Bethany Harries

Background: Men face numerous challenges when deciding whether to engage in help-seeking for abnormal lower urinary tract symptoms (LUTS), with help-seeking behaviour a multi-step process. Objective: This systematic review explores the barriers and facilitators to help-seeking behaviour in adult men for abnormal LUTS.Methods: Eight databases (PubMed, Web of Science, Cochrane Library, EBSCOhost, SCOPUS, OVID, ProQuest and PsychINFO) were searched between January 2023 and March 2024. Studies were required to meet the inclusion criteria informed by PRISMA guidelines. Qualitative and mixed method studies were included in the systematic review. Results: (N) = 17 full-text articles were included in the review, totalling (n) = 704 participants. The systematic review uncovered four key themes: men have poor relationships with the healthcare system, some minority groups have dysfunctional cultural beliefs and attitudes towards help-seeking behaviour, traditional gender views and perceptions of masculinity discourage help-seeking behaviour and men have intrapersonal and external barriers. Conclusions: Men face considerable challenges when deciding to engage in help-seeking for abnormal LUTS, with men generally lacking awareness and knowledge of what they should do when experiencing symptoms. This is more profound in men from minority groups. This review may have had a language bias as non-English studies were excluded. This review may be essential to inform the development of interventions to facilitate help-seeking behaviour for abnormal LUTS in men, specifically men from minority populations.

Spending time in natural environments is associated with enhanced well-being, including reduced stress and improved cognitive restoration. This experimental study investigates whether these benefits can be amplified by providing environmental prompts to direct attention towards specific features (natural versus human-made) within the environment.Seventy-nine participants were randomly allocated to one of three conditions: Restorative prompting; Human-made prompting; or control. In the Restorative prompting group, participants were asked to notice natural features within the environment (natural sounds, smells, views, plants and biodiversity). In the human-made prompting group, participants were asked to notice built elements in the environment (buildings, pathways, and human-made sounds). Participants in the control group received no instructions.This study was conducted at Royal Horticultural Society (RHS) Wisley botanical gardens. Measures of state well-being (Short Warwick Edinburgh Mental Wellbeing Scale), positive affect (Discrete Emotions Questionnaire) and perceived restoration (Restoration Outcome Scale) were taken before and after participants spent 20 minutes in the garden completing attentional prompting activities.Participants in the restorative prompting group reported significantly higher state well-being, positive affect and restoration compared to those in the human-made prompting group and the no prompting controls.These findings suggest that the well-being and restorative effects of spending time in natural environments are enhanced when individuals actively attend to nature and emotions. This has significant practical implications for the design and management of natural spaces, both public and private, such as parks and gardens that attract visitors seeking leisure and relaxation. The study provides valuable insights into how people can get the most out of these visits to support and enhance their well-being, highlighting the potential of interventions such as interpretive signage, digital trails or guided experiences to promote more meaningful engagement with nature.

This study aimed to identify what specific plants and garden features in an intentionally designed wellbeing garden influence emotional reactions and perceived restoration. To test this 142 garden visitors were recruited and asked to complete a survey as they walked around the wellbeing garden. The survey guided participants around the garden instructing them to stop at four specific Zones. They were asked questions concerning how the different Zones of the garden made them feel (sad, happy, excited, calm, and perceived restoration). In addition, the survey included open-ended questions where participants were asked to identify the features such as water elements, plants, views, and structures (sculptures, seating, paving) they felt evoked their emotional response. Using a mixed methods approach with ANOVA and Content Analysis, results found key garden design features linked to emotional reactions and perceived restoration include sounds of flowing water, open seating areas, far-reaching views, and a variety of planting (colour, height, texture, scents, attracting wildlife). This evidence can be used to inform the design of gardens that optimise wellbeing outcomes.

Evidence demonstrates the benefits of gardens for promoting wellbeing. Some gardens are now being designed specifically to promote wellbeing; however, there are currently no evidence-based guidelines or recommendations available for designers to support such endeavours. The present study undertakes a systematic review of garden design literature to: (1) identify the defining characteristics of a garden that promotes wellbeing in non-clinical populations; and (2) summarize existing evaluations of garden designs into recommendations that can promote wellbeing. Online databases were used to identify papers published before October 2022, from which 17 publications were reviewed. This review was conducted following PRISMA and framework for scoping reviews. Results: The defining characteristics of wellbeing gardens centred around six design aspects: accessibility, wayfinding, fostering serenity, multisensory planting, spatial organization, and cultural artefacts. From these, recommendations were developed for garden designers to create wellbeing gardens.