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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.

Hyperglycemia is a key risk factor for death and disability worldwide. To better inform prevention strategies, we aimed to delineate and predict the temporal, spatial, and demographic patterns in mean fasting plasma glucose (FPG) levels and their related disease burden globally. Based on the Global Burden of Disease Study 2019, we estimated the distributions of mean FPG levels and high FPG-related disease burden by age, sex, year, socioeconomic status (SES), and geographical region from 1990 to 2050. We also investigated the possible associations of demographic, behavioral, dietary, metabolic, and environmental factors with FPG levels and high FPG-related disease burden. In 2019, the global mean FPG level was 5.40 mmol/L (95% uncertainty interval [UI]: 4.86–6.00), and high FPG contributed to 83.0 deaths (95% UI, 64.5–107.1) and 2,104.3 DALYs (95% UI: 1,740.7–2,520.7) per 100,000 people. For both historical (1990–2019) and future (2020–2050) periods, the mean FPG levels and the high FPG-related disease burden increased globally, with greater increases among the middle-aged and elderly, and people in low-to-middle SES countries, relative to their counterparts. Aging, unhealthy lifestyles, elevated body mass index, and lower air temperatures were potential risk factors for high FPG levels and the high FPG-related disease burden. This study demonstrates that high FPG continues to contribute to the global disease burden and is expected to do so for at least the next 30 years. Older people and those living in low-to-middle SES countries should receive more attention in glycemic management health interventions. In addition, effective interventions that target identified risk factors should be adopted to handle the increasingly large disease burden of high FPG.

Associations between neighborhood greenness and socioeconomic status (SES) are established, yet intra-neighborhood context and SES-related barriers to tree planting remain unclear. Large-scale tree planting implementation efforts are increasingly common and can improve human health, strengthen climate adaptation, and ameliorate environmental inequities. Yet, these efforts may be ineffective without in-depth understanding of local SES inequities and barriers to residential planting.We recruited 636 residents within and surrounding the Oakdale Neighborhood of Louisville, Kentucky, USA, and evaluated associations of individual and neighborhood-level sociodemographic indicators with greenness levels at multiple scales. We offered no-cost residential tree planting and maintenance to residents within a subsection of the neighborhood and examined associations of these sociodemographic indicators plus baseline greenness levels with tree planting adoption among 215 eligible participants.We observed positive associations of income with Normalized Difference Vegetation Index (NDVI) and leaf area index (LAI) within all radii around homes, and within yards of residents, that varied in strength. There were stronger associations of income with NDVI in front yards but LAI in back yards. Among Participants of Color, associations between income and NDVI were stronger than with Whites and exhibited no association with LAI. Tree planting uptake was not associated with income, education, race, nor employment status, but was positively associated with lot size, home value, lower population density, and area greenness.Our findings reveal significant complexity of intra-neighborhood associations between SES and greenness that could help shape future research and equitable greening implementation. Results show that previously documented links between SES and greenspace at large scales extend to residents’ yards, highlighting opportunities to redress greenness inequities on private property. Our analysis found that uptake of no-cost residential planting and maintenance was nearly equal across SES groups but did not redress greenness inequity. To inform equitable greening, further research is needed to evaluate culture, norms, perceptions, and values affecting tree planting acceptance among low-SES residents.

This study aimed to develop a theoretical framework explaining how aspects of the technology acceptance model (TAM) and flow theory explain user attitudes and behavioral intentions in a virtual reality surfing experience. Using data from 251 participants, relationships between the TAM and flow theory concepts were tested with structural equation modeling (SEM). Results revealed that hedonic factors (experiencing a flow state) and utilitarian aspects (perceived usefulness and ease of use) drove intentions to adopt VR for virtual surfing. These findings support the argument that incorporating hedonic factors (i.e., flow experience) into the TAM increases its predictive power in understanding antecedents of consumer behavioral intentions toward new technology. These findings also contribute to the technology acceptance literature concerning VR technology in leisure activities. Regarding managerial implications, the study suggests that VR provides potential surfing consumers with a realistic, immersive, and enjoyable way to learn to surf. VR can apply to other leisure and tourism sectors requiring remote locations and increase their behavioral intentions to participate.

Background and objective: Prior studies have shown higher green cover levels are associated with beneficial health outcomes. We sought to determine if residential green cover was also associated with direct healthcare costs. Methods: We linked residential Normalized Difference Vegetation Index (NDVI) satellite data for 5,189,303 members of Kaiser Permanente Northern California (KPNC) to direct individual healthcare costs for 2003–2015. Using generalized linear regression to adjust for confounding, we examined the association between direct healthcare costs and green cover within 250, 500, and 1000 meters (m) of an individual’s residence. Costs were determined from an internal cost accounting system that captures administrative and patient care costs for each clinical encounter. Sensitivity analyses included adjustments for comorbidity and an alternative measure of green cover, tree canopy. Results: We observed a significant inverse association between higher levels of residential green cover and lower direct healthcare costs. The relative rate of total cost for the highest compared to the lowest decile of NDVI was 0.92 (95% CI 0.90–0.93) for the 500 m buffer. The association was robust to adjustment from a broad array of confounders, found at each buffer size, and largely driven by hospitalization, and emergency department visits. Individuals in the top decile of residential green cover had adjusted healthcare costs of $374.04 (95% CI $307.31-$439.41) per person per year less than individuals living in the bottom or least green decile. Sensitivity analyses including tree canopy cover as the green space measure yielded similar findings. Analyses that included adjustment for comorbidity were consistent with the hypothesis that green cover reduces healthcare costs by improving health status. Conclusion: Green cover was associated with lower direct healthcare costs, raising the possibility that residential greening can have a significant healthcare cost impact across the population.

Physical activity is essential to maintain physical and mental health. Unfortunately, insufficient physical activity has become a common phenomenon worldwide in the past decade, and the absence of interest in physical activity is assumed a reason. Therefore, strategies for fostering interests and promoting public engagement are in need. We conducted a questionnaire survey during September 2021 that involved 1202 adults to capture data on sports and relevant cartoon watching experiences during childhood; Intensity and frequency of physical activity, depression (PHQ-9), and anxiety (GAD-7) during adulthood. Structural equation modeling was employed to examine pathways between watching sports cartoon in childhood and physical activity and mental health in adulthood. The results suggest that childhood sports cartoon watching may have indirect and positive impacts on adult physical activity and, in turn, on mental health. Childhood sports experience is a critical mediator role linking childhood sports cartoon watching, adult physical activity, and adult mental health. In conclusion, watching sports cartoon may help cultivate sports interests and promote children's participation in sports, and the sports experiences may be a continuous and beneficial factor that connects childhood and adulthood. These findings indicate a framework to understand the durative positive impact of cartoons and maybe other children's film and television works.

Multiple systematic reviews on greenspace and health outcomes exist, but the overall evidence base remains unclear. Therefore, we performed an umbrella review to collect and appraise all relevant systematic reviews of epidemiological studies on greenness exposure and health. We searched PubMed, Embase, and Web of Science from inception to June 28, 2021, and screened references of relevant articles. Systematic reviews with or without meta-analyses of epidemiological studies that examined the associations of greenness with any health outcome were included. Two independent investigators performed study selection and data extraction. We also evaluated the methodological quality of the included systematic reviews using the “Assessing the Methodological Quality of Systematic Reviews 2” checklist. A total of 40 systematic reviews and meta-analyses were included, of which most were cross-sectional studies conducted in high-income countries. Greenspace exposure was estimated with various objective and subjective parameters. Beneficial associations of greenspace with all-cause and stroke-specific mortality, CVD morbidity, cardiometabolic factors, mental health, low birth weight, physical activity, sleep quality, and urban crime were observed. No consistent associations between greenspace and other health outcomes (e.g., cancers) were observed. Most of the included systematic reviews and meta-analyses had one or more limitations in methodology. Our findings provide supportive evidence regarding the beneficial effects of greenspace exposure on some aspects of human health. However, the credibility of such evidence was compromised by methodological limitations. Better performed systematic reviews and meta-analyses as well as longitudinal designed primary studies are needed to validate this conclusion. Public summary: • The evidence concerning greenspace and health outcomes remains unclear • We performed an umbrella review of 40 systematic reviews on greenspace and health • Greenspace exposure was estimated with various objective and subjective parameters • Greenspace was beneficially associated with several aspects of human health

As evidence continues to mount that areas with more natural spaces also have healthier residents, researchers are beginning to suspect that these benefits extend beyond health to other related factors, such as healthcare spending. If more nature translates to better health, does more nature ultimately reduce the need for and spending on healthcare, and is this especially true for the elderly and disabled, who benefit differently from nature? This study aims to answer that question, employing a cross-sectional, ecological study design on county-level, annual per-capita Medicare spending in the United States. We examine the association between Medicare spending and the amount of total greenness in a county as well as the amount of blue space, or open water, in a county while controlling for demographic, socioeconomic, and healthcare access confounders. Our results show a significant and inverse association between greenness and spending and mixed results in regard to blue spaces and spending. The greenness-spending association persists in varying levels of the urban–rural spectrum, including both the most and least urban counties.

Remote sensing-based vegetation index (VI) data are significantly impacted by cloud contamination. Spatiotemporal reconstruction methods demonstrate higher accuracy than temporal reconstruction methods. However, the computing time and random access memory (RAM) consumption of these spatiotemporal reconstruction methods for large-scale reconstruction remains unclear. In this study, a method called spatial-interannual reconstruction (SIR) was proposed to reconstruct cloud-contaminated pixels in MODIS normalized difference VI (NDVI) and enhanced VI (EVI) data. SIR has four major advantages: (1) High accuracy. The average mean absolute error of SIR was 0.0338, which was 20.2% and 23.4% lower than that of two state-of-the-art spatiotemporal reconstruction methods (i.e. interpolation of the mean anomalies (IMA) and Gapfill). (2) High computing speed. The average computing time of SIR was 99.7% and 98.8% lower than IMA and Gapfill, respectively. (3) Low RAM consumption. (4) Simultaneous reconstruction of all invalid values. Reconstructed 250 m spatial resolution and 16-day composite NDVI and EVI datasets in China from 2000 to 2022 (written as ReVIChina) were developed based on the SIR method and MODIS MOD13Q1 data. Spatiotemporal analyses revealed that the reconstructed datasets were more reliable than the original product and a similar dataset. [ABSTRACT FROM AUTHOR]

Human behaviors that contribute to the spread of aquatic invasive species are influenced by myriad social psychological factors that vary across contexts and populations. Understanding such behavior is crucial for forming successful management strategies that minimize environmental impacts while generating support and cooperation among stakeholders. We identify several reasons why recreational anglers and boaters make decisions that benefit the environment. Specifically, our study addresses the following objectives: (1) examine reported behaviors that minimize the spread of aquatic invasive species, (2) test the effects of social normative beliefs on reported behaviors, and (3) determine the role of human-nature relationships in explaining behavioral patterns. Drawing on a path model of the decisions made by respondents who completed an on-site survey at two nature-based case study sites in Illinois, we observed that reported behavior was positively influenced by normative beliefs about those behaviors and human-nature relationships. Specifically, the Participant in Nature and Partner with Nature orientations were positively and negatively correlated with norms, respectively. In turn, norms positively predicted reported stewardship behaviors. These findings advance research on the human dimensions of aquatic invasive species by providing insights on the role of stable psychological processes that shape behavior, while informing management decisions aimed at minimizing biological invasions in freshwater ecosystems. [ABSTRACT FROM AUTHOR]

Keywords: conflicts; COVID-19; emergency care; planetary health; public health; SARS-CoV-2; Ukraine; COVID-19 coronavirus disease 2019 SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 UN United Nations EN conflicts COVID-19 emergency care planetary health public health SARS-CoV-2 Ukraine COVID-19 coronavirus disease 2019 SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 UN United Nations 568 569 2 07/14/22 20220801 NES 220801 A pandemic has ravaged the world. Conflicts, COVID-19, emergency care, public health, SARS-CoV-2, Ukraine, COVID-19 coronavirus disease 2019 SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 UN United Nations, planetary health A similar situation was observed during the first year of the pandemic during the conflict between Armenia and Azerbaijan, followed by massive COVID-19 surges in both countries.6 Only 34% of people in Ukraine have received two doses of a COVID-19 vaccine, and less than two percent have received a third dose.7 Such low vaccination rates are insufficient to keep highly contagious viruses like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) under control.7 Further, low vaccination rates in Ukraine are likely to increase COVID-19 infections in neighboring countries as millions of Ukrainians flee to those countries. [Extracted from the article]

Background: Several studies have evaluated whether the distribution of natural environments differs between marginalized and privileged neighborhoods. However, most studies restricted their analyses to a single or handful of cities and used different natural environment measures. Objectives: We evaluated whether natural environments are inequitably distributed based on socioeconomic status (SES) and race/ethnicity in the contiguous United States. Methods: We obtained SES and race/ethnicity data (2015-2019) for all U.S. Census tracts. For each tract, we calculated the Normalized Different Vegetation Index (NDVI) for 2020, NatureScore (a proprietary measure of the quantity and quality of natural elements) for 2019, park cover for 2020, and blue space for 1984-2018. We used generalized additive models with adjustment for potential confounders and spatial autocorrelation to evaluate associations of SES and race/ethnicity with NDVI, NatureScore, park cover, and odds of containing blue space in all tracts (n = 71,532) and in urban tracts (n = 45,338). To compare effect estimates, we standardized NDVI, NatureScore, and park cover so that beta coefficients presented a percentage increase or decrease of the standard deviation (SD). Results: Tracts with higher SES had higher NDVI, NatureScore, park cover, and odds of containing blue space. For example, urban tracts in the highest median household income quintile had higher NDVI [44.8% of the SD (95% CI: 42.8, 46.8)] and park cover [16.2% of the SD (95% CI: 13.5, 19.0)] compared with urban tracts in the lowest median household income quintile. Across all tracts, a lower percentage of non- Hispanic White individuals and a higher percentage of Hispanic individuals were associated with lower NDVI and NatureScore. In urban tracts, we observed weak positive associations between percentage non-Hispanic Black and NDVI, NatureScore, and park cover; we did not find any clear associations for percentage Hispanics. Discussion: Multiple facets of the natural environment are inequitably distributed in the contiguous United States. https://doi.org/10.1289/EHP11164, Introduction Of all high- and middle-income countries, the United States has among the highest income-related disparities in self-reported health and health care measures. (1) Health disparities have been attributed to [...]