***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background In recent years , the physiological relaxation effects of natural environments have been widely exploited , and although individual differences in the effects of forest therapy are known , assessment methods have not been clearly established . This study used a classification based on Type A and Type B behavior patterns to explain individual differences in physiological responses to forest environments . Methods We performed physiological experiments in 44 forest and urban ( controls ) areas . In total , 485 male university students ( age , 21.8 ± 1.6 years ) participated in the study . The subjects were asked to visit forest or urban environments r and omly and observe each l and scape for 15 min . The subjects ’ pulse rates and blood pressures were tested to evaluate their physiological responses . The Kwansei Gakuin daily life question naire was used to identify Type A and Type B behavior patterns in subjects . Results The pulse rate was significantly lower in the Type B group after exposure to forest areas than after exposure to urban areas , whereas no significant difference was observed in the Type A group . In addition , the pulse rate was significantly lower in the low scoring subjects in the Type B group , which was consistent with changes in their diastolic blood pressure . Conclusions These results suggest that individual differences in pulse rate and blood pressure in response to forest environments can be explained by Type A and Type B behavior patterns Research ers are increasingly exploring how neighborhood greenness , or vegetation , may affect health behaviors and outcomes . Greenness may influence health by promoting physical activity and social contact ; decreasing stress ; and mitigating air pollution , noise , and heat exposure . Greenness is generally measured using satellite-based vegetation indices or l and -use data bases linked to participants ’ addresses . In this review , we found fairly strong evidence for a positive association between greenness and physical activity and a less consistent negative association between greenness and body weight . Research suggests greenness is protective against adverse mental health outcomes , cardiovascular disease , and mortality , though most studies were limited by cross-sectional or ecological design . There is consistent evidence that  greenness  exposure during pregnancy is positively associated with birth weight , though findings for other birth outcomes are less conclusive . Future research should follow subjects prospect ively , differentiate between greenness quantity and quality , and identify mediators and effect modifiers of greenness-health associations OBJECTIVE To provide scientific evidence supporting the efficacy of forest bathing as a natural therapy for human hypertension . METHODS Twenty-four elderly patients with essential hypertension were r and omly divided into two groups of 12 . One group was sent to a broad-leaved evergreen forest to experience a 7-day/7-night trip , and the other was sent to a city area in Hangzhou for control . Blood pressure indicators , cardiovascular disease-related pathological factors including endothelin-1 , homocysteine , renin , angiotensinogen , angiotensin II , angiotensin II type 1 receptor , angiotensin II type 2 receptor as well as inflammatory cytokines interleukin-6 and tumor necrosis factor α were detected . Meanwhile ,  profile of mood states ( POMS ) evaluation was used to assess the change of mood state of subjects . In addition , the air quality in the two experimental sites was monitored during the 7-day duration , simultaneously . RESULTS The baselines of the indicators of the subjects were not significantly different . Little alteration in the detected indicators in the city group was observed after the experiment . While subjects exposed to the forest environment showed a significant reduction in blood pressure in comparison to that of the city group . The values for the bio-indicators in subjects exposed to the forest environment were also lower than those in the urban control group and the baseline levels of themselves . POMS evaluation showed that the scores in the negative subscales were lowered after exposure to the forest environment . Besides , the air quality in the forest environment was much better than that of the urban area evidence d by the quantitative detection of negative ions and PM10 ( particulate matter < 10 μm in aerodynamic diameter ) . CONCLUSION Our results provided direct evidence that forest bathing has therapeutic effects on human hypertension and induces inhibition of the renin-angiotensin system and inflammation , and thus inspiring its preventive efficacy against cardiovascular disorders OBJECTIVE To provide scientific evidence of the health benefits of forest therapy in terms of physiological indices . DESIGN Within-group comparison made by conducting field experiments . PARTICIPANTS Forty-eight young male adults . METHODS Field experiments were conducted at four local sites in Japan . At each site , 12 adults participated in a three-day experiment . To compare physiological reactions between two environmental stimuli , experiments were conducted in forest and urban environments . The participants were r and omly assigned to visit either the forest or an urban setting and were instructed to view the l and scape in a seated position . The physiological reactions of each participant were recorded before , during , and after viewing the stimuli , and the differences in physiological indices were compared between the two groups . RESULTS Physiological data revealed that participants demonstrated significantly different reactions in the forest and urban environments . Analysis of heart rate revealed that participants showed a significantly higher ln(HF ) and a lower ln(LF/HF ) in the forest environment than in the urban environment . Systolic and diastolic blood pressures , pulse rate , and salivary cortisol concentration significantly decreased in the forest environment compared with the urban environment . Subjective evaluation data were generally in accordance with physiological reactions , showing significantly higher scores for " comfortable , natural , soothed , and refreshed feelings " in the forest environment than in the urban environment . CONCLUSIONS This study provided very clear scientific evidence of the physiological effects of forest therapy . Our data indicate that forest therapy can decrease stress and facilitate physiological relaxation Objective : This article aim ed to develop the “ forest therapy ” program , which is a cognitive behavior therapy (CBT)-based intervention program using forest environment , and investigate its effects on blood pressure ( BP ) , salivary cortisol , and quality of life ( QoL ) measures in patients with hypertension . Methods : A total of 56 men and women were enrolled for this study , being referred from local health centers in Republic of Korea , from April to October 2009 . They were conveniently assigned to either “ forest ” group participating in the forest therapy program or control group doing self-monitoring of BP . Measurements of salivary cortisol level and QoL were done at initial visits and at 8-week final visits . Results : Both groups did not differ significantly in baseline clinical characteristics . The BP change at week 4 and week 8 did not differ between the two groups . Salivary cortisol level reduction was significantly larger and QoL measures improved significantly more in the forest group at week 8 compared with the control group . Conclusions : The forest therapy program did not induce prolonged systolic blood pressure ( SBP ) reduction . However , considering the significant decrease in cortisol level and improvement in QoL measures , this may be a useful model of community hypertension management program 
    Output:
    
Systolic blood pressure of the forest environment was significantly lower than that of the non-forest environment .
Additionally , diastolic blood pressure of the forest environment was significantly lower than that of the non-forest environment .
Conclusions This systematic review shows a significant effect of Shinrin-yoku on reduction of blood pressure