Name Designation
Department/
Major Field
Chairman Dr.R.Nagaraju Assistant professorHorticulture
Member Dr.K.Swarajya lakshmiAssociate professorHorticulture
Member Dr.B.Govindarajulu Principal scientist
Pathology
Member Dr.D.Srinivas reddyAssistant professor
Entomology
Case Studies Case StudiesDesign Guidelines
Design GuidelinesTypes of therapeutic gardens
Types of therapeutic gardensTherapeutic garden
Therapeutic garden
Topic divisionHistory & Introduction
History & Introductionconclusion
conclusion85
85
The World Health Organisation defines health as
complete physical, mental and social well-being. 84
84
Healing:-
•Process that promotes overall well-being (Cooper Marcus &
Barnes 1999).
•In particular, it is a process that the body restores or recovers
both physically or/and mentally. Moreover, it is a
multidimensional process which includes physical, mental,
spiritual, emotional and social aspects. 83
83
Gardening works on many
different levels which makes
it a powerful and flexible
medium for improving
health and quality of life. 82
82
•A Therapeutic Garden is an outdoor garden
space that has been specifically designed to
meet the physical, psychological, social and
spiritual needs of the people81
81
For a patient, visitor, or member of staff,
spending long hours in a hospital can be a
stressful experience.
Nearby access to natural landscape or a garden
can enhance people’s ability to deal with stress
and thus potentially improve health outcomes.80
80
A therapeutic garden referred to different garden
features that have the ability to foster restoration
from stress and also have other positive effects on
patients staffs and visitors. and “should contain
prominent amounts of real nature content such as
green vegetation, flowers, and water.”
Ulrich, 198479
79
History
•“The idea of healing garden is both ancient and modern”(Cooper
Marcus & Barnes, 1999).
•Historically, people have always used nature as a powerful healing
source and as a resource for recovery (Cooper Marcus and Barnes,
1999).
•Persian garden, the Japanese Zen garden and the Monastic
Cloister gardens are some of examples of a healing environment
which appeared throughout history in different parts of the world.
•The Greeks created healing temples for their gods. The temple for
the god Aesclepius (god of healing) was built in pastoral settings
with mineral springs, bathing pools, gymnasiums, and healing
gardens. Here people would come to worship, lodge, recreate, and
heal.78
78
•In the 19th century, Dr. Benjamin Rush was first to document
the positive effect working in the garden had on individuals with
mental illness.
•In US, horticultural therapy blossomed after World War II, with
homecoming soldiers in need of restorative therapy.
•Since the mid-1980s, research has indicated that gardens, parks
and areas with natural greenery have beneficial effects on human
health, well-being and capacity (Kaplan,R and Kaplan, S.1989).
77
77
•Friends Asylum - first known example of psychiatric hospitals
using gardening activities opening in 1813 in Philadelphia.
•In 1972, foundation teamed with the Horticulture Department
at Kansas State University provided first horticultural therapy
curriculum in the U.S.
•1973 – NCTRH (National council for therapy and
rehabilitation)
•1988 – AHTA (American Horticultural Therapy Association)76
76
Medieval monastic cloister gardenMedieval monastic cloister garden
Early example of restorative outdoor space for sick Early example of restorative outdoor space for sick
patientspatients75
75
Raised Beds Raised Beds 74
74
16
INTRODUCTION
“Quality of life,” “well-being,” and “healing” are
phrases that embody concepts being recognized
with increasing importance in the 21st-century.
However, over the last 50 years with the rapid
growth of medical technology and economic
pressure, this ancient concept has been neglected.
Presently, Healthcare costs are climbing. Hence in
hospitals and healthcare institutions often keep
up extensive gardens and landscapes as an
important part of healing. 73
73
17
Therapeutic Gardens can be found in a variety of
settings, including but not limited to hospitals, skilled nursing
homes, assisted living residences, continuing care retirement
communities, out-patient cancer centers, hospice residences,
and other related healthcare and residential environments.
The focus of the thereupetic gardens is primarily on
incorporating plants and friendly wildlife into the space near
to hospitals and healthcare centers for the better health
outcomes of the peoples.72
72
18
•The Joint Commission for the Accreditation of Hospitals
Organization (JCAHO) has stated, “Patients and visitors
should have opportunities to connect with nature through
outside spaces, plants, indoor atriums, and views from
windows” (1999).
•There is significant evidence indicating that environmental
exposures, such as contact with plants and animals, viewing
landscapes, and participating in wilderness experiences, may
have positive impact on mental and physical health
(Frumkin, 2001, 2004),71
71
Table 1: Responses from 143 garden users at four San Francisco
Bay Area hospitals
Healing Gardens in Hospitals
Cooper Marcus and Barnes, 199570
70
2069 69
Benefits of therapeutic gardening
• Psychological
• Social
• Physical68
68
Facilitates stress reduction, helps body reach more
balanced state
Helps person summon up own inner healing
resources
Provide a setting where staff can conduct physical
therapy, horticultural therapy, etc. with patients
Helps patient come to terms with incurable medical
condition
Provide a relaxed setting for patient-visitor
interaction away from the hospital interior.
Provides needed retreat for staff from stress of work67
67
•Therapeutic landscape designed for people
with vision loss, outside London, England.88
66
Types of Therapeutic Gardens
•Alzheimer's Gardens: adult day care programs and
dementia residences
•Healing Gardens: acute care hospitals, skilled nursing
facilities and other healthcare facilities
•Rehabilitation Gardens: rehabilitation hospitals
•Restorative Gardens: psychiatric hospitals
•Senior Community Gardens: assisted living, continuing
care retirement communities and other senior living
residences
•Cancer Gardens: chemotherapy facilities
•Enabling Gardens: vocational schools, arboretum
•Meditation Gardens: religious institutions and other
faith based settings87
65
ElementsElements
Familiar plantings
Plants that attract birds and butterflies
Ornamental plants
Non-toxic and non-injurious plantings
Annuals
Soil
Sunlight and natural shade
Wind
Precipitation
Natural elementsNatural elements8d
64
Patio
Paved walking
Seatings
Landscape lighting
Raised beds
Shade
Water features
Electrical outdoor
outlet; for music and
related activities
Constructed garden elementsConstructed garden elements8N
63
POTENTIAL
ACTIVITIES IN
A
THERAUPEUTIC
GARDEN8U
62
Views through a windowViews through a window8v
61
Sitting outsideSitting outside
Reading/Reading/
doing paper work outsidedoing paper work outside8g
60
Therapeutic garden characteristicsTherapeutic garden characteristics
1.Scheduled and programmed activities
2.Features modified to improve accessibility
3.Well defined perimeters
4.A profusion of plants and people interactions
5.Supportive conditions
6.Universal design
7.Recognizable place making
AHTA, 20157b
58
Design Principles in
Therapeutic Landscapes
Before starting the design process it is important to
know the user groups.
In designing a healing garden the focus should be on
the people who are going to use the garden.
Depending on user groups there should be a balance
between the physical activities and just being and
experiencing the garden passively (Stigsdotter & Grahn
2002). 7f
57
Sustainability
Understanding of its therapeutic value,
activity programs and maintenance regime
Garden’s success very much depends
upon the staff’s understanding of the design
AHTA, 2012 77
55
Orientation
•Locate gardens where they can be easily viewed from inside the
building
•Simple path system
AHTA, 2012 7d
54
Accessibility
Ensure garden accessible with people by removing the physical and
mental barriers
Ensure there is plenty of shade
Offer a range of garden beds at differing heights for ease of access
AHTA, 2012 7N
53
Socialisation
AHTA, 2012
•Enhance the quality of life
•Include elements that encourage interaction between
family members7U
52
Enhancing the sense of smell to relax
Scented flowers
Blue bottle (Centaurea cyanus L.)Stock (Mathiola incana L.)
Lavendula angustifolia
Rosa damascenadb
48
Trees for shade (Tropical region)
Indian devil tree
(Alstonia scholaris)
Indian Beech Tree
(Pongamia pinnata)
Neem
(Azadirachta indica)
dd
44
Healing garden entrance with arbor at Cortesia’s Healing
Sanctuary in Oregon.dn
43
•View of raised beds and work tables dS
42
Case studies..Case studies..dH
41
“EFFECT OF HEALING GARDEN USE ON
STRESS EXPERIENCED BY PARENTS OF
PATIENTS IN A PEDIATRIC HOSPITAL”
Toone (2008)d2
40
•Dell Children’s Medical Center in Austin.
•To test the hospital healing garden had an effect on
the on stress levels of parents of pediatric hospital
patients.
•27 participants, equating 9 to group.
•Data was collected in the form of surveys and
behavioral observation.n6
39
Dell Children’s Medical Center in Austin.Dell Children’s Medical Center in Austin.nm
38
7pguitHjtt4uutUTiCUhbft7hfputo& IefhItoahTitp 5tMIhfrh put
YrbfTibbtttttttttttttttttt
tttttttttttttttt oWIIiT& toahTib Table 1- All Pre/Post Total Symptom Score and Emotional
Distress
Summery ScoresnO
37
Total Symptom Score
Setting N Range Minimum Maximum Mean
Garden 9 22.83 -1.67 21.17 7.333
2 North 9 34.67 -28.17 6.50 -1.796
Surgery 8 8.83 -3.33 5.50 1.222
Emotional Distress Summery Score
Setting N RangeMinimum Maximum Mean
Garden 9 30.75 -6.50 24.25 5.722
2 north 9 30.25 -24.00 6.25 -2.361
Surgery 8 10.50 -3.50 7.00 1.0557pguitSjtYibaTrefr3itofpfrbfrabth9t.Bp citoahTibt7rfBr tLThWeb
Table 2- Descriptive Statistics of Change Scores Within Groupsn8
36
7pguitnjt7ruah9h torc i5tDp :bt7ibf Table 3- Wilcoxon Signed Ranks Test
Total
symptom
score
P
Emotional
Distress
Summery
Score
P
Garden .015 Garden .214
2 North .678 2 North .953
Surgery .161 Surgery .514n;
35
.h auWbrh
8
stunTyTstGnir h2shuThGyhcr tr Uuhtnhur chyuhtihr TGr
inuhiir eRhGr iTnnTGUr TGr nRhr 6htSTGUr DtuchGr malunvtucr
nRtGreRhGrTGrhTnRhuraprnRhrTGnhuTauristyhiM Conclusion
participants experienced a greater decrease in
stress when sitting in the Healing Garden Courtyard
than when in either of the interior spaces.nd
34
1ipur ctpftpt1hberfputLpT5i <t0 ficTpfrh th9t
UB&braputp 5tFh jUB&braput4beiafb Healing at a Hospital Garden: Integration of
Physical and Non-Physical Aspects
Asano, 2008nn
33
Fig. 1. The garden design layout of the Kansai Rosai Hospital, Japan.nS
32
Fig. 2. Minutes spent visiting the
Kansai Rosai Hospital garden.
Fig 3: Frequency of visits to the
Kansai Rosai Hospital gardennH
31
Fig. 4. Reported use of the Kansai Rosai Hospital garden by
respondents of a survey (multiple answers).n2
30
Table 1. Changes reported by patient visitors to a hospital garden.
N=142 n
Relaxed 43
Refreshed 24
Enjoyable 8
Healed 5
Other (feels like my own
garden, let children play with
peace, able to be private )
3
Unaware 1
No change 3
No answer 59S6
29
Fig 5: Frequency of visit and if the hospital staff ever recommended the
garden responses by hospital staffSm
28
Fig. 6. Kansai Rosai Hospital nurses response to the possibility
of rehabilitation or therapeutic use of the hospital gardenSO
27
j U8v588Y8Mathd8thMacenTun cU8nph8the Uc8hdhMhcnes8lRTlaehs8
uct8lTaUTuMM cU8ar8u8phud cU8ducteHulho Fig 7: A model demonstrating the design elements, purpose,
and programming of a healing landscape.S8
26
Landscape preference evaluation for hospital
environmental design
Petros and Georgi. 2011 S;
25
7
8 7ph8Mu c8Uaud8ar8np e8enRtm86ue8na8
cGhen Uunh8RehTLe8unn nRthe8na6uTte8ducteHulh8
the Uc8ThUuTt cU8nph8hW en cU8uct8rRnRTh8
MlTaGhMhcne8na8aRntaaT8UTaRcte8uct8eluHhes8 The main goal of this study was to
investigate user’s attitudes towards landscape
design regarding the existing and future
improvements to outdoor grounds and spaces, Sd
24
7ugdh8C58&a68eun er ht8uTh8maR86 np8nph8HRTThcn8aRntaaT8eluHh8uThu8ar8nph8
pael nudO8N34 Table 1: How satisfied are you with the current outdoor space area of the
hospital? (%)
A lot A little Not at all
Doctors 5 45 50
Nurses 12.5 75 12.5
Administrative staff13.6 63.7 22.7
Medical students 8.3 75 16.77ugdh8.589p Hp8luTn8ar8nph8aRntaaT8eluHh8ar8nph8pael nud86aRdt8maR86 ep8na8 cHThuehO 8N348
Table 2: Which part of the outdoor space of the hospital would you wish to increase? (%)
Green
areas
Parking
areas
Rest areasIsolated
areas
Water
formations
Doctors 90 5 5 0 0
Nurses 50 4.2 37.5 8.3 0
Administrative
staff
63.6 18.3 13.6 0 4.5
Medical
students
52.8 13.9 25 8.3 0Sn
23
87Theraprutihcr tirhGder7rn7SceHrAGMNrMSee.r7HcrTi.Ne.rGHrMNertiMcttSr./71ert4rMNer
Nt./GM7hrMtre-G.M0rFLDr Table 3: Would you like a garden with trees and bushes in the outdoor space of the
hospital to exist? (%)
A lot A little Not at all
Doctors 90 10 0
Nurses 70.8 29.2 0
Administrative
staff
77.3 18.2 4.5
Medical students 80.6 16.6 2.887Theroprltr tirTehGeUerMN7Mrh7Hc.17/erce.GnHrAGMNrnSeeHr7Se7.rGHrMNertiMcttSr./71ert4r
MNerNt./GM7hrA tihcr/t.GMGUeh r744e1Mr tiSr/. 1NthtnG1r.M7Mi.0rFLDr
Table 4: Do you believe that landscape design with green areas in the outdoor space of
the hospital would positively affect your psychologic status? (%)
Yes May be No
Doctors 95 5 0
Nurses 79.2 20.8 0
Administrative
staff
72.7 18.2 9.1
Medical students 91.7 8.3 0yy
22
87Ther26rltr tirA7HMrMtr./eHcr tiSrSe.MrMGmerGHr7rAehhgce.GnHecrh7Hc.17/er
.iSStiHcGHnrMNerNt./GM7h0rFLDr Table 5. Do you want to spend your rest time in a well-designed landscape
surrounding the hospital? (%)
Yes No
Doctors 85 15
Nurses 95.8 4.2
Administrative staff 81.8 18.2
Medical students 94.4 5.687Therj6ruN7MrdGHcrt4rUeneM7MGtHrAtihcr tirhGderMtrTer/h7HMecrGHrMNerNt./GM7hC.rrrrrrrrrr
n7SceH0rFLDr
Table 6. What kind of vegetation would you like to be planted in the hospital’s
garden? (%)
High
trees
Medium
height trees
Small
trees
BushesTrees+bushes
Doctors 5 15 15 15 50
Nurses 4.2 29.2 20.8 8.3 37.5
Administrative
staff
9.2 45 13.6 0 72.7
Medical
students
11.0 22.2 11.1 0 55.6y5
21
87TherW6rltr tirAG.Nr4tSrA7MeSr4e7MiSe.rGHrMNertiMcttSr./71ert4rMNer
Nt./GM7h0rFLDr Table 7. Do you wish for water features in the outdoor space of the
hospital? (%)
Yes No
Doctors 70 30
Nurses 91.7 8.3
Administrative staff 50 50
Medical students 80.6 19.487TherO6ruN7Mr1tmTGH7MGtHrt4r1thtS.rAtihcr tirhGderMtr.eer/SeU7GhGHnrGHrMNer
Nt./GM7hC.rn7SceH0rFLD
Table 8. What combination of colors would you like to see prevailing in the
hospital’s garden? (%)
Monochromatic Limited number of
colors
Variegation
Doctors 10 50 40
Nurses 8.3 41.7 50
Administrative
staff
4.5 63.7 31.8
Medical students 8.3 47.3 44.4yB
20
87Ther76ruN7MrdGHcrt4r71MGUGMGe.rAtihcr tirAG.NrMtre-eS1G.erGHrMNerNt./GM7hC.r
n7SceH0rFLD6r Table 9. What kind of activities would you wish to exercise in the hospital’s
garden? (%).
Rest Landscape
observation
PicnicAvoidance of
stressful
environment
Walking
Doctors 50 10 10 30 0
Nurses 41.7 8.3 8.3 29.2 12.5
Administrative
staff
36.4 9.1 22.7 31.8 0
Medical
students
61.1 0 19.4 16.7 2857
19
5O 1887Ther5B6r 87Th7eTrapuataTiTci GadTn7epGTSapHTASaTHiAuadAMTA7T aN7ta .T/14-T
Table 10. Do you believe a garden would help the patients to recover? (%).
:tH1hi.GtH
8
SDD1 H7Th7er1 ecro7NHcH1 h71 hlc1 rie/cU1 v./c1 .1 o7rrMsMDMhU1 741
MAoe7/MNv1 hlc1 olUrM7D7vMT1 rh.hir1 741 hlc1 o.hMcNhr1 yMhl1 7ihH77e1
v.eHcNrG
8
2lc1 rh.441 iNHcerh77H1 h71 .1 D.evc1 c6hcNhm1 hlc1 MAo7eh.NTc1 741 l./MNv1 .1
veccN1 D.NHrT.oc1 47e1 MAoe7/MNv1 hlc1 orUTl7D7vU1 .NH1 lc.DMNv1 741
o.hMcNhrG1 Conclusion
All doctors responded to the survey gave a possibility of
improving the physiologic status of the patients with outdoor
gardens.
The staff understood to a large extent, the importance of having a
green landscape for improving the psychology and healing of
patients. 5W
17
0FHiNAT7LTDi GadudcTYNAutuAuaMT7dTRHaNuipT
oSupG adlTiToiMaTRAeGh Impact of Gardening Activities on Special
Children: a Case Study
Riaz et al., 20125j
16
UirpalTvsT8uMA ureAu7dT7LTNSupG adTiNN7 GudcTA7TicayTcadGa TidGT
putudcTHpiNa- Table: 1- Distribution of children according to age, gender and
living place.52
15
2uce alTv-T6iAe aT7LTuFHiu FadATudTMHaNuipT
TTTTTTTTTTTTTTTTTTT NSupG ad- Figure: 1. Nature of impairment in special
children.5o
14
2uce alTm-TgpiNaMTA7TraTeMaGTrhTNSupG adTL7 T
TTTTTTTTTTTTTTTTTTT ci GadudcTiNAutuAuaM- Figure: 2. Places to be used by children for
gardening activities.5a
13
2uce alTj-TCHudu7dT7LT aMH7dGadAMTir7eATci GadudcTiMT
TTTTTTTTTTTTTTTTTTT iTFaidMTL7 TiTNp7Ma T apiAu7dMSuHTraAnaadTT
TTTTTTTTTTTTTTTTTTT Hi adAMTidGTNSupG ad- Figure: 3. Opinion of respondents about gardening as
a means for a closer relationship between
parents and children.5y
12
2uce alTb-T ;/GHGtHrt4r./e1G7hr1NGhcSeHr7TtiMr
rrrrrrrrrrrrrrrrr N7UGHnr4tiHM7GH.r7StiHc6 Figure: 4. Opinion of special children about
having fountains around.55
11
2uce alTf-T&udGMT7LTHpidAMTudTnSuNSTMHaNuipTNSupG adTna aT
TTTTTTTTTTTTTTTTTT udAa aMAaGTiATMNS77pTidGTS7Fa- Figure: 5. Kinds of plants in which special children were
interested at school and home.5B
10
2uce alTI-TReccaMAu7dT7LT aMH7dGadAMTir7eAT
TTTTTTTTTTTTTTTTTT ci GadudcTA7TraTeMaGTiMTHi AT7LTiTT
TTTTTTTTTTTTTTTTTT MNS77pTNe uNepeF- Figure: 6. Suggestion of respondents about
gardening to be used as part of a
school curriculum.7
9
2uce alT5-TUaiNSa MTSitudcTGuMNeMMu7dT7LT
TTTTTTTTTTTTTTTTTTT ci GadudcTnuASTMAeGadAMTudTNpiMM- Figure: 7. Teachers having discussion of
gardening with students in class.O
8
2uce alTW-TO7GaT7LTudt7ptaFadAT7LTNSupG adTudT
TTTTTTTTTTTTTTTTTT ci GadTiNAutuAuaM- Figure: 8. Mode of involvement of children in
garden activities.W
7
2uce alT3-TRiAuMLiNAu7dTpatapT7LTHi adAMTir7eAT
TTTTTTTTTTTTTTTTTT ci GadudcTLiNupuAuaMTiATMNS77p- Figure: 9. Satisfaction level of parents about
gardening facilities at school.j
6
o7dNpeMu7d Conclusion7
2lc1ecriDhr1741hlMr1rhiHU1rl7y1hlc1o7rMhM/c1MAo.Thr1
741v.eHcNMNv147e1hlc1TlMDHecN1yMhl1rocTM.D1NccHr1MN1
ecrocTh1h71AcNh.Dm1r7TM.D1.NH1.DD1.DDMcH1scNc4Mhr1.NH1
7ihT7Acr1hl.h1.ec1NccHcH147e1hlcMe1schhceAcNhG
7
2c.Tlcer1.NH1o.ecNhr1741riTl1TlMDHecN17srce/cH1
v.eHcNMNv1.r1.1/ceU1MAo7eh.Nh1.ThM/MhU147e1hlcMe1
olUrMT.D1.NH1orUTl7D7vMT.D1lc.Dhl1.D7Nv1yMhl1hlc1
7hlce1he.MNMNvr1.NH1cHiT.hM7N1.h1rTl77DrG
The results of this study show the positive impacts
of gardening for the children with special needs in
respect to mental, social and all allied benefits and
outcomes that are needed for their betterment.
Teachers and parents of such children observed
gardening as a very important activity for their
physical and psychological health along with the
other trainings and education at schools.2
5
gev.NMj.hM7Nr Organizations
American horticulture therapy association www.ahta.org
Canadian horticultural therapy association www.chta.org
City farm www.resourcecentrechicago.org
Gardening leave www.gardeningleave.org
Farming for health www.farmingforhealth.com
Garden partners www.gardenpartners.org
German association for horticulture and therapy
Horticultural therapy institute www.htinstitute.org
Human issues in horticulture- horticultural therapy, Hawaii
Michigan horticultural therapy association www.michiganhta.org
Thrive www.thrive.org.uk
Trellis www.trellisscotland.org.uk
Urban meadows www.urbanmeadows.org
ASHA foundation trust www.ashafoundation.org o
4
1 2lc1hlce.ocihMT1v.eHcN1Mr1.1oecTcHMNv1T7NTcohm1Mh1Mr1scMNv1
ec/M/cH1MN1A7HceN1hMAcr1scT.irc1741hlc1T7AoeclcNrM/c1
hlce.ocihMT1scNc4MhrG1
3h1Mr1.1N.hie.D1Achl7H1h71ecHiTc1rhecrrm1hcNrM7Nm14.hMvicm1o.MNm1
r.HNcrrm1HcoecrrM7N1.NH1.N6MchUG13h1MNTec.rcr1o7rMhM/c1A77Hm1
cNcevU1.NH14ccDMNv1741T.DA1.NH1cNT7ie.vc1liA.NIN.hiec1
MNhce.ThM7NrG
2lc1rMvNM4MT.NTc1741hlc1HMrTMoDMNc1.NH1hlc1T7NheMsihM7N1Mh1T.N1
A.5c1h71.H/.NTMNv1lc.Dhl1.NH1ycDD1scMNv1l.r19irh1scviN1h71sc1
iNHcerh77HG1C7NhMNicH1ecrc.eTl1rhiHMcr1yMDD1lcDo1T7NheMsihc1
h71c/MHcNTc1s.rcH1ecrc.eTl1.NH14iehlce1MAoDcAcNh.hM7N1741scrh1
oe.ThMTcrG
1 The therapeutic garden is a preceding concept, it is being
revived in modern times because of the comprehensive
therapeutic benefits.
It is a natural method to reduce stress, tension, fatigue, pain,
sadness, depression and anxiety. It increases positive mood,
energy and feeling of calm and encourage human-nature
interactions.
The significance of the discipline and the contribution it can
make to advancing health and well being has just begun to be
understood. Continued research studies will help contribute
to evidence based research and further implementation of best
practices.
a
3
Conclusion
y 2
Doubts…???Doubts…???
“We are not ourselves when nature
being oppressed, commands the
mind to suffer with the body”
Shakespeare 5
1