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PubMed2005

Recreational gun use by California adolescents.

Most research on adolescents and firearms focuses on urban populations, handguns, and homicide. This study examines the prevalence and correlates of recreational gun use (RGU)--for hunting or target shooting--among 5,801 community-residing 12- to 17-year-old Californians. Data are from the first statewide California Health Interview Survey (CHIS), and person, design, and population weights were applied to the data. About one fifth (22.4%) of California adolescents report that they have gone hunting or target shooting. Nearly two thirds (62.8%) have hunted with a family member, typically (67.3%) their father. Recreational gun use among adolescents appears to be linked to a few basic demographic characteristics; most notably, male adolescents had an adjusted odds ratio of RGU nearly five times that of female adolescents. Some of the variables associated with RGU are consistent with those for violent gun use; differences, however, suggest that separate approaches to preventing firearm-related injury may be warranted.

Adolescent↗
PubMedDate not supplied

Therapeutic recreation interventions for need-driven dementia-compromised behaviors in community-dwelling elders.

This study describes a clinical trial of at-home recreational therapy for community dwelling older adults with dementia and disturbing behaviors. After two weeks of daily, individualized recreational therapy interventions (TRIs), results indicated a significant decrease in levels of both passivity and agitation. Biograph data collection was useful in identifying the physiological changes that occurred with each intervention technique. Specific information is included on the time of day each behavior occurred and the most effective interventions, as well as implications for service delivery.

Aged↗
PubMed2001

Residential and recreational acquisition of possible estuary-associated syndrome: a new approach to successful diagnosis and treatment.

Evidence suggests that the estuarine dinoflagellates, Pfiesteria piscicida Steidinger & Burkholder and P. shumwayae Glasgow & Burkholder, members of the toxic Pfiesteria complex (TPC), may release one or more toxins that kill fish and adversely affect human health. In the current study we investigated the potential for undiagnosed cases of possible estuary-associated syndrome (PEAS), as termed by the Centers for Disease Control and Prevention (CDC), in a population that had residential and/or recreational exposure to TPC-affected estuaries, but that did not have direct contact with fish kills or lesioned fish. Age-adjusted visual contrast sensitivity (VCS) was significantly lower and the presence of PEAS-associated symptoms was much higher in the estuary cohort (n = 77) than in combined-control cohorts (n = 87), one without exposure to bodies of water (n = 53) and one with exposure to marine waters (n = 34). In the estuary cohort, 37 individuals met the CDC case definition for PEAS and had significantly lower VCS than non-PEAS cases. The VCS improved and symptoms abated after 2 weeks of treatment with cholestyramine. Cholestyramine, the original drug approved for treatment of hypercholesterolemia, has previously been reported to enhance the elimination rates of a variety of toxins, presumably by interruption of enterohepatic recirculation through toxin entrapment in its polymeric structure and/or anion-exchange process. Control studies showed that repeated VCS testing alone did not improve VCS scores and that cholestyramine treatment did not affect VCS in patients with elevated cholesterol levels. These results suggested that a) susceptible individuals may acquire PEAS through residential and/or recreational contact with TPC-affected estuaries in the absence of an active fish kill; b) VCS is a useful indicator in PEAS diagnosis and treatment monitoring; and c) PEAS can be effectively treated with cholestyramine. Because the study did not use population sampling techniques, the results do not indicate PEAS prevalence. Furthermore, definitive diagnosis of PEAS and association with TPC toxin(s) must await identification of, and a serologic test for, the putative TPC toxin(s).

Adolescent↗
PubMed2003

Evaluation of recreational health risk in coastal waters based on enterococcus densities and bathing patterns.

We constructed a simulation model to compute the incidences of highly credible gastrointestinal illness (HCGI) in recreational bathers at two intermittently contaminated beaches of Orange County, California. Assumptions regarding spatial and temporal bathing patterns were used to determine exposure levels over a 31-month study period. Illness rates were calculated by applying previously reported relationships between enterococcus density and HCGI risk to the exposure data. Peak enterococcus concentrations occurred in late winter and early spring, but model results showed that most HCGI cases occurred during summer, attributable to elevated number of exposures. Approximately 99% of the 95,010 illness cases occurred when beaches were open. Model runs were insensitive to 0-10% swimming activity assumed during beach closure days. Comparable illness rates resulted under clustered and uniform bather distribution scenarios. HCGI attack rates were within federal guidelines of tolerable risk when averaged over the study period. However, tolerable risk thresholds were exceeded for 27 total days and periods of at least 6 consecutive days. Illness estimates were sensitive to the functional form and magnitude of the enterococcus density-HCGI relationships. The results of this study contribute to an understanding of recreational health risk in coastal waters.

California↗
PubMed2006

A randomized controlled trial assessing infectious disease risks from bathing in fresh recreational waters in relation to the concentration of Escherichia coli, intestinal enterococci, Clostridium perfringens, and somatic coliphages.

We performed epidemiologic studies at public freshwater bathing sites in Germany to provide a better scientific basis for the definition of recreational water quality standards. A total of 2,196 participants were recruited from the local population and randomized into bathers and nonbathers. Bathers were exposed for 10 min and had to immerse their head at least three times. Water samples for microbiological analysis were collected at 20-min intervals. Unbiased concentration-response effects with no-observed-adverse-effect levels (NOAELs) were demonstrated for three different definitions of gastroenteritis and four fecal indicator organisms. Relative risks for bathing in waters with levels above NOAELs compared with nonbathing ranged from 1.8 (95% CI, 1.2-2.6) to 4.6 (95% CI, 2.1-10.1), depending on the definition of gastroenteritis. The effect of swallowing water provided additional evidence for true dose-response relationships. Based on the NOAELs, the following guide values for water quality are suggested: 100 Escherichia coli, 25 intestinal enterococci, 10 somatic coliphages, or 10 Clostridium perfringens per 100 mL. Recreational water quality standards are intended to protect the health of those consumers who are not already immune or resistant to pathogens that may be associated with indicator organisms. In contrast to current World Health Organization recommendations, we concluded that standards should be based on rates of compliance with NOAELs rather than on attributable risks determined above NOAELs, because these risks depend mainly on the unpredictable susceptibility of the cohorts. Although in theory there is no threshold in real concentration-response relationships, we demonstrated that a NOAEL approach would be a more robust and practical solution to the complex problem of setting standards.

Clostridium perfringens↗
PubMed2002

Experienced, recreational scuba divers in Australia continue to dive despite medical contraindications.

OBJECTIVE: In Australia, a medical examination is required before undertaking a scuba diving course in order to screen for contraindications to diving. No further medical screening is required, and yet divers may develop diseases during their diving careers. This study aimed to survey experienced recreational scuba divers to determine the prevalence of diseases contraindicated in diving. METHODS: A cross-sectional, postal survey was taken of divers belonging to scuba diving clubs across Australia. RESULTS: Three hundred forty-six divers returned completed questionnaires. Two hundred fifty-four (73.4%) were male, and 258 (74.6%) were aged 31 to 60 years. The mean years of diving equaled 10.6 +/- 9.18 years, and the mean number of dives undertaken was 414 +/- 740 dives. One hundred sixty-two (46.8%) divers were overweight, 45 (13.0%) divers required regular medication, and 39 (11.3%) divers smoked. Thirty-six (10.4%) divers reported a past or present history of asthma, and the same number reported hypertension or coronary heart disease. Eighty-six (24.9%) divers reported past or present psychological symptoms. Forty-two (12.1%) divers reported hearing difficulties, and 81 (23.4%) divers reported past or present tinnitus. Two divers had a past history of epilepsy, 2 had a history of pneumothorax, and I was diabetic. CONCLUSIONS: Experienced, recreational scuba divers continue to dive despite medical contraindications. This raises the questions: Did the divers fail to disclose these conditions at the initial examination, or did these conditions develop subsequently? Is the risk associated with these conditions clinically significant, and should screening examinations be undertaken at regular intervals? The high prevalence of hearing difficulties and tinnitus may be the result of aural barotrauma and requires further research.

Adult↗
PubMed2005

Injury and illness during a multiday recreational bicycling tour.

OBJECTIVE: To describe the incidence and types of injury and illness treated during a multiday recreational bicycling tour. METHODS: In July 2001, 2100 bicyclists rode 520 miles from Minneapolis, MN, to Chicago, IL, during the 2001 Heartland AIDS Ride. A volunteer medical staff provided medical care along the route. All patient encounters were recorded in an injury and illness log. Information from the log was used to describe the incidence and types of injury and illness treated during the event. RESULTS: A total of 2100 riders participated, with 244 patient encounters recorded. The 2 most common reasons for requiring medical care were dehydration (35%) and orthopedic injuries (27%). Forty patients were transferred to the hospital and 7 required admission. CONCLUSIONS: Individuals charged with providing medical care for recreational bicycling events should be prepared to treat a wide variety of injuries and illnesses. In this and other studies, dehydration, heat illness, and overuse injuries were the most common reasons to require medical care. The results of this study suggest that implementation of prevention strategies before and during bicycling events may significantly reduce the requirement for on-site medical care.

Athletic Injuries↗
PubMed2005

Recreational injuries in Washington state national parks.

OBJECTIVES: The objectives of this study were to identify the number and types of recreational injuries sustained by visitors to Mount Rainier National Park and Olympic National Park in Washington State and to compare the nature of injuries sustained by children compared with adults. METHODS: We retrospectively reviewed case incident reports obtained by rangers in Mount Rainer National Park and Olympic National Park between 1997 and 2001. Data collected included victim age, gender, date of injury, activity preinjury, type of injury, and mechanism of injury. RESULTS: There were 535 cases of recreational wilderness injuries (including 19 total deaths), yielding a rate of 22.4 injuries per million visits. The mean age of injury victims was 34 years. Males were more likely to sustain injury than were females (59% vs 41%). Most injuries occurred during summer months between noon and 6:00 PM, and 90% occurred during daylight hours. The most common preinjury activities included hiking (55%), winter sports (15%), and mountaineering (12%), and the most common types of injuries included sprains, strains and soft tissue injuries (28%), fractures or dislocations (26%), and lacerations (15%). A total of 121 (23%) of the injuries occurred in children (<18 years of age). There were 19 deaths in the 2 national parks (18 men, 1 woman); all victims were adults. Hiking (58%) and mountaineering (26%) were the most common activities at the time of death. Mechanism of death included falls (37%), medical (eg, myocardial infarction) (21%), drowning (5%), and suicide (5%). CONCLUSIONS: The most common type of injury was soft tissue injury, and injuries occurred most commonly while hiking, during daylight hours, and in the summer. Preinjury activities and types of injuries were different in children compared with adults. Knowledge of how and when injuries occur in national parks can assist in determining what resources are needed to help provide a safer environment for park visitors. This study may also aid prevention strategies in the national parks, guide training of rangers, aid in the preparation of first aid kits, and further the education of people who participate in wilderness activities.

Adolescent↗
PubMed2004

[Phytoplankton community in a recreational fishing lake, Brazil].

OBJECTIVE: The assessment of water quality and phytoplankton community in recreational environments allows to setting management programs aiming at preventing potential harm to human health. The purpose of the present study was to describe phytoplankton seasonal changes in a freshwater system and their relation to water quality. METHODS: The recreational fishing lake is located in the southern area of the city of São Paulo, Brazil. Water samples were collected in three previously selected sites in the lake throughout a year and analyzed regarding floristic composition and physical and chemical parameters. RESULTS: The phytoplankton qualitative analysis revealed 91 taxa distributed among eight classes: Chlorophyceae, Cyanophyceae, Euglenophyceae, Zygnemaphyceae, Bacillariophyceae, Xantophyceae, Dinophyceae, and Chrysophyceae. Some physical and chemical parameters seemed to influence phytoplankton community behavior. Chlorophyceae development was favored by local conditions. Among the species of cyanobacteria identified, Microcystis paniformis, Cylindrospermopsis raciborskii, and Anabaena species were the most important due to their ability to produce toxins, posing a high risk to public health. CONCLUSIONS: Some physical and chemical parameters had an impact on the structure of phytoplankton community. The presence of Microcystis paniformis, Cylindrospermopsis raciborskii and Anabaena species indicates toxic potential and likelihood of public health problems unless there is constant monitoring. Further studies are recommended to prevent hazardous effects to the environment and public health.

Animals↗
PubMed1989

Potential for exposure to tick bites in recreational parks in a Lyme disease endemic area.

Eight recreational parks located in a Lyme disease endemic area of southern New York State were surveyed for the presence of ticks during the summer of 1985 by drag sampling. Ixodes dammini, the primary vector of Lyme disease in the northeast, was found in all but one park and accounted for 580 (91.8 per cent) of the 632 ticks collected. Of these, 18 per cent were larvae, 80 per cent were nymphs, and 2 per cent were adults. An I. dammini encounter distance, defined as the mean number of meters traveled before encountering a nymphal or adult I. dammini on a drag cloth, ranged from 36 m in high-risk parks, to infinity (no tick encounters). Generally, areas of high use presented higher encounter distances (lower risk) than those of the entire park. Two of the three parks with the highest annual attendance also had the highest I. dammini population indices as projected from our sampling regimen. These results indicate that recreational parks in Lyme disease endemic areas represent a substantial human risk for tick bites and Lyme disease.

Animals↗
PubMedDate not supplied

Outdoor recreation participation across the lifespan: abandonment, continuity, or liberation?

The purpose of this study was to examine the extent to which outdoor recreation participation changes across the lifespan. Age differences and age changes in leisure involvement were examined within the framework of abandonment, liberation, and continuity. Personal interview data were gathered as part of the 1982-1983 Nationwide Recreation Survey (NRS). The NRS was conducted on a sample of individuals (N = 6720) twelve years of age or older in the non-institutionalized United States population. The data indicated that neither the abandonment nor liberation perspective are accurate reflections of what happens with increasing age. In fact, there appears to be as much variation within age groups as across those groups. If any one pattern does occur more often than the other, it is continuity. There does, however, appear to be a perception of future abandonment among the oldest group of respondents. The findings of this study indicate variables other than age may account for expansion, contraction, and continuity across the lifespan.

Adolescent↗
PubMed1987

Outdoor recreation in two European countries.

A questionnaire randomly distributed to 138 elderly individuals in Luxembourg and 100 in Thionville, France, revealed the high extent of participation in outdoor recreation in the two European countries. This cross-cultural study of a subject shown by others to be an important predictor of successful aging, identified similarities and differences in socio-economic characteristics, attitudes, and environmental factors associated with outdoor recreation participation in the two industrialized countries.

Aged↗
PubMed1994

Recreational exercise and cardiovascular status in the rural community of Tecumseh, Michigan.

BACKGROUND: Because of population stability, Tecumseh, a rural community in Michigan, was the site of health surveys over a period of three decades. METHODS: In the recent survey anthropometrics, blood pressure (BP), blood chemistry, echo/Doppler cardiac exam, personality and exercise questionnaires were collected on site. RESULTS: In this rural community 70% of subjects (447 men, 410 women, average age 30 years) do not engage in recreational exercise. Sedentary subjects were heavier (4 kg), had higher BP (2.3/2 mm Hg), faster heart rate (4 beats/min), and lower stroke volume (2 ml/m2) than physically more active subjects (p = 0.02 to 0.00001). Measures of cardiac structure and function were more favorable in exercising subjects. Cholesterol (+8 mg/dl), triglycerides (+15 mg/dl) and insulin (+2.4 microU/ml) were higher and HDL cholesterol was lower (-2 mg/dl) in the sedentary group (p = 0.04 to 0.003). Being sedentary was associated with more anxiety, anger and feeling time pressure (p = 0.001 to 0.00001). Exercise demands at work had no effect while even once a week recreational exercise was associated with a more favorable cardiovascular risk status. A difference in cardiovascular status between the sedentary and exercising subjects was not apparent throughout childhood, adolescence or early adult life, suggesting that subjects who exercise presently were not a priori healthier than presently sedentary subjects. CONCLUSIONS: Seventy percent of the residents studied in Tecumseh are physically inactive and have a less favorable cardiac risk profile. Enhancement of exercise habits may beneficially affect cardiovascular status and, presumably, the prognosis.

Adolescent↗
PubMed2003

Risks associated with the microbiological quality of bodies of fresh and marine water used for recreational purposes: summary estimates based on published epidemiological studies.

The current European standards for microbiological quality of bathing water (i.e., all running or still fresh waters or parts thereof and/or sea water [with the exception of water intended for therapeutic purposes and water used in swimming pools]) were issued in 1976 and are currently undergoing revision. In this article, the authors propose parameters for select microorganism indicators to assist in the establishment of public-health-based objectives for fresh and marine water quality. A type-II meta-analysis of the results of 18 published epidemiological studies was implemented in an attempt to characterize the relationship(s) between concentrations of bacterial indicators and rates of acute gastrointestinal diseases among bathers who had used fresh or marine water for recreational purposes. The authors fit multiple linear-regression models, which allowed for random effects across studies, to derive dose-response curves. Several confounders and effect modifiers were controlled for in the analyses. Risks were then estimated for a hypothetical individual who would bathe 20 times/yr in water that contained a given concentration of microorganisms. For fresh-water-associated highly credible gastrointestinal illnesses, a level of 10 fecal coliforms/100 ml water yielded an attributable risk of 0.2 cases/1,000 person-years; a risk of 2 cases/1,000 person-years was found for fecal streptococci. The corresponding yearly attributable risks were 1 and 13 cases/1,000 person-years, respectively, for 100 bacteria/100 ml fresh water. Risks associated with fecal coliforms were found to be lower in marine water than in fresh water. Irrespective of the type of water examined, total coliforms were related only weakly with acute digestive morbidity. Developers of future bathing-water standards should state the level of risk deemed acceptable for public health. The authors of this study maintain that levels of fecal coliforms and fecal streptococci should be used as criteria for infectious risk management associated with bodies of marine and fresh water used for recreational purposes.

Bathing Beaches↗
PubMedDate not supplied

Awareness and use of a university recreational trail.

The purpose of this study was to assess awareness and use of a university recreational trail. The authors used an Internet questionnaire developed by the university's Institutional Research Department, with questions derived from the Environmental Supports for Physical Activity Questionnaire and the National College Health Risk Behavior Survey Physical Activity Module. Four hundred and sixty-seven undergraduate college students participated. Ninety-one percent of students reported being aware of the trail, and 73% reported using the trail. Sixty-four percent of students reported seeing signage referring to the recreational trail. Sixty-seven percent of the students reported using the trail once in the past week, 7% reported using the trail twice in the past week, and only 2% of the students reported using the trail more than 3 times in the past week. Sixty-two percent reported using the trail with another individual. Students who were aware of the trail were more likely to use the trail. However, of the individuals who used the trail, the majority only used the trail 1 day a week. University programming is needed to increase trail usage among college students.

Adolescent↗
PubMed2001

Therapeutic recreation in the nursing home. Reinventing a good thing.

The purpose of this article is to increase awareness of therapeutic recreation as a treatment option for nursing home residents. It addresses recent regulations and documentation changes that have occurred under the prospective payment system, and summarizes efficacy research documenting the possible health outcomes of recreation therapy.

Activities of Daily Living↗
PubMed2001

Recreational scuba diving, patent foramen ovale and their associated risks.

Scuba diving has become a popular leisure time activity with distinct risks to health owing to its physical characteristics. Knowledge of the behaviour of any mixture of breathable gases under increased ambient pressure is crucial for safe diving and gives clues as to the pathophysiology of compression or decompression related disorders. Immersion in cold water augments cardiac pre- and afterload due to an increase of intrathoracic blood volume and peripheral vasoconstriction. In very rare cases, the vasoconstrictor response can lead to pulmonary oedema. Immersion of the face in cold water is associated with bradycardia mediated by increased vagal tone. In icy water, the bradycardia can be so pronounced, that syncope results. For recreational dives, compressed air (i.e., 4 parts nitrogen and 1 part oxygen) is the preferred breathing gas. Its use is limited for diving to 40 to 50 m, otherwise nitrogen narcosis ("rapture of the deep") reduces a diver's cognitive function and increases the risk of inadequate reactions. At depths of 60 to 70 m oxygen toxicity impairs respiration and at higher partial pressures also functioning of the central nervous system. The use of special nitrogen-oxygen mixtures ("nitrox", 60% nitrogen and 40% oxygen as the typical example) decreases the probability of nitrogen narcosis and probably bubble formation, at the cost of increased risk of oxygen toxicity. Most of the health hazards during dives are consequences of changes in gas volume and formation of gas bubbles due to reduction of ambient pressure during a diver's ascent. The term barotrauma encompasses disorders related to over expansion of gas filled body cavities (mainly the lung and the inner ear). Decompression sickness results from the growth of gas nuclei in predominantly fatty tissue. Arterial gas embolism describes the penetration of such gas bubbles into the systemic circulation, either due to pulmonary barotrauma, transpulmonary passage after massive bubble formation ("chokes") or cardiac shunting. In recreational divers, neurological decompression events comprise 80% of reported cases of major decompression problems, most of the time due to pathological effects of intravascular bubbles. In divers with a history of major neurological decompression symptoms without evident cause, transoesophageal echocardiography must be performed to exclude a patent foramen ovale. If a cardiac right-to-left shunt is present, we advise divers with a history of severe decompression illness to stop diving. If they refuse to do so, it is crucial that they change their diving habits, minimising the amount of nitrogen load on the tissue. There is ongoing debate about the long term risk of scuba diving. Neuro-imaging studies revealed an increased frequency of ischaemic brain lesions in divers, which do not correlate well with subtle functional neurological deficits in experienced divers. In the light of the high prevalence of venous gas bubbles even after dives in shallow water and the presence of a cardiac right-to-left shunt in a quarter of the population (i.e., patent foramen ovale), arterialisation of gas bubbles might be more frequent than usually presumed.

Atrophy↗
PubMedDate not supplied

Getting it right: appropriate therapeutic recreation programs for community based consumers of mental health services.

Over the last two decades in Australia, the deinstitutionalization process, which began with the intent of moving consumers of mental health services from in-patient facilities and then seeking to integrate these same individuals into the community, has served to highlight a wide range of consumer needs that have remained largely unfulfilled throughout the process. One such need has been the provision of appropriate therapeutic recreation programs for the community based consumers of the various state co-ordinated mental health services. This paper argues a case for a change in the approach which professional staff provide and lead therapeutic recreation based programs to enable participants to be empowered, rather than disempowered, through their involvement. Further, this paper contends that there is a need for health care staff, more generally, to accept the concept of such programs for the community based consumers of various mental health services as a valued one.

Australia↗