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PubMed1985

Performance appraisal system for therapeutic recreation.

Therapeutic Recreation professionals continually strive for effective performance standards for their clients. In addition to standards for clients, Therapeutic Recreation Specialists must also develop performance standards for themselves to meet the continual challenge of accountability in the 80's. This paper identifies the need to develop a performance appraisal system as well as the benefits. The elements of the standards include: specificity, observability, measurability, attainment and mutual determination. The paper also reviews the process of assignment of relative weights, categories of review and detailed standards for the Director of Therapeutic Recreation and Therapeutic Recreation Specialist at the Rehabilitation Institute of Detroit.

Employee Performance Appraisal↗
PubMed1984

Third party reimbursement: is therapeutic recreation too late?

The Social Security Amendments of 1983 have brought added concerns about the feasibility of securing third-party reimbursement for therapeutic recreation services. Retrospective, cost-based reimbursement is compared with prospective payment systems, and potential impacts on therapeutic recreation services are explored. Present status of third-party reimbursement for therapeutic recreation is outlined, and suggestions are offered for therapeutic recreation managers to utilize in responding to the changing health care industry.

Insurance, Health, Reimbursement↗
PubMed1985

The dilemma of an unresolved philosophy in therapeutic recreation.

The therapeutic recreation profession is at a major crossroads. The demands of a society concerned with accountability, cost-effectiveness, productivity and reduced governmental support, on the one hand, and the quality of life on the other, provide a context for understanding the dilemma facing the field. Therapeutic recreators are being called upon to make decisions about the future direction of the field, including the choice of professional organizations. Without a strong philosophical foundation, choices that are made are likely to be based primarily on external influences. A solid professional philosophy will increase our security with our unique professional capabilities and will enhance our ability to be responsive to changing societal conditions. Various philosophical positions and some of their implications for therapeutic recreation are discussed. Therapeutic recreation professionals are encouraged to further explore the philosophical premises which guide their professional and organizational decisions.

Leisure Activities↗
PubMed2004

Nonfatal and fatal drownings in recreational water settings--United States, 2001-2002.

Drowning is the seventh leading cause of unintentional injury deaths for all ages and the second leading cause of all injury deaths in children aged 1-14 years. Many of these injuries occur in recreational water settings, including pools, spas/hot tubs, and natural water settings (e.g., lakes, rivers, or oceans). To examine the incidence and characteristics of nonfatal and fatal unintentional drownings in recreational water settings, CDC analyzed 2001-2002 data from the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) and National Vital Statistics System (NVSS) death certificate data from 2001. This report summarizes that analysis, which indicated that, during 2001-2002, an estimated 4,174 persons on average per year were treated in U.S. hospital emergency departments (EDs) for nonfatal unintentional drowning injuries in recreational water settings. Approximately 53% of persons required hospitalization or transfer for more specialized care. During 2001, a total of 3,372 persons suffered fatal unintentional drownings in recreational settings. Nonfatal and fatal injury rates were highest for children aged < or =4 years and for males of all ages. To reduce the number of drownings, environmental protections (e.g., isolation pool-fences and lifeguards) should be adopted; alcohol use should be avoided while swimming, boating, or water skiing or while supervising children; and all participants, caregivers, and supervisors should be knowledgeable regarding water-safety skills and be trained in cardiopulmonary resuscitation (CPR).

Adolescent↗
PubMed2004

Assessment of microbial infection risks posed by ingestion of water during domestic water use and full-contact recreation in a mid-southern African region.

A customised Water-related Quantitative Microbial Risk Assessment (WRQMRA) process was used to determine risk of infection to water ingested by users in the south-eastern Free State, South Africa. The WRQMRA consisted of an observed-adverse-effect-level approach (OAELA) and a quantitative microbial risk assessment (QMRA). The OAELA was based on the occurrence of E. coli in the study waters to determine the possible risk of infection and the QMRA probable risk of infection by salmonellae. The WRQMRA was applied to recreational surface resource waters as well as waters from an unprotected spring and waters from the treated municipal supply that were stored in containers for domestic purposes. E. coli numbers were measured against expected infection levels expressed in water quality guidelines, while Salmonella counts were calculated to give the probable infection risk (Pi). Ingestion was based on intake volumes compiled for the various water uses. E. coli occurred in numbers <10(6) in the surface waters, while the untreated spring and treated supply water contained E. coli of <10(2) and <10(1) respectively. Salmonella occurred in numbers of <10(3) in recreational waters, and <10(-1) in water used for domestic purposes. A single exposure to the mean (as well as 95th percentile) risk was calculated using a beta-Poisson dose-response model at ingestion volumes of 100 mL (for full-contact recreation) and 1,318 mL (for domestic water use). Both the OAELA and the QMRA approaches indicated a risk of infection to recreational and domestic water users, even for a single exposure event, with the OAELA either over- or under-estimating the risk of infection for singular exposure events. This indicated that this method, used on its own, could not reliably predict a realistic risk of infection. It is recommended that the full WRQMRA process be used, and further developed to address several uncertainties that became evident during this study.

Drinking↗
PubMed2004

Amount, type, and timing of recreational physical activity in relation to colon and rectal cancer in older adults: the Cancer Prevention Study II Nutrition Cohort.

Physical activity has consistently been associated with lower risk of colon cancer, but information is limited on the amount, type, and timing of activities. The relationship between physical activity and rectal cancer is unclear. We examined characteristics of recreational physical activity in relation to colon and rectal cancer in the Cancer Prevention Study II Nutrition Cohort of 70,403 men and 80,771 women (median age, 63 years); 940 colon and 390 rectal cancers were identified from enrollment in 1992 to 1993 through August 1999. The multivariate-adjusted rate ratios (95% confidence intervals) associated with any recreational physical activity compared with none were 0.87 (0.71-1.06) for colon cancer and 0.70 (0.53-0.93) for rectal cancer. Colon cancer risk decreased significantly with increasing total hours (P for trend without reference group = 0.007) and metabolic equivalent hours (P for trend = 0.006) per week of activities. No clear decrease in rectal cancer risk was seen with increasing hours per week of physical activity. Rate ratios (95% confidence intervals) were 0.72 (0.52-0.98) for <2 hours, 0.68 (0.47-0.97) for 2 to 3 hours, 0.59 (0.41-0.83) for 4 to 6 hours, and 0.83 (0.59-1.16) for >/=7 hours per week of physical activity compared with none. Past exercise, as reported in 1982, was not associated with risk of either colon or rectal cancer. We conclude that increasing amounts of time spent at recreational physical activity are associated with substantially lower risk of colon cancer and that recreational physical activity is associated with lower risk of rectal cancer in older men and women.

Aged↗
PubMed2006

A public health evaluation of recreational water impairment.

Water quality objectives for body contact recreation (REC-1) in Newport Bay, CA are not being attained. To evaluate the health implications of this non-attainment, a comprehensive health-based investigation was designed and implemented. Bacterial indicator data indicate that exceedances of the water quality objectives are temporally sporadic, geographically limited and most commonly occur during the time of the year and/or in areas of the bay where the REC-1 use is low or non-existent. A disease transmission model produced simulated risk estimates for recreation in the Bay that were below levels considered tolerable by the US EPA (median estimate 0.9 illnesses per 1,000 recreation events). Control measures to reduce pathogen loading to Newport Bay are predicted to reduce risk by an additional 16% to 50%. The results of this study indicate that interpreting the public health implications of fecal indicator data in recreational water may require a more rigorous approach than is currently used.

California↗
PubMed1988

Off-road recreational motor vehicle accidents: hospitalization and deaths.

There is increasing concern over the unregulated use of recreational off-road motor vehicles. A review of 207 patients admitted to a tertiary care hospital over a 5-year period, as well as deaths due to use of recreational vehicles, elicited the following information. Recreational accidents predominantly involved men in their mid-twenties. Children younger than 16 years were more frequently involved in all-terrain vehicle (ATV) or dirt-bike accidents and constituted more than one-third of the total. There was a ninefold increase in ATV accidents over the study period, so that by 1985 ATVs were the primary cause of off-road injuries (52%). The musculoskeletal system was most frequently injured (66%) followed by the head and face (25%). There was permanent disability in 10.6%, and 33% of the recreational deaths were in children younger than 16 years. The inherent instability of ATVs was confirmed by the finding that in 60% of accidents the vehicle had rolled or flipped. Stricter licensing requirements should be implemented, and public education is required to draw attention to the danger of these vehicles, particularly to children. There is a need for proper safety equipment and driver training. The issue of vehicle design must also be addressed by the industries concerned.

Accidents↗
PubMedDate not supplied

Carbon monoxide poisoning among recreational boaters.

OBJECTIVE: To describe the case characteristics of a series of patients poisoned with carbon monoxide (CO) while boating for recreation. DESIGN: Cases of patients referred for treatment of CO poisoning with hyperbaric oxygen were reviewed. Those cases that occurred during recreational boating were selected for analysis. SETTING: A private, urban, tertiary care center studied from July 1984 to June 1994. PATIENTS: Thirty-nine patients ranging in age from 6 months to 69 years who were poisoned in 27 separate incidents. MAIN OUTCOME MEASURES: Characteristics of the poisoning incidents were assessed at initial patient presentation, immediately following treatment, and with follow-up telephone interviews. RESULTS: Of 512 patients treated for acute unintentional CO poisoning, 39 cases (8%) occurred in 27 incidents related to recreational boating activities. Individuals typically lost consciousness as a result of the poisoning. Most cases occurred aboard a boat that was older than 10 years, had an enclosable cabin, was longer than 22 feet, was powered by a gasoline engine, and was without a CO detector on board. CONCLUSIONS: Carbon monoxide poisoning is a serious hazard associated with recreational boating. The installation of CO detectors aboard boat types typically associated with this syndrome should be strongly encouraged.

Adolescent↗
PubMed1998

Sporting and recreational injuries. In a general practice setting.

OBJECTIVE: To collect data on sporting and recreational injuries presenting to a general practice clinic in metropolitan Melbourne, to gain better knowledge about the range of these injuries commonly seen in general practice and in the community. METHOD: A survey was conducted for four, 2 week periods, at 3 monthly intervals, over approximately 1 year, at a general practice clinic in metropolitan Melbourne. All patients who presented with a new sporting or recreational injury were asked to complete a questionnaire, seeking information on the nature, circumstances, risk factors and severity of their injury, as well as why they had chosen to present to a general practice clinic, in preference to a hospital emergency department. It was completed by both the patient and the treating doctor. RESULTS: The main findings of the survey were that patients who presented to the clinic with a sporting or recreational injury were most likely to be male and in their twenties. The most common sports that had been played prior to injury were Australian rules football, soccer and hockey. The majority of injuries were relatively mild, with sprains and bruises accounting for 78% of injuries, while 89% of patients required conservative forms of treatment. The ankle, fingers and knee were the most common body parts affected. CONCLUSION: Data from general practice provides important information about the epidemiology of sporting and recreational injuries in the community.

Adolescent↗
PubMed1998

[Hygienic assessment of conditions for education and recreation of students in children's homes].

The study was carried out in 1995 in all children's homes listed in the sanitary-epidemiological stations in the country, with 16,471 inmates, among them 13,778 were attending elementary and secondary schools. The conditions for education and recreation in these homes were studied by the workers of the children and adolescent sections of the sanitary-epidemiological stations overseeing children's homes in the area of their coverage. For the study a uniform questionnaire was used. On the basis of the results the conclusion is put forward, that the conditions of education and recreation of children differ considerably from one home to another. In most homes the conditions for education and recreation are good. In certain homes short-comings were found, e.g. insufficient lighting of working places, which require actions for their elimination to avoid possible consequences for health. The actions undertaken for sending in 1995 of a possibly high number of inmates to summer or winter camps were brought into realization in a considerable degree. In summer 71% and in winter 23% of the inmates attending schools participated in various forms of organized recreation.

Adolescent↗
PubMed1998

Linking the Wilderness Perception Mapping Concept to the Recreation Opportunity Spectrum

/ This paper examines the application of a wilderness perception mapping (WPM) approach to enhancingthe recreation opportunity spectrum (ROS). WPM provides a greater understanding of the multiple relationships between wilderness environments and wilderness user experience. The results from a case study indicate that different recreation opportunity settings provide experiential conditions of wilderness for different groups. Wilderness perception mapping complements the use of ROS and can be applied to wilderness management.KEY WORDS: Geographical information systems; Recreation opportunity spectrum; Outdoor recreation planning; Wilderness management; Wilderness perception mapping; New Zealand

Journal Article↗
PubMed1998

Attitudes About Recreation, Environmental Problems, and Estuarine Health Along the New Jersey Shore, USA.

/ Management of ecosystems has advanced by an improvement in our understanding not only of how ecosystems function, but of how people perceive their functioning and what they consider to be environmental problems within those systems. Central to such management is understanding how people view estuaries. In this article I explore the perceptions and attitudes of people about coastal recreation, environmental problems, and future land use along the New Jersey shore (USA) by interviewing people who attended a duck decoy and craft show on Barnegat Bay. The people who were interviewed engaged in more days of fishing than any other recreational activity and engaged in camping the least. There were significant differences in recreational rates as a function of gender and location of residence, with men hunting and fishing more than women and photographing less than women. Jet skis were perceived as the most severe environmental problem, with chemical pollution, junk, oil runoff and overfishing as second level problems. Birds were perceived as not an environmental problem at all. Fishing, hiking, preservation, and camping ranked as the highest preferred future land uses for the two sites examined (Oyster Creek Nuclear Generating Station, Naval Weapons Station Earle). The preferred future land uses for these two sites, which are not under consideration for land-use changes, were very similar to those of people living near the Department of Energy's Savannah River Site in South Carolina, despite the media attention and considerations of nuclear storage.KEY WORDS: Recreation; Perceptions; Environmental problem; Gender; Land use; Coastal

Journal Article↗
PubMed1993

Recreational drugs and sexual behavior in the Chicago MACS/CCS cohort of homosexually active men. Chicago Multicenter AIDS Cohort Study (MACS)/Coping and Change Study.

Since initial reports emerged of an association between recreational drug use and high-risk sexual behaviors in gay men, there has been interest in studying this relationship for its relevance to behavioral interventions. Reported here are the longitudinal patterns of alcohol and recreational drug use in the Chicago Multicenter AIDS Cohort Study (MACS)/Coping and Change Study (CCS) of gay men. A pattern of decreasing drug use over 6 years was observed that paralleled a decline in high-risk sexual behavior (i.e., unprotected anal intercourse). In contrast, alcohol consumption tended to be more stable over time, and to show no relationship to sexual behavior change. Men who combined volatile nitrite (popper) use with other recreational drugs were at highest risk both behaviorally and in terms of human immunodeficiency virus-1 (HIV) seroconversion throughout the study. Popper use also was associated independently with lapse from safer sexual behaviors (failure to use a condom during receptive anal sex). Use of other recreational substances showed no relationship to sexual behavior change patterns, and stopping popper use was unrelated to improvement in safer sexual behavior. When popper use and lapse from safer sex were reanalyzed, controlling for primary relationship status, popper use was associated with failure to use condoms during receptive anal sex among nonmonogamous men only. These findings suggest an association between popper use and high-risk sexual behavior among members of the Chicago MACS/CCS cohort that has relevance to HIV prevention intervention efforts.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Health effects of recreational exposure to Moreton Bay, Australia waters during a Lyngbya majuscula bloom.

A survey of residents in an area subject to annual toxic cyanobacterial blooms was undertaken to examine potential health effects of cyanobacteria toxins. The survey assessed the health of marine recreational water users in Deception Bay/Bribie Island area in northern Moreton Bay, Queensland, which is exposed to blooms of the nuisance and potentially harmful cyanobacterium Lyngbya majuscula. A postal survey was mailed to 5000 residents with a response rate of 27%. High numbers of people (78%) responding to the survey reported recreational water activity in Moreton Bay. Of those having marine recreational water activity, 34% reported at least one symptom after exposure to marine waters, with skin itching the most reported (23%). Younger participants had greater water exposure and symptoms than older participants. Participants with greater exposures were more likely to have skin and eye symptoms than less exposed groups, suggesting agents in the marine environment may have contributed to these symptoms. Of those entering Moreton Bay waters 29 (2.7%) reported severe skin symptoms, 12 of whom attended a health professional. Six (0.6%) reported the classic symptoms of recreational water exposure to L. majuscula, severe skin symptoms in the inguinal region. Participants with knowledge of L. majuscula were less likely to report less skin, gastrointestinal and fever and headache symptoms. In conclusion, high numbers of participants reported symptoms after exposure to waters subject to L. majuscula blooms but only a small number appeared to be serious in nature suggesting limited exposure to toxins.

Adolescent↗
PubMed2004

Derivation of numerical values for the World Health Organization guidelines for recreational waters.

In April 2001, draft 'Guidelines' for safe recreational water environments were developed at a World Health Organization (WHO) expert consultation. Later the same month, these were presented and discussed at the 'Green Week' in Brussels alongside the on-going revision of the European Union Bathing Water Directive 76/160/EEC. The WHO Guidelines cover general aspects of recreational water management as well as define water quality criteria for various hazards. For faecal pollution, these include faecal indicator organism concentrations and an assessment of vulnerability to faecal contamination. Central to the approach set out in the WHO Guidelines are: (i) the concept of beach profiling to produce a 'sanitary inspection category' which implies a priori hazard assessment as a core management tool and (ii) the prediction of poor water quality to assist in real time risk assessment and public health protection. These management approaches reflect a harmonized approach towards the assessment and management of risk for water-related infectious disease being applied by WHO. Numerical microbiological criteria for intestinal enterococci are proposed in the new Guidelines. These were developed using a novel approach to disease burden assessment, which has been applied to both recreational waters and urban air quality. This paper explains the scientific rationale and mathematical basis of the new approach, which is not presented in the WHO Guidelines for recreational waters.

Cities↗
PubMed1998

Comparison of lifestyle and substance use factors related to accidental injuries at work, home and recreational events.

The purpose of this study was to examine whether risk factors vary for injuries that occur at work, at home, at recreational events and at multiple settings. Three major types of factors were investigated: lifestyle factors such as sleep, stress and exercise; substance use; and demographic characteristics. Data were obtained from a household survey of 882 Ontario adults. In order to determine whether different factors were related to different kinds of accidental injuries, chi 2 tests were conducted among five injury groups: no injuries; work; home; recreational; and multiple injury episodes (i.e. at least two separate injury episodes in two different settings). The first set of comparisons were conducted between those with zero injuries and each of the aforementioned four injury groups. Those with multiple injury episodes were significantly more likely than those with no injuries to be single, under the age of 30, and have lifestyle problems (i.e. sleep problems, financial problems and a desire for counselling) and substance use/problems (i.e. cigarettes, alcohol, licit and illicit drugs). For comparisons between each of the work, home and recreational injury groups and no injury group, eight factors were significant altogether, but no single factor was significantly related to more than one injury group. Contrasts between all combinations of injury group pairs (i.e. excluding the no injury group) indicated that risk factors for those with multiple injury episodes differed significantly from those with home and recreational injuries for several characteristics. This exploratory study provides some support that risk factors may vary, depending on the injury group.

Accidents, Home↗
PubMed2002

[Pneumomediastinum as a complication of recreational ecstasy use].

Ecstasy recreational use dramatically increased during the last decade in France. Multiples complications associated with ecstasy consumption have been reported. We describe an exceptional case of pneumomediastinum related to ecstasy recreational use. The patient was a 19-year old patient whose medical history was significant for asthma and was a moderate tobacco smoker. He reported regular ecstasy recreational use. He presented at the emergency unit for chest pain and cough, 48 hours after the ingestion of three tablets of ecstasy and the inhalation of three other tablets. Blood pressure was 90/60 mmHg, pulse rate was 120 per minute, respiratory rate was 32 per minute and pulse oximetry was 93%. Neck emphysema was noted. Chest radiograph and scanner diagnosed pneumomédiastinum. Outcome was favorable with symptomatic treatment and the patient was discharged home eight days later. Pneumomediastinum is an exceptional complication after ecstasy recreational use. Physician should be aware of the risk of such event.

Adult↗