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Respite care provides temporary relief to families who maintain their handicapped child at home. With the recent interest and growth in respite care, therapeutic recreators need to consider the role they may play in providing this type of service. The paper examines the various models of respite care currently in use, and considers the function of therapeutic recreators in such settings.
Activity directors must recognize variables which increase patient involvement by nursing home residents. Refreshments are one variable which can be used to increase the attendance of the aged at recreation activities. This study was conducted to determine if refreshments had an effect on attendance at recreation activities for residents requiring various care levels and in different activities in a nursing home. The mean attendance at activities when refreshments were provided was compared to the mean attendance at activities when refreshments were not provided for three resident care levels. A paired-comparison t-test indicated refreshments were effective in increasing attendance at activities for residents at all competence levels. These results will be helpful to activity directors who may desire to increase attendance.
The improvement and expansion of home health care for the elderly is receiving priority attention from a variety of professions. A need exists for therapeutic recreation professionals to expand their expertise and establish services as a necessary component of comprehensive home health care for this population. The article addresses this need and provides a description of one such effort. An exemplary program entitled REACH: Recreation and Exercise Activities Conducted at Home, is presented and discussed relative to benefits received by participants, problems encountered, and programmatic implications.
This study investigated the relationship between work-related variables and perceived levels of burnout of therapeutic recreation personnel who work with long-term psychiatric patients in Veterans Administration hospitals. Subjects completed a three-part instrument composed of a demographic questionnaire, the Maslach Burnout Inventory and the Work Environment Scale. Of the 511 subjects surveyed, 287 (56%) responded with usable questionnaires. The demographic, job- and profession-related variables were found to be significantly related to burnout. The eta values were somewhat low. The WES variables accounted for 20.9% of the variance in the burnout measures. The WES variables accounted for 20.9% of the variance in the burnout measures. The most salient relationships emerged between the emotional exhaustion and the depersonalization subscales and clarity, supervisor support, involvement, work pressure, autonomy, innovation, peer cohesion, task orientation and physical comfort. In comparison with other groups of human service professionals, therapeutic recreation personnel experienced low levels of emotional exhaustion, moderate levels of depersonalization, and somewhat lower levels of personal accomplishment.
As the number of people with AIDS (PWA) continue to increase, so will the demand for therapeutic recreation professionals to design specific programs to meet these needs. After reviewing the epidemiology, transmission and spectrum of HIV infection the author describes the objectives, programs and activities of a therapeutic recreation program for PWA's sponsored by the Gay Men's Health Crisis. Marketing strategies and program plans for three core activities are highlighted: stress reduction, nutrition and volunteering.
This article describes the implications of the AIDS epidemic for therapeutic recreation practitioners in various settings. The AIDS disease spectrum, its epidemiology, transmission, and health effects are discussed in light of the attitudes, education, policy, and program issues that therapeutic recreation practitioners will confront in working with clients and staff in settings that are attempting to deal with the AIDS epidemic. Most health care professions will be challenged to address what has been viewed as history's greatest natural tragedy. Yet, only those professions which seek answers to defining and accepting their roles in dealing with the AIDS epidemic will contribute to the quality of life for persons with AIDS.
In 1983, medicare began paying general hospitals by a prospective payment system based on diagnostically-related groupings (DRGs). The majority of therapeutic recreation settings (including psychiatric hospitals, rehabilitation centers, long-term care hospitals, and children's hospitals) have been exempted. However, in 1985, a plan and subsequent decision will be made on how to integrate these settings into this new system. This article provides an historical review of the medicare program, the rationale behind this new system, the method for implementing the DRGs, and the implications and strategies for therapeutic recreation.
Increased concern for rising costs of disability-related programs, coupled with various manpower and economic projections, have resulted in major shifts in federal program priorities. The shift from institutional support to "self-help programs" mandates service providers to demonstrate the extent to which their programs promote independent living skills among the handicapped. As a result of recent and projected trends, leisure service providers must begin to articulate and justify their roles as essential to vocational training and successful placement of handicapped individuals within the community. The purpose of this article is to present a Special Adaptive Recreation Support Systems Model, which demonstrates the utilization of special recreation programs as a supportive service to educational, vocational, transitional, and community programs for the handicapped.
Therapeutic recreation is a viable rehabilitation treatment for orthopaedic disabilities. Interdisciplinary treatment teams should consider therapeutic recreation interventions using the Health Prevention/Health Promotion Model in management of orthopaedic disabilities to enhance the client's present level of functioning to optimal health.
We surveyed the opinions of 16 water quality experts in order to develop a water quality index for contact recreation in freshwaters in New Zealand. The index was developed by postal surveys using the Delphi method, involving feedback of information to the panel members at each iteration. Determinands selected for use in the index were as follows: faecal bacterial indicators (faecal coliforms or E. coli), pH, Munsell colour, visual clarity indicators (black disc visibility or turbidity), and nutrients promoting nuisance growths (filtered BOD5, and dissolved forms of phosphorus and nitrogen). "Sub-index" curves relating suitability-for-use to these water quality determinands have been developed. The mean ("consensus") sub-index curves can be used to interpret water quality data in terms of suitability-for-use scores. We advocate using the lowest suitability-for-use score for a water as its overall index value for contact recreation. Thus the water body's suitability-for-use is determined by its "poorest" characteristic. The index is now ready to be tested by water managers for its utility in state-of-environment reporting.
'GirlPower,' a participatory action research project, explored how participation in recreation might contribute to the achievement of BC's Health Goals and nurture social capital. After identifying their health issues, up to 43 young women participated in recreational activities for 10 months, gradually taking responsibility for the planning of the weekly sessions. Data collection methods included weekly participation rates, two surveys to measure self-perceptions and health habits, focus groups with participants to assess needs and as a process evaluation tool, a qualitative summative evaluation with participants, key informant interviews with staff, a journal kept by the project leader and fieldnotes of researchers' observations. Quantitative findings did not support the propositions that the project contributed to the health of participants. However, analysis of the qualitative data suggests that GirlPower participants emerged from the project with a better sense of control over their lives and feeling more connected to their community.
BACKGROUND: There have been repeated calls for research on the factors that promote the spread of successful local health promotion initiatives from one community to another. We examined the factors that affected the uptake of an initiative designed in one community to improve the health of women living below the poverty line through increased access to community recreation. METHODS: Workshops were held in three other communities and uptake efforts were tracked for one year through follow-up site visits and telephone interviews with workshop participants. RESULTS: Making the issue a priority, actively involving the women in planning, pooling resources, sharing responsibility through partnerships, and addressing the structural dimensions of poverty were factors that enabled uptake. Factors that inhibited uptake included an emphasis on revenue generation, professionally led planning, inadequate attention to structural barriers, the undervaluing of certain resources, and an over-reliance on one idea champion. CONCLUSION: A shift in how municipal recreation departments view their role as partners in community health promotion is required if programs are to promote health and be accessible to under-served populations.
Pseudomonas aeruginosa remains an important agent of opportunistic infection in patients, particularly those with respiratory complications and burns. One natural niche of this organism is water and water-associated facilities, hence the aim of this study was to examine specimens from recreational and hydrotherapy pools in Northern Ireland over a two-year period. Water specimens (n = 3,510) were obtained from three amenity categories, namely, 13 hydrotherapy pools (specimen number [n] = 323), 51 Jacuzzis/spas (n = 1,397) and 68 swimming pools (n = 1,790). Specimens (100 ml) were filtered through a cellulose acetate (0.45 micron pore size) gridded filter and the membrane was placed on Pseudomonas CFC agar (Oxoid CM559 + SR103) and incubated at 37 degrees C for 48 +/- 2 h. Colonies that clearly showed pyocyanin production or met other identification criteria were considered P. aeruginosa. Of the amenities examined 4/13 hydrotherapy pools (30.8%), 37/51 Jacuzzis/spas (72.5%) and 26/68 swimming pools (38.2%) were positive for P. aeruginosa. The most heavily contaminated amenity category was the Jacuzzi/spa, where 34.7% and 12% of private and public sites respectively were positive for P. aeruginosa at a level of greater than 1,000 cfu 100 ml-1. Approximately twice as many samples were positive in private Jacuzzis/spas compared to publicly operated facilities. There was a similar trend with respect to public and private hydrotherapy pools, though bacterial counts did not exceed 1,000 cfu 100 ml-1. Recreational and therapeutic amenities involving the use of water may be a potential source of P. aeruginosa for susceptible patient groups, including patients with cystic fibrosis and bronchiectasis. This may vary depending on amenity type and public/private ownership of such amenities.
Decay rates in coastal water and sediment for the bacterial pathogens Salmonella typhimurium and S. derby were compared in laboratory-based microcosms with results previously obtained for a number of faecal indicators. In general, the decay rates of Salmonella spp. were greater than either enterococci or coliphage in overlying water and sediment. Decay rates of E. coli were similar to Salmonella spp. in overlying water, although greater in sediment. Raised temperature resulted in an increased decay rate for all organisms in the overlying water (and to a lesser extent in the surface sediment layer). It was demonstrated that decay rates for both S. typhimurium and S. derby were greater in overlying water compared with sediment. This suggested that sediments may be acting as a reservoir for pathogenic microorganisms released into the coastal environment during recreational activity and should be considered when estimating environmental exposure. Using measured decay rates and available dose-response data, a quantitative microbial risk assessment (QMRA) utilising Monte Carlo simulation was undertaken to estimate the risk of infection to Salmonella spp. following exposure to recreational coastal water subject to a range of faecal contamination levels. In waters of extremely poor quality, subject to contamination by faecal coliforms (10(6) CFU/100 mL), the maximum probability of infection on the day of an accidental release was above 2.0 x 10(-1) and remained above 1 x 10(-3) for three days following the initial high concentration.
Participation in everyday activities is considered to be a vital part of children's development, which is related to their quality of life and future life outcomes. Research studies indicate that children with disabilities are at risk for lower participation in ordinary activities at home and in the community. This article presents a conceptual model of 11 environmental, family, and child factors that are thought to influence children's participation in recreation and leisure activities. The article outlines the existing evidence for the influence of these factors on one another and on children's participation. The review encompasses four bodies of literature: the participation of children or adults with disabilities, the risk and resilience of children facing adversity, the determinants of leisure and recreation activities, and the factors influencing physical activity and exercise. The proposed model is expected to be a useful tool for guiding future research studies and for developing policies and programs for children with disabilities and their families.
Several countries fail to systematically collect statistical data on accidents in bathing waters of recreational areas. Yet, drowning, near-drowning, head trauma and spinal chord injuries are important causes of mortality and morbidity throughout the world. In Italy, the available statistical data are circumscribed to drowning, and show that between 1969 and 1997 the mortality dropped from some 1,200 to some 500 cases/year, and its rate from 21 to 7.5 deaths per million resident/year. The mortality for drowning is much higher in males than in females, but in the period examined it halved in both the sexes. From 1969 to 1997, the mortality rates considerably decreased in all the age subgroups, but particularly in that of young people. The analysis of these data indicates that some general factors have played an important role, like a better education and information, a greater surveillance by adults and a better organisation of summer resorts. A national strategy aimed at preventing recreational accidents would provide much better results than those obtained without any planning.
Over 4000 eye injuries, including 449 blind eyes, have been reported in sports and recreational activities in Canada over the past 20 years. This is not only a great personal loss but also a financial loss, both to the injured person and to the community. Statistics should be tabulated on catastrophic injuries that leave the person with a physical or mental deficit, such as a blind eye, and efforts should be directed toward preventing such injuries. Changing and enforcing game rules and providing proper eye protection has proved very beneficial in Canadian hockey, racket sports and war games. Educational programs supported by the media and government that alert players to the need for eye protection are required. Such measures may lead to the prevention of up to 90% of injuries in sports and recreational activities in Canada.
BACKGROUND: Severe decompression illness (DCI) could be more likely in cigarette smokers because of airway obstruction or vascular disease. The present study evaluated the severity of DCI as a function of cigarette smoking in recreational divers. METHODS: We examined all DCI reports recorded in the Divers Alert Network (DAN) database from 1989 through 1997. Smoking history was quantified as heavy (>15 pack-years), light (0 to 15 pack-years), and never smoked. DCI symptoms were classified as severe (alteration in consciousness, balance or bladder/bowel control, motor weakness, visual symptoms, convulsions), moderate (other neurological symptoms), or mild (pain, skin, or nonspecific symptoms). The proportional odds model and generalized logits were used for the adjusted analysis when accounting for other covariates. RESULTS: There were 4,350 patients included in the analysis. After adjustment for confounding variables, heavy smokers were more likely to have severe vs. mild symptoms than nonsmokers (OR = 1.88) (95% CI 1.36, 2.60) or light smokers (OR = 1.56) (95% CI 1.09, 2.23). Heavy smokers and light smokers were more likely to have severe vs. moderate symptoms than nonsmokers (OR = 1.36) (95% CI 1.06, 1.74) and (1.22) (1.02, 1.46), respectively. Although these data do not reveal whether smoking predisposes to DCI, the results are consistent with a tendency, when DCI occurs, for cigarette smoking to trigger more severe symptoms. CONCLUSIONS: The data suggest that when DCI occurs in recreational divers, smoking is a risk factor for increased severity of symptoms.