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Health-promoting outdoor environments designed for people living with dementia (PLwD) has proved to be an effective non-pharmacological intervention for treatment of symptoms and improved well-being. However, for individuals with Young-Onset Dementia (YOD), who have particular symptoms and needs, the content and design of these environments are underexplored. This study aimed to explore the needs of individuals with YOD in a garden setting, to generate design-related knowledge for 'dementia-friendly' outdoor environments, while contributing to the field of Evidence-Based Design (EBD). An 8-week long nature-based program was carried out in Alnarp's rehabilitation garden, a specifically developed garden based on research from e.g., landscape architecture, environmental psychology and medical science. The study used a triangulation of qualitative methods including six participants with YOD and a multidisciplinary team of five staff members. Content analysis was used for all gathered data, including 17 semi-structured interviews with participants with YOD and with staff. Data collection and analysis was performed based on the evidence-based Quality Evaluation Tool (QET). The study led to a target group adapted version of the QET for people with YOD containing 20 developed environmental qualities for designers to pursue in therapeutic gardens, including the additional quality of Calmness. A progression was noted, as a result of perceived positive effects during the intervention, indicating possible change and development of the group's needs and preferences in the outdoors.

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Bioaerosols are more likely to accumulate in the residential environment, and long-term inhalation may lead to a variety of diseases and allergies. Here, we studied the distribution, influencing factors and diffusion characteristics of indoor and outdoor microbiota pollution in six residential buildings in Guangzhou, southern China over a period of one year. The results showed that the particle sizes of bioaerosol were mainly in the range of inhalable particle size (<4.7 µm) with a small difference among four seasons (74.61 % ± 2.17 %). The microbial communities showed obvious seasonal differences with high abundance in summer, but no obvious geographical differences. Among them, the bacteria were more abundant than the fungi. The dominant microbes in indoor and outdoor environments were similar, with Anoxybacillu, Brevibacillus and Acinetobacter as the dominant bacteria, and Cladosporium, Penicillium and Alternaria as the dominant fungi. The airborne microbiomes were more sensitive to temperature and particulate matter (PM2.5, PM10) concentrations. Based on the Sloan neutral model, bacteria were more prone to random diffusion than fungi, and the airborne microbiome can be randomly distributed in indoor and outdoor environments and between the two environments in each season. Bioaerosol in indoor was mainly from outdoor. The health risk evaluation showed that the indoor inhalation risks were higher than those outdoor. The air purifier had a better removal efficiency on 1.1-4.7 µm microorganisms, and the removal efficiency on Gram-negative bacteria was better than that on Gram-positive bacteria. This study is of great significance for the risk assessment and control of residential indoor bioaerosol exposure.

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Getting lost could lead to frustration, anxiety, and even fatal accidents. Previous research primarily focused on disorientation in indoor or outdoor environments separately. The indoor-outdoor transition received little attention, yet it is in this complex transition that individuals often lose their way. Therefore, the effects of indoor-outdoor route alignment, visual access, and age on wayfinding performance and spatial cognition were examined. Twenty older adults (aged 18-25) and twenty young adults (aged 65-82) participated in an experiment through desktop Virtual Reality (VR). They traversed indoor-outdoor environments and were informed within a building to quickly navigate an item inside another building. They also drew the route map. Participants repeated tasks in four different environments. Their spatial cognition and wayfinding performance were analyzed. Four main findings were derived. Firstly, the accuracy of global representation of the routes in the indoor-outdoor route alignment environment was higher than that in the non-aligned environment. Secondly, in environments with higher visual access, the accuracy of global representation of the routes for older adults was higher than that with lower visual access. Thirdly, enhancing visual access attenuated the negative impact of the non-aligned route on global representation of the routes. This effect is particularly beneficial for older adults. Fourthly, the younger adults outperformed the older adults in both wayfinding performance and global representation of the routes in indoor-outdoor environments. This difference could potentially be attributed to variations in education level, mental rotation ability, and digital experience. These findings provide valuable implications for urban design and wayfinding strategies.

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We simultaneously assessed the associations for a range of outdoor environmental exposures with prevalent tuberculosis (TB) cases in a population-based health program with 1940,622 participants ≥ 15 years of age. TB status was confirmed through bacteriological and clinical assessment. We measured 14 outdoor environmental exposures at residential addresses. An exposome-wide association study (ExWAS) approach was used to estimate cross-sectional associations between environmental exposures and prevalent TB, an adaptive elastic net model (AENET) was implemented to select important exposure(s), and the Extreme Gradient Boosting algorithm was subsequently applied to assess their relative importance. In ExWAS analysis, 12 exposures were significantly associated with prevalent TB. Eight of the exposures were selected as predictors by the AENET model: particulate matter ≤ 2.5 µm (odds ratio [OR]=1.01, p = 0.3295), nitrogen dioxide (OR=1.09, p < 0.0001), carbon monoxide (OR=1.19, p < 0.0001), and wind speed (OR=1.08, p < 0.0001) were positively associated with the odds of prevalent TB while sulfur dioxide (OR=0.95, p = 0.0017), altitude (OR=0.97, p < 0.0001), artificial light at night (OR=0.98, p = 0.0001), and proportion of forests, shrublands, and grasslands (OR=0.95, p < 0.0001) were negatively associated with the odds of prevalent TB. Air pollutants had higher relative importance than meteorological and geographical factors, and the outdoor environment collectively explained 11% of TB prevalence.

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This study investigated the applicability of expanded metal meshes (EMMs) in horizontal shading devices. We performed simulations and experiments with EMMs with different opening ratios and directions. We established various experimental and control groups to measure air temperature, surface temperature, and black globe temperature. After the comparison of simulation and experimental data, we used Grasshopper to simulate long-term climate situations. The research results can serve as reference for users in Tainan and provide customized suggestions. The findings can serve as a paradigm for parametric design to analyze EMMs. In design projects involving outdoor horizontal shading devices, these results can be used in the design phase for evaluation. Full-day measurements revealed that EMMs with small openings exhibited favorable shading effects. In the Tainan area, we suggest using north-facing EMMs; in our simulations result, 70% of sunshine did not pass through the mesh in a day. For shading equipment in the morning, west-facing EMMs should be used because they blocked 50-90% of sunshine. For recreational areas in the afternoon and evening, east-facing EMMs can block 50-90% of sunshine after noon. In Taiwan, south-facing EMMs are not advised because their shading performance is suboptimal in the morning and afternoon.

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Introduction: During COVID-19, the mental health of Chinese university students has been a pressing concern. But the internal mechanism of perceived campus outdoor environment and learning engagement affecting college students' mental health during the COVID-19 pandemic has not been fully discussed. Methods: The current study used cross-sectional data from 45 Chinese universities to explore the relationship among perceptions of campus outdoor environments, learning engagement, and college student mental health, and focused on differences among college students in different grades. Results: Our study revealed the mental health problems of Chinese college students during the COVID-19 pandemic were more severe. The mental health of postgraduates was generally poor, and their risk of depression was higher than that of undergraduates. More importantly, for postgraduates, the direct impact of the perceived campus outdoor environment on their mental health was stronger. For undergraduates, the indirect impact of learning engagement on the effect of the perceived campus outdoor environment on their mental health was stronger. Conclusion: The results of the study have implications for campus planners, landscape architects, and university planners to pay particular attention to the needs of postgraduates for campus outdoor environments, which is of great significance to improve the overall mental health of students during the COVID-19 pandemic.

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BACKGROUND: Studies have shown that outdoor play in nature is associated with a higher physical activity level than indoor play. We aimed to examine the effect of outdoor versus conventional kindergartens on objectively measured physical activity. METHOD: Using a pre-test-post-test design, we collected data in four kindergartens that provided a rotating outdoor and conventional kindergarten setting. Step counts were measured during one week in the outdoor setting and one week in the conventional setting. Differences in step counts between the outdoor and conventional setting were analysed using a paired t-test. RESULTS: In total, 74 children were included. There was no statistically significant difference in total daily step counts between children in the two settings. When we looked at step counts during kindergarten hours, we saw that children were more physically active in the outdoor setting compared to the conventional setting (mean difference: 1089, p < 0.0001). When we looked at activity during time outside the kindergarten, we discovered that children had a lower step count in the outdoor setting as compared to the conventional setting (mean difference -652, p = 0.01). CONCLUSION: This study indicates that children are more physically active during the time they spend in outdoor kindergartens compared to conventional kindergartens, but may compensate with more inactivity outside kindergarten hours.

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Whenever people spend time outdoors during hot weather, they are putting themselves in potentially stressful situations. Being able to predict whether a person is overheating can be critical in preventing heat-health issues. There is a clear relationship between body core temperature and heat health. However, measuring body core temperature is expensive. Identifying a non-invasive measure that could indicate a person's thermal strain would be valuable. This study investigated five physiological measures as possible surrogates: finger mean skin temperature (FSKT), finger maximum skin temperature (FMSKT), skin conductance level (SCL), heart rate (HR), and heart rate variability (HRV). Furthermore, they were compared against the results of participants' subjective thermal sensation and thermal comfort in a range of hot microclimatic conditions in a hot and humid climate. Results showed that except for SCL, each of the other four physiological measures had a positive significant relationship with thermal sensation, but a negative relationship with thermal comfort. Furthermore, through testing by cumulative link mixed models, HRV was found to be the most suitable surrogate for predicting thermal sensation and thermal comfort through a simple, non-invasive measure in outdoor environment in summer in a hot and humid area. This study highlights the method for predicting human thermal strain and contributes to improve the public health and well-being of urban dwellers in outdoor environments.

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In this study, we assessed the direct and indirect thermal benefits of growing creepers on a building during four life stages (green, yellowish, yellowing, and wilting) based on field measurements of the temperature and humidity, and theoretical analysis. The results showed that the direct thermal benefits of creepers were significant in the green, yellowish, and yellowing stages, where they gradually decreased as the life stages progressed, with cooling gains of up to 8 °C in the green stage compared with the concrete wall, and the insulation benefits were still approximately 1 °C in the wilting stage. Creepers also had significant indirect thermal benefits in the green, yellowish, and yellowing stages, where the best cooling effect was obtained in the yellowish stage, but no significant indirect thermal benefits were found in the wilting stage. In addition, creepers could reduce the ambient air temperature by increasing the relative humidity in the surrounding environment. The results obtained in this study may provide a scientific reference to facilitate the construction of vertical greening in cold regions and to determine the specifications for related applications, as well as providing insights into vertical greening research at the same latitude.

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Full-duplex (FD) and reconfigurable intelligent surface (RIS) are potential technologies for achieving wireless communication effectively. Therefore, in theory, the RIS-aided FD system is supposed to enhance spectral efficiency significantly for the ubiquitous Internet of Things devices in smart cities. However, this technology additionally induces the loop-interference (LI) of RIS on the residual self-interference (SI) of the FD base station, especially in complicated urban outdoor environments, which will somewhat counterbalance the performance benefit. Inspired by this, we first establish an objective and constraints considering the residual SI and LI in two typical urban outdoor scenarios. Then, we decompose the original problem into two subproblems according to the variable types and jointly design the beamforming matrices and phase shifts vector methods. Specifically, we propose a successive convex approximation algorithm and a soft actor-critic deep reinforcement learning-related scheme to solve the subproblems alternately. To prove the effectiveness of our proposal, we introduce benchmarks of RIS phase shifts design for comparison. The simulation results show that the performance of the low-complexity proposed algorithm is only slightly lower than the exhaustive search method and outperforms the fixed-point iteration scheme. Moreover, the proposal in scenario two is more outstanding, demonstrating the application predominance in urban outdoor environments.

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In the last few years, interest about the natural environment and its influences on health conditions has been growing. In particular, physical activity interventions carried out in blue and green environment are being investigated as a potential strategy to increase health outcomes in people with and without chronic conditions. Many recent studies reported positive results, but a high number of these studies were focused on people with mental or physical disorders. In this scenario, the present systematic review, conducted according to the PRISMA statement, was aimed at investigating the existing evidence regarding the effects of physical activity interventions carried out in green-blue space settings involving healthy people. A literature search was performed through PubMed, Cochrane, Cinahl, and Psychinfo, and the quality of each study was assessed. Out of 239 identified articles, 75 full texts were screened. Six eligible studies showed an improvement in health outcomes, such as well-being, mood, and physical performance, in the experimental group compared with the control group. No exhaustive conclusion can be drawn based on available evidence. However, this systematic review highlighted the need to extend this kind of intervention to reveal more robust evidence that green and blue exercises benefit health.

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Stroke survivors face unique challenges in the outdoor environment when returning to their home community following a stroke. Challenges include navigating uneven terrain, social stigma, and adapting to changes in functioning. Outdoor environments may serve as potential points of intervention to promote independence and participation post stroke. This study aimed to understand lived post-stroke experience in the outdoor environment as it pertains to independent mobility. METHODS: Qualitative semi-structured interviews were conducted with 20 stroke survivors (8 males, 12 females; mean age 64.2 years: range 45 years-90 years). Participants were eligible if they were over the age of 45, could communicate in English, lived outside a nursing home, able to walk safely outdoors, were a minimum of six-months post stroke, and had no severe cognitive impairment. Interviews with participants were tape recorded, audio files were transcribed verbatim, codes were created and applied to transcripts, and themes were generated using interpretative phenomenological analysis. RESULTS: Post-stroke experiences in the outdoor environment were multidimensional. Three themes emerged from the stroke survivors' description of personal experiences in the outdoor environment. These themes included feelings of vigilance, employing adaptation strategies, and management of dynamic relations between the self and context. DISCUSSION: The findings highlight the post-stroke experience traversing the outdoor environment. Investing in the public outdoor environment to remove barriers and install facilitators could reduce feelings of apprehension and hypervigilance while walking in the outdoor environment. Future research is needed to evaluate the role of environmental interventions on hypervigilance in the outdoor environment post stroke.

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Particle dispersions have been widely studied inside rooms, but few databases have examined the transmission risk of respiratory droplets outdoors. This study investigated the wind effect on the dispersion of coughed droplets and the influence of social distancing on the infection risk in different susceptible persons using computational fluid dynamics simulations. Infection risk was evaluated based on direct depositions and exposure fractions. The results indicated that a reverse and upward flow formed in front of an infected man, and it enhanced as the wind strengthened, which transported more medium particles higher and increased the deposition on both infected and susceptible persons. Small particles moved above the neck, and they rarely deposited on the body. Medium particles larger than 60 µm were more likely to deposit and could reach the head of a healthy person under stronger winds. The exposure fraction achieved peak values when numerous particles passed the breathing zone. Although longer social distancing could alleviate the particle deposition on the face and delay the most dangerous time, its effect on infection risk was ambiguous. The infection risk was larger for a shorter susceptible person because more particles were deposited on the face, and the exposure fraction contributed by particles above the neck was larger.

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There is limited empirical knowledge about how older adults living with dementia enact their social citizenship through out-of-home participation. This study aimed: (a) to investigate out-of-home participation among older adults with and without dementia in four countries and (b) to compare aspects of stability or change in out-of-home participation. Using a cross-sectional design, older adults with mild-to-moderate dementia and without dementia, aged 55 years and over, were interviewed using the Participation in ACTivities and Places OUTside the Home questionnaire in Canada (n = 58), Sweden (n = 69), Switzerland (n = 70), and the United Kingdom (n = 128). Data were analyzed using descriptive statistics and a two-way analysis of variance. After adjustment for age, diagnosis of dementia and country of residence had significant effects on total out-of-home participation (p < .01). The results contribute to policies and development of programs to facilitate social citizenship by targeting specific activities and places.

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In recent times, we have seen a massive rise in vision-based applications, such as video anomaly detection, motion detection, object tracking, people counting, etc. Most of these tasks are well defined, with a clear idea of the goal, along with proper datasets and evaluation procedures. However, perimeter intrusion detection (PID), which is one of the major tasks in visual surveillance, still needs to be formally defined. A perimeter intrusion detection system (PIDS) aims to detect the presence of an unauthorized object in a protected outdoor site during a certain time. Existing works vaguely define a PIDS, and this has a direct impact on the evaluation of methods. In this paper, we mathematically define it. We review the existing methods, datasets and evaluation protocols based on this definition. Furthermore, we provide a suitable evaluation protocol for real-life application. Finally, we evaluate the existing systems on available datasets using different evaluation schemes and metrics.

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The COVID-19 pandemic impacted mental health. Growing research has identified the mental health benefits of nature contact, including gardening. We used a cross-sectional survey to investigate the association between gardening and other outdoor activities with anxiety among U.S. adults. The RANG (Reducing Anxiety with Nature and Gardening) survey was distributed online from June−September 2020 through social media (Twitter and Facebook) and a national Master Gardeners listserv. Survey questions captured demographics, COVID-19 experiences, gardening, outdoor activities, and anxiety using the Generalized Anxiety Disorder 7-item scale. Data were analyzed using chi-square, Fisher's exact, and Kruskal−Wallis tests, as well as logistic regression. Among participants, 46% reported anxiety symptoms. Participants who had gardened ≥ 15 years and those gardening > 8 h over two weeks had lower anxiety scores. Spending more time outdoors on weekdays also decreased anxiety scores. After adjusting for covariates, lower odds of anxiety were identified for 50−69 and 70−89-year-olds vs. 18−29-year-olds; males vs. females; and Texas vs. Maryland residents. These findings confirm increased anxiety during the COVID-19 pandemic and suggest that sustained gardening and other outdoor activities could help reduce anxiety.

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Objective To investigate the prevalence of allergic and infectious diseases in children， and to assess the influence of indoor and outdoor environmental factors on these two common diseases in children. Methods A questionnaire was used to investigate the prevalence of allergic and infectious diseases in 140 children of 7 years old in Laizhou Bay， Shandong Province. Logistic regression was used to analyze the associations between indoor and outdoor environmental factors and children’s allergic and infectious diseases， respectively. Results The prevalence of previous eczema and other allergic diseases for the past year in children was 37.9% and 15.0%， respectively， and the prevalence of infectious diseases for the past year was 35.7%. As for allergic diseases， eye irritation due to outdoor air （ OR =2.977； 95% CI ： 1.407‒6.296） and nose irritation due to outdoor air （ OR =5.147； 95% CI ： 1.272‒20.827） were the risk factors for previous eczema in children. Indoor musty taste increased the risks of urticaria （ OR =4.306； 95% CI ： 1.062‒17.454） and previous eczema （ OR =3.853； 95% CI ： 1.080‒13.743）. The use of cockroach killers indoors increased the risk of rhinitis （ OR =6.102； 95% CI ：1.297‒28.697）. As for infectious diseases， having outdoor pollution sources increased the risk of gastrointestinal infection （ OR =4.937； 95% CI ： 1.050‒23.216）， and the use of mosquito coils and clothing mothproofing agents increased the risks of respiratory （ OR =6.333； 95% CI ： 1.397‒28.714） and gastrointestinal infections （ OR =3.218； 95% CI ： 1.074‒9.644）， respectively. However， we did not find associations between indoor passive smoking and allergic or infectious diseases. Conclusion Except outdoor passive smoking， all the other indoor and outdoor environmental factors increase the risks of children’s allergies and infectious diseases.

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Objective To investigate the prevalence of allergic and infectious diseases in children， and to assess the influence of indoor and outdoor environmental factors on these two common diseases in children. Methods A questionnaire was used to investigate the prevalence of allergic and infectious diseases in 140 children of 7 years old in Laizhou Bay， Shandong Province. Logistic regression was used to analyze the associations between indoor and outdoor environmental factors and children’s allergic and infectious diseases， respectively. Results The prevalence of previous eczema and other allergic diseases for the past year in children was 37.9% and 15.0%， respectively， and the prevalence of infectious diseases for the past year was 35.7%. As for allergic diseases， eye irritation due to outdoor air （ OR =2.977； 95% CI ： 1.407‒6.296） and nose irritation due to outdoor air （ OR =5.147； 95% CI ： 1.272‒20.827） were the risk factors for previous eczema in children. Indoor musty taste increased the risks of urticaria （ OR =4.306； 95% CI ： 1.062‒17.454） and previous eczema （ OR =3.853； 95% CI ： 1.080‒13.743）. The use of cockroach killers indoors increased the risk of rhinitis （ OR =6.102； 95% CI ：1.297‒28.697）. As for infectious diseases， having outdoor pollution sources increased the risk of gastrointestinal infection （ OR =4.937； 95% CI ： 1.050‒23.216）， and the use of mosquito coils and clothing mothproofing agents increased the risks of respiratory （ OR =6.333； 95% CI ： 1.397‒28.714） and gastrointestinal infections （ OR =3.218； 95% CI ： 1.074‒9.644）， respectively. However， we did not find associations between indoor passive smoking and allergic or infectious diseases. Conclusion Except outdoor passive smoking， all the other indoor and outdoor environmental factors increase the risks of children’s allergies and infectious diseases.

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BACKGROUND AND OBJECTIVES: There has been a proliferation of research on dementia-friendly communities in recent years, particularly on interpersonal and social aspects. Nonetheless, the neighborhood built environment remains a co-constituent of the lived experience of people living with dementia (PLWD) that is amenable to interventions for health and well-being in the community. This scoping review presents a narrative synthesis of empirical research on dementia-friendly neighborhoods, with a focus on the built environment and its associated sociobehavioral aspects. Planning and design principles are distilled to identify research and policy implications. RESEARCH DESIGN AND METHODS: We reviewed 29 articles identified through a systematic search of AgeLine, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Global Health, Medical Literature Analysis and Retrieval System Online, and Scopus. Peer-reviewed articles that employed quantitative and/or qualitative methods in community settings were included. RESULTS: An equal number of studies focused on behavioral/psychosocial aspects of the built environment and assessment of specific environmental features. The former often used qualitative methods, whereas statistical methods were common in studies on discrete features of the neighborhood built environment. Few studies focused on rural contexts. Emerging research areas include interactions between dementia risk factors and neighborhood environments to support primary and secondary prevention. DISCUSSION AND IMPLICATIONS: The body of literature needs expansion into planning and design fields to foster community participation of PLWD by optimizing environmental stimuli, minimizing environmental barriers, and engaging PLWD in dementia-friendly community initiatives. While evidence has accumulated on landmarks and social participation at the individual level, research at the community and policy levels is limited. This requires advanced mixed methods.

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Participation in regular physical activity has significant physical, psychological, and social benefits, including the prevention and treatment of Type 2 Diabetes (T2D). The primary aim of this paper was to evaluate the impact of theeCoFit physical activity intervention on depression and anxiety symptoms among adults at risk of, or diagnosed with, T2D. The primary outcomes were assessed using Patient Health Questionnaire-9, and Generalised Anxiety Disorder-7. The secondary aim was to test for the potential mediators for the intervention effect on mental health. The 20-week intervention was evaluated using a two-arm randomised controlled trial with await list control group. The intervention included two phases: Phase 1 integrated group face-to-face sessions and the use of the eCoFit smartphone application (app); and Phase 2 that included the use of the app only. Participants (n = 84) were assessed at baseline and 10- and 20-weeks post-baseline. Social support, self-efficacy, nature-relatedness, and perceived sleep quality were examined as potential mechanisms for the intervention effects on mental health. A significant interaction for depression severity was observed at 20-weeks (-1.76, CI -3.48, -05, p= .044, d= -0.35). There were no significant intervention effects for anxiety or any of the potential mechanisms.

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