The Donwood Institute: resort of last resort.
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Alcoholism↗
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Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise.
Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.
Activities of Daily Living↗
A case study in resort climatology of Phoenix, Arizona, USA.
Tourists often use weather data as a factor for determining vacation timing and location. Accuracy and perceptions of weather information may impact these decisions. This study: (a) examines air temperature and dew points from seven exclusive resorts in the Phoenix metropolitan area and compares them with official National Weather Service data for the same period, and (b) utilizes a comfort model called OUTCOMES-OUTdoor COMfort Expert System-in a seasonal appraisal of two resorts, one mesic and one xeric, compared with the urban Sky Harbor International Airport first-order weather station site in the central urban area of Phoenix, Arizona, USA (lat. 33.43 degrees N; long. 112.02 degrees W; elevation at 335 m). Temperature and humidity recording devices were placed within or immediately adjacent to common-use areas of the resorts, the prime recreational sites used by guests on most resort properties. Recorded data were compared with that of the official weather information from the airport station, a station most accessible to potential tourists through media and Web sites, to assess predicted weather for vacation planning. For the most part, Sky Harbor's recorded air temperatures and often dew points were higher than those recorded at the resorts. We extrapolate our findings to a year-round estimate of human outdoor comfort for weather-station sites typical of resort landscapes and the Sky Harbor location using the OUTCOMES model to refine ideas on timing of comfortable conditions at resorts on a diurnal and seasonal basis.
Arizona↗
Seasonal changes in poisoning exposures reported to a regional poison center from coastal resort areas.
This study examined the role of seasonality in the reporting of poisoning exposures from geographically distinct regions, specifically from coastal resort and vacation areas. The monthly distribution of calls received by a regional poison control center from counties with popular beach and vacation resorts was compared with the monthly distribution of the overall calls to the center. A chi-square goodness-of-fit test was used to determine if there was a significant difference between the monthly distribution of calls received from the resort counties and the overall calls received by the poison center. Further, exposure and information calls from the resort counties were separately examined to determine if they were equally distributed between months. The monthly distribution of calls received from coastal resort counties was significantly different from the monthly distribution of overall calls received by the center. Significantly more calls were received from the resort counties during the months of July and August at the height of the vacation season. While there was no seasonal variation in the number of information calls from these counties, the poisoning exposure calls were not equally distributed between months, as there were more such calls during the months of July and August. Seasonality appears to play a role in the number of calls received by a regional poison center from coastal areas with popular beach resorts. Poisoning exposure calls seem to increase particularly during the months of July and August. A greater effort may have to be put into activities related to poison control and prevention into such areas during the vacation season.
Epidemiologic Studies↗
A descriptive analysis of HIV risk behavior among men having sex with men attending a large sex resort.
This study assessed the prevalence of various HIV-associated risk behaviors among men who have sex with men (MSM) attending a popular sex resort in the southern United States. One hundred fifty men completed an anonymous self-administered questionnaire (91% response rate). Men currently resided in 14 states. One sixth reported being HIV-positive. During a typical resort visit, men averaged 4 sex partners. About two thirds of the men had anal sex during a typical resort stay; of these, 21% reported never using condoms and 41% reported always using condoms. HIV risk behavior over the past few months was also assessed. Men averaged 10 sex partners. Meeting partners by means of the Internet (57%) and bathhouses--excluding sex resorts--(40%) was common. Most men (62%) reported having group sex. About one half (49%) engaged in unprotected anal sex. Significant differences in recent frequency of unprotected anal sex between HIV-positive and HIV-negative men were not found (P = 0.74). Among those using condoms, 20% reported not using condoms from start to finish of sex, 7% reported breakage, and 6% reported slippage. Twenty-three percent had anal sex without lubrication. Fisting and the use of nonprescription sildenafil citrate (Viagra) was reported by about one sixth of the men. The findings suggest that MSM attending sex resorts may experience substantial risk of HIV infection. Sex resorts may be an important venue for HIV prevention.
Condoms↗
[Mental health among elderly relocated to a rural resort area].
OBJECTIVE: This study examined mental health and its related factors comparing elderly relocated to a rural resort area to elderly living in a rural old area. METHODS: Each sample of 400 aged 65 and over were randomly obtained. Valid responses obtained from the resort area and the old area were 193 and 242 respectively. Mental health was measured from two aspects: Geriatric Depression Scale (GDS) and Life Satisfaction Index A (LSIA). We used self-evaluated living environment, social support, social activities, Activities of Daily Living (ADL), economic status, decision to move, and reason for move (push- and pull-factor), as factors which seem to be related to mental health. RESULTS: The findings were as follows: 1) Respondents in the resort area showed lower GDS and higher LSIA than respondents in the old area. 2) Although for the respondents in the resort area assessment that their community was safe, participation in community groups, or involvement in recreational activities occupied a significant higher level in their mental health, these factors had no significant impact on the mental health among the respondents in the old area. 3) A difference in self-evaluated housing condition, ADL, and economic status between both groups had a cause for the area differences in mental health among the elderly. 4) Push-factor had both a direct effect and an indirect effect mediated by decision to move on GDS. Pull-factor had both a direct and an indirect effect on LSIA. CONCLUSION: Elderly relocated to a rural resort area had better mental health than elderly living in an old area, partly because they had better physical health, better economic status, and better housing condition. Self evaluated living environment and social activities were related to the mental health of the elderly in the resort area stronger than that of the elderly in the old area. Reason for move was related to the mental health of the elderly both directly and indirectly mediated by decision to move.
Aged↗
[Industrial waste as indicator of population size: possible utilization in mountain resort tourist stations?].
BACKGROUND: Epidemiological studies, conducted in touristic resorts, often face the difficulty of assessing the size of the referent population. Recently, some population size indicators, have been tested. Among them, the amount of municipal waste seems to be easy and readily accessible. The purpose of the study is to describe how this indicator can be used in touristic mountain resorts. METHODS: Four touristic resorts were chosen in Isère departement (France): Alpe d'Huez, Deux Alpes, Chamrousse, plateau du Vercors. The evolution of municipal waste over several years was used to compute an individual output level for residents and for tourists. This waste indicator was compared with data on tourists reservations in hotels in the resorts. RESULTS: We found a good fit during touristic seasons in three resorts (Spearman test). For the last one (Chamrousse), the correlation rate was low. We think that the type of tourism is different in this resort with many non residents. CONCLUSIONS: This indicator is reliable but needs further validation by sample surveys across several sites and several types of lodging. We propose to estimate the size of the referent population, based on an individual output of 1 kg per person and per day for residents and 0.5 kg per person per day for tourists.
France↗
Sexual risk behavior of men who have sex with men: comparison of behavior at home and at a gay resort.
This study compared sexual behavior of gay and bisexual men (N = 551) while at their primary residence to their behavior while vacationing at a gay resort community. Participants reported behavior for the days they spent in the resort and for their last 60 days in their home residences. Overall, 11 times more non-main partners were reported for unprotected anal intercourse (UAI) per day while in the resort as for the "at home" period. Regression analysis identified negative attitudes toward condoms, less concern about AIDS, and daily number of non-main, male partners at home with whom UAI occurred as significant predictors of the daily number of non-main male partners with whom holidaymakers engaged in UAI while in the resort area. The results suggest that sexual risk taking by men who have sex with men (MSM) while on holiday may be elevated over that at home and that prevention efforts need to be promoted in gay resorts. Behavioral surveillance research would be helpful in better characterizing the current social contexts of sexual risk taking by MSM. Theory-based studies of the nature of risk-taking and sexual decision-making on "gay holiday" could inform the development of empirically proven and conceptually grounded interventions.
Adult↗
Helmet availability at skiing and snowboarding rental shops. a survey of Colorado ski resort rental practices.
BACKGROUND: Many studies have determined that head injuries are serious and potentially life threatening in skiers and snowboarders. Helmets have proven to be effective in reducing the risk of head and brain injury in blunt trauma from bicycling, climbing, skiing, and snowboarding. The objective of this study was to evaluate the availability, cost, and prevelance of helmet rental to skiers and snowboarders at Colorado ski resorts. METHODS: A survey of rental shops based at Colorado ski areas was conducted during the 1998-1999 ski season. Surveys were mailed to 27 Colorado ski areas. The establishments surveyed were skiing/snowboarding rental shops owned, operated, or both by the resorts based at respective mountains. RESULTS: Nineteen of 26 responding Colorado ski resorts rented helmets, and helmet rental has been increasing in popularity. However, helmets were not considered as part of the standard rental package by any of the resorts, and only one resort offered a discount on helmet rental with a package. While 2% to 38% of skiers/snowboarders rented equipment, less than 1% to 8.6% of renters rented helmets. Subjectively, helmet rental was encouraged mostly for children. CONCLUSIONS: The data acquired should represent a reasonable picture of current helmet rental practices at Colorado ski areas. While helmet use is increasing, it has not yet become generally accepted.
Adolescent↗
Shigellosis at a Caribbean resort. Hamburger and North American origin as risk factors.
During a three-week period in 1984, 339 tourists and expatriate employees with diarrhea visited the infirmary at a Caribbean resort club. Epidemiologic studies suggested that over 60% of the 1,893 tourists at the resort club during that time may have been ill. Shigella flexneri 4a was isolated from seven of 18 stool specimens. A few cases of diarrheal illness occurred at the resort club before the onset of the outbreak, which was temporally related to illness in a butcher. North American residence, eating raw or very rare hamburger, having a roommate who was ill and younger age were significantly associated with acquiring disease. Control measures, principally elimination of ill food handlers from the kitchens, were followed by a prompt and marked reduction in new cases. Isolated resorts pose problems in disease control similar to those on cruise ships, with hundreds of foods available, large numbers of short-stay visitors with few outside exposures, and many food handlers in whom pathogens can persist between groups of visitors. Resort clubs can reduce the risk of traveler's diarrhea, without using mass prophylaxis against pathogenic bacteria, by appropriate handling and preparation of food and by surveillance for diarrheal illnesses.
Adult↗
[Health resort treatment of preschool children with cerebral palsy].
In the Pyatigorsk resort, 226 children from 3-7 years of age with different forms of cerebral paralysis were studied. For therapeutic purposes, besides general health improvement measures, remedial gymnastic and massage, such resort factors as carbon dioxide and sulfurated hydrogen and radon baths of different concentrations and mud procedures were used. As a result of such studies, some indications for referrals of preschool children with cerebral paralysis to balneomud resorts were outlined. Differentiated complexes of resort treatment, depending upon the form and severity of clinical sings were elaborated, as well as the possibility of resort therapy in children with cerebral paralysis, complicated by the intracranial hypertensive syndrome.
Baths↗
Waterborne outbreak of Norwalk virus gastroenteritis at a southwest US resort: role of geological formations in contamination of well water.
From April 17 to May 1, 1989, gastroenteritis developed in about 900 people during a visit to a new resort in Arizona, USA. Of 240 guests surveyed, 110 had a gastrointestinal illness that was significantly associated with the drinking of tap water from the resort's well (relative risk = 16.1, 95% confidence interval 14.5 to 17.8) and this risk increased significantly with the number of glasses of water consumed (p less than 0.005). Three of seven paired sera tested for antibodies to the Norwalk agent had a four-fold or greater rise in titre. Water contaminated with faecal coliforms was traced back to the deep water well, which remained contaminated even after prolonged pumping. Effluent from the resort's sewage treatment facility seeped through fractures in the subsurface rock (with little filtration) directly into the resort's deep well. Although the latest technology was used to design the resort's water and sewage treatment plants, the region's unique geological conditions posed unexpected problems that may trouble developers faced with similar subsurface geological formations and arid climatic conditions in many parts of the world. In these areas, novel solutions are needed to provide adequate facilities for the treatment of sewage and supply of pure drinking water.
Cohort Studies↗
The role of an international nightlife resort in the proliferation of recreational drugs.
AIMS: The study compares types, frequencies and quantities of substances used by young people while holidaying in the international dance resort of Ibiza (Spain) with their patterns of use in the United Kingdom. It measures changes in substance use at both locations between 1999 and 2002 and examines the role of dance resorts in recruiting individuals into using new substances. DESIGN: Data were collected from visitors to Ibiza in 1999 (n = 846) and 2002 (n = 868). Information on drug use was surveyed through a short anonymous questionnaire. SETTING: Individuals were sampled at Ibiza airport just prior to returning to the UK. FINDINGS: Most individuals visiting Ibiza used illicit drugs in the United Kingdom (57.4% in 2002), with nearly all users continuing to use in Ibiza. Use of most drugs in Ibiza was characterized by binge behaviour, with many individuals using drugs 5 or more nights per week. Proportions using cocaine, ecstasy and GHB have risen significantly (1999-2002) in both locations, as have numbers of ecstasy tablets taken on a usual night. Substance use was associated positively with number of previous visits to Ibiza and new users were recruited into use while abroad (17.4 and 33.1 per 1000 people were introduced to cocaine and ecstasy use, respectively, in Ibiza). CONCLUSIONS: The emergence of international nightlife resorts increasingly links drug use abroad with that in individuals' countries of origin. Our results indicate that resorts such as Ibiza offer tourists the opportunity to increase levels of drug consumption and try different substances in an atmosphere conducive to experimentation. Patterns of recreational drug use in leading international resorts may help predict developments in drug use elsewhere and as such be an important tool in planning appropriate interventions.
Adolescent↗
Wastewater reclamation for use in snow-making within an alpine resort in Australia--resource rather than waste.
The Mt Buller Alpine Resort is located approximately 200 km north of Melbourne, in Victoria, Australia. A wastewater treatment plant services the resort and currently treats to advanced nutrient removal standards. The treated effluent is presently discharged into the Howqua River. Most Australian ski resorts are not blessed with abundant snow cover on a regular basis. Artificial snow allows most of the popular ski runs to operate for the whole of the season. At the Mt Buller resort, snow-making is presently limited by lack of water supply in the catchment. The conditions at Mt Buller resort present a unique opportunity to utilise reclaimed wastewater to allow increased snow-making capacity. It is one of the unique opportunities where the wastewater is valued as a resource rather than merely viewed as a waste problem. Wastewater reclamation for snow-making will require additional treatment for pathogen removal. It is proposed that following advanced nutrient removal, the effluent will require further treatment, including membrane ultrafiltration, so as to ensure a minimum of four barriers for pathogen removal. Pilot plant operation of a membrane ultrafiltration system commenced in June 2000 and will continue until the end of 2001, to primarily demonstrate the extent of pathogen removal.
Australia↗
The role and effects of sanatoriums and health resorts in the Russian Federation.
There is a unique system of sanatoriums and health resorts in the Russian Federation that is not so well known outside the country. These facilities are used for prophylactic treatment of the working population, but they are not part of the health care system. As a result of the historical development, the sanatoriums and health resorts are instead a responsibility of the Russian system of social insurance. Based on three different empirical studies and a review of research in the field, this article describes the development of sanatoriums and health resorts, the different prophylactic treatments they provide, the medical and economic effects of their treatments, and the role of these facilities in the Russian society. The conclusion is that this system of sanatoriums and health resorts seems to be beneficial, both for the people and for the national economy, but there are a number of issues that have to be addressed if the system shall be able to survive in the present economic situation.
Health Resorts↗
[Evaluation of air hygiene in health resorts].
Concerning the maintenance and restoration of health in patients being subjected to health resort treatment, the spas play an important role. Therefore, legal provisions in this field establish the elimination of unfavourable environmental conditions, as air pollution, for instance. The geographical situation of a health resort exercises influences on its air quality considered in terms of hygiene. This is linked with different atmospheric and bioclimatic conditions in various regions. The major source of air pollution in a health resort is represented by housing and the communal area, by traffic on the roads and partly by industry. Instructions for measuring and evaluating of pollutants are given. Furthermore, various possibilities for improving the air quality in health resorts are mentioned.
Air Pollutants↗
[Means for increasing the effectiveness of rehabilitation at the sanatorium-health resort stage in nonspecific lung diseases among the inhabitants of southwestern Siberia].
Rehabilitation of patients with nonspecific pulmonary diseases in the "Barnaulsky" sanatorium (521 patients) resulted in a 3.5-fold decrease in the number of cases of exacerbation during one year after treatment, the duration of temporary disability was decreased 2.7-fold; these indices for the Belokurikha health resort (346 patients) were 3.2- and 6-fold, respectively; for prophylactic sanatoria at factories (709 patients)--3.3- and 3-fold; for a Crimean health resort in Yalta (266 patients)--3.2- and 2.5-fold. After rehabilitation in sanatoria dysadaptation reactions were noted in 69% of the patients treated in the contrast climatic area and in 16% of the patients treated in local sanatoria. Rehabilitation efficacy in patients with dysadaptation was twice less. Dysadaptation reaction prophylaxis raised 2-fold the efficacy of treatment in sanatoria. The development of specialized pulmonologocal care of patients with nonspecific pulmonary diseases in local Siberian sanatoria and health resorts and the development of problems related to the etiology, pathogenesis and prophylaxis of dysadaptation reactions in patients during treatment in contrast climatic health resort areas hold great promise for raising the efficacy of rehabilitation of patients residing in the South of West Siberia.
Adaptation, Physiological↗
[Basic principles of health resort treatment of children with sequelae in nervous system diseases].
As a result of many-year studies of the effectiveness of using health resort factors for treating children with various nervous system diseases basic principles of that treatment have been determined. A particular importance is attached to combined application of different health resort factors with consideration for the specificity of their therapeutic action and the peculiarities of the disease. The scope of the therapeutic measures should be dynamic in character and dose, so as to preserve the effect of each principal therapeutic factor on the patient's body. Attention is paid to the necessity of careful selection of patients for the health resort treatment, as well as to he therapeutic strategy in subsequent periods. Data on the effectiveness of treating various groups of patients at health resorts are presented.
Aftercare↗