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      Effects of horticultural therapy on elderly’ health: protocol of a randomized controlled trial

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          Abstract

          Background

          Due to a rapidly ageing population in the world, it is increasingly pertinent to promote successful ageing strategies which are cost-effective, easily accessible, and more likely to be acceptable to the elderly. Past research associates exposure to natural environments and horticultural therapy (HT) with positive psychological, social and physical health benefits. This Randomized Controlled Trial (RCT) is designed to evaluate the efficacy of HT in promoting Asian elderly’ mental health, cognitive functioning and physical health.

          Methods/design

          70 elderly participants aged 60 to 85 years old will be randomized to participate in either the active horticultural therapy group or be in the waitlist control. Sessions will be weekly for 12 weeks, and monthly for 3 months. Mental health will be assessed through self-reports of depressive and anxiety symptomatology, life satisfaction, social connectedness and psychological well-being, collaborated with immunological markers. Outcome measures of cognitive functioning and physical health include neuropsychological tests of cognitive function and basic health screening. Outcomes will be assessed at baseline, 3 months and 6 months post-intervention.

          Discussion

          This RCT comprehensively investigates the efficacy of a non-invasive intervention, HT, in enhancing mental health, cognitive functioning and physical health. The results have tremendous potential for supporting future successful ageing programs and applicability to larger populations.

          Trial registration

          ClinicalTrials.gov NCT02495194. Trial registration date: July 13, 2015. Retrospectively registered.

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          Most cited references26

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          Random allocation software for parallel group randomized trials

          Background Typically, randomization software should allow users to exert control over the different aspects of randomization including block design, provision of unique identifiers and control over the format and type of program output. While some of these characteristics have been addressed by available software, none of them have all of these capabilities integrated into one package. The main objective of the Random Allocation Software project was to enhance the user's control over different aspects of randomization in parallel group trials, including output type and format, structure and ordering of generated unique identifiers and enabling users to specify group names for more than two groups. Results The program has different settings for: simple and blocked randomizations; length, format and ordering of generated unique identifiers; type and format of program output; and saving sessions for future use. A formatted random list generated by this program can be used directly (without further formatting) by the coordinator of the research team to prepare and encode different drugs or instruments necessary for the parallel group trial. Conclusions Random Allocation Software enables users to control different attributes of the random allocation sequence and produce qualified lists for parallel group trials.
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            Measuring Social Isolation in Older Adults: Development and Initial Validation of the Friendship Scale

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              "Cultivating health": therapeutic landscapes and older people in northern England.

              While gardening is seen, essentially, as a leisure activity it has also been suggested that the cultivation of a garden plot offers a simple way of harnessing the healing power of nature (The therapeutic garden, Bantam Press, London, 2000). One implication of this is that gardens and gardening activity may offer a key site of comfort and a vital opportunity for an individual's emotional, physical and spiritual renewal. Understanding the extent to which this supposition may be grounded in evidence underpins this paper. In particular, we examine how communal gardening activity on allotments might contribute to the maintenance of health and well being amongst older people. Drawing on recently completed research in northern England, we examine firstly the importance of the wider landscape and the domestic garden in the lives of older people. We then turn our attention to gardening activity on allotments. Based on the findings of our study, we illustrate the sense of achievement, satisfaction and aesthetic pleasure that older people can gain from their gardening activity. However, while older people continue to enjoy the pursuit of gardening, the physical shortcomings attached to the aging process means they may increasingly require support to do so. Communal gardening on allotment sites, we maintain, creates inclusionary spaces in which older people benefit from gardening activity in a mutually supportive environment that combats social isolation and contributes to the development of their social networks. By enhancing the quality of life and emotional well being of older people, we maintain that communal gardening sites offer one practical way in which it may be possible to develop a 'therapeutic landscape'.
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                Author and article information

                Contributors
                chan_hui_yu@u.nus.edu
                roger_ho@nuhs.edu.sg
                pcmrathi@nus.edu.sg
                a0047115@u.nus.edu
                nurtwsw@nus.edu.sg
                iris_rawtaer@nuhs.edu.sg
                phctanch@nus.edu.sg
                Anis_Larbi@immunol.a-star.edu.sg
                lei_feng@nuhs.edu.sg
                angelia_sia@nparks.gov.sg
                Maxel_ng@nparks.gov.sg
                lee_gan_goh@nuhs.edu.sg
                ee_heok_kua@nuhs.edu.sg
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                29 August 2017
                29 August 2017
                2017
                : 17
                : 192
                Affiliations
                [1 ]ISNI 0000 0001 2180 6431, GRID grid.4280.e, Department of Psychological Medicine, Yong Loo Lin School of Medicine, , National University of Singapore, ; Singapore, Singapore
                [2 ]ISNI 0000 0004 0621 9599, GRID grid.412106.0, Department of Psychological Medicine, , National University Hospital, ; Singapore, Singapore
                [3 ]ISNI 0000 0001 2180 6431, GRID grid.4280.e, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of. Medicine, , National University of Singapore, ; Singapore, Singapore
                [4 ]ISNI 0000 0001 2180 6431, GRID grid.4280.e, Department of Pharmacology, Yong Loo Lin School of Medicine, , National University of Singapore, ; Singapore, Singapore
                [5 ]ISNI 0000 0004 0637 0221, GRID grid.185448.4, Singapore Immunology Network, Agency for Science, , Technology and Research, ; Singapore, Singapore
                [6 ]ISNI 0000 0004 0620 8814, GRID grid.467827.8, Centre for Urban Greenery and Ecology Research, , National Parks Board, ; Singapore, Singapore
                [7 ]ISNI 0000 0004 0620 8814, GRID grid.467827.8, Horticulture & Community Gardening Division, , National Parks Board, ; Singapore, Singapore
                [8 ]ISNI 0000 0004 0621 9599, GRID grid.412106.0, Division of Family Medicine, , National University Hospital, ; Singapore, Singapore
                Article
                588
                10.1186/s12877-017-0588-z
                5576101
                28851276
                c7352d8e-46fa-4623-bf45-bd05ad9ed2e2
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 March 2016
                : 17 August 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001466, National Parks Board - Singapore;
                Funded by: NUS Mind-Science Centre
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2017

                Geriatric medicine
                horticultural therapy,gardening,elderly,mental health,cognitive functioning,physical health,randomized controlled trial

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