The Influence of Different Forest Landscapes on Physiological and Psychological Recovery

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The topic of this manuscript is reasonable, but less innovative, and the research conclusion is not of much value. The following problems need to be explained and modified.

1.      The authors and the participates are not from the same work places. How could these experiments be coordinated? This study was approved by the Institutional Review Board of Chungbuk National University. Why was this study not carried out at Chungbuk National University?

2.      All photographs should be supplemented in 2.2 Experimental Materials.

3.      Figures 5 (line 288), 7 (line 306), 9 (line 342) and 11 (line 357) in 3 result are inconsistent with the analysis, and the the figures should be modified.

4.      References should be reorganized and those not highly relevant should be deleted.

Author Response

Response to Reviewer 1 Comments

 

Dear reviewer:

Thanks very much for taking your time to review this manuscript (ID:Forest-2843593 entitled “The Influence of Forest landscapes on Physiological and Psychological recovery”). We really appreciate all your comments and suggestions on our manuscript! We have carefully considered the suggestion of Reviewer and make some changes and we have tried our best to improve and made some corrections in the re-submitted files.

We have studied comments carefully and have made correction and revised portion are marked in red and the number of lines where the content has been modified is indicated, and strikethrough font for deletions. Similarity statements in the manuscript have been changed and marked with blue font. Revision point-to-point are given as follows:

[Comments and Suggestions for Authors]

The topic of this manuscript is reasonable, but less innovative, and the research conclusion is not of much value.

Response: We are extremely grateful to reviewer for pointing out these problems. Although the research methodology of this study is common and the results have been demonstrated several times in prior studies, Enhancing the diversified value of landscapes by explored the differences in physical and mental restoration between purely vegetated landscapes and water landscapes with vegetated elements in forests to informed decisions about landscape design and health care interventions. In the future, examining the long-term effects of such indirect nature exposure on various populations could provide valuable insights into its efficacy as a sustainable mental health intervention. We have made careful changes based on your specific suggestions.

1. The authors and the participates are not from the same work places. How could these experiments be coordinated? This study was approved by the Institutional Review Board of Chungbuk National University. Why was this study not carried out at National Chungbuk University?

Response: Thank you for checking our manuscript carefully. We deeply apologize for the disturbance caused to you because the authors and participants are from different workplaces. The first author and corresponding author of this article are both from Chungbuk National University, Korea, and the first author is from China. The second author is also from China, and the second author provided great assistance in the experimental process, including recruiting experimental subjects, coordinating the experimental site, etc., and carrying out the experiments together with the first author. The third author, a Chinese researcher studying at UBC, provided very helpful advice on the measurement tools and experimental procedures at the beginning of the experiment, as well as assistance in writing the article in English.

The institutional application was submitted to Chungbuk National University because the first author, who was responsible for conducting the study, is a researcher affiliated with this university, and corresponding author is also a professor at this university. Additionally, in the preparatory stage of the study, it was considered that not only this study, but also the next study would like to compare the demographic characteristics of subjects from three countries, namely China, South Korea, and Canada, under the same experimental conditions.

2. All photographs should be supplemented in 2.2 Experimental Materials.

Response: We appreciate the reviewer’s valid concerns. All the image materials used for the experiments have been described in text in 2.2, and due to the length, which may affect the reading experience of the article, we have added a description in Appendix A. (Line 610-616)

3. Figures 5 (line 288), 7(line 306), 9(line 342) and 11(line 357) in 3 result are inconsisten with the analysis, and the figures should be modified.

Response: Thank you for your precious comments and advice. The analysis in Results regarding Figures 3,5,7,9 describes specific statistical values for the differences between the three landscapes. However Figures are labeled only for significance. Therefore, in conjunction with another reviewer's suggestion, we replaced all Figures in Results with Tables, to explain the results of this study in more detail.

4. References should be reorganized and those not higyly relevant should be deleted.

Response: Thank you for your careful comments. We re-read the manuscript carefully, and quotations that were not highly relevant to the purpose of the study, the research hypothesis of this paper, were removed and are indicated in the text by strikethrough.

Our manuscript has been extensively revised, including individual chapters in the original text, in conjunction with revisions made by other reviewers. And we also edited another version that have no corrections named “Second revision”, we submitted it together as an attachment for further review and comments.

Thank you for your careful review. We really appreciate your efforts in reviewing our manuscript during this unprecedented and challenging time. We wish good health to you, your family, and community. Your careful review has helped to make our study clearer and more comprehensive. We look forward to hearing from you regarding our submission. We would be glad to respond to any further questions and comments that you may have.

 

Reviewer 2 Report

Comments and Suggestions for Authors

Dear authors,

 

Thank you for the opportunity to review this original study report.

 

This study compared the effect of viewing images representing three different landscapes on stress, depression and anxiety in a group of students. It contributes to the literature by adding more information on the difference (or absence of it) in the effect different landscapes have on stress levels and mood. The topic has a significant value and the study does address some gaps in the literature. The methods and the results support the conclusion. For these reasons, I think this study deserves publication. However, there are some important issues in the way the articles is structured and these should be addressed before publication.

 

I will provide specific recommendations below.

 

General

1. The spacing was a bit messy in the version I read. For example, there was a space before some references but not other. This should be uniform. Same for before and after mathematical symbols.

2. In the manuscript you refer to vegetated vs water landscape. Could you clarify if the water landscape included elements or vegetation or not? If yet, then you may be comparing natural landscape with or without water features. Please clarify.

 

Abstract

1. I recommend avoiding the terms 'restorative' and 'recovery' unless they are explained. You can just mention that exposure to nature decreases stress level and improves mood.

2. The method should be more specific. For example, each student was exposed consecutively to three pictures representing a landscape for 3 minutes. [Outcomes] were assessed before and after each exposure.

3.  I would remove the statistical analysis from the abstract as it is relatively standard.

4. Please provide values, including mean differences and p values for the key results (you may want to define a primary outcome)

5. I suggest to combine all the outcomes in the same sentence. For example, both natural landscapes reduced stress and improved mood and self-confidence more than the urban landscape (p < 0.05 for all).

6. Your conclusion should be a bit clearer. I would remove the aspect on indirect experience as it was not your main objective. 

 

Introduction

1. The introduction is too long. Some aspects are not necessary to understand the context of the research.

2. You should define 'restorative effect' with appropriate references. It seems that you are trying to say is that modern urban lifestyle has a negative impact on health and that exposure to nature can mitigate this effect. Please clarify.

3. Line 110 to 140 are not relevant to the introduction, as they do not explain where the objective of the study comes from. It also did not explain clearly why picture were used instead of virtual reality. I would remove this entire section and simply explain why you used pictures instead of virtual reality in the methods section. It may be simply that virtual reality requires more resources and that you need more evidence that there is a difference between exposure to green vs water landscapes to justify the use of these resources in a future study. 

4. Hypothesis 1 does not address a gap in the literature, we already know that exposure to nature can improve stress and mood. The main point of the study seems to be comparing vegetated landscape to water landscape.

5. I suggest to mention briefly the impact the results could have on decision-making in terms of landscape design and health care interventions for example. This would highlight the value of your study for the society in general.

Material and methods

1. Please clarify the rationale for the effect size and also to which difference it refers to.

2. power is beta, not alpha. 

3. Line 165, please provide references for the previous studies

4. Please define 'portals' (line 166)

5. Line 171 'et al.' seems to be a typo

6. Line 193, please clarify what type of device uBio is and what is measures.

7. You should differentiate between 'outcome' and 'outcome measures'. For example, you measure 'mood' (outcome) with the 'POMS scale' (outcome measures). The whole 2.3. section should be re-written by highlighting outcomes, not measures.

8. You do not need to provide the Cronbach alpha for this study

9. Section 2.4, please provide a rationale for the order of exposures. The order may have impacted the effect the exposure had on the subject and unless you have a good reason to think it did not, this should be stated as a limitation of the study. 

10. Please provide the rationale for the 180 s exposure.

11. Could you clarify if the subjects were asked to watch the picture? 

12. The questionnaires you have used generally detect changes over longer periods (a few weeks). Please justify, based on the literature, why you think they can be used for acute exposure and measuring acute changes. Otherwise, this should be stated as a limitation.

 

Results

1. Please use a table to report all the results. The figures do not add any additional information

2. There must be a mistake in paragraph 3.1.1., the pre-exposure values are the same for the three landscapes however they refer to three different timepoints (before each exposure). Please correct.

 

Discussion

1. Please restructure the discussion section. The first paragraph should summarise the main findings for ALL the outcomes. Try to use one sentence for all of them. For example, 'there was no significant difference between the nature and nature+water landscape, except for X outcome and Y outcome'.

2. The section 4.3. seems disconnected from the objective of the study. I would remove it completely. Your results shows that exposure to nature with or without water has the same effect, which suggest that landscape design or outdoors activities should not focus on the water feature.

3. I suggest to place the second paragraph of 4.3. after the limitations and expand more on this paragraph.

 

Conclusions.

This paragraph needs to be changes. Please focus on the difference/absence of difference between nature and nature+water and the implications of these findings.

Comments on the Quality of English Language

The quality is good in general. I can provide more specific comments if the manuscript is moved to the next step.

Author Response

Response to Reviewer 2 Comments

Dear reviewer:

Thank you for the time and effort that you have put into reviewing the manuscript (ID:Forest-2843593 entitled “The Influence of Forest landscapes on Physiological and Psychological recovery”). We really appreciate all your generous comments and suggestions! Your suggestions have enabled us to improve our work as well as the important guiding significance to our researches. We have studied comments carefully and have made correction and revised portion are marked in red and the number of lines where the content has been modified is indicated, and strikethrough font for deletions. Similarity statements in the manuscript have been changed and marked with blue font. The main corrections in the paper and the responds to the reviewer’s comments are as flowing:

 

[General]

 

1. The spacing was a bit messy in the version I read. For example, there was a space before some references but not other. This should be uniform. Same for before and agter mathematical symbols.

Response: We are extremely grateful to reviewer for pointing out this problem. We are very sorry for the trouble caused by this mistake. We have referenced the style of other articles in the 'forest' journal, adding spaces before the citation and highlighting it in yellow. The math symbols in the results have also been corrected.

 

2. In the manuscript you refer to vegetated vs water landscape. Could you clarify if the water landscape included elements or vegetation or not? If yet, then you may be comparing natural landscape with or without water features. Please clarify.

Response: Thank you for your approving this suggestion. The vegetation landscape and water landscape mentioned in the text are landscape elements based on the forest environment. Vegetation landscape refers to all kinds of vegetation in the forest environment, such as broad-leaved forests, coniferous forests and so on. Water landscape refers to the naturally occurring water landscape in the forest environment, including rivers, waterfalls, etc. including vegetation. We explain this in the text. (Line 128-129, Line 202-203) In addition, landscape pictures appear in Appendix A as supplementary material.

 

[Abstract]

 

1. I recommend avoiding the terms 'restorative' and 'recovery' unless they are explained. You can just mention that exposure to nature decreases stress level and improves mood.

Response: Thank you for checking our manuscript carefully. We very much recognize your suggestion that these two terms could not be paraphrased in the abstract due to their potentially excessive length. We therefore follow your suggestion and replace ‘estorative effects’ with 'reducing stress and improving mood' (Line 14-15)and ‘recovery’ with 'health', in the abstract section (Line 17, Line 29). And in the body of the text, we explained "restorative effect" as it is stated several times in the main body. (Line 68-71)

 

2. The method should be more specific. For example, each student was exposed consecutively to three pictures representing a landscape for 3 minutes. [Outcomes] were assessed before and after each exposure.

Response: Thank you very much for sincerely reviewed our manuscript. The section's description of the methodology has been edited to be more specific. Namely, ‘Physiological and psychological assessment was performed before the experiment for each student, followed by each student was exposed consecutively to 9 landscape images for 3 minutes (each type), and assessed after each exposure.’ (Line 19-22)

 

3. I would remove the statistical analysis from the abstract as it is relatively standard.

Response: Thank you for underlining this deficiency. Based on your suggestion, the introduction of statistical analysis was removed.

 

4. Please provide values, including mean differences and p values for the key results (you may want to define a primary outcome)

Response: Thank you for your careful suggestion. In conjunction with the fifth modification, the results were corrected to read " The results showed that both forest landscapes decreased stress (p < 0.05 for all), and improved mood and self-esteem (p < 0.01 for all). In contrast, water landscapes showed a slightly higher impact on physical and mental recovery health than vegetated landscapes, but there was no significant difference. Conversely, only about self-esteem, the restorative effects response of after viewing vegetated landscapes (SD = 29.06 ± 3.38) were better than water views (SD = 28.21 ± 2.48)." Although differences in the means of these results are expected to be reported, only p-values are provided due to the length of article. (Line 27-32)

 

5. I suggest to combine all the outcomes in the same sentence. For example, both natural landscapes reduced stress and improved mood and self-confidence more than the urban landscape (p < 0.05 for all).

Response: We appreciate the reviewer’s valid concerns. According on your suggestion, we have organized and revised it together with the revision of the fourth comment. (Line 27-32)

 

6. Your conclusion should be a bit clearer. I would remove the aspect on indirect experience as it was not your main objective. 

Response: Thank you for your precious comments. The description of indirect experience in this section has been removed and is intended to provide greater clarity to the findings of the study, and was changed to ‘Our findings observed that both forest landscapes provide positive changes for physical and mental health in college students, but there was no significant difference between the two types.’ (Line 34-36)

 

[Introduction]

 

1. The introduction is too long. Some aspects are not necessary to understand the context of the research.

Response: Thank you for underlining this logic deficiency. We have re-examined the overall article, and have removed content that was not highly relevant to the research purpose of this article. For example, lines 134~163 of your third review comment regarding indirect experiences and experimental tools.

 

2. You should define 'restorative effect' with appropriate references. It seems that you are trying to say is that modern urban lifestyle has a negative impact on health and that exposure to nature can mitigate this effect. Please clarify.

Response: We appreciate the reviewer’s positive evaluation of our manuscript. The 'restorative effect' refers to the process by which exposure to natural environments or their representations supports recovery from psychological stress and cognitive fatigue, enhancing overall mental and physical well-being. The ‘restorative’ in our study refer to the positive changes in physical and mental health, that after exposure to natural landscapes, including stress relief and improved mood. This concept is pivotal in understanding how modern urban lifestyles, characterized by high levels of stress and environmental stimuli, can detrimentally impact health. In contrast, engaging with nature, even indirectly, can mitigate these negative effects by invoking a state of relaxation and mental rejuvenation. We define this term briefly in the manuscript (Line 68-71), which reads as follow:

(Line 68-71): ‘Restorative primarily translates into physiological and psychological advantages of exposure to the natural environment. That is, exposure to forest landscapes, positive physiological and psychological changes have a restorative effect on people.’ 

 

3. Line 110 to 140 are not relevant to the introduction, as they do not explain where the objective of the study comes from. It also did not explain clearly why picture were used instead of virtual reality. I would remove this entire section and simply explain why you used pictures instead of virtual reality in the methods section. It may be simply that virtual reality requires more resources and that you need more evidence that there is a difference between exposure to green vs water landscapes to justify the use of these resources in a future study. 

Response: We are extremely grateful to reviewer for pointing out this problem. We have given due consideration to your suggestion to remove this section (Line 134-162) and have briefly described the rationale for using pictures as experimental tools (Line 163-168). In addition, in order to justify the use of pictures of green landscapes and water landscapes for our experiments, evidence related to the difference between green landscapes and blue landscapes for physiological and psychological effects has been added to the article. (Line 114-121)

 

4. Hypothesis 1 does not address a gap in the literature, we already know that exposure to nature can improve stress and mood. The main point of the study seems to be comparing vegetated landscape to water landscape.

Response: Thank you very much for your careful review, and we fully understand your concerns about the Hypothesis 1. After much deliberation, we believe that while the general benefits of nature exposure on stress and mood are well-documented, our study aims to delve deeper into the comparative effects of different types of natural landscapes, specifically vegetated and water landscapes. The hypothesis posits that both types of landscapes contribute positively to health, yet our focus is on discerning subtle differences that may exist between them. This distinction is crucial for advancing our understanding of how specific elements within natural environments influence psychological well-being. Our intent is not to reiterate the established benefits of nature contact but to refine our comprehension of these benefits in the context of diverse natural settings. By maintaining this hypothesis, we seek to contribute to a nuanced understanding of nature's restorative effects, thereby addressing an existing gap in the literature regarding the comparative efficacy of different natural landscapes.

 

5. I suggest to mention briefly the impact the results could have on decision-making in terms of landscape design and health care interventions for example. This would highlight the value of your study for the society in general.

Response: Thank you very much for your sincere suggestion, which is a crucial reference for the social values that our study may reveal. We followed your suggestion and wrote in the article "Enhancing the diversified value of landscapes by exploring the differences in physical and mental restoration between purely vegetated landscapes and water landscapes with vegetated elements in forests to inform decisions about landscape design and health care interventions." (Line 171-174)

 

[Material and methods]

 

1. Please clarify the rationale for the effect size and also to which difference it refers to.

Response: Thank you for your precious comments and advice. In statistics, an effect size is a value measuring the strength of the relationship between two variables on a numeric scale, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the value of a parameter for a hypothetical population, or to the equation that operationalizes how statistics or parameters lead to the effect size value. The larger the effect size, the more pronounced the effect. In the one-way ANOVA, the small effect size was 0.1, the medium was 0.25, the large was 0.4. We added the brackets after ‘with an effect size of 0.25’  in the article to clarify that (Line 184). And in our study, the effect size refer to the mean difference between the psychological and physiological aspects of viewing the three types landscape.

 

2. power is beta, not alpha. 

Response: Thank you for checking our manuscript carefully. We sincerely apologize for misspelling beta as alpha. We had been corrected and labeled in the manuscript. (Line 185)

 

3. Line 165, please provide references for the previous studies.

Response: Thank you for your carefully suggestions. In the section of introduction, we mentioned that the capacity of forest environments to improve human health was influenced by landscape type and characteristics. According to this reason, the landscape images of our experiment was selected. References are noted after the phrase “Based on the analysis of the landscape types obtained from the previous studies” and are highlighted in red. (Line 201) 

 

4. Please define 'portals' (line 166)

Response: Thank you for your precious comments. ‘portals’ in the article is to ‘web portals’, defined as：A web portal is a web-based platform that offers a central access point for employees, customers, and suppliers to access personalised information and collaborate effectively. It can enhance interactions and processes, increase the visibility of relevant information and provide flexibility for users on desktop or mobile devices,（Comprehensive Guide to Web Portals (applications-platform.com)）and it was explained as ‘web portals such as google, sohu’ in the article. (Line 201-202)

 

5. Line 171 'et al.' seems to be a typo

Response: Thank you for underlining this mistake. Please pardon our writing oversight, we have replaced ‘et al’ with ‘etc’. (Line 207)

 

6. Line 193, please clarify what type of device uBio is and what is measures.

Response: Thank you for your approving this suggestion. We briefly clarified what type of device uBio is and what intervention it is. (Line 252-253 with red font and yellow highlight for additions)

 

7. You should differentiate between 'outcome' and 'outcome measures'. For example, you measure 'mood' (outcome) with the 'POMS scale' (outcome measures). The whole 2.3. section should be re-written by highlighting outcomes, not measures.

Response: We appreciate the reviewer’s positive evaluation of our manuscript. We have confused outcomes with outcome measures, which was our mistake. According to your suggestion, section 2.3. has been re-written in its entirety. We hope this revised section could more clearly separates the outcomes of our study (Line 233-259, Line 283-304). The revised article is as follow:

 

(Line 233-259): “In this investigation, we aimed to assess the effects of visual exposure to natural environments on two key outcomes: stress levels and autonomic nervous system activity.  The outcomes and their respective measures are detailed below:

Stress Levels: To evaluate stress levels, an outcome indicative of the sympathetic nervous system's response to psychological stress, we measured salivary alpha-amylase (SAA) activity.  Increases in SAA activity are directly correlated with heightened sympathetic nervous system activity, serving as a biomarker for stress [71,72].  For this purpose, salivary samples were collected using sublingual reagent paper. Participants were instructed to moisten their mouths and place the reagent paper under their tongues for 60 seconds. The soaked test paper was then inserted into a SAA monitor (Nipro, Osaka, Japan) to record the SAA activity.

Autonomic Nervous System Activity: Heart rate variability (HRV) was assessed as a physiological marker to measure the activity of the autonomic nervous system, encompassing both its sympathetic and parasympathetic components.  High-frequency (HF) power, indicative of parasympathetic nervous system activity, is typically elevated during states of relaxation.  Conversely, the low-frequency to high-frequency (LF/HF) ratio reflects the balance between sympathetic and parasympathetic nervous system functions. To measure these indicators, the uBio Macpa (Biosense Creative, Seoul, Korea), a portable HRV measuring instrument, was utilized. This device allows for the detection of the autonomic nervous system's response to various environments through 2 minutes and 30 seconds of uninterrupted measurements.

By focusing on these outcomes (stress levels and autonomic nervous system activity) this study underscores the physiological responses to environmental stimuli. The use of SAA activity and HRV as outcome measures provides a nuanced understanding of how visual exposure to natural landscapes can influence psychological and physiological states.”

 

(Line 283-304): “In this study, we focused on evaluating several key psychological indices: mood, perceived stress, and self-esteem. To measure these indices, we employed various validated tools.

Mood: The primary index of mood was assessed using the Profile of Mood States (POMS), developed by Grove et al. in 1992 [88] and translated into a Chinese version [89]. POMS is a comprehensive tool that evaluates mood across seven sub-scales: Tension (T), Anxiety (A), Depression (D), Fatigue (F), Confusion (C), Vigor (V), and Esteem-Related Affect (E), encompassing a total of 40 questions [88]. To analyze the overall mood state changes in participants, we used the Total Mood Disturbance (TMD) score, calculated as follows:

TMD = T + A + D + F + C - (V + E) +100

Perceived Stress: As a secondary outcome, we assessed participants' perceived stress levels using the Perceived Stress Scale (PSS). This self-report tool, originally developed by Cohen et al. [92] and later translated into Chinese [93], consists of 10 items rated on a 5-point Likert scale, from 'never' to 'very often' with total scores range from 0 to 40, with higher scores indicating greater perceived stress. Adequate reliability and validity were demonstrated[92,94].

Self-Esteem: Finally, self-esteem was measured using the Self-Esteem Scale (SES), developed by Rosenberg and translated into Chinese by Yu and Ji [96]. This scale is used to rate an individual's overall feelings about self-worth and self-acceptance[95]. comprises 10 items rated on a 4-point Likert scale, featuring both positive and negative statements.”

 

8. You do not need to provide the Cronbach alpha for this study

Response: Thank you for your precious comments. In conjunction with the previous comment given, in conjunction with the seventh review, there is no Cronbach alpha in the revised paragraph. (Line 294-304)

 

9. Section 2.4, please provide a rationale for the order of exposures. The order may have impacted the effect the exposure had on the subject and unless you have a good reason to think it did not, this should be stated as a limitation of the study. 

Response: We are extremely grateful to reviewer for pointing out this problem. The settings of the pictures of each landscape type in our experimental materials are sorted comprehensively according to their attribute characteristics. For example, vegetation landscapes were sorted according to vegetation type, landscape element characteristics, sensory dimensions, and so on. As you said, the exposure order may affect the subjects' responses because we did not pre-survey the subjects after sorting based on certain principles, so this is explained as a limitation of the study in the Limitations section based on your suggestion.

 

10. Please provide the rationale for the 180 s exposure.

Response: Thank you for checking our manuscript carefully. Attention Restoration Theory (ART) proposes that exposure to forest landscape images for 3 to 5 minutes can yield comparable mental and physical restoration effects to direct forest visit,  and has been discussed in studies. ART posits that natural environments possess inherent qualities that replenish depleted cognitive resources, suggesting that even brief visual engagement with nature imagery can facilitate recovery from mental fatigue and stress. We explained in Line 314-318, as shown below:

(Line 314-318): “Attention Restoration Theory (ART) proposes that exposure to forest landscape images for 3 to 5 minutes can yield comparable mental and physical restoration effects to direct forest visit, which suggesting that even brief visual engagement with nature imagery can facilitate recovery from mental fatigue and stress. Therefore, after a 1 min rest following baseline measurement.”

 

11. Could you clarify if the subjects were asked to watch the picture? 

Response: Thank you for underlining this deficiency. This is our omission. In the preparation stage of the experiment, we briefly stated the forest landscape pictures as the experimental material in the recruitment announcement, and informed the subjects about the experiment content again before the start of the experiment, and the experiment was carried out only after repeated confirmations and informed consents were obtained. And we have added a description in the ‘participants’ and ‘experiment design’ section as shown below:

(Line 189): “Each participant consented to the study by signing a research informed consent prior to involvement.”

(Line 308-309): “After obtaining informed consent for the experiment,”.

 

12. The questionnaires you have used generally detect changes over longer periods (a few weeks). Please justify, based on the literature, why you think they can be used for acute exposure and measuring acute changes. Otherwise, this should be stated as a limitation.

Response: Thank you for your precious comments. While the Profile of Mood States (POMS), Self-Esteem Scale (SES), and Perceived Stress Scale (PSS) are typically employed in studies measuring changes over extended periods, recent literature also supports their effectiveness in capturing the psychological impacts of short-term interventions. For instance, The effects were validated in Ernest Bielinis et al.’s study where each participant engaged in each psychological measure four times in one day [2021]. Additionally, these psychological measurement scales were validated for acute exposure measures in some studies that used VR as an experimental stimulus [Yu et al., 2018; Mostajeran et al., 2021].

These studies have demonstrated the utility of these scales in assessing immediate psychological responses following brief exposure to therapeutic interventions or stress-relieving activities. These findings suggest that POMS, SES, and PSS can be sensitive enough to detect changes in mood, self-esteem, and perceived stress levels in the aftermath of short-duration interventions, offering valuable tools for rapid assessment in psychological research and practice. However, these are elements that we were concerned would detract from the coherence of the manuscript if presented in the methods section.

 

References:

Ernest Bielinis, Emilia Janeczko, Norimasa Takayama, Anna Zawadzka, Alicja Słupska, Sławomir Piętka, Maija Lipponen, Lidia Bielinis. 2021. The effects of viewing a winter forest landscape with the ground and trees covered in snow on the psychological relaxation of young Finnish adults: A pilot study. PLOS ONE, https://doi.org/10.1371/journal.pone.0244799 January 7, 2021.

Yu, C.-P.; Lee, H.-Y.; Luo, X.-Y. The effect of virtual reality forest and urban environments on physiological and psychological responses. Urban For. Urban Green. 2018, 35, 106–114. 

Mostajeran, F.; Krzikawski, J.; Steinicke, F.; Kühn, S. Effects of exposure to immersive videos and photo slideshows of forest and urban environments. Sci. Rep. 2021, 11, 3994.

 

[Results]

 

1. Please use a table to report all the results. The figures do not add any additional information.

Response: We deeply appreciate the reviewer’s suggestions. The figures in our manuscript, by simply labeling significance while clearly showing the differences in the variables, do not match the values in the analysis of the results. And following your advice, we have replaced the figures with tables to report these results. (Table 1-12)

 

2. There must be a mistake in paragraph 3.1.1., the pre-exposure values are the same for the three landscapes however they refer to three different timepoints (before each exposure). Please correct.

Response: We appreciate the reviewer’s valid concerns. As shown in Figure 1, we took one measurement before the experiment started as a baseline, and each subsequent exposure was compared to the baseline by a t-test or z-test. So the pre-exposure values are the same for all three landscapes. In order to explain the results more clearly, we replace ‘pre-’ with ‘baseline’ in the whole article.

 

[Discussions]

 

1. Please restructure the discussion section. The first paragraph should summarise the main findings for ALL the outcomes. Try to use one sentence for all of them. For example, 'there was no significant difference between the nature and nature+water landscape, except for X outcome and Y outcome'.

Response: Thank you for your valuable suggestions. We have reorganized the discussion section. Incorporating your suggestions, the main findings of all the results in the original article were edited as the first paragraph, and removed sentences that are not relevant to the main findings of our article (Line 472-482, Line 501-507). However, the other detailed parts of the discussion were not changed because we felt that they coincided with the findings, which were important for the article as a whole.

 

2. The section 4.3. seems disconnected from the objective of the study. I would remove it completely. Your results shows that exposure to nature with or without water has the same effect, which suggest that landscape design or outdoors activities should not focus on the water feature.

Response: We deeply appreciate the reviewer’s suggestions. The first paragraph of section 4.3 has been completely deleted, and as your comments, it is disconnected from the purpose of the article. At the same time the second paragraph on directions for future research was extended in its social significance and placed at the end of the limitation section. (Line 570-581)

 

3. I suggest to place the second paragraph of 4.3. after the limitations and expand more on this paragraph.

Response: We are extremely grateful to reviewer for pointing out this problem. In revising the previous comment, we also thought it might be a good idea to expand this paragraph for future studies. Thus, in the fifth paragraph of ‘Limitations’ section, we added these contents. (Line 570-581)

 

[Conclusion]

 

This paragraph needs to be changes. Please focus on the difference/absence of difference between nature and nature+water and the implications of these findings.

Response: We appreciate the reviewer’s positive evaluation of our manuscript. In the conclusion section, we removed unnecessary elements and added the significance of the presence or absence of water elements in forested landscapes in reality (Line 592-594), as shown below:

(Line 591-592): “we noted that the presence or absence of water elements in forest landscapes has an almost consistent effect on improving emotion and reducing stress.”

 

 

Our manuscript has been extensively revised, including individual chapters in the original text, in conjunction with revisions made by other reviewers. And we also edited another version that have no corrections named “Second revision”, we submitted it together as an attachment for further review and comments.

We tried our best to improve the manuscript and made some changes marked in red in revised paper which will not influence the content and framework of the paper. We appreciate for reviewer’s warm work earnestly, and hope the correction will meet with approval. Once again, thank you for your precious comments. We would be glad to respond to any further questions and comments that you may have.

 

 

 

Reviewer 3 Report

Comments and Suggestions for Authors

This research was conducted using methods commonly seen in this type of forest landscape research. The results are nothing new either.

Please consider the following points.

①This research uses photographs of forest landscapes. Results may vary depending on the composition of the photo, image accuracy, and subject's preferences.

② A simple pairwise comparison of a forest landscape and a city landscape is performed, but it is unclear what the results would have been if additional landscape elements such as the sea, plateau, or resort had been included as an option. Therefore, it is scientifically incorrect to draw conclusions about recovery effects based solely on the method used in this study.

Author Response

Response to Reviewer 3 Comments

Dear reviewer:

Thank you for your precious comments and advice for our manuscript (ID:Forest-2843593 entitled “The Influence of Forest landscapes on Physiological and Psychological recovery”). Those comments are all valuable and very helpful for revising and improving our paper. Based on your comment and request, we have made extensive modification on the original manuscript. Revisions in this manuscript are marked in red and the number of lines where the content has been modified is indicated, and strikethrough font for deletions. Similarity statements in the manuscript have been changed and marked with blue font. Presented by point-to-point as following.

 

[Comments and Suggestions for Authors]

 

This research was conducted using methods commonly seen in this type of forest landscape research. The results are nothing new either.

Response: Thank you for checking our manuscript carefully. Although the research methodology of this study is common and the results have been demonstrated several times in prior studies, Enhancing the diversified value of landscapes by explored the differences in physical and mental restoration between purely vegetated landscapes and water landscapes with vegetated elements in forests to informed decisions about landscape design and health care interventions. In the future, examining the long-term effects of such indirect nature exposure on various populations could provide valuable insights into its efficacy as a sustainable mental health intervention. We have made careful changes based on your specific suggestions.

 

1. This research uses photographs of forest landscapes. Results may vary depending on the composition of the photo, image accuracy, and subject’s references.

Response: Thank you very much for sincerely reviewed our manuscript. Your suggestions were very informative for our study. Followed your suggestion, the composition, accuracy, and subject bias of these pictures can affect the results of the study, and we strongly agree with this and have added a note in the limitations section. In addition, we selected representative pictures of vegetated landscapes and water features containing vegetated elements as experimental materials explained in article 2.2, at the same time, the picture material used for our experiment was submitted as an appendix.

 

2. A simple pairwise comparison of a forest landscape and a city landscape is performed, but it is unclear what the results would have been if additional landscape elements such as the sea, plateau, or resort had been included as an option, Therefore, it is scientifically incorrect to draw conclusions about recovery effects based solely on the method used in this study.

Response: Thank you very much for your suggestions on the manuscript, which are very important and substantial for our study. In our study, we set up three groups of landscapes for comparison: urban landscapes, vegetated landscapes, and water environments with vegetation. In addition to the pairwise comparisons with the baseline, the both differences between vegetated landscapes and between water landscapes were also explored with the aim of verifying whether purely vegetated landscapes in forests and water landscapes with vegetated elements have different stress-reducing and mood-improving effects. At the same time, in conjunction with another reviewer's comments, we also paid more attention to the differences between vegetated and water landscapes and the implications of these findings in the conclusion section. (Line 592-594)

Also, perhaps the term "restorative effects" should be interpreted to mean that exposure to forested landscapes can mitigate the negative health effects of urbanized lifestyles. However, this use of the term, without explanation, lacks a strong connection to the conclusions. Therefore, this term was clarified in the article. (Line 68-71)

 

 

We have made changes in the original text, and we also edited another version that have no corrections named “second revision”, we submitted it together as an attachment for further review and comments. We look forward to hearing from you regarding our submission.

We appreciate your positive evaluation of our work. We deeply appreciate for your warm work earnestly, and hope the correction will meet the approval. Once again, thank you very much for your comments. We would be glad to respond to any further questions and comments that you may have.

 

Reviewer 4 Report

Comments and Suggestions for Authors

I evaluate the reviewed article in general positively. The research problem is important, the structure of the paper is correct, the results of the experimental design are clearly presented. However, I have several comments that I think should be included in the final version of the article.

1. The research context presented in the introduction, I propose to expand a little. I think it is appropriate to refer to M. Lalonde's report "A New Perspective on the Health of Canadians, a working document" (1974). This document introduces the holistic paradigm in defining human health, It more broadly considers the environmental context, which plays a key role in analyses of the determinants of health. In addition, I suggest referring to the theory of therapeutic landscapes (Gesler 1992 and others) and encourage attention to the contemplative landscape model (Olszewska-Guizzo et al. 2023). It is also worth defining forest landscapes.

2. The introduction should clearly state the aim of the research and the purpose of the article. I also encourage the formulation of research questions.

3.In the methodology section, I think there should be a justification for the choice of students as the group participating in the experiment; although there are some remarks about this in the introduction, I think they should be in the methodology section; besides, I wonder if the place of residence of the students (urban, rural) was taken into account.

4. In lines 169-174 the authors write "Finally, as shown in Appendix A, a total of three types of forest landscapes were selected: urban image ...; forest landscape ...; water landscape...". Urban image is not a type of forest landscapes! Neither is water landscape, although forest may be a part of it. 

5. It is very good that the authors recognize the limitations of the research project.  Indeed, it would be interesting to include landscape elements within each landscape type individually. It is also significant to include auditory/sound elements, and perhaps still olfactory/smell elements? In addition, I think it is important to note the limitation of the study to a group of students and to consider in the future extending the study to other social groups (e.g., seniors).

6. The conclusions are correct, although their generality is surprising. I propose to refer to the hypotheses and expand on the applications of the research results.

After taking into account the mentioned comments, I recommend the article for publication.

Author Response

Dear reviewer:

Thank you for the time and effort that you have put into reviewing the manuscript (ID:Forest-2843593 entitled “The Influence of Forest landscapes on Physiological and Psychological recovery”). We really appreciate all your generous comments and suggestions! Your suggestions have enabled us to improve our work as well as the important guiding significance to our researches. We have studied comments carefully and have made correction and revised portion are marked in red and the number of lines where the content has been modified is indicated, and strikethrough font for deletions. Revision point-to-point are given as follows:

 

1. The research context presented in the introduction, I propose to expand a little. I think it is appropriate to refer to M. Lalonde's report "A New Perspective on the Health of Canadians, a working document" (1974). This document introduces the holistic paradigm in defining human health, It more broadly considers the environmental context, which plays a key role in analyses of the determinants of health. In addition, I suggest referring to the theory of therapeutic landscapes (Gesler 1992 and others) and encourage attention to the contemplative landscape model (Olszewska-Guizzo et al. 2023). It is also worth defining forest landscapes.

Response: We appreciate the reviewer’s positive evaluation of our manuscript. In our study, the effects of environmental stress on the human health were described and landscape images were used as experimental stimuli to evaluate psychological and physiological changes. However, it was not detailed that the environment is an important health determinant, nor was it clarified that forest landscapes are therapeutic landscapes. Based on your suggestions, we have clarified and revised the text.(Line 57-63)

 

2. The introduction should clearly state the aim of the research and the purpose of the article. I also encourage the formulation of research questions.

Response: We are extremely grateful to reviewer for pointing out this problem. At the end of introduction, we succinctly and clearly state the purpose of our study, and replaced the original hypothesis with the formulation of two research questions. (Line 154-163)

 

3. In the methodology section, I think there should be a justification for the choice of students as the group participating in the experiment; although there are some remarks about this in the introduction, I think they should be in the methodology section; besides, I wonder if the place of residence of the students (urban, rural) was taken into account.

Response: Thank you for checking our manuscript carefully. We have made some adjustments based on your suggestions. We removed the line 49-52, and the reasons for participants selection were briefly described in the method section. (Line 169-171)

 However, the place of residence of the experimental subjects was not taken into account. The reason for this is that the experimental design of this study was a short exposure to physiological and psychological responses and it was not a field experiment. Also, the experiment was conducted when the students were already in the new semester and living intensively in the student dormitories. We understand that your concern may be that there are some underlying perceptual differences in the long-term effects of different living environments on students. We will include Korean and Canadian subjects in a follow-up study to make some comparisons based on different demographic characteristics, and at that time, we will add the factor of place of residence.

 

4. In lines 169-174 the authors write "Finally, as shown in Appendix A, a total of three types of forest landscapes were selected: urban image ...; forest landscape ...; water landscape...". Urban image is not a type of forest landscapes! Neither is water landscape, although forest may be a part of it.

Response: Thank you for checking our manuscript carefully. We sincerely apologize for this mistake. In the section of experimental materials, we clarified that there are two typical landscape types of forest environment and urban landscape without natural elements as the control landscape. However, we hen wrote “a total of three types of forest landscapes were selected”. It was a blunder that we are ashamed of. Therefore, we have removed “forest” in this sentence from the original manuscript. (Line 194)

 

5. It is very good that the authors recognize the limitations of the research project.  Indeed, it would be interesting to include landscape elements within each landscape type individually. It is also significant to include auditory/sound elements, and perhaps still olfactory/smell elements? In addition, I think it is important to note the limitation of the study to a group of students and to consider in the future extending the study to other social groups (e.g., seniors).

Response: We appreciate the reviewer’s positive evaluation of our manuscript. We have taken your suggestion fully into account by integrating the first and third limitations (Line 473-480), and then changed the third limitation to read "Although college students are typically a stressed population, in reality, other populations also experienced a variety of stressors. In the future, the long-time effects of such indirect nature exposure on various populations such as seniors, manual laborers, stay-at-home moms, etc. could provide valuable insights into its efficacy as a sustainable intervention. " (Line 489-493)

 

6. The conclusions are correct, although their generality is surprising. I propose to refer to the hypotheses and expand on the applications of the research results.

Response: Thank you for your carefully suggestions. Our description of the research findings in the original conclusion section was too general to cover the true nature of these findings and lacked social value. So based on your kind advice, we have rewritten the conclusion section based on the hypothesis (research questions) of the article. (Line 522-544)

 

Our manuscript has been extensively revised, including individual chapters in the original text, in conjunction with revisions made by other reviewers. And we also edited another version that have no corrections named “Revised version”, we submitted it together as an attachment for further review and comments.

Thank you for your careful review. We really appreciate your efforts in reviewing our manuscript during this unprecedented and challenging time. Your careful review has helped to make our study clearer and more comprehensive. We look forward to hearing from you regarding our submission. We would be glad to respond to any further questions and comments that you may have.

 

 

Reviewer 5 Report

Comments and Suggestions for Authors

This is an interesting article concerning influence of natural landscapes on physiological and psychological recovery of humans. The positive impact of nature / natural landscapes on people's well-being is widely experienced and reported, but there is a shortage of scientific evidence and measurements of its effectivenes. Research presented in this paper is a trial on delivering more concrete evidence for this issue - an interesting and quite effective trial. The Authors tried to measure / evaluate e.g. influence on mood, perceived stress and self-esteem. However, the results of the investigation have been rather easy to predict (so the problem of obviousness of the Hypothesis 1 occures).

However, the article adds more knowledge and more possibility of qualitative and quantitative evauation of natural landscapes influence on human physiological and psychological well-being. The most important / valuable thing is the methodical approach, in which the interesting research plan is presented on FIGURE 1 (very good figure). Scheme of work, sequence of a few methods and statistics analysis are OK. and interesting - could inspire other researchers.

Detailed comments:

Ad ABSTRACT - in the end, please, formulate better (more clearly) the aim of study and the essence of research results.

Ad CONCLUSIONS - please, formulate better - this part of paper is too short and too general. 

Line 142 - insert the number of a subsection

Line 172 - insert the space between words.

Generally, the paper is interested and elaborated well.

 

Comments on the Quality of English Language

English is fine

Author Response

Dear reviewer:

Thanks very much for taking your time to review this manuscript (ID:Forest-2843593 entitled “The Influence of Forest landscapes on Physiological and Psychological recovery”). We really appreciate all your comments and suggestions on our manuscript! We have carefully considered the suggestion of Reviewer and make some changes in the re-submitted files.

We have studied comments carefully and have made correction and revised portion are marked in red and the number of lines where the content has been modified is indicated, and strikethrough font for deletions. Revision point-to-point are given as follows:

 

[Comments and Suggestions for Authors]

This is an interesting article concerning influence of natural landscapes on physiological and psychological recovery of humans. The positive impact of nature / natural landscapes on people's well-being is widely experienced and reported, but there is a shortage of scientific evidence and measurements of its effectivenes. Research presented in this paper is a trial on delivering more concrete evidence for this issue - an interesting and quite effective trial. The Authors tried to measure / evaluate e.g. influence on mood, perceived stress and self-esteem. However, the results of the investigation have been rather easy to predict (so the problem of obviousness of the Hypothesis 1 occures).

However, the article adds more knowledge and more possibility of qualitative and quantitative evauation of natural landscapes influence on human physiological and psychological well-being. The most important / valuable thing is the methodical approach, in which the interesting research plan is presented on FIGURE 1 (very good figure). Scheme of work, sequence of a few methods and statistics analysis are OK. and interesting - could inspire other researchers.

Response: We are extremely grateful to reviewer for pointing out this problem (Hypothesis 1). Hypothesis 1 is a foundational hypothesis based on numerous prior studies; however, the focus of this study was to assess the differences between vegetated landscapes in forests and water landscapes containing vegetated elements. Therefore, based on your suggestion and in conjunction with other reviewer’s comments, hypothesis 1 has been removed and the other two original hypotheses have been replaced by formulating the research question. (Line 154-163)

In addition, thank you very much for your approval of the methodological part of this study In the next study, we plan to include experimental subjects from other countries in an attempt to analyze whether there are slight differences between different demographic backgrounds based on the positive effects of natural landscapes on human well-being that have been widely reported.

 

[Detailed comments]

1. Ad ABSTRACT - in the end, please, formulate better (more clearly) the aim of study and the essence of research results.

Response: Thank you for your precious comments and advice. According to your suggestion, at the end of the abstract, we briefly elucidate the results and value of the research obtained through the purpose of the study. (Line 28-31)

 

2. Ad CONCLUSIONS - please, formulate better - this part of paper is too short and too general. 

Response: We appreciate the reviewer’s positive evaluation of our manuscript. The description in the discussion section is not sufficient to cover the true nature of our research findings and lacks social value. We have rewritten the conclusion section based on the hypotheses (research questions) of the article. (Line 522-544)

 

3. Line 142 - insert the number of a subsection.

Response: Thank you very much for sincerely reviewed our manuscript. We apologize for any distress caused to you. We have completed our revisions and revisited the full text to ensure that such mistakes are avoided! (Line 164)

 

4. Line 172 - insert the space between words.

Response: Thank you for checking our manuscript carefully. We sincerely apologize for this shameful mistake. We have modified the missing space and highlighted it in yellow. (Line 196)

 

 

We tried our best to improve the manuscript and made some changes marked in red in revised paper which will not influence the content and framework of the paper. And we also edited another version that have no corrections named “Revised version”, we submitted it together as an attachment for further review and comments. We appreciate for reviewer’s warm work earnestly, and hope the correction will meet with approval. Once again, thank you for your precious comments. We would be glad to respond to any further questions and comments that you may have.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript has undergone extensive revisions and many improvements. However, the conclusion and value of the research are general.

The impact of forest landscape and water landscape on human perception restoration in natural environment is the result of multi-sensory coordination. The indirect contact method used indoors is based on visual perception, and the most intuitive influence of visual perception is the eye tracking index. The changes of HRV and SAA were detected in this paper, which also seems to have a perceptual change process. In short, the physiological changes did not seem to be consistent with the experimental design.

Author Response

Dear reviewer:

Thank you for your precious comments and advice for our manuscript (ID:Forest-2843593 entitled “The Influence of Forest landscapes on Physiological and Psychological recovery”). Your suggestions have enabled us to improve our work as well as the important guiding significance to our researches. Based on your comment and request, We have carefully make some changes and we have tried our best to improve and made some corrections in the re-submitted files.

 

[Comments and Suggestions for Authors]

The manuscript has undergone extensive revisions and many improvements. However, the conclusion and value of the research are general.

The impact of forest landscape and water landscape on human perception restoration in natural environment is the result of multi-sensory coordination. The indirect contact method used indoors is based on visual perception, and the most intuitive influence of visual perception is the eye tracking index. The changes of HRV and SAA were detected in this paper, which also seems to have a perceptual change process. In short, the physiological changes did not seem to be consistent with the experimental design.

Response: Thank you very much for sincerely reviewed our manuscript and for recognized our last revision. Additionally, we also appreciate your positive evaluation for the article!

We recognize the generality and breadth of our research, however, enhancing the diversified value of landscapes by exploring the differences in physical and mental restoration between purely vegetated landscapes and water landscapes with vegetated elements in forests to inform decisions about landscape design and health care interventions. However, we fully understand your concerns, we extended the application of the findings in the conclusion section. (Line 522-544)

In our study, HRV and SAA were measured as markers of the sympathetic nervous system, which is inextricably linked to physiologic changes. Using salivary amylase activity (SAA) to quantify stress levels has been validated in previous research (Nater et al., 2005; Yamaguchi et al., 2006). For example, when parasympathetic nerves are activated, heart rate slows down and blood pressure decrease, and the balance between sympathetic and parasympathetic nerves is important for the proper functioning of the cardiovascular system, etc. Additionally, some indoor experiments such as Yu et al.(2018), Shin et. al.(2017), and Song et al.(2018) used HRV or SAA as physiologic measures. These findings showed that viewing forest landscape stimulated the activity of the parasympathetic nervous system, which reduced stress.

 

References:

Yamaguchi, M.; Deguchi, M.; Miyazaki, Y. The effects of exercise in forest and urban environments on sympathetic nervous activity of normal young adults. J. Int. Med. Res. 2006, 34, 152–159.

Nater, U.M.; Rohleder, N.; Gaab, J.; Berger, S.; Jud, A.; Kirschbaum, C.; Ehlert, U. Human salivary alpha-amylase reactivity in a psychosocial stress paradigm. Int. J. Psychophysiol. 2005, 55, 333–342.

Yu, C.P., Lee, H.Y., Luo, X.Y. The effect of virtual reality forest and urban environments on physiological and psychological responses. Urban Forestry & Urban Greening. 2018. 35, 106-114.

Shin, J.W., Choi, J.H. The Effects of Viewing the Forest Landscape on Physiological and Psychological Status in Radiologists. Journal of People, Plants, and Environment. 2017. 20(3), 283-291.

Song, C.; Ikei, H.; Miyazaki, Y. Physiological effects of visual stimulation with forest imagery. Int. J. Environ. Res. Public Health 2018, 15, E213.

 

Our manuscript has been extensively revised, including individual chapters in the original text, in conjunction with revisions made by other reviewers. And we also edited another version that have no corrections named “Revised version”, we submitted it together as an attachment for further review and comments.

We appreciate your positive evaluation of our work. We have modified our manuscript according to your sincere comments, and deeply appreciate for your warm work earnestly, and hope the correction will meet the approval. Once again, thank you very much for your comments. We would be glad to respond to any further questions and comments that you may have.