Our systems are based on peer reviewed research in scientific journals.
The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity
Roger Ulrich, Xiaobo Quan, Center for Health Systems and Design, College of Architecture, Texas A&M University
Craig Zimring, Anjali Joseph, Ruchi Choudhary, College of Architecture, Georgia Institute of Technology
In this project, research teams from Texas A&M University and Georgia Tech combed through several thousand scientific articles and identified more than 600 studies—most in top peer-reviewed journals—that establish how hospital design can impact clinical outcomes. The team found scientific studies that document the impact of a range of design characteristics, such as single-rooms versus multi-bed rooms, reduced noise, improved lighting, better ventilation, better ergonomic designs, supportive workplaces and improved layout that can help reduce errors, reduce stress, improve sleep, reduce pain and drugs, and improve other outcomes. The team discovered that, not only is there a very large body of evidence to guide hospital design, but a very strong one. A growing scientific literature is confirming that the conventional ways that hospitals are designed contributes to stress and danger, or more positively, that this level of risk and stress is unnecessary: improved physical settings can be an important tool in making hospitals safer, more healing, and better places to work.
Multi-Sensory Design as a Health Resource: Customizable, Individualized, and Stress-Regulating Spaces
Ute Ziegler
The focus of this research project is the conception and development of low-threshold design interventions to improve ambience and atmosphere in hospitals, to reduce stress and anxiety, and to allow patients an individualized retreat. The research is performed at the University of Lucerne of Applied Sciences and Arts in the Design Management Research Group under the direction of Professor Claudia Acklin. The design interventions are developed in context and carried out in cooperation with Swiss hospitals.
The Impact of Monaural Beat Stimulation on Anxiety and Cognition
Leila Chaieb, Elke C. Wilpert, Christian Hoppe, Juergen Fell, Department of Epileptology, University of Bonn, Bonn, Germany
Nikolai Axmacher, Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, University of Bochum, Bochum, Germany
Application of auditory beat stimulation has been speculated to provide a promising new tool with which to alleviate symptoms of anxiety and to enhance cognition. In spite of reportedly similar EEG effects of binaural and monaural beats, data on behavioral effects of monaural beats are still lacking. Therefore, we examined the impact of monaural beat stimulation on anxiety, mood and memory performance. We aimed to target states related to anxiety levels and general well-being, in addition to long-term and working memory processes, using monaural beats within the range of main cortical rhythms. Theta (6 Hz), alpha (10 Hz) and gamma (40 Hz) beat frequencies, as well as a control stimulus were applied to healthy participants for 5 min. After each stimulation period, participants were asked to evaluate their current mood state and to perform cognitive tasks examining long-term and working memory processes, in addition to a vigilance task. Monaural beat stimulation was found to reduce state anxiety. When evaluating responses for the individual beat frequencies, positive effects on state anxiety were observed for all monaural beat conditions compared to control stimulation. Our results indicate a role for monaural beat stimulation in modulating state anxiety and are in line with previous studies reporting anxiety-reducing effects of auditory beat stimulation.
The Circadian Clock and Human Health
Roenneberg T, Merrow M. Curr Biol. 2016 May 23;26(10):R432-43. doi: 10.1016/j.cub.2016.04.011. PMID: 27218855.
Epidemiological studies provided the first evidence suggesting a connection between the circadian clock and human health. Mutant mice convincingly demonstrate the principle that dysregulation of the circadian system leads to a multitude of pathologies. Chrono-medicine is one of the most important upcoming themes in the field of circadian biology. Although treatments counteracting circadian dysregulation are already being applied (e.g., prescribing strong and regular zeitgebers), we need to comprehend entrainment throughout the body's entire circadian network before understanding the mechanisms that tie circadian dysregulation to pathology. Here, we attempt to provide a systematic approach to understanding the connection between the circadian clock and health. This taxonomy of (mis)alignments on one hand exposes how little we know about entrainment within any organism and which 'eigen-zeitgeber' signals are used for entrainment by the different cells and tissues. On the other hand, it provides focus for experimental approaches and tools that will logically map out how circadian systems contribute to disease as well as how we can treat and prevent them.
Forest 404
Smalley et al., 2022
Published in Global Environmental Change
Extensive ecosystem degradation and increasing urbanization are altering human relationships with nature. To explore these trends, we created a transdisciplinary, narrative-led podcast series produced by the BBC, called Forest 404. The series explored the implications of a world without nature. An online experimental component mobilized audience participation (n = 7,596) to assess responses to natural soundscapes with and without abiotic, biotic, and poetic elements across five biomes. Conditions featuring the sounds of wildlife, such as bird song, were perceived to be more psychologically restorative than those without. Participants’ personal lived experiences were strongly related to these outcomes; those who had memories triggered by the sounds were more likely to find them psychologically restorative and exhibited a greater motivation to preserve them. Moreover, the effects of both soundscape composition and memories on preservation behavior were partially mediated by restorative potential; respondents were more likely to want to protect the sounds they heard if they thought they might offer therapeutic outcomes. Our findings highlight the value of art-science collaborations and demonstrate how maintaining contact with the natural world can promote wellbeing and foster behaviors that protect planetary health.
Ephemeral phenomena
Smalley and White, 2023
Published in the Journal of Environmental Psychology
Landscape views can be dynamic; many of the elements within an environmental vista may change from one moment to the next. Features such as a vibrant sunrise or sudden storm are often brief and unexpected, they are ephemeral, and might significantly alter the way an environment is perceived and experienced. Yet existing research has tended to focus on appraisals of urban and rural scenes under uniformly clement, ‘blue-sky’ conditions, with few studies considering how diurnal rhythms and fleeting meteorological processes might impact landscape appraisals. To address this gap, we conducted an online experiment that presented participants (n = 2,509) with either an urban or natural virtual setting, strictly matched in terms of scenic structure, within which six ‘ephemeral phenomena’ were applied. We assessed ratings of beauty, awe, and willingness-to-pay to visit in each condition. Supporting existing findings, results demonstrated the natural setting was generally rated more positively than the urban setting. However, ephemeral phenomena substantially moderated this effect, with rainbows, storms, and nightfall each reducing the divergence. Sunrise and sunset were the most valued conditions within both environments, outcomes that were partially mediated through increased ratings of beauty and awe. We find that whilst an urban-nature dichotomy exists in landscape appraisals, acknowledging the effects of ephemeral, non-structural phenomena could have important implications for landscape research and design.
Music and nature
Smalley et al., 2023
Published in the Journal of Environmental Psychology
From walking through a park to sitting on a beach, much is known about the therapeutic potential of direct contact with natural environments. Yet routinely in the UK, millions of people encounter nature in a completely different way: through their television screens. Despite the ubiquity of natural history programming, little is understood about its impact on the restorative and affective experiences of audiences. Nowhere is this truer than in the bold orchestral scores that accompany almost all nature documentaries. Whilst considerable evidence suggests that separately, both nature and music can provide a range of psychological benefits, how their pairing might affect the wellbeing potential of virtual nature encounters remains largely unknown. Similarly, scant research has considered how viewers’ own experiences, recalled through memories, might influence outcomes. To explore these areas, we formed a transdisciplinary broadcast initiative, called BBC Soundscapes for Wellbeing. Part of this project involved a randomized and controlled experiment that presented participants (n = 7636) with a dynamic nature scene accompanied by one of four acoustic tracks. Results demonstrated that whilst adding music to this scene led to increased feelings of excitement, it led to no other restorative or affective benefits when compared to silence. In contrast, the addition of natural sounds was associated with greater feelings of restorative potential, calmness, and excitement. Natural sounds also drove significant increases in the complex emotions of awe and nostalgia. Crucially, results showed the substantial moderating effects of participant memories. Those with positive memories stimulated by the experience reported significantly greater effects across all conditions and dependent variables. We find that although the acoustic design of virtual nature encounters can affect a range of emotional responses, the memories triggered by these experiences may be far more important for predicting viewer outcomes.
What is the best way of delivering virtual nature for improving mood? An experimental comparison of high definition TV, 360° video, and computer generated virtual reality
N.L. Yeo, M.P. White, I. Alcock, R. Garside, S.G. Dean, A.J. Smalley, B. Gatersleben
Exposure to ‘real’ nature can increase positive affect and decrease negative affect, but direct access is not always possible, e.g. for people in health/care settings who often experience chronic boredom. In these settings ‘virtual’ forms of nature may also have mood-related benefits (e.g. reducing boredom) but it has been difficult to separate effects of nature content from those of delivery mode. The present laboratory-based study explored whether exposure to three different delivery modes of virtual nature could reduce negative affect (including boredom) and/or increase positive affect. Adult volunteer participants (n = 96) took part in a boredom induction task (to simulate the emotional state of many people in health/care settings) before being randomly assigned to view/interact with a virtual underwater coral reef in one of three experimental conditions: (a) 2D video viewed on a high-definition TV screen; (b) 3600 video VR (360-VR) viewed via a head mounted display (HMD); or (c) interactive computer-generated VR (CG-VR), also viewed via a HMD and interacted with using a hand-held controller. Visual and auditory content was closely matched across conditions with help from the BBC's Blue Planet II series team. Supporting predictions, virtual exposure to a coral reef reduced boredom and negative affect and increased positive affect and nature connectedness. Although reductions in boredom and negative affect were similar across all three conditions, CG-VR was associated with significantly greater improvements in positive affect than TV, which were mediated by greater experienced presence and increases in nature connectedness. Results improve our understanding of the importance of virtual nature delivery mode and will inform studies in real care settings.
The nature of suffering and the goals of medicine
E J Cassel
The question of suffering and its relation to organic illness has rarely been addressed in the medical literature. This article offers a description of the nature and causes of suffering in patients undergoing medical treatment. A distinction based on clinical observations is made between suffering and physical distress. Suffering is experienced by persons, not merely by bodies, and has its source in challenges that threaten the intactness of the person as a complex social and psychological entity. Suffering can include physical pain but is by no means limited to it. The relief of suffering and the cure of disease must be seen as twin obligations of a medical profession that is truly dedicated to the care of the sick. Physicians' failure to understand the nature of suffering can result in medical intervention that (though technically adequate) not only fails to relieve suffering but becomes a source of suffering itself.
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