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Anxiety and panic in recreational scuba divers.

Scuba diving is a high-risk sport; it is estimated that 3 to 9 deaths per 100,000 divers occur annually in the US alone, in addition to increasing numbers of cases of decompression illness each year. However, there has been a tendency within the diving community to de-emphasise the risks associated with scuba diving. While there are numerous factors responsible for the injuries and fatalities occurring in this sport, there is general consensus that many of these cases are caused by panic. There is also evidence that individuals who are characterised by elevated levels of trait anxiety are more likely to have greater state anxiety responses when exposed to a stressor, and hence, this sub-group of the diving population is at an increased level of risk. Efforts to demonstrate that selected interventions such as hypnosis, imagery, mediation and relaxation can reduce stress responses in anxious divers has not yielded consistent findings, and there is a need for systematic research dealing with the efficacy of selected intervention strategies.

Accidents↗

Epilepsy in sports and recreation.

In the US, millions of people participate in physical activity on a regular basis. However, among the many people with epilepsy, few incorporate exercise into their daily routine. Whether it is because of parental or physician restriction, the fact remains that people with epilepsy are less fit and are not getting the exercise they need. For many years, patients with seizure disorders have been discouraged from participating in physical fitness and team sports due to the fear that it will exacerbate their seizure disorder. However, this overprotective attitude has been slowly changing in light of more recent data on this subject. The evidence shows that patients with good seizure control can participate in both contact and non-contact sports without adversely affecting seizure frequency. This article reviews the effects of exercise on seizure control among patients with epilepsy. It examines the morbidity and mortality associated with exercise, as well as its psychological and physiological effects. Various topics concerning antiepileptic drugs and exercise are also discussed.

Anticonvulsants↗

An exploratory study of recreational drug use and nutrition-related behaviors and attitudes among adolescents.

This study examined drug use and eating behaviors among adolescents. The data were collected by phone interviews from 401 northern Nevadan students in grades seven to twelve. Students were divided for comparison into three groups according to their involvement with drugs: Abstainers, conventional users, and high-risk users. Analyses indicated that high-risk users less frequently ate lunch, meals at home, and with their families, and ate more often at convenience stores, fast food restaurants, and with friends. In addition, female high-risk users had significantly more negative perceptions regarding their food choices than the other female groups, and were more concerned with dieting than their high-risk using male peers. Male and female high-risk users believed that their drug use affected their eating habits. Implications for prevention programming and future research are discussed.

Adolescent↗

Persistent neuropsychological problems after 7 years of abstinence from recreational Ecstasy (MDMA): a case study.

This case study concerns a 26-yr.-old male who had consumed large amounts of Ecstasy seven years previously. He stated that his increasingly intensive use of ecstasy over a 4-yr. period had led to the emergence of multiple psychiatric and psychological problems. Given these problems, he stopped using Ecstasy, but the problems had not resolved despite seven years of abstinence. The neurocognitive profile was very similar to that shown by current heavy Ecstasy users, with deficits in immediate and delayed verbal recall, moderately impaired memory function, but normal expressive language ability and perceptual functioning. Extremely high pathology was evident, including depression and phobic anxiety. Severe problems with sleep and sex were also reported. Further studies involving larger groups of abstinent former users are needed; adverse sequelae associated with intensive Ecstasy use may sometimes be enduring.

Adrenergic Uptake Inhibitors↗

Recreational propane inhalation in an adolescent male.

Propane inhalation may be widespread, yet only a few cases have been reported. The victims were usually found dead, and only one other report describes firsthand the sought-after effects. We report on a 17 year-old male with a six month history of repeated inhalation. The patient manifested no pathophysiologic signs, but the ready availability of propane may result in an increase in its abuse. This activity carries considerable risk for trauma and/or sudden death. Our patient was able to recruit others to the practice by finding ways to avoid some of the unique, inherent deterrents.

Adolescent↗

[What to do? The Ontario government and the illegal recreational use of drugs, 1966-1972].

This paper deals with the social construction of illegal drug use in the context of the counterculture movement. It looks at the actions and reactions of three groups in particular: the Ontario government, the Addiction Research Foundation of Ontario and citizens. It demonstrates that the debate about drug use took place in particular circumstances characterized by ignorance about the health consequences of illegal drug use but also within a moral panic context. Medical expertise was solicited to provide guidance to the Ontario government but it was gradually challenged by other medical groups and citizens who, by sending letters to their Provincial Premier and the Minister of Health, tried to shape public policy.

Canada↗

Recreating communities to support active living: a new role for social marketing.

The lack of routine physical activity has become an all too pervasive health threat in the United States. Social marketing can be used directly to promote increased physical activity among people who have access to active living options (e.g., safe and convenient sidewalks or bike paths). A second, albeit indirect, use of social marketing to promote physical activity--and the focus of this article--involves promoting behaviors that influence the built environment for the purpose of increasing people's access to active living options. This use of social marketing involves changing the behavior of consumers, developers, distribution channels (e.g., real estate agents) and policy makers. The approach offers public health and other organizations a disciplined, consumer-focused means of mobilizing their available resources in a manner that maximizes the odds of creating active living communities. These means include understanding the competition, understanding target markets, creating mutually beneficial exchanges, segmenting markets and targeting them based on anticipated return. This article identifies specific opportunities for applying the social marketing approach to create active living communities, and identifies opportunities at the state and national level that will enhance the effectiveness of local efforts.

Community Health Planning↗

Paroxysmal atrial fibrillation after recreational marijuana smoking: another "holiday heart"?

Paroxysmal atrial fibrillation (AF) is a common arrhythmia that may occur after various triggers. With the exception of the well recognized "holiday heart" associated with acute alcohol consumption, the cause of AF is rarely identified in young adults. We report a case of paroxysmal AF after marijuana smoking in a 22 year old female with no other identifiable triggers and normal echocardiography. Marijuana smoking should be included in the list of possible triggers in young adults presenting with paroxysmal AF, once cardiac disease and other common causes of AF have been excluded.

Adult↗

Poisoning with the recreational drug paramethoxyamphetamine ("death").

OBJECTIVE: To describe the clinical features of paramethoxyamphetamine (PMA; "death") poisoning and to compare these with those of people with self-reported "ecstasy" poisoning. DESIGN: Retrospective casenote review. PARTICIPANTS AND SETTING: 22 patients who presented to the Emergency Department of the Royal Adelaide Hospital (RAH), a major metropolitan teaching hospital, between 1 January 1996 and 31 December 1998 with PMA poisoning identified through urine drug screens; and 61 patients with self-reported ecstasy poisoning between 1 September 1997 and 31 December 1998 found through the hospital databases. RESULTS: Patients with PMA poisoning presented with tachycardia (64%), hyperthermia (temperature > 37.5 degrees C; 36%), coma (41%), seizures (32%), arrhythmias (23%), and QRS intervals > or = 100 ms (50%) with greater frequency and often greater severity than those with self-reported ecstasy poisoning. Two patients with PMA poisoning presented with severe hypoglycaemia (blood glucose level, < 1.5 mmol/L) accompanied by hyperkalaemia (K+ concentration, > 7.5 mmol/L). CONCLUSIONS: At our hospital, PMA poisonings accounted for most of the severe reactions among people who believed they had taken ecstasy. Hypoglycaemia and hyperkalaemia may be specific to PMA poisoning. PMA toxicity should be suspected with severe or atypical reactions to "ecstasy", and confirmed by chromatographic urine drug screens.

Adolescent↗

Periodontal and dental lesions in raccoons from a farming and a recreational area in Illinois.

Dental health was evaluated in two populations of raccoons (Procyon lotor) in western Illinois (USA); one was from a rural agricultural area with low human density and the other from a nearby state park heavily used by humans and raccoons. From 1989 through 1993, 300 raccoons were live-trapped in the agricultural area and 246 raccoons were live-trapped in the park. Oral health was assessed using gingival and calculi indices and by measuring loss of attachment and tooth wear. Raccoons from the park were significantly older and smaller, but not thinner, than raccoons from the farmed area. Gingival and periodontal indices, tooth wear, tooth loss, and caries increased significantly from juveniles to yearlings to adults, at both sites. Males had higher levels of gingivitis and loss of periodontal attachment than females, but were similar on other dental measures. There were no seasonal differences between raccoons in dental indices. Animals with high scores for one oral measure tended to have high values for all indices. Dental health was generally good for juveniles and yearlings from both sites. Among adults, periodontal indices and the prevalence of caries were significantly higher in the park, but prevalence of broken or missing teeth was similar for both populations. There was no association between body condition, and a higher dental score or more missing or broken teeth.

Age Factors↗