The included studies suggest that both synchronous and asynchronous teleconsultations for diabetes care are feasible, cost-effective, and reliable. However, it should be noted that many of the included studies showed no significant differences between control (usual care) and intervention groups. This might be due to the diversity and lack of quality in study designs (e.g., inaccurate or incompletely reported sample size calculations). Future research needs quasi-experimental study designs and a holistic approach that focuses on multilevel determinants (clinical, behavioral, and care coordination) to promote self-care and proactive collaborations between health care professionals and patients to manage diabetes care. Also, a participatory design approach is needed in which target users are involved in the development of cost-effective and personalized interventions. Currently, too often technology is developed within the scope of the existing structures of the health care system. Including patients as part of the design team stimulates and enables designers to think differently, unconventionally, or from a new perspective, leading to applications that are better tailored to patients' needs.

Objectives: This field study investigated the potential stress-reducing effects of exposure to real or artificial nature on patients in a hospital waiting room. Additionally, it was investigated whether perceived attractiveness of the room could explain these effects. Design: In this between-patients experimental design, patients were exposed to one of the following: real plants, posters of plants, or no nature (control). These conditions were alternately applied to two waiting rooms. Location: The location of this study was two waiting rooms at the Radiology Department of a Dutch hospital. Subjects: The subjects comprised 457 patients (60% female and 40% male) who were mostly scheduled for echocardiogram, dual-energy x-ray absorptiometry, magnetic resonance imaging, computed tomography scans, or nuclear research. Results: Patients exposed to real plants, as well as patients exposed to posters of plants, report lower levels of experienced stress compared to the control condition. Further analyses show that these small but significant effects of exposure to nature are partially mediated by the perceived attractiveness of the waiting room. Conclusions: Natural elements in hospital environments have the potential to reduce patients' feelings of stress. By increasing the attractiveness of the waiting room by adding either real plants or posters of plants, hospitals can create a pleasant atmosphere that positively influences patients' well-being.

Virtual reality (VR) distraction has become increasingly available in health care contexts and is used in acute pain management. However, there has been no systematic exploration of the importance of the content of VR environments. Two studies tested how interacting with nature VR influenced experienced and recollected pain after 1 week. Study 1 (n = 85) used a laboratory pain task (cold pressor), whereas Study 2 (n = 70) was a randomized controlled trial with patients undergoing dental treatment. In Study 1, nature (coastal) VR reduced both experienced and recollected pain compared with no VR. In Study 2, nature (coastal) VR reduced experienced and recalled pain in dental patients, compared with urban VR and standard care. Together, these data show that nature can improve experience of health care procedures through the use of VR, and that the content of the VR matters: Coastal nature is better than urban.

In the present research, we evaluated the restorative impacts of green walls with living plants in classrooms of two elementary schools using a controlled, prospective design with baseline measurements and follow-ups at 2 and 4 months. At each time of measurement, children’s ( n = 170, age = 7-10) cognitive performance, well-being, and classroom evaluations were measured with attentional tests and self-report questionnaires. Results show that children in the four classrooms where a green wall was placed, as compared with children in control groups, scored better on a test for selective attention; processing speed was not affected by the green wall. The green wall also positively influenced children’s classroom evaluations. There were no measurable effects of the green wall on children’s self-reported well-being. The green walls were generally evaluated positively during the two follow-ups. These results provide some of the first empirical support for green walls as a means for restorative classroom design.

As consumers increasingly turn to luxury brands and associated benefits, brand managers face the question how to convey luxury perceptions via marketing communications such as packaging and advertising design. Inspired by theories addressing embodied cognition and symbolic meaning portrayal, this paper argues that visual cues inspiring verticality perceptions (i.e., camera angle and advertising background orientation) affect luxury perceptions and, consequently, consumer evaluations and price expectations. Across three experiments, verticality cues fostered perceptions of product luxury but differentially affected price expectations and purchase considerations depending on product type. Moreover, findings show that effects of vertical orientation are more pronounced for participants high on sociable dominance. Implications of these findings for visual brand management are discussed.