DEFINITION OF TERMS

ADMINISTRATIVE SERVICES

MEDICAL SERVICES

CHIEF PHYSICIAN - A chief physician, also called a head physician, physician inchief, senior
consultant, or chief of medicine, is a physician in a senior management position at a hospital or
other institution https://en.m.wikipedia.org/wiki/Chief_physician

WASTE COLLECTION ROOM - is the transfer of solid waste from the point of use and disposal to
the point of treatment. Waste holding area for removal by external contractors. Contaminated waste
bins should not be accessible to the public and should preferably be out of sight in a secure area.

area for
moving and destroying or storing damaged, used or other unwanted domestic, agricultural or industrial 
products and substances. Disposal includes burning, burial at landfill sites or at sea, and recycling.

refer to all patient care areas and include but are not limited to: exam rooms, treatment rooms, imaging
rooms, operating rooms, post anesthesia recovery rooms, units, dialysis rooms/units, infusion
rooms/units, labor/delivery/recovery rooms and observation rooms/units. All examination, diagnostic
and treatment rooms shall be accessible. Toilet rooms that are accessed from an examination,
diagnostic or treatment room shall also be accessible.

Outpatient department

https://www.collinsdictionary.com/dictionary/english/admitting-officeR

Most of us recognise the calming effect of a walk by the river or along a beach.
Victorian doctors used to prescribe the "sea air" as a cure for an assortment of
agues and ailments. But while the health benefits of green space are now well
known, thanks to the pioneering research of Roger Ulrich and the Kaplans among
others, little analysis has been made of "blue space" – the impact of the sea,
rivers, lakes, and even urban water features on our health and wellbeing.

On Devon's south coast, Professor Michael Depledge and his team are attempting
to put that right. Depledge was formerly the chief scientist for the Environment
Agency before founding the European Centre for Environment and Human
Health (ECEHH) in Plymouth in 2011, and launching the Blue Gym project in
2012 to study the health and wellbeing benefits of aquatic environments.

Teaming up with environmental psychologist Mat White, Depledge began by

repeating one of Ulrich's early studies. By showing photographs of a variety of
landscapes to a group of participants, Ulrich was able to demonstrate that stress
levels were lowered according to how much greenery was in the picture. The
difference this time was that, "we started introducing water into the images", says
Depledge, "going from a pond right through to a coastline, with increasing
amounts of water in the images, and we found that people showed a strong
preference for more and more water in the images.

"We repeated that with urban scenes, from fountains in squares to canals running
through the city, and once again people hugely preferred the urban environments
with more water in them."

Images with green space received a postive response, as Ulrich has found. But
images with both green and blue got the most favourable response of all.

This was enough to suggest that they might be on to something and their next
study, published in September, was more conclusive. Using data from Natural
England with anonymous self-reported health information by postcode, a team
from ECEHH were able to see if health varied according to proximity to water.

"Self-reported health correlates very well with real health," says Depledge. "For
the first time, we have had this information according to postcode, and we found
that the closer you live to the English coast the healthier you are. There was some
evidence that other aquatic environments helped too."

Future research at the ECEHH includes studies looking at the effect of video
screens showing aquatic environments in elderly care homes, and the benefits of
views over sea or water from home or hospital windows. PhD student Deborah
Cracknell is also looking into the effects of watching fish in aquariums and tanks.
"There have been studies in the past looking at the health benefits of fishtanks,
often in healthcare settings for Alzheimer's patients or the elderly, says Cracknell.

"But we're also looking at the effect of what's in the tank, from a biodiversity
aspect … We've looked at the effect of [aquarium] exhibits on heart rate, blood
pressure and mood. Early results are quite encouraging. We even found that
people responded well just watching the water without any fish."

All of which prompts the question, why? Just what is it about water that attracts
us in such a way that could improve our mental wellbeing and even our physical
health? "The simple answer, is we don't know," says Depledge, "but we are trying
to find out."

"There are all sorts of intriguing possibilities. One is that human beings have
evolved in intimate contact with nature, and it is only really in the last 200 years
that people have been increasingly removed from nature. Professor Sir Alister
Hardy first suggested that the big step in human evolution was not necessarily
when hominids came out of the trees and into the savannah, but was when they
got to the coast and were able to access sea food rich in omega 3 fatty acids …
there is something deeply profound about water and humans, and it may reflect
evolutionary history."

Someone else who is trying to find the answer is Jenny Roe, lecturer in the School
of the Built Environment at Heriot-Watt University in Edinburgh. At the
forefront of research into "green health", Roe is looking at cortisol as a
physiological measure of how the body responds to different environments.

"We've also just published a study using a mobile neural cap which taps into
brain activity and can give an objective measure of stress in different [green]
environments," Roe says. "But 'blue health' really lags way behind – it has started
a bit like green health did, with laboratory experiments using photographic
images and there's nothing wrong with that, but we've got other methods now,
and that's what we're keen here in Scotland to press on with."

Roe highlights the potential for geographic differences. "It does require
geographic studies in specific climate zones to tease out whether the effect of
water is as great under a cloudy sky as it is in sunny climes. The south-west of
England is very different climatically to a country like Scotland.

"For me, [the research] needs to ground itself in issues of climate change.
Our scoping study looked at the psychological trauma of living in a flood risk
zone and the effect on very vulnerable populations so it's not just the positive,
health-improving benefits of being close to or having access to water, it's also
about how we manage that water flow and how we use sustainable design
strategies to minimise the risk of flood-damaged communities."

Both Roe and Depledge are keen to look at the impact of water within urban
environments too, with potential practical applications for planners and
developers. Depledge argues that, "we have spent a lot of time putting green
spaces into urban environments – and 85% of the UK population now live in
urban environments – but are we paying any attention to designing in blue
space?"

She adds: "I think water features in general are beneficial; fountains in cities,
ponds in parks … Birmingham restored the canal running through the city, and
that has been hugely successful."

Roe also cites Sheffield and Manchester as cities that have introduced popular
water features to their city centres with potentially regenerating effects.

There is also the prospect of economic benefits. Both ECEHH and Heriot-Watt
University are enlisting the help of health economists to understand the cost
benefits of access to green and blue space if the benefits effects are such that they
reduce GP visits. It's a tantalising prospect, but there's a long way to go.

https://www.theguardian.com/sustainable-business/impact-sea-lakes-rivers-peoples-health

‘Blue spaces’ help improve public health

SEPTEMBER 7, 2018
tags: Blue Spaces, Ecosystem Services, EU
Horizon, Freshwater, Marine, Public Health, Recreation
by freshwaterblog

Spending time near water has even greater health benefits than
visiting a forest or park, according to researchers. Image: Frederica
Diamanta / Unsplash
A post from our partners at Horizon: the EU Research &
Innovation Magazine.
–
Living close to bodies of water such as a river or even a fountain
can help improve public health, whilst also reducing medical costs
for governments, according to researchers.
There is growing evidence that spending time in the natural
environment can foster important mental and physical health
benefits, and help prevent illness and reduce medical bills. One
study found that people in England made 1.23 billion active
trips to parks and woodlands, which was estimated to be worth
£2.18 billion in terms of annual health benefits.
Now research by the same team suggests that so-called ‘blue
spaces‘ – areas with water features like a river, ocean, spring, or
even a fountain in a city centre – could be particularly beneficial.
‘What we find time and time again is that being exposed to blue
environments often has even greater (health benefits) than visiting a
green space (like a park or forest),’ said Dr Mathew White, an
environmental psychologist at the University of Exeter, in the UK,
who helped conduct the research.
One reason is that people who take trips to bodies of water are
more likely to also go for longer walks or cycles – as well as
swimming – which can help lower their risk of developing chronic
disease like diabetes, heart disease and cancer. But water can have
other benefits too.
‘Blue spaces can directly reduce psychological stress and improve
mood,’ said Dr White, who is also a lead researcher in BlueHealth,
an EU project examining the relationship between this type of blue
infrastructure and people’s health and wellbeing.
The reasons why water is mentally therapeutic may be connected to
the open vistas, reflected light and associated
soundscapes, according to the researchers. Depression has also
been linked to detachment from the natural environment so blue
spaces are useful for ‘reducing the negative and improving the
positive,’ said Dr White.
The mental and physical benefits of blue spaces may seem obvious
to the 200 million people in Europe who live close to the coast.
However, to help the general public embrace the full health benefits,
it requires specifically designed ways of safely accessing and
appreciating blue spaces.
‘One thing we are interested in is how to quantify blue spaces so we
can put an economic value on them to justify infrastructure
investment,’ said Dr White.
BlueHealth is aiming to gather data to help convince policymakers
to invest in blue spaces, particularly in urban areas. They recently
conducted an international survey asking 18,000 people about the
kinds of activities they do in blue spaces across Europe, in an
attempt to determine the implications this has for public health. The
results are expected later this year.
A new coastal amphitheatre in Plymouth, UK, will allow school
children to spend more time by the water. Image: BlueHealth
‘Urban acupuncture’ to connect communities to water

BlueHealth is also working on innovative ways to increase public

access to blue spaces, from using virtual reality for those physically
unable to make the journey to the ocean,  to improving access
through local community interventions termed ‘urban acupuncture’.
Urban acupuncture is an urban planning concept that involves
working with local communities to make small adjustments to bodies
of water to connect the potential physical and mental health benefits
to the public. This can include a viewing platform along a lake or a
pathway to a river.
Improving access to water, however, does increase risks such as
public exposure to flooding, or potential drownings if a blue space is
left unsupervised. However, according to Professor Lora
Fleming from the University of Exeter and the principal investigator
of BlueHealth, ‘natural environments have both risks and benefits’,
but you can still improve access to blue spaces with these in mind.
In one of several case studies across Europe, BlueHealth
researchers worked with Plymouth City Council on England’s south
coast to help regenerate an area along the seafront in an attempt to
boost local health and wellbeing. By engaging with local residents
and stakeholders, they helped build a small coastal facing
amphitheatre and safe playing area for children, which will host
special family events and school sessions run by, among others, the
local aquarium and wildlife trust.
The researchers also considered the potential impacts of rising sea
levels due to climate change and coastal erosion, building the
theatre in such a way as to protect it for decades to come.
Projects designed like this can help to connect children with the
natural environment for generations and improve their health and
wellbeing over their lives, but in order to be successful, local
communities need to be involved. ‘Otherwise they won’t use it,’ said
Prof. Fleming.
Working with local people when developing blue space access can
also bring environmental advantages, according to Professor
Sheila Heymans, the executive director of the European Marine
Board (EMB), a research think-tank specialising in marine science
policy.
She believes that once people begin to appreciate blue spaces
more they will want to protect them from pollution, overfishing and
poor urban planning. But to design ways of providing safe access to
blue spaces that incorporates all these factors will require significant
investment, from researching the local needs to choosing a site and
then the actual construction.
Supporting human and environmental health through ‘blue thinking’

‘There isn’t a single place where blue spaces are actually

coordinated from,’ Prof. Heymans said. ‘Incorporating blue spaces
very much depends on one or two people in the local authority.’
Prof. Heymans believes that government policies need to be
moulded so that they complement each other and support more
‘blue thinking’ across sectors such as health, environment, tourism,
and transportation.
‘Some of the policies and directives in Europe are
counterproductive, the habitat and bird directives expect you to save
seabirds, but the reduction in discards from the reform of the
common fisheries policy will reduce food for seabirds that are
dependent on these discards, so different policies can sometimes
work at cross purposes,’ said Prof. Heymans.
Policymakers therefore need specific information that can help
convince local authorities about the combined potential
environmental, economic, social, and health benefits.
The EMB are now working with the Exeter BlueHealth team to
coordinate a new project called SOPHIE, which is examining how
the marine environment and human health are inextricably linked.
‘There is a link to the health of humans to the health of the oceans,’
said Prof. Heymans. ‘You need to fund interdisciplinary research to
make that clear.’
https://freshwaterblog.net/2018/09/07/blue-spaces-help-improve-public-health/

Can "Blue Space" Provide

Therapeutic Benefits?
Research suggests that a shoreline walk may offer an extra
dose of happiness.
Posted Mar 22, 2019

SHARE

TWEET

EMAIL

MORE
Source: skynesher/iStock

Travel ads are filled with images of beckoning beaches for a reason. It's
difficult to resist a beautiful water view, and that allure hasn’t been lost on
psychological and environmental researchers. Thanks to a spate of recent
studies, there’s growing evidence that being around "blue space"—natural
aquatic features such as lakes, rivers, and coastal waters—can be good for
our mental health.

That may explain why so many of us feel drawn to the water when it’s time for
rest and relaxation. In England alone, one survey found that people make a
whopping 271 million recreational visits to coastlines and beaches each year.
And the most popular activity during these visits isn’t sunbathing, swimming,
or fishing. It’s walking along the shore.

Happier, Out of the Blue

Psychological and environmental researchers around the globe have become
increasingly intrigued by our psychological response to blue space. Here’s a
sampling of what they’ve found:

 A 2018 study from Hong Kong showed that people who regularly visited
blue spaces in their free time reported greater well-being, compared to
those who didn’t make such visits. They also had a lower risk
of depression. Likewise, another recent study, this one from Ireland,
found that better views of the sea were associated with lower
depression scores in older adults.
 A review of 35 earlier studies, led by researchers at the Barcelona
Institute for Global Health, showed that interacting with blue spaces had
a positive impact on mental health and stress reduction. Being around
 blue space was also linked to greater physical activity—and that, in
itself, can help further enhance well-being and reduce the risk for
depression.
 Some studies have focused on how participating in outdoor aquatic
activities (such as fly-fishing, kayaking, and surfing) may help people
with specific health challenges (such as post-traumatic stress disorder,
drug and alcohol addiction, and breast cancer). Overall, the studies
suggested that many participants benefited both psychologically and
socially.
The latter group of studies didn’t specifically address walking by the water. But
other research suggests that social connectedness, such as you might feel
when strolling side-by-side with someone, adds to the potential for reducing
anxiety and depression while raising self-esteem.

Soaking Up the Serenity

Of course, you don’t have to wait for a vacation to enjoy walking along the
shore of an ocean, lake, or river. Many people naturally gravitate toward the
nearest blue space for their regular walks.

“I make it a point to go on a beach walk with my husband and our two dogs at
least twice a week,” says Christine Scott-Hudson, M.A., LMFT, ATR, a
psychotherapist and art therapist in Santa Barbara, California. “Going on a
beach walk has restorative powers that exercising inside of a gym just does
not have. Looking out onto the blue water is both relaxing and healing.”

It’s not only the sights; it’s also the sounds that make a beach walk so
appealing. “I believe that the sounds of the crashing waves or lapping water
help us regulate our internal rhythm,” says Scott-Hudson. “Listening to the
repetitive sounds of the waves is soothing to our maxed-out nervous systems.
The tranquility brings us back to a predictable pace, and we can co-regulate
our breathing in harmony with the waves.”

For Michael Alcee, Ph.D., a clinical psychologist in Tarrytown, New York, the

draw is the Hudson River rather than the Pacific Ocean. But the payoffs sound
strikingly similar.
“My wife and I love going to the walking path by the river overlooking the new
Tappan Zee Bridge,” Alcee says. “We walked there as a couple before our
son was born to enjoy a romantic getaway right near home. I have gone on
my own to get some much-needed introvert recharge time. And now, with our
one-year-old, we all go together to stroll and commune with nature.”

ARTICLE CONTINUES AFTER ADVERTISEMENT

Alcee, like Scott-Hudson, believes that walking near the water is innately
soothing. “Being by the water and watching the waves echoes the Romantic
notion that our inner world is beautiful because, like nature, it is constantly in
flux,” Alcee says. “I find it comforting and connecting to know that my personal
feelings are mirrored in something bigger than myself.”

The happiness boost that comes from being near the water is well-known to

avid beach, lakeshore, and riverside walkers. That’s why you’ll frequently find
Scott-Hudson and her husband strolling along Santa Barbara’s beautiful
Arroyo Burro Beach (known locally as Hendry’s Beach).

“It is an instant mood-lifter and helps me become mindful of the present

moment every time,” Scott-Hudson says. “It is both my favorite self-care
activity and the one I recommend most to my anxious or
depressed therapy clients, with powerful results.”

https://www.psychologytoday.com/intl/blog/minding-the-body/201903/can-blue-space-provide-
therapeutic-benefits