Article

Interactions with artificial water features: A scoping review of health-related outcomes

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Abstract

There is growing evidence that people’s interactions with water are beneficial to their health. However, existing studies have focused primarily on natural bodies of water such as seas, rivers, and lakes. Artificial water features such as ponds and fountains have received relatively little attention. This literature review aims to examine existing evidence on the health-related benefits of artificial water features and identify knowledge gaps. Following the PRISMA extension for Scoping Review (PRISMA-ScR) guidelines, five databases (Web of Science, PsycINFO, CINAHL, MEDLINE, and Garden, Landscape & Horticulture Index) were searched for peer-reviewed journal articles published in English between 1980 and 2020. Twenty-one articles were included in this review. The results showed that people could gain different levels of health-related benefits from artificial water features. Studies have supported significant psychological benefits (e.g., stress restoration) and behavioral benefits (e.g., physical activity and social interaction) of artificial water features, while direct physical and social health benefits have not been well documented. In terms of the types of interactions with water features, passive interactions (e.g., viewing and listening) were more popularly studied than active interactions. Despite the multiple health benefits reported in these studies, the breadth and depth of existing studies on the health significance of artificial water features were limited. Future research is needed, covering a broader range of settings, users, interaction types, and health-related outcomes and addressing the complex pathways between artificial water features and human health outcomes.

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... green areas with a cultural character, but also added arches and garden streams [89][90][91] Several studies of small, centrally located parks suggest a number of important levels or variations of these attributes, which we chose to include in this study (below and Table 1) Based on our literature review, the following attributes and levels were finally selected. We chose three levels of water features, namely ponds, fountains and garden stream [69,[92][93][94]. Moreover, we chose three types of seating: wooden, concrete and meta park benches [95][96][97][98]. ...
... Several other studies also mentioned these attributes being important in green areas with a cultural character, but also added arches and garden streams [89][90][91] Several studies of small, centrally located parks suggest a number of important levels or variations of these attributes, which we chose to include in this study (below and Table 1) Based on our literature review, the following attributes and levels were finally selected. We chose three levels of water features, namely ponds, fountains and garden stream [69,[92][93][94]. Moreover, we chose three types of seating: wooden, concrete and metal park benches [95][96][97][98]. ...
... Based on our literature review, the following attributes and levels were finally selected. We chose three levels of water features, namely ponds, fountains and garden stream [69,[92][93][94]. Moreover, we chose three types of seating: wooden, concrete and metal park benches [95][96][97][98]. ...
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... The effects of these waters on urban residents, incentives for activity, and desire to spend more time outdoors were not studied much. Efforts beyond the current focus on aesthetic and decorative characteristics are needed to better understand the behavioral and experiential qualities of various water features (Xie et al., 2021). ...
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Blue space can be regarded as a key component of urban development as it contributes to sustainability, landscape contextualisation, environmental quality, quality of life and human health. However, existing studies on urban blue spaces do not differentiate between size and type of space and do not explain the mechanisms of how urban blue spaces interact with appropriations that affect health. In our study, we chose seven urban open spaces in Germany with different types of urban blue (in the cities of Bielefeld, Gelsenkirchen, Dusseldorf, Cologne). We conducted standardised qualitative interviews with n = 211 urban blue space visitors, assessing their health-related appropriations of those spaces (use, experience, social, meaning). Via Correspondence Analysis, we profiled these seven spaces. Our results show that blue experience is an important appropriation in urban open spaces. The amount of green and blue space has a significant influence on health-related appropriative processes. Health-related appropriations shift with the profile of the blue urban open space and the proportion of land the blue space covers. Even in cities with few water features, urban blue induces intensive (restorative) experiences, creates meaning, attracts urban dwellers, promotes physical activity, and diversifies health experiences in urban contexts. We identify implications for public health, urban planning and landscape design. This paper is a valuable contribution to the current research trend in Germany to analyse the significance for human health and well-being of bodies of water in urban areas.
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Water is one of the most significant design elements that contributes to people feeling good physically, behaviorally and psychologically. This paper aims to reveal the landscape values of various water compositions. As a result of the assessment of 20 different water compositions using a questionnaire and landscape assessment approach in different places in Edirne, the effects of water on landscape perceptions and preferences were revealed.. With the help of the questionnaire answered by 100 people, visual preferences of the users, feelings and assessment of waters with the predetermined adjective pairs and landscape values were revealed for different water features. Variation analysis, correlation analysis and factor analysis were used in the study. It was found that waters with different features created different effects and they got higher values in terms of visual-spatial effects and functionality criteria when assessed in terms of landscape values. It was also revealed that natural and almost natural water scenes, wide water surfaces and silent or almost silent water scenes created a feeling of tranquility.
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Patient-specific gardens can provide general benefits related to the restorative effects of nature and respond to the specific needs of a particular patient population. These needs are to be considered in the design of outdoor space for healthcare. Our goal was to design a patient-specific garden for elderly people who live in Nursing Homes and Adult Day Services (RSA Famagosta, Milano). A participatory design process was used through the organization of focus groups. A focus group is a form of qualitative research in which a group of people are asked about a topic. Focus groups allowed us to study residents and staff in a more natural setting than a one-to-one interview. With this approach, users work closely together to create a program that has been implemented by landscape architects to design a patient-specific garden. The participatory process involving designers and clinical staff andresidents has been appreciated because the users felt involved in the decision process. Focus group approach has proved to be useful to provide information ohealing garden user needs: the findings were useful to draw design guidelines that has been incorporated into the "garden design".
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Water fountains are potential tools for soundscape improvement, but little is known about their perceptual properties. To explore this, sounds were recorded from 32 fountains installed in urban parks. The sounds were recorded with a sound-field microphone and were reproduced using an ambisonic loudspeaker setup. Fifty-seven listeners assessed the sounds with regard to similarity and pleasantness. Multidimensional scaling of similarity data revealed distinct groups of soft variable and loud steady-state sounds. Acoustically, the soft variable sounds were characterized by low overall levels and high temporal variability, whereas the opposite pattern characterized the loud steady-state sounds. The perceived pleasantness of the sounds was negatively related to their overall level and positively related to their temporal variability, whereas spectral centroid was weakly correlated to pleasantness. However, the results of an additional experiment, using the same sounds set equal in overall level, found a negative relationship between pleasantness and spectral centroid, suggesting that spectral factors may influence pleasantness scores in experiments where overall level does not dominate pleasantness assessments. The equal-level experiment also showed that several loud steady-state sounds remained unpleasant, suggesting an inherently unpleasant sound character. From a soundscape design perspective, it may be advisable to avoid fountains generating such sounds.
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Physical inactivity poses a significant challenge to physical and mental health. Environmental approaches to tackle physical inactivity have identified natural environments as potentially important public health resources. Despite this, little is known about characteristics of the activity involved when individuals visit different types of natural environment. Using Natural England's Monitor of Engagement with the Natural Environment Survey, we examined 71,603 English respondents' recreational visits to natural environments in the past week. Specifically, we examined the intensity of the activities they undertook on the visits (METs), the duration of their visit, and the associated total energy expenditure (MET minutes). Visits to countryside and urban greenspace environments were associated with more intense activities than visits to coastal environments. However, visits to coastal environments were associated with the most energy expenditure overall due to their relatively long duration. Results differed by the urbanity or rurality of the respondent's residence and also how far respondents travelled to their destination. Knowledge of what types of natural environment afford the highest volumes and intensities of physical activity could inform landscape architecture and exercise prescriptions. Isolating activity-supporting characteristics of natural environments that can be translated into urban design is important in providing physical activity opportunities for those less able to access expansive environments. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
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This article examines park use in relation to neighborhood social (safety and poverty) and urban form (pedestrian infrastructure and street network pattern) characteristics among youth and adult subpopulations defined by age and gender. We utilized System for Observing Play and Recreation in Communities (SOPARC) and Geographic Information Systems to objectively measure park use and park and neighborhood characteristics in 20 neighborhood parks. Heterogeneous negative binomial regression models indicated that the relationship between park use and types of activity settings, and park use and neighborhood attributes vary by age and gender. In general, the study found that park and activity setting size; activity settings such as playgrounds, basketball courts, pool and water features, shelters, and picnic areas; and availability of sidewalks and intersections in the park's neighborhood were positively associated with park use, whereas crime, poverty, and racial heterogeneity of the surrounding neighborhood were negatively associated with park use.
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OBJECTIVE To assess and synthesize available evidence in the infection control and healthcare design literature on strategies using the built environment to reduce the transmission of pathogens in water that cause healthcare-associated infections (HAIs). BACKGROUND Water can serve as a reservoir or source for pathogens, which can lead to the transmission of healthcare-associated infections (HAIs). Water systems harboring pathogens, such as Legionella and Pseudomonas spp., can also foster the growth of persistent biofilms, presenting a great health risk. TOPICAL HEADINGS Strategies for interrupting the chain of transmission through the built environment can be proactive or reactive, and include three primary approaches: safe plumbing practices (maintaining optimal water temperature and pressure; eliminating dead ends), decontamination of water sources (inactivating or killing pathogens to prevent contamination), and selecting appropriate design elements (fixtures and materials that minimize the potential for contamination). CONCLUSIONS Current evidence clearly identifying the environment's role in the chain of infection is limited by the variance in surveillance strategies and in the methods used to assess impact of these strategies. In order to optimize the built environment to serve as a tool for mitigating infection risk from waterborne pathogens—from selecting appropriate water features to maintaining the water system—multidisciplinary collaboration and planning is essential.
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Research suggests that a large percent of college students experience stress due to the demands of college life. Campus health professionals use a wide range of interventions to reduce student stress; however, the ability of green spaces on campuses to alleviate stress is often lacking in college health programs and related research. In this study, photovoice methodology was used to conduct a community-based participatory research project in order to identify and improve campus green spaces that students frequent for stress relief. Participants included 45 undergraduate students enrolled in an emotional health course. Students were instructed to take photos that addressed two open-ended questions: (1) What green spaces on campus do you visit to alleviate stress? (2) How could the green spaces on campus be improved for alleviating stress? Afterward, students analyzed and placed their photos into distinct themes. Results showed that students enjoyed green spaces that featured both man-made structures (e.g., swings, fountains, benches) and exclusively natural areas (e.g., magnolia trees, campus parks). Students indicated that campus areas in need of improvement for alleviating stress included trash cans, areas lacking landscaping, piles of cigarette butts, and a dilapidated campus tower. Spaces that helped alleviate stress and spaces that needed improvement were both reflective of Attention Restoration Theory. At the culmination of the project, the students shared their findings with the campus community at a photo exhibit. During the exhibit, students' voices were heard by campus administrators in positions of authority (e.g., chancellor, director of Facilities Operations, grounds crew supervisor).
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Fountains are delightful sceneries and can provide refreshing surrounding atmosphere, because of the cooling and humidifying effect of water droplets. To create more pleasant environment, it is valuable to quantify the thermal effect of fountains. This paper introduces a numerical fountain model based on particle-source-in-cell (PSI-Cell) model coupling the jet breakup process, the heat, mass and momentum transfer between droplets and air, and the CFD model of airflow, in which the influence of fountain is taken as source terms. A field measurement was conducted, where the data of one hour was selected to validate the fountain model. The presented model is proved to have good precision in the comparisons against the measured temperature and humidity. This new model is capable of estimating the trajectories of droplets, as well as the impact of fountains on the wind velocity, temperature and humidity in the ambient area. Both the numerical and experimental results show that the fountain can improve the thermal environment in the leeward area by strong cooling and humidifying effect, while minor changes have been made in the windward and lateral areas.
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Background: Green spaces have been associated with improved mental health in children; however, available epidemiological evidence on their impact on child behavioral development is scarce. Objectives: We investigated the impact of contact with green spaces and blue spaces (beaches) on indicators of behavioral development and symptoms of attention deficit/hyperactivity disorder (ADHD) in schoolchildren. Methods: This study was based on a sample of 2,111 schoolchildren (7-10 years of age) from 36 schools in Barcelona in 2012. We obtained data on time spent in green spaces and beaches and Strengths and Difficulties Questionnaires (SDQ) from parents, and ADHD/DSM-IV questionnaires from teachers. Surrounding greenness was abstracted as the average Normalized Difference Vegetation Index (NDVI) in buffers of 100 m, 250 m, and 500 m around each home address. Proximity to green spaces was defined as living within 300 m of a major green space (≥ 0.05 km2). We applied quasi-Poisson mixed-effects models (with school random effect) to separately estimate associations between indicators of contact with green spaces and SDQ and ADHD total and subscale scores. Results: We generally estimated beneficial associations between behavioral indicators and longer time spent in green spaces and beaches, and with residential surrounding greenness. Specifically, we found statistically significant inverse associations between green space playing time and SDQ total difficulties, emotional symptoms, and peer relationship problems; between residential surrounding greenness and SDQ total difficulties and hyperactivity/inattention and ADHD/DSM-IV total and inattention scores; and between annual beach attendance and SDQ total difficulties, peer relationship problems, and prosocial behavior. For proximity to major green spaces, the results were not conclusive. Conclusion: Our findings support beneficial impacts of contact with green and blue spaces on behavioral development in schoolchildren.
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This study seeks to find appropriate landscape patterns of campus based on students’ preferences. A photo questionnaire containing scenes of different types of campus landscapes was distributed among 200 students in University of Tabriz, Iran. The results emphasized the importance of vegetation, seating areas and water features of campuses. Also, students prefer open spaces consisting of lawn and grass (M = 3.31, S.D. = 1.00). Students also prefer a campus, which has a natural base, landscape elements and seating places, while the least preferred (M = 2.96, S.D. = 0.89) scenes comprise a large amount of hardscape. Students had a different preference for landscaping of open study area and leisure time place where the studying area should be designed with vertical natural elements. Shading trees and benches were also highlighted as very important furniture for these places. In terms of spatial organization, the content analysis revealed that these areas should be open and spacious. Places for leisure time need to be decorated with informal landscape design for creating a pleasant view. Designing a landscape with various forms will make these places more pleasant. Scenes of curved paths and colourful plants for these places showed a positive association with student socialization activities.
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Ecoacoustics explains how animal and human behavior are affected by environmental sounds. Many studies show the marked role that sound has on people's psychological health. Our world is more and more scarce in natural sounds that produce our well-being. In this sense, we explore what acoustic parameters are related to human comfort in cities. For this purpose, 16 water sounds, with very different acoustic characteristics in the number of harmonics, fundamental frequencies, spectral information and fractal dimension (=complexity), were sampled. Therefore, any previous psychological conditioning can be expected in the choice of these sounds, since they are all based on the same source. We evaluated responses of 135 students, teachers and administrative people of the University of Extremadura (UEX) in a comfort scale defined by five levels between -2 (very unpleasant) to +2 (very pleasant) being 0 indifferent. Relationships between sound parameters and comfort responses show that information related to harmonics is behind the preferences. We have defined some useful recommendations to use these results in the design of more comfortable and relaxing urban parks and gardens. In this sense, we demonstrated that fountains with large waterfalls or jets, produce a marked acoustic aversion to humans. It is to be expected that the same effect will happen with birds and other small vertebrates present in cities. Instead, we recommend in the design of urban parks and gardens, the adoption of artificial water channels with small jumps whose acoustic characteristics are ideal causing deep and sustained relaxation.
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Urban green spaces contribute to both aesthetic appreciation and health benefits for people. However, most previous researchers have focused on the effects of urban green spaces on aesthetic preference or stress restoration. Little research has involved both simultaneously. This paper uses a direct rating approach based on a single-item measurement to explore the effects of characteristics of urban green spaces on both aesthetic preference and perceived restorativeness of 24 images. These images were created using the photomontage technique by manipulating four dimensions: number of trees, flowers, water and small animals (birds or fish) relative to a baseline photograph taken in China. The results indicated that: (1) Aesthetic preference increased with the increase of number of trees and presence of flowers, water and fish in the images; while the restorative potential increased with the number of trees and presence of flowers or water, but was not affected by fish in the images; (2) Though birds increased fascination, they have no significant influence on both preference and overall restorative potential; and (3) there was a strong positive relationship between aesthetic preference and restorative potential. In regards to the approach, the results suggested that the single-item measurement could be applied to evaluate the perceived restorativeness. Potential applications to the practical design of urban green spaces include that planting more trees and brightly color flowers as well as providing access to clear water may be a reliable method to improve both aesthetic preference and restoration simultaneously.
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The potential benefits of aquatic environments for public health have been understudied in Asia. We investigated the relationships between blue space exposures and health outcomes among a sample of predominantly older adults in Hong Kong. Those with a view of blue space from the home were more likely to report good general health, while intentional exposure was linked to greater odds of high wellbeing. Visiting blue space regularly was more likely for those within a 10–15 min walk, and who believed visit locations had good facilities and wildlife present. Longer blue space visits, and those involving higher intensity activities, were associated with higher recalled wellbeing. Our evidence suggests that, at least for older citizens, Hong Kong's blue spaces could be an important public health resource. Full article available at https://www.sciencedirect.com/science/article/pii/S1353829218303745?via%3Dihub or on request.
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This study uses psychophysiological measures, alpha and beta waves, to examine the appropriateness of videos as visual media to represent a human-made lake. Results indicate that alpha brainwaves are associated more with peaks in the on-site condition than with peaks in the video condition, whereas beta waves show the opposite pattern. The findings suggest that people respond differently to a real lake and its video simulation. Moreover, the relationships between the brainwave responses of the participants across time and the environmental features shown in the video are identified. The findings show that four categories of landscape features may be associated with significant bursts of beta rhythms: conjunction/turns of paths, ambiguous water features, disadvantageous landscapes, and obtrusive artifacts. Design implications are discussed based on the results.
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Children’s experiences of outdoor environments have been studied now for more than 40 years yet no research has specifically focussed on children’s experiences of water play in constructed spaces of city centres. This article discusses the development of an observational mapping tool, called TOWEC, to record the interaction of children with water. It then reports findings and analysis from observations over a year-long period of 3,399 children interacting with water in the award winning public open space of the Peace Gardens in the centre of the City of Sheffield, UK. The findings reveal that children undertake both active and passive activities associated with the constructed water features and that these activities are influenced by gender, age and temperature, but not ethnicity. The water features were not designed for children to play in but the children realise the potential affordance that the water features provide.
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The research on the restorative capacity of soundscape has grown rapidly in recent decades. Most literature explores this topic using the single medium of soundscape. Their findings perhaps do not provide a cohesive guideline for practical design because a visitor perceives the landscape using the pattern of multi-sensory input, such as visual, auditory, tactile and olfactory. To fill this gap this study conducted an experiment, in which 20 photographs were combined with five sounds, and Short-version Revised Restoration Scale was used to measure the restorative quality of auditory-visual combinations evaluated by 382 college students. The results indicated that: (1) easy accessibility to waterscape and flat topography normally are the promoters for the restorative quality of silent landscape; (2) a landscape containing natural water and a high coverage of plants matches the visual association of a bird singing, adding the birdsong to this landscape will produce higher restorative potential; (3) introducing flowing water sound to the landscape with less still water is a better choice to improve the restorative capacity; (4) adding wind sound to the landscape possessing high coverage of vegetation increases the restorative quality; (5) adding traditional Chinese music to the landscape with less paved areas will promote the mental stress relief of users, and no results were found for the western music.
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As demographic changes abound, landscape planners should increase their understanding of both elderly people’s preferences concerning nature-based recreation and approaches to consider those preferences in planning. This study aims to synthesize existing knowledge about elderly people’s preferences, namely, how they interact with green spaces, what landscape characteristics they prefer or dislike, and how practitioners can improve planning to better meet elderly people’s needs. A systematic literature review based on the PRISMA method was conducted, including an in-depth analysis of 44 peer-reviewed journal articles. We find that published studies focus primarily on elderly people’s recreational activities in urban parks. Across different contexts, elderly people seem to have common preferences: landscape features that are natural, aesthetic, comprehensible, and diverse, with accessible and well-maintained infrastructure and facilities. Moreover, interactions between people and nature may affect the relative importance levels of the preferences. We recommend that landscape planning practitioners consider both scientific evidence and local conditions that could affect elderly people’s preferences, and explore the degree to which design options may fulfill these preferences. Further research is needed to explore differences in preferences between urban and rural dwellers, to quantify preferences, and to enhance understanding of elderly people’s emotional ties with nature.
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The number of malls in Malaysia has not only increased dramatically, but they have also been subject to continual expansion over the past few years. Despite this rate of expansion, there has not been enough attention paid to the quality of the spaces and interior landscaping of the malls on the basis of people's preferences. This study aimed to bring out people's preferences towards interior public spaces at shopping malls. Using a photo questionnaire, the results pointed to three major dimensions: the green dimension, the seating dimension, and the business dimension in open spaces of shopping malls where the green dimension received the highest preference. The green dimension includes water features, trees, plants, and shrubs. Moreover, legibility and coherence affected people's preferences for open spaces in shopping malls. People did not prefer the business dimension to spending leisure times, involving business equipment in shopping malls. The study suggested that shopping malls should be designed as truly public spaces with ample public areas. Green elements and water features should be used more in shopping mall public places. Moreover, policy makers can expand the “shopping town” approach for people's leisure in malls that should include characteristics such as rivers or waterfalls with a dynamic water flow, famous places, public libraries, gardens, town activities, and cultural activities.
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A cross-sectional analysis among 1041 urban residents was done to examine associations between self-reported walking distance to and use of freshwater urban blue space and health-related quality of life in two German cities: a city with “poor” urban blue space supply (Bielefeld; 0.8% blue space) and one with “better” urban blue space supply (Gelsenkirchen; 3.0% blue space). Health-related quality of life was assessed with the SF-12v2, which measures residents’ self-reported mental and physical health. Results showed a significant association between use frequency and perceived walking distance to blue space. Blue space use was a better indicator of health outcomes than perceived walking distance. After controlling for green space, socio-economic and demographic variables, use frequency was associated with higher mental health in Gelsenkirchen. These cross-sectional findings suggest that blue space use increases the probability of being healthier in highly urbanised areas in cities with an appropriate amount of blue space.
Article
Background: A growing number of quantitative studies have investigated the potential benefits of outdoor blue spaces (lakes, rivers, sea, etc) and human health, but there is not yet a systematic review synthesizing this evidence. Objectives: To systematically review the current quantitative evidence on human health and well-being benefits of outdoor blue spaces. Methods: Following PRISMA guidelines for reporting systematic reviews and meta-analysis, observational and experimental quantitative studies focusing on both residential and non-residential outdoor blue space exposure were searched using specific keywords. Results: In total 35 studies were included in the current systematic review, most of them being classified as of "good quality" (N=22). The balance of evidence suggested a positive association between greater exposure to outdoor blue spaces and both benefits to mental health and well-being (N=12 studies) and levels of physical activity (N=13 studies). The evidence of an association between outdoor blue space exposure and general health (N=6 studies), obesity (N=8 studies) and cardiovascular (N=4 studies) and related outcomes was less consistent. Conclusions: Although encouraging, there remains relatively few studies and a large degree of heterogeneity in terms of study design, exposure metrics and outcome measures, making synthesis difficult. Further research is needed using longitudinal research and natural experiments, preferably across a broader range of countries, to better understand the causal associations between blue spaces, health and wellbeing.
Article
Stormwater ponds are widely used in urban developments to control and clean stormwater and add aesthetic appeal to the landscape. This dual function of residential stormwater systems can create conditions at odds for the optimal performance of either function. This investigation sought to discover connections between aesthetics, plants, design, maintenance, and municipal codes as a means to improve water quality and stormwater pond appearance. To establish the connections between visual quality and environmental function, we conducted five focus groups, four interviews with landscape professionals, and reviewed regulatory codes for 46 municipalities. We concluded that homeowner preferences and the social influence of neighbors were closely linked to design, codes, and management issues. Insights gained include the shared social value of wildlife viewing and aesthetic preferences for diverse, but maintained shoreline planting. © 2017, American Society for Horticultural Science. All rights reserved. (This article can be downloaded from the ASHS website: https://journals.ashs.org/horttech/view/journals/horttech/27/3/article-p310.xml)
Article
Background: In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is beneficial to health. However, the processes generating these benefits and how they can be best promoted remain unclear. Objectives: During an Expert Workshop held in September 2016, the evidence linking greenspace and health was reviewed from a transdisciplinary standpoint, with a particular focus on potential underlying biopsychosocial pathways and how these can be explored and organized to support policy-relevant population health research. Discussions: Potential pathways linking greenspace to health are here presented in three domains, which emphasize three general functions of greenspace: reducing harm (e.g. reducing exposure to air pollution, noise and heat), restoring capacities (e.g. attention restoration and physiological stress recovery) and building capacities (e.g. encouraging physical activity and facilitating social cohesion). Interrelations between among the three domains are also noted. Among several recommendations, future studies should: use greenspace and behavioural measures that are relevant to hypothesized pathways; include assessment of presence, access and use of greenspace; use longitudinal, interventional and (quasi)experimental study designs to assess causation; and include low and middle income countries given their absence in the existing literature. Cultural, climatic, geographic and other contextual factors also need further consideration. Conclusions: While the existing evidence affirms beneficial impacts of greenspace on health, much remains to be learned about the specific pathways and functional form of such relationships, and how these may vary by context, population groups and health outcomes. This Report provides guidance for further epidemiological research with the goal of creating new evidence upon which to develop policy recommendations.
Thesis
The purpose of this study is to explore what makes water features in different urban open spaces attractive to children and what opportunities or constraints influence children’s ability to experience such water features. This thesis takes a qualitative triangulation approach to investigate children’s perceptions and experiences of water and how children's experience of these spaces are perceived, facilitated or controlled by parents and professionals, and this study’s findings are based on three urban open spaces in Sheffield with a different characteristics: water features in Sheffield city centre, particularly the Peace Gardens, Millhouses Park and Endcliffe Park. Understanding children’s experiences of the built environment in urban areas plays a key role on improving the quality of urban open space provision. How children’s different spaces are considered and the opportunities and constraints that effect children’s experiences has been established for many types of built environment. However, children’s experiences of water have hardly been researched to the current date. Although children’s attraction to water was observed on many occasions, evidence-based knowledge was extremely limited. Therefore, this research focuses on three dimensions: firstly, how children perceive and use different urban open spaces with water; secondly, how parents perceive and control water play; and lastly, how professionals facilitate and control the use of water features through their design and management. This research uses surveys undertaken with children as a main method for understanding children’s experiences from their perspective. Parent’s who took their children to spaces were interviewed and, in order to understand parent who would not take their children to these sites, this thesis also surveyed the parents. Additional site iii observations were used to create GIS-based behaviour mapping to illustrate children’s spatial use of those urban open spaces with water features. There are considerable differences about children’s experiences and parental attitudes between those urban open spaces with water features, although most of the issues and concerns related to water are similar among those areas. Discussions of results related to urban open spaces have identified strengths of different types of water features and issues and concerns related to them. This thesis establishes a number of potential themes for improving water play provision, especially natural water play. Melih Bozkurt
Article
Understanding how built environment characteristics influence recreational walking is of the utmost importance to develop population-level strategies to increase levels of physical activity in a sustainable manner. This study analyses the residential and non-residential environmental correlates of recreational walking, using precisely geocoded activity space data. The point-based locations regularly visited by 4,365 participants of the RECORD Cohort Study were collected between 2011 and 2013 in the Paris region using the VERITAS software (Visualization and Evaluation of Regular Individual Travel destinations and Activity Spaces). Zero-inflated negative binomial regressions were used to investigate associations between both residential and non-residential environmental exposure and overall self-reported recreational walking over 7 days. Density of destinations, presence of a lake or waterway, and neighborhood education were associated with an increase in the odds of reporting any recreational walking time. Only the density of destinations was associated with an increase in time spent walking for recreational purpose. Considering the recreational locations visited (i.e., sports and cultural destinations) in addition to the residential neighborhood in the calculation of exposure improved the model fit and increased the environment-walking associations, compared to a model accounting only for the residential space (Akaike Information Criterion equal to 52797 compared to 52815). Creating an environment supportive to walking around recreational locations may particularly stimulate recreational walking among people willing to use these facilities. Copyright © 2015. Published by Elsevier Inc.
Article
The study investigated the main restorative components of staff break areas in healthcare facilities, by assessing usage patterns, verbal/visual preferences, and perceived restorative qualities of specific design features found in break areas for hospital staff. Nurses are extremely important to the healthcare industry, and maintaining the quality of nursing care is a central concern for healthcare administrators. While healthcare leaders are concerned about improving nurses' satisfaction, performance, and job retention, they may overlook the importance of respite for nurses and underestimate the value of designing staff break areas to maximize their restorative potential. A multi-method approach combined qualitative explorations (focused interviews and narrative survey questions) with quantitative measurements (discrete survey questions and a visual ranking of break-room spaces), and the results were compared and triangulated. It was found that staff break areas are more likely to be used if they are in close proximity to nurses' work areas, if they have complete privacy from patients and families, and if they provide opportunities for individual privacy as well as socialization with coworkers. Having physical access to private outdoor spaces (e.g., balconies or porches) was shown to have significantly greater perceived restorative potential, in comparison with window views, artwork, or indoor plants. The results of this empirical study support the conclusion that improvements in the restorative quality of break areas may significantly improve nurses' satisfaction and stress reduction, potentially leading to improved care for the patients they serve. © The Author(s) 2015.
Article
Exposure to natural environments can help restore depleted emotional and cognitive resources. However, investigation of the relative impacts of different natural environments among large samples is limited. Using data from 4255 respondents drawn from Natural England's Monitoring Engagement with the Natural Environment survey (2009-2011), we investigated feelings of restoration (calm, relaxed, revitalized and refreshed) recalled by individuals after visits to different natural environments within the last week. Controlling for demographic and visit characteristics we found that of the broad environmental categories, coastal visits were associated with the most restoration and town and urban parks with the least. In terms of specific environmental types two "green space" locations (woodlands/forests and hills/moorland/mountains) were associated with levels of restoration comparable to coastal locations. Urban playing fields were associated with the least restoration. Restoration was positively associated with visit duration (a potential dose-response effect), and visits with children were associated with less restoration than visits alone. There was little evidence that different activities (e.g. walking, exercising) were associated with differences in restoration. The data may improve our understanding of the "cultural eco-system services" provided by different natural environments and help decision makers keen to invest scare resources in those environments most associated with psychological benefits. (c) 2013 Elsevier Ltd. All rights reserved.
Article
Recently, new perspectives upon healthy urban open spaces propose that open spaces can be regarded as urban green or blue spaces. However, there has so far been very little research into blue environments and their benefits for mental well-being. Our article focuses on the effects of water in cities, "urban blue" (as compared to "urban green"), on human health and well-being. To assess the mental well-being of visitors, we conducted qualitative semi-standardised interviews (n=113), asking which differences in well-being occur when visiting urban green and blue spaces in high-density areas of the inner city in Dusseldorf and Cologne, Germany. Although we found many similarities, some health-enhancing effects for users turned out to be prominent for urban blue in the four conceptual therapeutic landscape dimensions: experienced, symbolic, social and activity space. These effects include enhanced contemplation, emotional bonding, participation, and physical activity. The results suggest that urban blue as a health-promoting factor needs more detailed and accurate determination and examination of its general and local health-enhancing effects. Copyright © 2014 Elsevier Ltd. All rights reserved.
Article
Background Recent findings suggest that individuals living near the coast are healthier than those living inland. Here we investigated whether this may be related to higher levels of physical activity among coastal dwellers in England, arising in part as a result of more visits to outdoor coastal settings. Method Participants (n = 183,755) were drawn from Natural England’s Monitor of Engagement with the Natural Environment Survey (2009-2012). Analyses were based on self-reported physical activity for leisure and transport. Results A small, but significant coastal proximity gradient was seen for the likelihood of achieving recommended guidelines of physical activity a week after adjusting for relevant area and individual level controls. This effect was statistically mediated by the likelihood of having visited the coast in the last seven days. Stratification by region, however, suggested that while the main effect was relatively strong for west coast regions, it was not significant for those in the east. Conclusions In general, our findings replicate and extend work from Australia and New Zealand. Further work is needed to explain the marked regional differences in the relationship between coastal proximity and physical activity in England to better understand the coast’s potential role as a public health resource.
Article
How do humans respond to different water features used by designers in urban plazas? Thirty participants viewed colour photographs of controlled views of five kinds of water features (Still, Flowing, Falling, Jet and Combination) and rated each scene on nine bi-polar adjective scales. The analyses focused on three composite scales, one for Preference, one for Calming and one for Excitement. Although the water features generally received favourable ratings, analysis of variance and tests of effect sizes revealed that participants had higher preferences for jets and combination; they rated still water as most calming; and they rated moving water as higher in excitement than still water. To test the generalization of the findings, replications in more realistic conditions are called for.