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Study objective: To compare health walks, a community based lay-led walking scheme versus advice only on physical activity and cardiovascular health status in middle aged adults. Design: Randomised controlled trial with one year follow up. Physical activity was measured by questionnaire. Other measures included attitudes to exercise, body mass index, cholesterol, aerobic capacity, and blood pressure. Setting: Primary care and community. Participants: 260 men and women aged 40-70 years, taking less than 120 minutes of moderate intensity activity per week. Main results: Seventy three per cent of people completed the trial. Of these, the proportion increasing their activity above 120 minutes of moderate intensity activity per week was 22.6% in the advice only and 35.7% in the health walks group at 12 months (between group difference =13% (95% CI 0.003% to 25.9%) p=0.05). Intention to treat analysis, using the last known value for missing cases, demonstrated smaller differences between the groups (between group difference =6% (95% CI −5% to 16.4%)) with the trend in favour of health walks. There were improvements in the total time spent and number of occasions of moderate intensity activity, and aerobic capacity, but no statistically significant differences between the groups. Other cardiovascular risk factors remained unchanged. Conclusions: There were no significant between group differences in self reported physical activity at 12 month follow up when the analysis was by intention to treat. In people who completed the trial, health walks was more effective than giving advice only in increasing moderate intensity activity above 120 minutes per week.

Exposure of individuals to natural environments, such as forests and coastlines, can promote stress reduction and assist in mental recovery following intensive cognitive activities. Settings as simple as hospital window views onto garden-like scenes can also be influential in reducing patients’ postoperative recovery periods and analgesic requirements. This paper reviews the evidence supporting the exploitation of these restorative natural environments in future healthcare strategies. The paper also describes early research addressing the development of multisensory, computer-generated restorative environments for the benefit of patients with a variety of psychologically related conditions (including depression, attention deficit disorder, pain, and sleep deficit), who may be unable to access and experience real natural environments, such as those in hospices, military rehabilitation centers, and long-term care facilities. The Table of Contents art is a virtual reconstruction of Wembury Bay, in the southwest of the UK, based on imported Digital Terrain Elevation Data (DTED) to provide the topography and a high-resolution aerial image to provide a template for the location of 3D building and vegetation models, rock features, and pathways. The 3D environment is rendered using the Unity 3 Game Development Tool and includes spatial sound effects (waves, wind, birdsong, etc.), physics-based features (such as early morning sea mist), time-of-day cycles, and real-time weather changes. The Village Church of St. Werburgh can also be seen in this image.

We report a measurable effect of atmospheric conditions upon stroke incidence in a temperate climate.

BackgroundActive travel to school can be an important contributor to the total physical activity of children but levels have declined and more novel approaches are required to stimulate this as an habitual behaviour. The aim of this mixed methods study was to investigate the feasibility of an international walk to school competition supported by novel swipecard technology to increase children’s walking to/from school.MethodsChildren aged 9–13 years old participated in an international walk to school competition to win points for themselves, their school and their country over a 4-week period. Walks to and from school were recorded using swipecard technology and a bespoke website. For each point earned by participants, 1 pence (£0.01) was donated to the charity of the school’s choice. The primary outcome was number of walks to/from school objectively recorded using the swipecard tracking system over the intervention period. Other measures included attitudes towards walking collected at baseline and week 4 (post-intervention). A qualitative sub-study involving focus groups with children, parents and teachers provided further insight.ResultsA total of 3817 children (mean age 11.5 ± SD 0.7) from 12 schools in three cities (London and Reading, England and Vancouver, Canada) took part in the intervention, representing a 95% intervention participation rate. Results show a gradual decline in the average number of children walking to and from school over the 4-week period (week 1 mean 29% ± SD2.5; week 2 mean 18% ± SD3.6; week 3 mean 14% ± SD4.0; week 4 mean 12% ± SD1.1). Post intervention, 97% of children felt that walking to school helped them stay healthy, feel happy (81%) and stay alert in class (76%). These results are supported by qualitative findings from children, parents and teachers. Key areas for improvement include the need to incorporate strategies for maintenance of behaviour change into the intervention and also to adopt novel methods of data collection to increase follow-up rates.ConclusionsThis mixed methods study suggests that an international walk to school competition using innovative technology can be feasibly implemented and offers a novel way of engaging schools and motivating children to walk to school.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-014-0959-x) contains supplementary material, which is available to authorized users.

An effect that was consistent and generally strongest in populations in the north was observed between cold temperature and respiratory consultations. Better understanding of the mechanisms by which cold weather is associated with increases in consultations for respiratory infections could lead to improved strategies for prevention and reduced burdens for health services.

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Climate change can be viewed as human-induced change to climate and depletion of natural systems. It potentially the biggest global health threat of the 21st century. It is predicted to have wide-ranging impacts upon human mental health and well-being, through changes and challenges to people's environment, socioeconomic structures and physical security. Even the most conservative estimates of the health impacts are extremely alarming. Increasingly, the causes of poor human health and environmental damage are related. This implies that there are common solutions. For example, there are co-benefits to human health and biodiversity from mitigating and adapting to climate change (e.g. promoting active transport and reducing car use reduces CO2 emissions, benefits our environment and reduces morbidity and mortality associated with a sedentary lifestyle). This article outlines how climate change impacts upon mental health and well-being. It introduces ecological concepts, applies these to public health and outlines their implications in transforming the way that we prioritize and deliver public health in order to promote both environmental and human health. Evidence, from psychology and neuroscience, suggests that the perception of being disconnected from our inner selves, from each other and from our environment has contributed to poor mental and physical health. We argue that we must transform the way we understand mental health and well-being and integrate it into action against climate change. We describe a Public Health Framework for Developing Well-Being, based on the principles of ecological public health.