providers in mental health treatment, and incorporation of the Cultural Formulation Interview to provide culturally competent, person‐centered care. Treatment engagement is complex and multifaceted, but optimizing recovery‐oriented skills and attitudes is essential in delivery of services to those with serious mental illness.     

Exploring the efficacy of an aquatic invasive species prevention campaign among water recreationists

Water recreationists regularly engage in behavior that can contribute to the spread of aquatic invasive species (AIS), which can result in costly consequences for managers. As AIS prevention is more cost-effective than response, educational campaigns are implemented as a preventative management strategy. However, little is known about the efficacy of education campaigns in promoting recreationists’ knowledge, personal responsibility, and engagement in behaviors that can prevent AIS spread. This study explored the Stop Aquatic Hitchhikers!? (SAH!) campaign by conducting survey and focus group research with water recreationists’ in Illinois and Indiana. Results from the survey research indicate moderate campaign success (55 % were aware of the SAH! campaign), and that awareness is significantly related to increases in knowledge, personal responsibility, and engagement in four of the six recommended control behaviors. Additionally, findings demonstrate that boater-anglers were most aware of the campaign (69 %), most knowledgeable of AIS species, and felt the most personal responsibility for AIS control. However, focus group results demonstrate the need for campaign enhancement, including streamlining campaign messaging and increasing campaign exposure. Policy informed by our recommendations may improve the efficacy of educational campaigns to manage recreation behavior and corresponding environmental impacts among multiple water recreationist groups.     

Ethnographic closeness: methodological reflections on the interplay of engagement and detachment in immersive ethnographic research

With the reflexive turn in the social sciences, emotional engagement is an inevitable and crucial part of data-gathering and analysis. However, there is a glaring gap in methodological discussions to this end. Presenting ethnographic research into end of life with people living at home in England with heart failure, we argue for a methodological blend of engagement and detachment that shifts throughout the research process, and that sensory experience is a core part of engagement. We offer ethnographic examples which present and explore some alternatives to emotional engagement and objective detachment: (1) moving with participants to facilitate engagement during fieldwork through shared sensory experience; (2) detachment as a different way of relating when exiting the field and drawing participant relationships to a close; and (3) ethnographic closeness as the interplay of engagement and detachment in participant debriefing and data analysis. Based on well-established anthropological concepts, and taking both engagement and detachment as embodied and relational, we develop a notion of ethnographic closeness in which detachment is a necessary part. Our detailed methodological discussion thus offers theoretically grounded possibilities and alternatives for approaching and managing the core tension of ‘how close is too close?’ in ethnographic practice. Further contributions supporting researchers in navigating ethnographic research are needed.     

Firm-level perspectives on public sector engagement with private healthcare providers: survey evidence from Ghana and Kenya

Background

Health systems in Sub-Saharan Africa (SSA) are in urgent need of improvement. The private health sector is a major provider of care in the region and it will remain a significant actor in the future. Any efforts by SSA governments to improve health systems performance therefore has to account for the private health sector. Regional and international actors increasingly recognize importance of effectively engaging with the private health sector, and initiatives to improve engagement are underway in several countries. However, there is little systematic analysis of private health providers'' view and experience with engagement.

Methodology/Principal Findings

In this study we surveyed private health facilities in Kenya and Ghana to understand the extent to which and how governments interact and engage with these facilities. The results suggest that government engagement with private health facilities is quite limited. The primary focus of this engagement is “command-and-control” type regulations to improve the quality of care. There is little attention paid to building the capacity of health care businesses through either technical or financial assistance. The vast majority of these facilities also receive no government assistance in meeting public health and social goals. Finally, government engagement with private pharmacies is often neglected and clinics receive a disproportionate share of government assistance.

Conclusions/Significance

Overall, our findings suggest that there may be considerable untapped potential for greater engagement with private health facilities—particularly pharmacies. Improving engagement will likely help governments with limited resources to better take advantage of the private sector capacity to meet access and equity objectives and to accelerate the achievement of the Millennium Development Goals.     

Human–Dolphin Interactions: Relationships,Connections, and the Reinforcement of an Ongoing Nature Relationship

Although interactions between humans and wild animals have been explored in the literature, the mechanism for how such experiences influence wellbeing is an area needing further examination. This research used Interpretative Phenomenological Analysis to explore the narratives of wellbeing from eight semi-structured interviews with people who had experienced intense close encounters with dolphins. Despite idiographic differences between narratives, a common theme of Relationships and Connectedness between participants and nonhuman animals emerged. The expression of this indicates that human–dolphin experiences fulfill aspects of the human need for connection and relationships and that the experiences promote wellbeing and environmental behaviors. This is contextualized within an ongoing nature relationship and the importance of a lifelong connection with wildlife, to ensure that humans see themselves as part of the natural world. Such a dynamic is discussed within the frame of the biophilia hypothesis and the importance of human contact with nature to ensure wellbeing. The narratives reported here describe strong emotional connections, transmitted through both tangible and perceived contact with dolphins, which translate into positive senses of emotion and wellbeing. The connections described are powerful: perceptions of communion and mutual exchange become articulated through rhetoric of friendship and kinship. Importantly, it appears that dolphin encounters are signifiers of wider relationships, both with nature and people. In this case, participants are reinforcing established habits of nature connectedness, habits reflecting a lifelong involvement with nonhuman animals. How connection with wild animals as a part of nature can promote wellbeing and in turn encourage environmental behavior is discussed in the context of the contemporary need for human responsibility to ensure the protection of nature and the survival of nonhuman animal species and habitats.     

When We Should Worry More: Using Cognitive Bias Modification to Drive Adaptive Health Behaviour

A lack of behavioural engagement in health promotion or disease prevention is a problem across many health domains. In these cases where people face a genuine danger, a reduced focus on threat and low levels of anxiety or worry are maladaptive in terms of promoting protection or prevention behaviour. Therefore, it is possible that increasing the processing of threat will increase worry and thereby enhance engagement in adaptive behaviour. Laboratory studies have shown that cognitive bias modification (CBM) can increase or decrease anxiety and worry when increased versus decreased processing of threat is encouraged. In the current study, CBM for interpretation (CBM-I) is used to target engagement in sun protection behaviour. The goal was to investigate whether inducing a negative rather than a positive interpretation bias for physical threat information can enhance worry elicited when viewing a health campaign video (warning against melanoma skin cancer), and consequently lead to more adaptive behaviour (sun protection). Participants were successfully trained to either adopt a positive or negative interpretation bias using physical threat scenarios. However, contrary to expectations results showed that participants in the positive training condition reported higher levels of worry elicited by the melanoma video than participants in the negative training condition. Video elicited worry was, however, positively correlated with a measure of engagement in sun protection behaviour, suggesting that higher levels of worry do promote adaptive behaviour. These findings imply that more research is needed to determine under which conditions increased versus decreased processing of threat can drive adaptive worry. Various potential explanations for the current findings and suggestions for future research are discussed.     

Association of <Emphasis Type="Italic">MAOA-uVNTR</Emphasis> Polymorphism with Subjective Well-Being in Men

Quality of life and one’s subjective evaluation of one’s own happiness and well-being are the conventional focus of psychology and sociology. However, a genetic factor has recently been found to affect the subjective evaluation of well-being. The contribution of heredity to a personal level of happiness and life satisfaction has been estimated at 30–50% in twin studies. Individual genes associated with these traits have been identified, but the available data are rather discrepant. In this work, alleles of the monoamine oxidase A gene (MAOA) were tested for association with well-being components, such as happiness, health, dangers of living environment, and stress, in Russian men. Trait assessments were based on questionnaires filled out as part of the World Values Survey. It is shown that, among the uVNTR-3R allele carriers, the proportion of men who have high levels of stress, feel unhappy, and live in unsafe environments is lower. The results are discussed in the context of the gene plasticity concept, which provides a possible explanation for how expression of genes related to behavior changes in different environmental conditions.     

Migrants,health, and happiness: Evidence that health assessments travel with migrants and predict well-being

Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives’ and immigrants’ individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness.     

Submitting articles to the BMJ

ObjectiveTo investigate how doctors engage with patients with psychotic illness in routine consultations.DesignConversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder.SettingTwo psychiatric outpatient clinics in east London and south west London.Participants7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder.ResultsPatients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients'' concerns about their psychotic symptoms.ConclusionsPatients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients'' concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.

What is already known on this topic

Patients with psychotic illness are difficult to engage in the health servicesNo research has been published on how doctors engage with these patients in consultations

What this study adds

Patients actively attempt to talk about the content of their psychotic symptomsDoctors'' reluctance and discomfort in engaging with this topic is apparentAddressing patients'' concerns may lead to a more satisfactory outcome of the consultation and improve engagement with services     

Lessons from the field--health care experiences and preferences in a Latino community

As part of Midwest Bioethics Center's PATHWAYS to Improve End-of-Life Care project, we conducted an exploratory study in the Latino community of Kansas City to understand health beliefs, practices, and values, particularly as they relate to end-of-life care. We conducted ten focus groups and interviewed more than seventeen individuals who serve the Latino community in a social service, ministry, or health care capacity. We found that people were very concerned with "barriers to health care" (our term), and very willing to reveal their preferences for health care decision making and end-of-life care treatment options. We believe that bioethicists should conduct other, similar projects because they can improve our engagement with the Latino population and help Latinos find a greater voice in health care settings.     

Playing God and tampering with nature: popular labels for real concerns in synthetic biology

Public engagement in science with diverse cross-sections of the community is considered a critical aspect of responsible biotechnological innovation. While the research community shows willingness to engage with both ambivalent and supportive audiences about potentially disruptive technological advances, there is less enthusiasm for engaging with groups who hold deeply opposing views to such advances. ‘Playing God’ and ‘tampering with nature’ are popular examples of intrinsic objections often made in opposition to the development or use of novel genetic technologies. Historically appearing in arguments against the pursuit of genetically modified organisms in agriculture and food industries, intrinsic objections have previously been labelled by the science community as inconsistent, non-scientific, and vague. Now found in a range of innovation contexts, the domain of synthetic biology appears to attract such objections consistently. We present the findings from a large Australian study (N?=?4593) which suggests ‘playing God’ objections and their variants can be multilayered and, at times, accompanied by meaningful information about risk perceptions. We use qualitative analysis of open-ended responses from an online survey to show how these objections are articulated in response to selected synthetic biology applications across environmental and health domains. Our research invites a rethink of how the synthetic biology community perceives, and engages with, people who express intrinsic objections. These people may additionally hold extrinsic concerns that may be potentially addressed, or at least reasonably considered, through dialogue. We offer some concluding remarks for engaging with publics who employ these types of arguments to communicate unease with aspects of technology development and use.

     

Trends in the association of obesity and self-reported overall health in 30 years of the Integrated Health Interview Series

This research examines trends in the relationship between obesity based on self-report height and weight and self-perceived health over a 30-year period. Importantly, this period included the articulation of comprehensive public health campaigns on excess weight and thus provides opportunities for assessment of the efficacy of the campaign, as well as the broader psycho-social impact of excess weight. Using novel data from the Integrated Health Interview Series, odds ratios for the association between obesity and self-perceived health were estimated for repeated cross-sectional samples that are nationally representative of noninstitutionalized American adults aged 18-85 and older spanning 1976-2006. Our findings show that (i) there are weak associations between obesity and self-perceived poor health; (ii) these associations are particularly small among men, often to the point of being nonexistent; and (iii) weak relationships for both men and women have remained virtually unchanged over the past 30 years. Several reasons why the public health campaign around excess weight has had limited traction are discussed including the collective problem of excess weight in America and how this undermines current approaches in public health efforts addressing excess weight.     

Dreaming a Narrative and Conjuring an Image: Collaborative Filmmaking with People and Spirits in Melanesia

This article explores long-term creative engagement, through filmmaking, with a community in Papua New Guinea. It examines the process and results of three feature film projects done in collaboration with Melanesian communities. The films discussed here have employed diverse methods to engage with people creatively. All three of these ethnographic films seek to privilege local epistemologies through their construction, narrative approaches and subjects. The article details the methodologies employed for promoting indigenous ways of knowing. It is suggested that filmmaking and creative engagement have helped generate a meaningful site for Lak communities to explore their traditional practices and identity.     

Can general practitioners influence exercise habits? Controlled trial.

A health promotion campaign in the community organised by the general practitioner was evaluated by the use of a questionnaire before and after the campaign, both in the village where the campaign was based and in a control village. There was a general increase in the amount of exercise that people in both villages took. The results showed that having received a questionnaire, and been subject to the campaign, more people took exercise regularly.     

The social context of well-being

Large samples of data from the World Values Survey, the US Benchmark Survey and a comparable Canadian survey are used to estimate equations designed to explore the social context of subjective evaluations of well-being, of happiness, and of health. Social capital, as measured by the strength of family, neighbourhood, religious and community ties, is found to support both physical health and subjective well-being. Our new evidence confirms that social capital is strongly linked to subjective well-being through many independent channels and in several different forms. Marriage and family, ties to friends and neighbours, workplace ties, civic engagement (both individually and collectively), trustworthiness and trust: all appear independently and robustly related to happiness and life satisfaction, both directly and through their impact on health.     

Fighting pathophobia: how to construct constructive public engagement with biocontrol for nature without augmenting public fears

Social networks of stakeholders are necessary to foster public support for classical biological control for nature. Drawing from recent scholarship in policy-relevant social science fields, this article describes two key concepts that can improve science communication strategies to support invasive species management and biocontrol: lay public risk perception, and public engagement with science. This article then recommends a fundamental communication strategy: construct public trust in invasive species control efforts using public engagement processes that link trustworthy messengers and appropriate messages with the public. It draws examples from biocontrol projects that used pathogens as the natural enemy of choice, but more broadly seeks to inform efforts to engage the public about the use of classical biocontrol agents in nature conservation efforts.     

Mapping Public Engagement with Research in a UK University

Notwithstanding that ‘public engagement’ is conceptualised differently internationally and in different academic disciplines, higher education institutions largely accept the importance of public engagement with research. However, there is limited evidence on how researchers conceptualise engagement, their views on what constitutes engagement and the communities they would (or would not) like to engage with. This paper presents the results of a survey of researchers in the Open University that sought to gather data to fill these gaps. This research was part of an action research project designed to embed engagement in the routine practices of researchers at all levels. The findings indicate that researchers have a relatively narrow view of public engagement with research and the communities with which they interact. It also identified that very few strategically evaluate their public engagement activities. We conclude by discussing some of the interventions we have introduced with the aim of broadening and deepening future researcher engagement.     

Analyzing Personal Happiness from Global Survey and Weather Data: A Geospatial Approach

Past studies have shown that personal subjective happiness is associated with various macro- and micro-level background factors, including environmental conditions, such as weather and the economic situation, and personal health behaviors, such as smoking and exercise. We contribute to this literature of happiness studies by using a geospatial approach to examine both macro and micro links to personal happiness. Our geospatial approach incorporates two major global datasets: representative national survey data from the International Social Survey Program (ISSP) and corresponding world weather data from the National Oceanic and Atmospheric Administration (NOAA). After processing and filtering 55,081 records of ISSP 2011 survey data from 32 countries, we extracted 5,420 records from China and 25,441 records from 28 other countries. Sensitivity analyses of different intervals for average weather variables showed that macro-level conditions, including temperature, wind speed, elevation, and GDP, are positively correlated with happiness. To distinguish the effects of weather conditions on happiness in different seasons, we also adopted climate zone and seasonal variables. The micro-level analysis indicated that better health status and eating more vegetables or fruits are highly associated with happiness. Never engaging in physical activity appears to make people less happy. The findings suggest that weather conditions, economic situations, and personal health behaviors are all correlated with levels of happiness.