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Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy.

Physical activity has been associated with a reduced risk of gestational diabetes mellitus, but inferences have been hampered by recall and selection bias. The authors examined the relation between recreational physical activity before and during pregnancy and risk of gestational diabetes mellitus in a prospective cohort study. In 1996-2000, 909 normotensive, nondiabetic women in Seattle and Tacoma, Washington, were questioned during early gestation about physical activity performed during the year before and 7 days prior to the interview during pregnancy. Compared with inactive women, women who participated in any physical activity during the year before experienced a 56% risk reduction (relative risk (RR) = 0.44, 95% confidence interval (CI): 0.21, 0.91). Women spending >/=4.2 hours/week engaged in physical activity experienced a 76% reduction in gestational diabetes mellitus risk (RR = 0.24, 95% CI: 0.10, 0.64), and those expending >/=21.1 metabolic equivalent-hours/week experienced a 74% reduction (RR = 0.26, 95% CI: 0.10, 0.65) compared with inactive women. Physical activity during pregnancy was also associated with reductions in gestational diabetes mellitus risk. Women who engaged in physical activity during both time periods experienced a 69% reduced risk (RR = 0.31, 95% CI: 0.12, 0.79). Findings suggest that efforts to increase maternal physical activity may contribute to substantial reductions in gestational diabetes mellitus risk.

Adult↗

Relation between maternal recreational physical activity and plasma lipids in early pregnancy.

The authors examined the relation between recreational physical activity and plasma lipid concentrations in early pregnancy. Between 1996 and 2000, 925 normotensive, nondiabetic pregnant women in Washington State were interviewed at approximately 13 weeks' gestation regarding type, frequency, and duration of physical activity during the previous 7 days. Plasma triglyceride, total cholesterol, and high density lipoprotein cholesterol concentrations were measured in contemporaneous blood samples. After adjustment, mean triglyceride concentration was 12.7 mg/dl lower in women performing any physical activity versus none (95% confidence interval (CI): -22.7, -2.6). Mean triglyceride concentration was lower in women in the highest tertiles of time performing physical activity (-23.6 mg/dl, 95% CI: -34.9, -12.2), energy expenditure (-23.6 mg/dl, 95% CI: -35.1, -12.2), and peak intensity (-18.1 mg/dl, 95% CI: -29.5, -6.8) versus inactive women. Reductions in mean total cholesterol were also observed for women with the highest levels of time performing physical activity, energy expenditure, and peak intensity. Linear relations were observed across levels of physical activity measures for triglyceride and total cholesterol. No association was found between physical activity and high density lipoprotein cholesterol. These data suggest that habitual physical activity may attenuate pregnancy-associated dyslipidemia.

Adult↗

Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women.

Factors that influence circulating sex hormones, such as physical activity, have been proposed to influence ovarian cancer risk; however, results from previous epidemiologic studies have been inconsistent. The authors examined the association among physical activity, sedentary behavior, and ovarian cancer risk in the American Cancer Society Cancer Prevention Study II Nutrition Cohort, a prospective study of cancer incidence and mortality, using information obtained at baseline in 1992. From 1992 to 2001, 314 incident ovarian cancer cases were identified among 59,695 postmenopausal women who were cancer free at enrollment. Cox proportional hazards modeling was used to compute hazard rate ratios while adjusting for potential confounders. No overall association was observed between measures of past physical activity or with recreational physical activity at baseline and risk of ovarian cancer in this study (for the highest category of physical activity compared with none: hazard rate ratio = 0.73, 95% confidence interval: 0.40, 1.34). However, a prolonged duration of sedentary behavior was associated with an increased risk (for > or = 6 vs. < 3 hours per day: hazard rate ratio = 1.55, 95% confidence interval: 1.08, 2.22; p(trend) = 0.01). Results from this study suggest that high levels of sedentary behavior may increase the risk of ovarian cancer, but they do not support a major impact of light and moderate physical activity on ovarian cancer risk.

Aged↗

Maternal recreational physical activity is associated with plasma leptin concentrations in early pregnancy.

BACKGROUND: A limited amount of literature suggests that plasma leptin concentrations are reduced with habitual physical activity in men and non-pregnant women. We investigated the relationship between maternal physical activity and plasma leptin during early pregnancy. METHODS: The study population included 879 normotensive, non-diabetic pregnant women who reported physical activity type, frequency, and duration in early pregnancy. Plasma leptin, measured in blood samples collected <16 weeks gestation, were determined using enzyme immunoassays. Weekly duration (h/week) and energy expended on recreational physical activity [metabolic equivalent score (MET)-h/week] were categorized by tertiles among active women. Physical activity intensity was categorized as none, moderate (<6 MET) and vigorous (> or =6 MET). Differences in leptin concentrations across categories were estimated using linear regression procedures. RESULTS: Mean leptin was 5.8 ng/ml lower among active versus inactive women (P=0.001). Mean leptin was lower among women in the highest levels (>12.8 h/week) of time performing physical activity (-8.1 ng/ml, P<0.001) and energy expenditure (>70.4 MET-h/week) (-8.3 ng/ml, P=0.001) compared with inactive women. Leptin was inversely associated with the intensity of physical activity. CONCLUSIONS: Our findings are consistent with other reports suggesting an independent inverse relationship between habitual physical activity and leptin concentrations. Our findings extend the literature to include pregnant women.

Adult↗

The recreational pursuits of mentally handicapped adults.

The parents or care-givers of over 200 mentally handicapped adults, living at home in the city of Dublin, were interviewed as to how their son or daughter spent their leisure time. The picture that emerged was of a sheltered existence within the community. Mostly their activities were passive and solitary in nature - watching T. V.; listening to radio or records. Nearly half of the sample did not take part in any activity outside of the family; only one third took part in the community activity and only one fifth were reported to have non-handicapped friends. It would appear that parents are willing for this to continue, in that they had few suggestions for new activities; they felt their son or daughter was not interested and most thought that recreational activities should be supervised. It is argued that services should teach leisure skills in the same systematic and structured way as for other areas of the curriculum. This should reassure parents and help to ensure that mentally handicapped people not only live in the community but that they can participate in community activities.

Adolescent↗

Case-control study of lifetime occupational and recreational physical activity and risks of colon and rectal cancer.

Important aspects of the inverse relation between physical activity and colon cancer risk are still under discussion. In 2000-2003, 239 incident cases of colorectal cancer confirmed by histopathology and 239 hospital-based controls, matched by age and gender, were enrolled. In standardized interviews, data on occupational and recreational physical activity for ages 20, 30, 40, 50 and 60 years were collected from 98 colon cancer cases, 141 rectal cancer cases, and from 193 controls. Besides lifestyle and sociodemographic characteristics, a detailed food frequency questionnaire was assessed. In multivariate logistic regression for colon cancer, significant risk reductions for the highest quartile of total physical activity were found for almost all ages. For lifetime mean physical activity, the multivariate odds ratio for the highest quartile was 0.37 [95% confidence interval (CI) 0.17, 0.83]. For lifelong constantly high-exercisers compared with lifelong non-exercisers an odds ratio of 0.26 (95% CI 0.08, 0.84) was estimated. For rectal cancer, no consistent association with physical activity was found. No confounding effects were observed but the authors found effect modification with total energy intake. These data support an inverse association of colon cancer risk and physical activity which is most expressed if activity is kept up throughout life.

Adult↗

Sport and recreation-related head injuries treated in the emergency department.

OBJECTIVE: Head injury (HI) in sport is common and can have serious consequences. This study examines the epidemiology of sport/recreational (SR)-related HI presenting to the emergency department (ED). DESIGN: Retrospective review of medical records. SETTING: Five EDs in the Capital Health Region (Edmonton) located in the province of Alberta, Canada. PATIENTS: All persons in a 1-year period reporting to the EDs with an HI. HI was defined as IC9-CM coded skull fracture, loss of consciousness, or concussion. MAIN OUTCOME MEASURES: Hospitalization, utilization of diagnostic testing, and discharge destination. RESULTS: In total, 10,877 (3%) of 288,948 ED encounters were for sports and recreational injuries; 358 (3%) were for HI. Males (71%) were more frequently injured; patients < 20 years old were involved in 66% of all HI cases. The highest proportion of HI occurred during ice hockey (21%), cycling (13%), and playground-related activities (8%). 9% of HI were hospitalized (versus 4% admission rate for other SR injuries: p < 0.01). CONCLUSIONS: These results demonstrate the utility of an ED-based injury registry and indicate that patients with HI presenting to the ED from SR activities are common. These injuries appear to be more severe than other types of SR injuries treated in the ED.

Adolescent↗

Reducing illness transmission from disinfected recreational water venues: swimming, diarrhea and the emergence of a new public health concern.

Recreational water-related illnesses are associated with swimming in contaminated water venues. The transmission of diarrheal illness in disinfected settings is influenced by several factors which include: chlorine resistance in waterborne pathogens; poor facility maintenance of disinfectant levels; and lack of healthy swimming habits. Health care providers can help to disseminate healthy swimming messages to their patients and help to prevent and control this emerging public health concern.

Adolescent↗

Efficacy of recreational and occupational activities associated to psychologic support in mild to moderate Alzheimer disease: a multicenter controlled study.

We evaluated the efficacy of a stimulation program mainly based on recreational and occupational activities, associated with a brief cycle of support psychotherapy for patients and caregivers, in mild to moderate Alzheimer Disease (AD) associated or not with cerebrovascular lesions. Sixty-seven patients and 31 controls from 2 Italian towns entered the study. The control group was comprised of AD subjects who voluntarily declined to participate in the program for practical reasons. Patients were divided in groups of 4 subjects: treatment was delivered for 6 weeks. Multidimensional efficacy assessment of functional, behavioral, and neuropsychologic aspects was performed. When comparing baseline with posttraining condition, patients displayed a substantial reduction in disruptive behavior, and a tendency to a general reduction of behavioral symptoms compared with controls (Revised Memory and Behavior Problems Checklist--RMBPC--symptoms frequency-total P=0.07; frequency of disruptive behavior P=0.008). This reduction was mirrored by a significant reduction of caregiver reaction to behavioral disturbances (RMBPC caregiver reaction-total P=0.035; reaction to disruptive behavior, P=0.011). At 3 months follow-up, the reduction of caregiver reaction to behavioral symptoms results was confirmed (RMBPC caregiver reaction-total P=0.014, caregiver reaction to disruptive behavior P=0.028). No other significant difference was detected. These results partially confirm findings of previous studies, showing that AD patients treated with similar techniques demonstrated an improvement in behavioral disturbances.

Alzheimer Disease↗

A condition for designing bus-route type access site surveys to estimate recreational fishing effort.

A theoretical framework for using bus-route surveys to estimate recreational fishing effort has been established by taking into account the arrival and departure distributions of the fishing parties. Properties of a fishing effort estimator proposed by Robson and Jones (1989) are investigated. It is found that the estimator is not automatically unbiased; rather, a condition on the survey design has to be satisfied in order to be unbiased. The condition is simple and can be easily implemented.

Animals↗

Incorporation of recreational fishing effort into design of marine protected areas.

Theoretical models of marine protected areas (MPAs) that explore benefits to fisheries or biodiversity conservation often assume a dynamic pool of fishing effort. For instance, effort is homogenously distributed over areas from which subsets of reserves are chosen. I tested this and other model assumptions with a case study of the multiple-use Jervis Bay Marine Park. Prior to zoning of the park I conducted 166 surveys of the park's recreational fisheries, plotting the location of 16,009 anglers. I converted these plots into diagrams of fishing effort and analyzed correlates between fishing and habitat and the effect of two reserve designs-the draft and final zoning plans of the park-on the 15 fisheries observed. Fisheries were strongly correlated with particular habitats and had negatively skewed and often bimodal spatial distribution. The second mode of intensely fished habitat could be 6 SD greater than the fishery's mean allocation of effort by area. In the draft-zoning plan, sanctuary zone (no-take) area and potential subduction of fishing effort were similar. In the final plan, which was altered in response to public comment, the area of sanctuary zone increased, and the impact on fishing effort decreased. In only one case was a fishery's most intensely targeted location closed to fishing. Because of the discriminating manner with which fishers target habitats, if simple percentage targets are used for planning, sanctuary location can be adjusted to avoid existing fishing effort. According to modeled outcomes, the implication of this may be diminished reserve effectiveness. To address this, reserve area should be implicitly linked to subducted fishing effort when promoting or modeling MPAs.

Conservation of Natural Resources↗

Aircraft noise annoyance in recreational areas after changes in noise exposure: comments on Krog and Engdahl (2004).

When Gardermoen replaced Fornebu as the main airport for Oslo, aircraft noise levels increased in recreational areas near Gardermoen and decreased in areas near Fornebu. Krog and Engdahl [J. Acoust. Soc. Am. 116, 323-333 (2004)] estimate that recreationists' annoyance from aircraft noise in these areas changed more than would be anticipated from the actual noise changes. However, the sizes of their estimated "situation" effects are not credible. One possible reason for the anomalous results is that standard regression assumptions become violated when motivational factors are inserted into the regression model. Standardized regression coefficients (beta values) should also not be utilized for comparisons across equations.

Aircraft↗

Chrysotile asbestos in a California recreational area.

Dustfall along roads and trails being used recreationally in the Clear Creek area of San Benito County, California, located in the New Idria serpentinite, was found to be 90 percent or more chrysotile asbestos. Personal samplers worn by motorcyclists using one of the trails showed concentrations of airborne fibers ranging from 0.3 to 5.3 fibers per milliliter, according to methods prescribed for monitoring occupational exposures. The present workplace standard for brief exposures to asbestos is 10 fibers per milliliter; 5 fibers per milliliter is the proposed standard. The average total dust concentration estimated from personal samplers was approximately 20 milligrams per cubic meter of roughly 90 percent chrysotile. To our knowledge, this is the first demonstration of asbestos exposures of this magnitude, in size ranges known to be pathogenic, resulting from natural deposits not associated with mining, milling, or industrial use.

Air Pollutants↗

A virulence and antimicrobial resistance DNA microarray detects a high frequency of virulence genes in Escherichia coli isolates from Great Lakes recreational waters.

Escherichia coli is generally described as a commensal species with occasional pathogenic strains. Due to technological limitations, there is currently little information concerning the prevalence of pathogenic E. coli strains in the environment. For the first time, using a DNA microarray capable of detecting all currently described virulence genes and commonly found antimicrobial resistance genes, a survey of environmental E. coli isolates from recreational waters was carried out. A high proportion (29%) of 308 isolates from a beach site in the Great Lakes carried a pathotype set of virulence-related genes, and 14% carried antimicrobial resistance genes, findings consistent with a potential risk for public health. The results also showed that another 8% of the isolates had unusual virulence gene combinations that would be missed by conventional screening. This new application of a DNA microarray to environmental waters will likely have an important impact on public health, epidemiology, and microbial ecology in the future.

Anti-Bacterial Agents↗

Incidence of serious injury and death during sport and recreation activities in Victoria, Australia.

BACKGROUND: Participation in sport and recreation is widely encouraged for general good health and the prevention of some non-communicable diseases. However, injury is a significant barrier to participation, and safety concerns are a factor in the decision to participate. An understanding of the sport/recreation activities associated with serious injury is useful for informing physical activity choices and for setting priorities for the targeting of injury prevention efforts. OBJECTIVES: To describe the epidemiology of serious injuries sustained in sport/recreation activities by adults in Victoria, Australia. METHODS: The Victorian State Trauma Registry and the National Coroner's Information Service were used to identify and describe sport/recreation related serious injuries, including deaths, occurring during the period July 2001 to June 2003. Age adjusted rates of serious injury and death were calculated using participation figures for each sport and general population data. RESULTS: There were 150 cases of serious injury and 48 deaths. The rates of serious injury and death were 1.8 and 0.6 per 100,000 participants per year respectively. Motor, power boat, and equestrian sports had the highest rates of serious injury. Most deaths were due to drowning. CONCLUSION: Although the risk of serious injury through sport/recreation participation is low, motor, power boat, and equestrian sports should be priorities for further research into injury prevention. Most sport/recreation related deaths are due to drowning, highlighting this area for prevention efforts.

Adolescent↗

Improving recreational, residential, and vocational outcomes for patients with schizophrenia.

As Roder and colleagues propose, we have seen three eras in the development and refinement of social skills training for individuals with schizophrenia. In the 1960s, skills training relied on the use of operant conditioning, as exemplified by the token economy. Reinforcement contingencies succeeded in activating patients with negative symptoms and in improving their social behavior. Contemporary psychiatric rehabilitation can profit from the identification and use of reinforcers to motivate anergic individuals who lack insight to participate actively in community-based programs. During the second era, in the 1970s, social learning through modeling, coaching, role playing, and behavioral assignments was introduced into skills training. These techniques were used to improve nonverbal skills, such as eye contact, fluency of speech, gestures, and facial expression, as well as conversational skills, assertiveness, and emotional expressiveness. Intervention programs of the third and current era are incorporating cognitive methods into the skills training enterprise. For example, in the modules for training social and independent living skills developed and validated by Liberman and his colleagues at the University of California at Los Angeles (1), the deficits in attention, memory, and verbal learning often experienced by persons with schizophrenia are overcome by repetition, shaping of incremental behavioral improvements, video modeling, and feedback for galvanizing attention. Procedural learning techniques that do not rely on the brain capacities that mediate verbal awareness and insight are also used. In this month's Rehab Rounds column, Roder and his colleagues present another example of a skills training approach of the third era that includes elements of cognitive remediation. As autonomous offsprings of integrated psychological therapy (IPT), which was originally developed by Hans Brenner and Volker Roder and their colleagues at the University of Bern in Switzerland (2), the new programs address deficits in the residential, vocational, and recreational domains of community functioning. Overall, social skills training has been shown to be effective in the acquisition and maintenance of skills and their transfer to community life. Moreover, evidence is accumulating that structured and systematic skills training is more effective than other psychosocial treatments with which it has been compared, such as supportive group therapy and expressive modes of occupational therapy.

Activities of Daily Living↗

Young children in recreational sports. Participation motivation.

More than 20 million children between ages 6 and 16 years participate in nonschool sports programs, with increasingly more programs being established for younger-age children. A questionnaire based on previous research with adolescent athletes was developed to determine participation motivation of 6- to 10-year-old children. Three hundred fourteen boys participating in a basketball program were interviewed privately with this instrument. Of the 12 participation motivation items, "learn to do my best," "learn and improve skills," "have a coach to look up to," and "get stronger and healthier" were most highly rated, whereas "win games" and "become popular" were rated least important. When responses of 6 and 7 year olds were compared with those of 9 and 10 year olds, older children rated "feel part of a team", "have fun and excitement" and "be with and make new friends" higher at a statistically significant level (p less than 0.05). Older children rated "win games" and "become popular" lower at a statistically significant level (p less than 0.05). The authors conclude that young children in this recreational sports program make significant distinctions in their participation motivation and that some aspects of participation that motivate them change as they grow older.

Aging↗