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Reliability of adolescents' self-report of recent recreational injury.

PURPOSE: To assess the reliability of adolescents' self-report of recent recreational injury. METHOD: Identical written questionnaires were administered twice in a 3-week period to 75 randomly selected adolescents (aged 11-12 years and 15-16 years) in state primary and secondary schools in South Australia, Australia. The questionnaires sought information on injury sustained in the previous week. Parents of 60 of the adolescents were contacted in the same week as one of the questionnaire administrations, to verify their adolescent's most recent injury self-report. Intraclass and Pearson correlation coefficients provided evidence of agreement between responses, and stability of measure. RESULTS: There was high stability and good agreement between the parent and adolescent responses provided in the same week, suggesting that adolescents accurately reported recent recreational injury. The poor stability and low agreement between repeated adolescent responses over the 3-week period indicated not poor recall, but the changing nature of mostly minor recreational injury. These findings suggest that the nature of the injury reported in the first questionnaire had changed by the time of the second questionnaire administration, and that this was accurately reported. CONCLUSION: Confidence can be placed in adolescents' self-reports of recreational injury in the preceding week.

Adolescent↗

Self-concept and adaptive behaviour of people with intellectual disability in integrated and segregated recreation activities.

BACKGROUND: Leisure and recreation are areas in which the inclusion of people with intellectual disability (ID) in the community is required. In Israel, leisure activities have been developed over the past decade as part of the services provided to individuals with ID in the regular programmes of the community. However, even within those frameworks, people with ID are typically segregated from the whole population. METHODS: The purpose of the present study was to examine whether individuals with ID who participate in recreation activities with normal people as equals are different in their self-concept and adaptive behaviour from their counterparts who participate in segregated recreation programmes. Two hypotheses were examined: (1) whether people with ID who participate in integrated recreation programmes have a higher self-concept than those who participate in segregate programmes; and (2) whether individuals with ID who have better adaptive behaviour have a higher self-concept than people with ID who have lower adaptive behaviour. RESULTS: The hypotheses were partially confirmed. Differences were found in two subscales of self-concept. First, the physical self-concept of individuals with ID who participated in integrated programmes was found to be higher than that of their counterparts who participated in segregated programmes. Secondly, satisfaction with the whole self-concept of people with ID who participated in integrated programmes was found to be higher than of those who participated in segregated programmes. CONCLUSIONS: The implications of the research findings are discussed and future planning is recommended.

Adaptation, Psychological↗

Ventilatory function in experienced recreational scuba divers: Evidence of small airways disease?

Diving has shown long-term effects on respiratory function in trained professional divers, indicating the development of small airways disease. The results are more controversial in trained recreational divers because of the different degrees of exposure and training. The aim of this study was to investigate the effects of recreational diving on respiratory function in highly experienced divers. Volumes and expiratory flow rates were measured in 32 older recreational divers (51.6 +/- 7.4 years). The forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were higher (+ 4.9 % and + 6 %, respectively; p < 0.01) than the theoretical standards (ERS 93). These values tended to decrease more rapidly as the age advanced (age range: 43 - 73 years) (p < 0.05). Moreover, the mid-expiratory flows at 50 %, 25 % and 25 - 75 % of vital capacity (MEF(50 %), MEF(25 %) and MEF(25 - 75 %)) were significantly decreased. These early signs of decrease suggest slight small airways disease in older experienced recreational divers.

Adult↗

Simulation studies of the fidelity of biomolecular structure ensemble recreation.

We examine the ability of Bayesian methods to recreate structural ensembles for partially folded molecules from averaged data. Specifically we test the ability of various algorithms to recreate different transition state ensembles for folding proteins using a multiple replica simulation algorithm using input from "gold standard" reference ensembles that were first generated with a Go-like Hamiltonian having nonpairwise additive terms. A set of low resolution data, which function as the "experimental" phi values, were first constructed from this reference ensemble. The resulting phi values were then treated as one would treat laboratory experimental data and were used as input in the replica reconstruction algorithm. The resulting ensembles of structures obtained by the replica algorithm were compared to the gold standard reference ensemble, from which those "data" were, in fact, obtained. It is found that for a unimodal transition state ensemble with a low barrier, the multiple replica algorithm does recreate the reference ensemble fairly successfully when no experimental error is assumed. The Kolmogorov-Smirnov test as well as principal component analysis show that the overlap of the recovered and reference ensembles is significantly enhanced when multiple replicas are used. Reduction of the multiple replica ensembles by clustering successfully yields subensembles with close similarity to the reference ensembles. On the other hand, for a high barrier transition state with two distinct transition state ensembles, the single replica algorithm only samples a few structures of one of the reference ensemble basins. This is due to the fact that the phi values are intrinsically ensemble averaged quantities. The replica algorithm with multiple copies does sample both reference ensemble basins. In contrast to the single replica case, the multiple replicas are constrained to reproduce the average phi values, but allow fluctuations in phi for each individual copy. These fluctuations facilitate a more faithful sampling of the reference ensemble basins. Finally, we test how robustly the reconstruction algorithm can function by introducing errors in phi comparable in magnitude to those suggested by some authors. In this circumstance we observe that the chances of ensemble recovery with the replica algorithm are poor using a single replica, but are improved when multiple copies are used. A multimodal transition state ensemble, however, turns out to be more sensitive to large errors in phi (if appropriately gauged) and attempts at successful recreation of the reference ensemble with simple replica algorithms can fall short.

Algorithms↗

High false alarm rates on a vigilance task may indicate recreational drug use.

Neuropsychologists need more sensitive methods to detect and measure recreational drug use in both research and clinical settings. In a study comparing the sensitivity of information processing tasks and neuropsychological instruments to detect early HIV-related cognitive decrements, 18 of 129 subjects tested positive for recreational drugs. Sixteen of these 18 subjects had elevated false alarm rates on one of the information processing tasks, the vigilance task. Another 45 subjects who tested negative for recreational drugs also had elevated false alarm rates. Neuropsychological measures of premorbid functioning, attention, speed of information processing, and manual dexterity were lower in the high false alarm subjects than in the remaining 66 drug-negative, low false alarm subjects. These results suggest that a high false alarm rate may reflect long-standing cognitive disturbances and the effects of drug use. The vigilance task may be a sensitive and efficient screening tool for recreational drug use.

AIDS Dementia Complex↗

Recreational sports participation is associated with enhanced physical fitness in children.

The purpose of this study was to examine the association between seasonal participation in recreational sports and its influence on physical fitness measures in children. A total of 44 children (20 boys and 24 girls) all in the fifth grade (11.2 +/- 0.3 yr) were tested for flexibility, upper body strength, upper body power, and lower body power. Activity questionnaires examined seasonal participation rates in recreational sports. Spearman rank correlations showed significant correlations between sport participation rates and performance on selected physical fitness tests (p range between 0.34 and 0.55). Subjects participating in recreational sport programs throughout the year (fall, winter, and spring) performed significantly better in tests of upper body strength, upper body power, and lower body power than subjects who did not participate in any sport or subjects who participated in only one sport. These findings suggest that regular participation in recreational sports throughout the year may be associated with higher levels of muscular strength and anaerobic power in children.

Anaerobic Threshold↗

Drunk, drowsy, doped: skiers' and snowboarders' injury risk perceptions regarding alcohol, fatigue and recreational drug use.

The objective was to investigate perceptions of snowfield resort visitors about injury risk regarding alcohol, fatigue and recreational drug use. Visitors to a resort village in a large Australian snowfield region completed a brief survey about fatigue, alcohol and recreational drug use and injury risk perception. Participants stated their ability to ski or snowboard and drive safely following a lack of sleep, alcohol and recreational drug use. Intoxicated snowfield resort visitors were compared with non-intoxicated visitors. Safety beliefs across snow sport and transport were compared. Participants reported that they generally slept less than usual and 30% reported both drinking alcohol and using drugs more than usual while visiting the snowfields. Participants perceived driving as a greater injury risk than skiing/snowboarding (p < 0.001). Fatigue was perceived as a relatively weak injury risk factor, particularly whilst skiing and snowboarding. Awareness needs to be raised among snowfield resort visitors about the contribution of alcohol, fatigue and recreational drug use to snow sport and transport-related injury risk.

Adult↗

Recreational drug consumers: who seeks treatment?

BACKGROUND: Recreational drug consumption represents a complex issue, because of the lack of a shared definition, settings and patterns of consumptions, and poorness of evidence-based treatments. In spite of the great number of users, just few seek specific treatment, probably representing those at major risk of continuing and problematic use. The general objective of this study was to report the characteristics and main consumption patterns of recreational drug consumers treated in Regione Piemonte (Italy), in order to formulate hypotheses suitable for further research aimed at establishing more effective preventive intervention and treatment. METHODS: All addiction treatment services in the region were required to fill in, for each user, a questionnaire reporting: contact of the user with the service, socio-demographic data, drugs consumption and interventions/treatments. RESULTS: Among 441 users, 70.3% were new users, 85.5% were males and the average age of consumption onset was 22 years. Psychiatric and traumatics events were present in 13.3% and in 17.9% of cases, respectively. The most frequent primary substances were cocaine (76.9%) and ecstasy (13.8%). Substances taken in association with primary drug are quoted in 75% of cases. CONCLUSIONS: The users that get in touch with services are those showing greater problems, representing, therefore, the main target for preventive public health interventions. Some interesting points can be noted: among patients treated, cocaine represents the main issue; females seem to be more sensitive to recreational drug effects; social class (education), settings and use habits are similar for recreational drugs users and heroin users.

Adolescent↗

Review of epidemiological studies on health effects from exposure to recreational water.

BACKGROUND: In order to facilitate the setting of guidelines, this review article evaluates the health risks caused by poor microbiological quality of recreational natural water. METHODS: Studies on uncontrolled waters, such as sea, lakes and rivers were considered in this review through MEDLINE and WHO resources. Out of the 37 studies identified, 22 were reviewed because they addressed associations of interest and fulfilled the validity criteria. RESULTS: Most studies reported a dose-related increase of health risk in swimmers with an increase in the indicator-bacteria count in recreational waters. Relative risk (RR) values for swimming in polluted water versus clean water were often significant (usually 1.0 < RR < 3.0). The indicator microorganisms that correlate best with health outcomes were enterococci/faecal streptococci for both marine and freshwater, and Escherichia coli for freshwater. In both marine and freshwater, increased risk of gastro-intestinal symptoms was reported for water quality values ranging from only a few indicator counts/100 ml to about 30 indicator counts/100 ml. These values are low compared with the water qualities frequently encountered in coastal recreational waters. Studies which showed a higher threshold for increased risk and case-rate values in some countries may suggest immunity due to endemicity or a lower pathogen-to-indicator ratio in the natural waters. CONCLUSIONS: The review strongly suggests a causal dose-related relationship between gastrointestinal symptoms and recreational water quality measured by bacterial indicator counts.

Adolescent↗

Changes in alcohol, cigarette, and recreational drug use during pregnancy: implications for intervention.

From the Baltimore-Washington Infant Study, a regional epidemiologic study of congenital cardiovascular malformations, 1,336 mothers of infants selected as controls (a representative sample of the area birth cohort enrolled between April 1, 1981 and September 1, 1984) were studied with respect to alcohol, cigarette, and recreational drug use prior to and during pregnancy. Nearly half of the 1,336 women abstained from any substance use during pregnancy. Of the remainder, half restricted substance use to only alcohol or cigarettes. Only cigarette smokers showed a majority (68.5%) of women failing to successfully quit during pregnancy. Cigarette and recreational drug use during pregnancy was associated with lower socioeconomic status, while alcohol use was associated with higher social status. Cessation of cigarette and recreational drug use was more common among professionals and the college-educated, but these same characteristics, along with higher income, were associated with failure to quit drinking. Younger women were less likely to use alcohol and cigarettes and more likely to successfully quit these habits once adopted. Use of alcohol and tobacco was greater among whites, and recreational drug use was greater among black women, but race was not associated with quitting use of any substance. Length of time trying to become pregnant and the mother's perceived health were not found to be associated with substance use or quitting. This sociodemographic profile suggests subgroups which must be targeted for intervention by the prenatal care provider, as well as intervention strategies.

Adolescent↗

Comparison of glenohumeral joint laxity in elite and recreational swimmers.

OBJECTIVE: To investigate whether glenohumeral joint (GHJ) hyperlaxity is related to swimming training volume, we evaluated elite and recreational swimmers for differences in GHJ laxity and general joint hypermobility (GJH). PARTICIPANTS: Thirty male and female elite swimmers, aged 15-25 years, were compared with 30 recreational swimmers on five clinical GHJ laxity tests. GJH was assessed based on evaluation of hypermobility in four other joints or joint combinations. OUTCOME MEASURES: Group differences in both GHJ laxity and GJH were analyzed using chi 2 analysis. RESULTS: Compared with the recreational swimmers, the elite swimmers demonstrated significantly greater GJH, as well as significantly greater GHJ laxity on three of five laxity tests. The specific patterns of greater GHJ laxity demonstrated by the elite swimmers versus the recreational swimmers favour an acquired origin for these laxity differences, while the results of the GJH assessment suggest that these laxity differences are inherent. CONCLUSIONS: It was concluded that a combination of acquired and inherent factors contributes to the greater GHJ laxity demonstrated in elite swimmers. We discuss the implications of this study for the prevention of shoulder overuse dysfunction (SOD) in elite swimmers.

Adolescent↗

Recreational drugs and fetal gastroschisis: maternal hair analysis in the peri-conceptional period and during pregnancy.

OBJECTIVE: To objectively measure individual recreational drug groups in maternal hair samples timed for the period of conception and different stages of pregnancy in expectant mothers with a diagnosis of fetal gastroschisis. DESIGN: Prospective observational study. SETTING: Tertiary level Fetal Medicine Unit in a University teaching hospital. POPULATION: Pregnant women with a diagnosis of fetal gastroschisis (n= 22) and a control group of women (n= 25) with a normal fetus. METHODS: Hair samples were cut from the vertex of the head of expectant mothers with a diagnosis of fetal gastroschisis and a matched control group in whom the fetus was normal. The samples were analysed by enzyme-linked immunosorbent assay (ELISA) for individual drug groups. Confirmatory tests using gas chromatography with mass spectrometry (GCMS) were used. MAIN OUTCOME MEASURES: Presence of recreational drug compounds in hair samples. RESULTS: In the group with fetal gastroschisis there were four proven positive cases for recreational drug abuse (18%) and there were none in the control group. CONCLUSIONS: The incidence of recreational drug use in the peri-conceptional period and the first trimester by expectant mothers with a diagnosis of fetal gastroschisis is 18%. This association may be linked to the recent increase in the incidence of gastroschisis among younger mothers.

Adolescent↗

Intravascular haemolysis in the recreational runner.

Intravascular haemolysis has been found to result from prolonged endurance competition, rigorous military training and participation in impact sports. Haematological research involving the recreational runner is sparse. Recreational runners frequently vary their training to avoid monotony and improve endurance capacity. This study investigated the haematological effects of a typical day of increased distance training in 15 male recreational runners (62.4(3.1) ml kg-1 min-1 treadmill VO2max; 44.6(8.4) km per week training (means(s.d.)). Venous blood samples were collected before, immediately after, 1 day, 4 days, and 10 days after a 13-km training run (about twice the subjects' typical running distance) and analysed for changes in bilirubin, serum potassium, haematocrit, haemoglobin, red blood cell count, haptoglobin, poikilocytosis and reticulocytosis. Urine samples were collected at the same times as the blood samples and analysed for urobilinogen. Significant (P less than 0.05) 1-day and 4-day decreases in mean haemoglobin, red blood cell count, and haptoglobin values, compared to before training venous blood values and significant (P less than 0.05) post-training increases in bilirubin, serum potassium, urobilinogen and poikilocytosis provided evidence for increased intravascular haemolysis. After 10 days the values for haematocrit, bilirubin, serum potassium, red blood cell count, urobilinogen and poikilocytosis were not significantly (P less than 0.05) different from pre-training values while haemoglobin remained significantly (P less than 0.05) lower, exhibiting a constant but not significant increase over the period from 1 to 10 days. The results indicate that mild intravascular 'footstrike' haemolysis can occur in the recreational runner when typical training distance is increased. This condition appears to be transient and benign.

Anemia↗

Impaired cognitive performance in drug free users of recreational ecstasy (MDMA)

OBJECTIVES: Ecstasy (3,4-methylenedioxymethamphetamine (MDMA) and related congerers: MDA, MDEA) is the name given to a group of popular recreational drugs. Animal data raise concern about neurotoxic effects of high doses of ecstasy on central serotonergic systems. The threshold dose for neurotoxicity in humans is not clear and serotonin is involved in several functions including cognition. The purpose of this study was to investigate cognitive performance in a group of typical recreational ecstasy users. METHODS: A comprehensive cognitive test battery was administered to 28 abstinent ecstasy users with concomitant use of cannabis only and to two equally sized matched groups of cannabis users and non-users. The sample consisted of ecstasy users with a typical recreational use pattern and did not include very heavy users. RESULTS: Ecstasy users were unimpaired in simple tests of attention (alertness). However, they performed worse than one or both control groups in the more complex tests of attention, in memory and learning tasks, and in tasks reflecting aspects of general intelligence. Heavier ecstasy and heavier cannabis use were associated with poorer performance in the group of ecstasy users. By contrast, the cannabis users did not differ significantly in their performance from the non-users. CONCLUSIONS: The present data raise concern that use of ecstasy possibly in conjunction with cannabis may lead to cognitive decline in otherwise healthy young people. Although the nature of the emerging cognitive disturbance is not yet clear, an impairment of working memory might be the common denominator underlying or contributing to declines of performance in various tasks. The cognitive disturbance is likely to be related to the well recognised neurotoxic potential of ecstasy. The data suggest that even typical recreational doses of ecstasy are sufficient to cause neurotoxicity in humans.

Adolescent↗

Prevalence of allergy and asthma symptoms in recreational roadrunners.

PURPOSE: The prevalence of allergy and asthma symptoms and asthma medication use, which has been extensively studied in elite athletes, has received little attention in recreational roadrunners. METHODS: A validated questionnaire was used to determine the prevalence of allergy and asthma symptoms, the use of medication, and allergy specialty attention among recreational roadrunners. Comparison with the published prevalence of allergy and asthma symptoms in Olympic athletes was made. RESULTS: The prevalence of allergy and asthma symptoms were similar in two consecutive yearly surveys (2003, 2004). The response from 2004 was 11% (484 of 4398 runners). The study population was 60% male, 56% Caucasian, 10% non-Caucasian, and 34% undesignated. Subjects competed for 13.2 +/- 10.5 yr. Prevalence was 44% for symptoms of allergy, 31% for asthma, and 21% for both. Of those reporting allergy symptoms alone, 0.5% had prescription medications or medication before the race. Those with asthma and allergy or asthma alone were more likely to have prescription medication (allergy and asthma, 32%, P = 0.0001; asthma, 6%, P = 0.001), to take medication before the race (asthma and allergy, 27%, P = 0.0001; asthma, 5%, P = 0.007), or to seek specialty attention and medication (asthma and allergy, 39%, P = 0.0001; asthma, 7%, P = 0.004) than those with allergy symptoms alone. The comparison with results from a survey of Olympic athletes indicates that symptoms of allergy and asthma were more prevalent in recreational athletes (P = 0.0001 to 0.007), but roadrunners were less likely to be taking prescription medication (P = 0.025). CONCLUSION: These results suggest that the recreational roadrunner is more likely to report symptoms of allergy and/or asthma but less likely to have prescription medication than the Olympic athlete.

Adolescent↗

Rapidly measured indicators of recreational water quality are predictive of swimming-associated gastrointestinal illness.

Standard methods to measure recreational water quality require at least 24 hr to obtain results, making it impossible to assess the quality of water within a single day. Methods to measure recreational water quality in <or=2 hr have been developed. Application of rapid methods could give considerably more accurate and timely assessments of recreational water quality. We conducted a prospective study of beachgoers at two Great Lakes beaches to examine the association between recreational water quality, obtained using rapid methods, and gastrointestinal (GI) illness after swimming. Beachgoers were asked about swimming and other beach activities and 10-12 days later were asked about the occurrence of GI symptoms. We tested water samples for Enterococcus and Bacteroides species using the quantitative polymerase chain reaction (PCR) method. We observed significant trends between increased GI illness and Enterococcus at the Lake Michigan beach and a positive trend for Enterococcus at the Lake Erie beach. The association remained significant for Enterococcus when the two beaches were combined. We observed a positive trend for Bacteroides at the Lake Erie beach, but no trend was observed at the Lake Michigan beach. Enterococcus samples collected at 0800 hr were predictive of GI illness that day. The association between Enterococcus and illness strengthened as time spent swimming in the water increased. This is the first study to show that water quality measured by rapid methods can predict swimming-associated health effects.

Adult↗

Interactions between recreational drugs and antiretroviral agents.

OBJECTIVE: To summarize existing data regarding potential interactions between recreational drugs and drugs commonly used in the management of HIV-positive patients. DATA SOURCES: Information was obtained via a MEDLINE search (1966-August 2002) using the MeSH headings human immunodeficiency virus, drug interactions, cytochrome P450, medication names commonly prescribed for the management of HIV and related opportunistic infections, and names of commonly used recreational drugs. Abstracts of national and international conferences, review articles, textbooks, and references of all articles were also reviewed. STUDY SELECTION AND DATA EXTRACTION: Literature on pharmacokinetic interactions was considered for inclusion. Pertinent information was selected and summarized for discussion. In the absence of specific data, prediction of potential clinically significant interactions was based on pharmacokinetic and pharmacodynamic properties. RESULTS: All protease inhibitors (PIs) and nonnucleoside reverse transcriptase inhibitors are substrates and potent inhibitors or inducers of the cytochrome P450 system. Many classes of recreational drugs, including benzodiazepines, amphetamines, and opioids, are also metabolized by the liver and can potentially interact with antiretrovirals. Controlled interaction studies are often not available, but clinically significant interactions have been observed in a number of case reports. Overdoses secondary to interactions between the "rave" drugs methylenedioxymethamphetamine (MDMA) or gamma-hydroxybutyrate (GHB) and PIs have been reported. PIs, particularly ritonavir, may also inhibit metabolism of amphetamines, ketamine, lysergic acid diethylmide (LSD), and phencyclidine (PCP). Case series and pharmacokinetic studies suggest that nevirapine and efavirenz induce methadone metabolism, which may lead to symptoms of opiate withdrawal. A similar interaction may exist between methadone and the PIs ritonavir and nelfinavir, although the data are less consistent. Opiate metabolism can be inhibited or induced by concomitant PIs, and patients should be monitored for signs of toxicity and/or loss of analgesia. PIs should not be coadministered with midazolam and triazolam, since prolonged sedation may occur. CONCLUSIONS: Interactions between agents commonly prescribed for patients with HIV and recreational drugs can occur, and may be associated with serious clinical consequences. Clinicians should encourage open dialog with their patients on this topic, to avoid compromising antiretroviral efficacy and increasing the risk of drug toxicity.

Anti-HIV Agents↗

Ratings of perceived exertion and muscle activity during the bench press exercise in recreational and novice lifters.

This study examined ratings of perceived exertion (RPE) and electromyography (EMG) during resistance exercise in recreational and novice lifters. Fourteen novice (age = 21.5 +/- 1.5 years) and 14 recreationally trained (age = 21.9 +/- 2.2 years) women volunteered to perform the bench press exercise at 60 and 80% of their 1 repetition maximum (1RM). RPE and EMG were measured during both intensities. Statistical analyses revealed that active muscle RPE increased as resistance exercise intensity increased from 60% 1RM to 80% 1RM (12.32 +/- 1.81 vs. 15.14 +/- 1.74). Integrated EMG also increased as resistance exercise intensity increased from 60% 1RM to 80% 1RM (in the pectoralis major; 98.62 +/- 17.54 vs. 127.98 +/- 29.02). No significant differences in RPE or EMG were found between novice and recreational lifters. These results indicate that RPE is related to the relative exercise intensity lifted as well as muscle activity during resistance exercise for both recreational and novice lifters. These results support the use of RPE as a method of resistance exercise intensity estimation for both types of lifters.

Adolescent↗