Additional research and newly developed methods are needed to quantify short- and long-term health effects of exposure to perceived and objectively measured species diversity, including health effects of nature-based solutions and exposure to microbiota.

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Two studies are reported that tested the fear-avoidance (FA) model using path analytic techniques. In Study 1, 429 employees with back pain at baseline and back pain at 18 months follow-up completed questionnaires assessing sociodemographic information, pain severity, negative affect, pain-related fear, and disability. Results indicated that pain severity at baseline predicted pain related fear and disability at follow-up, and that pain-related fear is rather a consequence than an antecedent of pain severity. Results further revealed that the disposition to experience negative affect has a low impact upon pain severity and disability, and is best