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Understanding the wicked nature of "unmanaged recreation" in Colorado's Front Range.

Unmanaged recreation presents a challenge to both researchers and managers of outdoor recreation in the United States because it is shrouded in uncertainty resulting from disagreement over the definition of the problem, the strategies for resolving the problem, and the outcomes of management. Incomplete knowledge about recreation visitors' values and relationships with one another, other stakeholders, and the land further complicate the problem. Uncertainty and social complexity make the unmanaged recreation issue a wicked problem. We describe the wickedness inherent in unmanaged recreation and some of the implications of wickedness for addressing the problem for the Front Range of the Rocky Mountains in Colorado. Conclusions about the nature of the problem are based on a problem appraisal that included a literature review and interviews of key informants. Addressing wickedness calls for institutional changes that allow for and reward the use of trust building, inclusive communication, and genuinely collaborative processes.

Colorado↗

Recreational and social activities of orthognathic surgery patients.

The present study examined changes in recreational and social activities after orthognathic surgery. Because this is often an expectation of patients seeking surgery, it was hypothesized that activity levels would increase gradually after surgery, particularly for patients who become more extroverted and for unmarried patients. Information on the frequencies of recreational and social activities, and the persons with whom these activities were performed, were obtained from 53 patients in a self-administered questionnaire administered at least 2 days before surgery and again 3 weeks, 4 months, and 9 months after surgery. In addition, patients were assessed on introversion-extroversion before and after surgery. The results indicated that (1) for both married and single patients, recreational and social activities dropped immediately after surgery and gradually increased to a level similar to that prior to surgery at nine months after surgery; (2) contrary to expectations, the single patients over age 15 did not increase their recreational and social activities with friends of the opposite sex after surgery; and (3) the degree of change in introversion-extroversion after surgery was not associated with the degree of change in recreational and social activities performed with others. Implications for postsurgical adjustment of orthognathic patients and recommendations for future research are discussed.

Adolescent↗

Peer relationships and social and recreational activities among adolescents and adults with autism.

In this study, we investigate peer relationships and participation in social and recreational activities among 235 adolescents and adults with autism who live at home. The prevalence of having friendships, peer relationships, and participating in social and recreational activities were all low and comparable to previous research. Both individual and environmental factors were investigated as predictors of having peer relationships and participation in social and recreational activities. Having peer relationships was predicted by individual characteristics (younger age, and less impairment in social interaction skills), but not by characteristics of the environment. Greater participation in social and recreational activities was predicted by characteristics of the individual with autism (greater functional independence, less impairment in social interaction skills, higher levels of internalizing behaviors) and characteristics of the environment (greater maternal participation in social and recreational activities, greater number of services received, and inclusion in integrated settings while in school).

Adolescent↗

Enumeration of faecal coliforms from recreational coastal sites: evaluation of techniques for the separation of bacteria from sediments.

AIMS: To identify the most efficient techniques for the separation of micro-organisms from coastal sediments and, using these techniques, to determine the concentration of faecal indicator organisms in recreational coastal water and sediment. METHODS AND RESULTS: Sediment samples were taken from a range of recreational coastal sites and subjected to various physical techniques to separate micro-organisms from sediment particles. Techniques investigated included manual shaking, treatment by sonication bath for 6 and 10 min, respectively, and by sonication probe for 15 s and 1 min, respectively. The use of the sonication bath for 10 min was the most successful method for removing micro-organisms from sediment particles where sediments consisted mainly of sand. When sediments contained considerable proportions of silt and clay, however, manual shaking was most successful. Faecal coliforms were then enumerated by membrane filtration in both water and sediment from three recreational coastal sites, chosen to represent different physical sediment characteristics, over a 12-month period. Faecal coliform concentrations were generally greater in sediment compared with overlying water for all samples. This was most evident in sediment consisting of greater silt/clay and organic carbon content. CONCLUSIONS: This study demonstrated the importance of sediment characteristics in determining the most efficient method for the separation of micro-organisms from coastal sediments. Sediment characteristics were also found to influence the persistence of micro-organisms in coastal areas. SIGNIFICANCE AND IMPACT OF THE STUDY: Recreational coastal sediments can act as a reservoir for faecal coliforms; therefore, sampling only overlying water may greatly underestimate the risk of exposure to potentially pathogenic micro-organisms in recreational waters.

Bacteriological Techniques↗

Provision of recreational activities in hospices in the United States.

Quality of life issues encompass the philosophies of both hospice and recreation participation. This study examines the status of recreational activities provision in hospices in the United States. The offering, frequency of offering, and location of offering of 39 recreational activities in a random sample of hospices in the United States were surveyed. The functional levels of participating patients were also recorded. Reading to patients at bedside daily was determined to be the most frequently provided recreational activity. Recreational activities are being offered in 40% of the larger U.S. hospices on a varying schedule in different locations.

Hospices↗

The incidence of recreational genitourinary and abdominal injuries in the Western New York pediatric population.

PURPOSE: We estimate the incidence of recreation related pediatric abdominal, testis and kidney injuries. MATERIALS AND METHODS: Trauma registry data at the regional pediatric trauma center for 1993 to 2000 were analyzed for recreational injuries. The data were divided into the 3 age groups of 5 to 11, 12 to 14 and 15 to 18 years. The recreation, and site and severity of injury were cross referenced. Injury incidence was calculated using United States census data. RESULTS: Of 4,921 children 34 boys and 2 girls (0.73%) had a genitourinary or abdominal injury due to recreation. Kidney injuries were the most common (44.4%), followed by spleen (36.1%) and liver (19.5%). No testicle injuries were reported. Skiing was the most common cause of injury (22.2%). Hockey, football, snowboarding, sledding and bicycling accounted for 83% of all injuries. There were no injuries related to basketball and soccer. The 12 to 14-year-old group had 50% of the injuries. Records were available for 15 kidney injuries, of which 11 were on the left side, 1 was bilateral, 3 required transfusion and 1 required nephrectomy. Injury grades were I in 2 cases, II in 5, III in 4, IV in 3 and V in 1. Kidney and spleen injury incidence due to recreation per year per million children was 6.9 and 5.6, respectively. CONCLUSIONS: Kidney injuries were more common than spleen injuries. Skiing, sledding and snowboarding accounted for more injuries than team sports. Testicle injuries were not seen and are rare. Basketball and soccer caused no injuries. Middle school-age children appear to be at greatest risk.

Abdominal Injuries↗

Risk assessment of adenoviruses detected in treated drinking water and recreational water.

AIMS: Human adenoviruses (HAds) have previously been detected in sewage and polluted river and dam water, as well as treated drinking water. The 51 serotypes of HAds cause a wide range of infections with clinical manifestations associated with the gastrointestinal, respiratory and urinary tracts, and the eyes. Water may play a meaningful role in the transmission of many of these HAd serotypes, specifically the enteric HAds which are transmitted via the faecal-oral route. The presence of these viruses in water used for drinking and recreational purposes is considered to constitute a potential health risk. In this study, the risk of infection by the group of HAds previously detected over a period of 1 year in selected drinking water supplies, as well as river and dam water used for recreational purposes, was assessed. METHODS AND RESULTS: Adenoviruses were previously detected in nine of 204 (4.41%) samples of two drinking water supplies (A and B) treated and disinfected according to international specifications, in four of 51 (7.8%) samples of river water and nine of 51 (17.7%) samples of dam water. Application of these previously published results in an exponential risk assessment model indicated an annual risk of infection of 1.01 x 10(-1) and 1.7 x 10(-1) for drinking water supplies A and B, respectively, assuming a daily consumption of 2 l day(-1). The daily risk of infection constituted by HAds in the river water was calculated as 1.71 x 10(-4), and in the dam water as 3.12 x 10(-5), assuming a consumption of 30 ml of water per day. CONCLUSIONS: The risk of infection exceeded the tolerable risk of one infection per 10 000 consumers per year proposed for drinking water. However, the results for river and dam water used for recreational purposes were within the tolerable risk of one infection per 1000 bathers per day proposed for environmental waters used for recreational purposes. SIGNIFICANCE AND IMPACT OF THE STUDY: The study showed that the risk of HAd infection calculated for the drinking water supplies and the recreational water may overestimate the actual risk of infection, as conservative values were assumed for some of the variables. For a more accurate assessment of the potential risk of infection research should at least include a thorough investigation of the water consumption of individuals in South Africa, and the efficiency of recovery of the glass wool adsorption-elution method.

Adenoviridae↗

Effect of total knee arthroplasty on recreational and sporting activity.

BACKGROUND: Common concerns of patients undergoing total knee arthroplasty (TKA) are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present study was designed to determine preoperative and postoperative activities, the numbers participating and the time to resume these activities. METHODS: Between 1 and 2 years after TKA, patients who had undergone 144 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability. Their preoperative and postoperative activity along with the time to resume was recorded. The Oxford knee score and estimate of physical activity was also collected. RESULTS: Out of the 144 TKA performed, 122 participated in sport and recreational activity preoperatively and 108 participated postoperatively. Patients stated that the surgery had a beneficial effect on their performance of sporting and recreational activities although the number of sporting events decreased. By multiplying individuals by the number of activities they participated in, there were 254 occurrences of sport and recreational activities preoperatively giving a mean for the group of 1.76 sports/patient. Postoperatively this had reduced to 204, giving a mean of 1.41. Three activities showed a significant change for individual patients from pre- to postoperation. Those which showed an increase were exercise walking, where 19 patients (13.2%) who did not walk before surgery took up walking afterwards (P < 0.006) and aqua aerobics, where five took up aqua aerobics postoperatively for the first time (P < 0.025). Golf was the only sport which had a significant fall in participation from pre- to postoperation, with 10 out of 19 golfers giving up (P < 0.025). CONCLUSION: The present study has shown that patients are adopting lower impact activities to participate in after TKA. The total number of patients performing a sport decreases postoperatively and the total amount of sport played decreases. These data will help to counsel patients.

Arthritis, Rheumatoid↗

Annoyance with aircraft noise in local recreational areas and the recreationists' noise situation at home.

Few socioacoustic studies have examined the effect of noise on outdoor recreationists. Most studies concentrate on one setting of the everyday life of a noise-exposed population, which mainly has been the residential setting. This article relates annoyance with aircraft noise in outdoor recreational areas to the recreationists' noise situation at home. In conjunction with the relocation of the main airport of Norway in 1998, field studies were conducted before and after the change in one area near the old airport (1930 survey respondents), and one area near the new airport (1001 survey respondents). Multivariate linear regression analyses of the relationship between annoyance and aircraft noise exposure (LAeq for the aircraft events) in the recreational areas were conducted, controlled for noise annoyance at home, or aircraft noise exposure at home, the situation (before/ after the change), context- and demographic variables. People more highly annoyed at home tended to be more annoyed than others while in the recreational areas. A significant effect of aircraft noise exposure at home on annoyance in the recreational setting was not found. More research is warranted regarding the relationship between noise exposure at home and outdoor recreational demands.

Aircraft↗

Epidemiology of medically treated sport and active recreation injuries in the Latrobe Valley, Victoria, Australia.

OBJECTIVE: To quantify and describe medically treated sport and active recreation injuries in a defined region of the Latrobe Valley from 7 November 1994 to 6 November 1995. METHOD: A geographic target area was defined, restricted to the six postcodes that fell wholly within the catchment area of the Latrobe Regional Hospital. Data describing medically treated sport and active recreation injuries to Latrobe Valley residents aged over 4 years (about 70,000) were selected by postcode from three sources: the Victorian Admitted Episodes Dataset (hospital admissions), the Victorian Injury Surveillance System (presentations to hospital emergency departments), and the Extended Latrobe Valley Injury Surveillance (ELVIS) project (presentations to general practitioners). RESULTS: At least 2300 cases of medically treated sport and active recreation injury were recorded. This corresponds to a hospital admission rate of 16/10,000 population, emergency department presentation rate of 169/10,000 population, and a general practitioner presentation rate of 187/10,000 population. There were more male patients than female, and younger age groups were also overrepresented, but these data may reflect the greater participation of these groups in sport and active recreation. Australian football was associated with the highest number of injuries (accounting for 24.0% and 22.0% of presentations to emergency departments and general practitioners respectively) followed by cycling (15.7% and 12.6%) and basketball (17.5% and 13.5%). CONCLUSIONS: This study shows that routine health sector data collections in defined populations can provide useful information on the size, distribution, and characteristics of the problem of sport and active recreation injuries at the community level. However, all current health sector systems for injury data collection and surveillance require attention to improve case capture and identification and data quality.

Adolescent↗

Supporting high school students to engage in recreational activities with peers.

The authors investigated the effects of an intervention package to support five high school students with extensive support-needs to initiate and engage in recreational activities with general-education peers in their physical education classes. The intervention components were (a) assessing participants' recreational activity goals, (b) teaching self-prompting using a picture book, (c) programming common stimuli, and (d) asking participants to assess daily performance and evaluate daily goal achievement. The intervention was associated with increases in participants' initiation of and engagement in recreational activities with general-education peers, as well as increases in ratings of quality of interaction. In addition, participants typically assessed with accuracy their performance of recreational activities and whether they had achieved their recreational goals. Findings are discussed with respect to future research and practice.

Adolescent↗

Epidemiology of recreational exposure to freshwater cyanobacteria--an international prospective cohort study.

BACKGROUND: Case studies and anecdotal reports have documented a range of acute illnesses associated with exposure to cyanobacteria and their toxins in recreational waters. The epidemiological data to date are limited; we sought to improve on the design of some previously conducted studies in order to facilitate revision and refinement of guidelines for exposure to cyanobacteria in recreational waters. METHODS: A prospective cohort study was conducted to investigate the incidence of acute symptoms in individuals exposed, through recreational activities, to low (cell surface area < 2.4 mm2/mL), medium (2.4-12.0 mm2/mL) and high (> 12.0 mm2/mL) levels of cyanobacteria in lakes and rivers in southeast Queensland, the central coast area of New South Wales, and northeast and central Florida. Multivariable logistic regression analyses were employed; models adjusted for region, age, smoking, prior history of asthma, hay fever or skin disease (eczema or dermatitis) and clustering by household. RESULTS: Of individuals approached, 3,595 met the eligibility criteria, 3,193 (89%) agreed to participate and 1,331 (37%) completed both the questionnaire and follow-up interview. Respiratory symptoms were 2.1 (95%CI: 1.1-4.0) times more likely to be reported by subjects exposed to high levels of cyanobacteria than by those exposed to low levels. Similarly, when grouping all reported symptoms, individuals exposed to high levels of cyanobacteria were 1.7 (95%CI: 1.0-2.8) times more likely to report symptoms than their low-level cyanobacteria-exposed counterparts. CONCLUSION: A significant increase in reporting of minor self-limiting symptoms, particularly respiratory symptoms, was associated with exposure to higher levels of cyanobacteria of mixed genera. We suggest that exposure to cyanobacteria based on total cell surface area above 12 mm2/mL could result in increased incidence of symptoms. The potential for severe, life-threatening cyanobacteria-related illness is likely to be greater in recreational waters that have significant levels of cyanobacterial toxins, so future epidemiological investigations should be directed towards recreational exposure to cyanotoxins.

Adolescent↗

Youth's recreation and drug sensations: is there a relationship?

Adolescents' social behaviors remain a mystery to parks and recreation providers. Adolescence is a "high-risk" time for all youth in terms of experimenting with potentially health-compromising behavior, whether alcohol, drugs, or sex. Most of these antisocial behaviors occur during adolescents' leisure time. These inferences gave impetus to this research effort. The study was designed to ascertain information on adolescents' preferences for pleasure: drugs or recreation. Data were collected from a sample of 100 high school students from a medium-sized college town, and 100 students from a rural town in Florida. Findings revealed four statistically significant associations in the motives or pleasures sought in recreation and in drug behaviors: "enhancement of popularity," "provision of a means for self-discovery," "achievement of personal goal," and means to rebel against parents. In reference to the latter motive, findings revealed that neither drugs nor recreation were used to rebel against parents. Findings also provide documentation of the value of recreation in insulating adolescents against many of the stressors of contemporary life.

Adolescent↗

"I came here to die:" a look at the function of therapeutic recreation in nursing homes.

Generally the elderly are identified as a stigmatized subculture victimized by society's denial or avoidance of their physical problems, social needs and psychological issues. So much more the case for the nursing home resident, who is characterized as helpless, passive and socially insensible. The article questions the efficacy of recreational activities as they exist in the nursing home milieu today. Does therapeutic recreation take into account the physical, social and emotional needs of the nursing home resident? What is the basis for rationale in building therapeutic recreation programs? Where is the didactic emphasis in university programs designed to educate the recreational therapist? It is concluded that recreational activities become therapeutic only when they have evolved from a detailed knowledge of the problems germane to a given population.

Aged↗

A panic attack in therapeutic recreation over being considered therapeutic.

Ancillary professions have been called upon to account for therapeutic benefits from their services or be eliminated from the health care system. A singular focus on therapy, however, would negate the unique contribution of therapeutic recreation within, while simultaneously restricting services to health care settings. It is proposed that panic over therapeutic recreation services meeting health care goals has hindered evaluation and solidification of the leisure-based philosophy presented in the NTRS Philosophical Position Statement (NTRS, 1982). It is argued that emphasizing the leisure orientation of the philosophical position statement can secure therapeutic recreation's position within, yet, not deny services to those outside of the health care system. An overview is presented on the adequacy of the position statement philosophy for therapeutic recreation. A potential danger of attempting to explain therapeutic recreation in terms of non-leisure based philosophies is also discussed.

Humans↗

A survey of leisure and recreation programs offered by agencies serving traumatic head injured adults.

This article describes a study conducted to determine the status of leisure and recreation programs currently being offered to head injured individuals participating in post-acute rehabilitation programs. A questionnaire was sent to 135 post-acute rehabilitation programs. Responses were received from 52% of the sample. Of the agencies surveyed, 88.5% currently offer recreation programs. Lack of funding and staff shortages were the most common reasons cited for non-existent recreation and leisure programs. The recreation and leisure education goals which were viewed as most important included social skill development and reduction of inappropriate behaviors in order to promote successful community reintegration. Assessment tools and a list of leisure skills/activities for the head injured population were the types of assistance recommended by respondents. This study is the first national survey which has examined existing recreation programs in head injury rehabilitation settings.

Craniocerebral Trauma↗

In-service training in therapeutic recreation for persons with severe handicaps.

The majority of persons with severe handicaps have been excluded from most therapeutic recreation programs because they are less skill proficiency and more difficult to involve. In many cases recreation leaders are neither trained nor prepared to work with severely disabled individuals. The described in-service training project was successful in increasing recreation leaders' competency for working with persons who have severe handicaps. The project consisted of lectures, audio-visual presentations, simulations, role playing, and group discussion. It was found that the participants' self ratings of their competency in assessment, task analysis, writing individualized recreational objectives, using a behavioral approach, data collection, and program reevaluation were significantly increased (P less than .01). Their overall self evaluation was also increased. This in-service project was effective in promoting staff training and increasing opportunities for therapeutic recreation for persons with severe handicaps.

Persons with Disabilities↗

Skin cancer prevention in outdoor recreation settings: effects of the Hawaii SunSmart Program.

CONTEXT: Skin cancer is the most common form of cancer in the United States, and it is one of the most preventable. Interventions for young children and their parents can help prevent future cases of skin cancer. OBJECTIVE: To determine whether a skin cancer prevention program implemented at outdoor recreation sites improved children's sun-protection behaviors and site sun-protection policies. DESIGN: Randomized trial of 14 outdoor recreation sites on the island of Oahu, Hawaii. The trial had three arms: control, education only, and education/environment. INTERVENTION: The education arm included staff training, on-site activities, take-home booklets, behavior-monitoring boards, and incentives. The education/environment arm included all education components plus provision of sunscreen and promotion of sun-safe environments. PARTICIPANTS: Children 6 to 8 years of age and their parents. OUTCOME MEASURES: Reports from parents of children's sun-protection behaviors and the sun-protection policies of recreation sites. The cohort for analysis from baseline to 6 weeks after testing had 383 participants; the cohort from 6 weeks after testing to 3 months of follow-up had 285 participants. RESULTS: Program implementation was high in the education only and the education/environment sites. Compared with control sites, children's sun-protection behaviors and, in particular, the use of sunscreen improved significantly at sites where the two interventions were implemented. In addition, sun-protection policies of recreation sites were markedly higher at intervention arm sites. The education/environment intervention was not superior to education alone. Changes were partly maintained at 3 months of follow-up. CONCLUSION: A creative, engaging, multicomponent skin cancer prevention program in outdoor recreation settings can lead to modest improvements in children's sun-protection behaviors.

Adult↗