Recreational Venues Research Articles

Drug use and nightlife: more than just dance music

BackgroundResearch over the last decade has focused almost exclusively on the association between electronic music and MDMA (3,4-Methylenedioxymethamphetamine or "ecstasy") or other stimulant drug use in clubs. Less attention has been given to other nightlife venues and music preferences, such as rock music or southern/funky music. This study aims to examine a broader spectrum of nightlife, beyond dance music. It looks at whether certain factors influence the frequency of illegal drug and alcohol use: the frequency of going to certain nightlife venues in the previous month (such as, pubs, clubs or goa parties); listening to rock music, dance music or southern and funky music; or sampling venues (such as, clubs, dance events or rock festivals). The question of how these nightlife variables influence the use of popular drugs like alcohol, MDMA, cannabis, cocaine and amphetamines is addressed.MethodsThe study sample consisted of 775 visitors of dance events, clubs and rock festivals in Belgium. Study participants answered a survey on patterns of going out, music preferences and drug use. Odds ratios were used to determine whether the odds of being an illegal substance user are higher for certain nightlife-related variables. Furthermore, five separate ordinal regression analyses were used to investigate drug use in relation to music preference, venues visited during the last month and sampling venue.ResultsRespondents who used illegal drugs were 2.5 times more likely to report that they prefer dance music. Goa party visitors were nearly 5 times more likely to use illegal drugs. For those who reported visiting clubs, the odds of using illegal drugs were nearly 2 times higher. Having gone to a pub in the last month was associated with both more frequent alcohol use and more frequent illegal substance use. People who reported liking rock music and attendees of rock festivals used drugs less frequently.ConclusionsIt was concluded that a more extended recreational environment, beyond dance clubs, is associated with frequent drug use. This stresses the importance of targeted prevention in various recreational venues tailored to the specific needs of the setting and its visitors.

Jeitos de corpo: cor/raça, gênero, sexualidade e sociabilidade juvenil no centro de São Paulo

Neste texto discutimos resultados de partes da pesquisa realizada em São Paulo entre 2006 e 2008, dentro do projeto mais amplo, "Relations among 'race', sexuality and gender in different local and national contexts". Comparamos espaços de sociabilidade juvenil reconhecidos como homo e heterossexuais na região do centro histórico da cidade, tendo por fio condutor os modos como marcadores de diferença referidos a cor/raça, classe, gênero e sexualidade operam para classificar frequentadores, numa lógica de produção de sujeitos desejáveis (ou não) e de preferências de parcerias afetivo-sexuais; assim como para ordenar padrões de interação Refletimos sobre os modos e condições em que essas diferenças - que informam e constroem representações de hierarquia e discriminação - são agenciadas por determinados sujeitos em campos específicos de relações, tendo em vista suas trajetórias sociais.

Desire, Hierarchy, and Agency: Youth, Homosexuality, and Difference Markers in São Paulo

In this article, we present the results of ethnographic research undertaken in areas with concentrated recreational venues frequented by diverse youth groups in the city of Sao Paulo, Brazil. This material is part of the larger “Relationships between race, gender and sexuality in different national and local contexts” research initiative. Here, we focus upon data collected through ethnographic observation and interviews conducted in various locales where young men meet to engage in homoerotic sociability, demonstrating different degrees of conviviality among groups of different socioeconomic profiles and distinct esthetic preferences, consumer habits, and body types. We explore the production of styles and body presentations that link markers of color/race, gender, and sexuality, as well as the relationships that these maintain with opening or restricting possibilities for the establishment of erotic and affective partnerships involving these boys.

Cryptosporidium surveillance and risk factors in the United States

Surveillance for Cryptosporidium in the United States indicates that the reported incidence of infection has increased dramatically since 2004. The reasons for this increase are unclear but might be caused by an actual increase in incidence, improved surveillance, improved awareness about cryptosporidiosis, and/or increases in testing practices resulting from the licensing of the first-ever treatment for cryptosporidiosis. While regional differences remain, the incidence of cryptosporidiosis appears to be increasing across the United States. Onset of illness is most common during the summer, particularly among younger children. Cryptosporidiosis case reporting also influences outbreak detection and reporting; the recent rise in cases coincides with an increase in the number of reported cryptosporidiosis outbreaks, particularly in treated recreational water venues. Risk factors include ingesting contaminated recreational or drinking water, exposure to infected animals, having close contacts with cryptosporidiosis, travel to disease-endemic areas, and ingestion of contaminated food. Advances in molecular characterization of clinical specimens have improved our understanding of the changing epidemiology and risk factors. Prevention and control of cryptosporidiosis requires continued efforts to interrupt the transmission of Cryptosporidium through water, food, and contact with infected persons or animals. Of particular importance is continued improvement and monitoring of drinking water treatment and advances in the design, operation, and management of recreational water venues coupled with behavioral changes among the swimming public.

Risk factors associated with smoking behaviour in recreational venues: findings from the International Tobacco Control (ITC) China Survey

ObjectiveTo explore the determinants of smoking behaviour in recreational venues and to provide scientific bases for establishing smoke-free measures applying to these locations.MethodsThe International Tobacco Control (ITC) China Survey—a face-to-face...

Sexual risk behaviour for women working in recreational venues in Mwanza, Tanzania: considerations for the acceptability and use of vaginal microbicide gels

Qualitative research was conducted to explore the social context of sexual-risk behaviour among women working in recreational occupations, during a feasibility study in preparation for the Phase III clinical trial of vaginal microbicides in Mwanza, Tanzania. Participant observation was conducted in 68 recreational venues. Six focus group discussions were conducted with women working in recreational occupations and two with male customers at these venues. Findings revealed that these women are at risk of HIV due their dependence on sexual transactions to improve their economic circumstances, which take place in environments and relationships where condom use is difficult. However, the findings revealed that, in spite of constraints, women did take actions to prevent HIV by negotiating for condom use or avoiding perceived risky practices or partnerships, in particular moving to more casual partnerships where condom negotiation is more acceptable. This indicates that, given their perception of their own risk, women working in recreational occupations will welcome an effective microbicide. However, sustained use will depend on how formulations overcome the difficulties women currently experience with condom negotiation and the specific environments and relationships in which they engage in sex.

Communitywide Cryptosporidiosis Outbreak—Utah, 2007

Cryptosporidiosis is a nationally notifiable gastrointestinal illness caused by chlorine-resistant protozoa of the genus Cryptosporidium. Fecal-oral transmission of Cryptosporidium occurs via ingestion of contaminated recreational water, drinking water, or food, or via contact with infected persons or animals (e.g., cattle). Incidence peaks in late summer and coincides with the summer swimming season. The number of nonoutbreak cryptosporidiosis cases reported nationally increased from 3,411 cases in 2004 to nearly 8,300 in 2007 (CDC, unpublished data, 2008). This substantial increase (143%) mirrors the increase in the number of nationally reported cryptosporidiosis outbreaks associated with treated recreational water venues (e.g., pools, water parks, and interactive fountains): seven reported treated recreational water-associated outbreaks in 2004, 19 in 2006, and, as of September 5, 2008, provisional reports of 26 in 2007 (CDC, unpublished data, 2008). This report describes a communitywide cryptosporidiosis outbreak in Utah that likely was associated initially with treated recreational water venues and subsequently with person-to-person transmission. Cryptosporidium's ability to cause communitywide outbreaks, which is attributable to factors such as its chlorine resistance, underscores the need for more rapid implementation of control measures once an increase in case reporting is noted rather than waiting for an outbreak investigation to implicate a specific source of transmission. Such a response should include 1) pre-outbreak planning and preparation, 2) pre-outbreak adoption of a disease action threshold (e.g., a twofold to threefold increase in cases over baseline), and 3) rapid mobilization of community partners to implement control measures once the threshold is exceeded.

Business Policies Affecting Secondhand Smoke Exposure

Despite recent legislative and voluntary policy changes, a significant number of workplaces, recreational venues, and public facilities do not offer the public full protection from secondhand smoke exposure. The current study assessed smoking policies, attitudes toward smoke-free policies, and support for policy change among business owners and managers of businesses open to the public in North Carolina. Business owners and managers were interviewed over the phone. Businesses included all airports, arcades, malls, bowling alleys, and arenas (seating more than 500) in the state as well as a random sample of grocery and convenience stores. A 100% smoke-free policy was reported in 53% of businesses, ranging from 12% in bowling alleys to 97% in arenas. A large majority of business owners and managers understand the health risks of secondhand smoke exposure (82%-89%) and support restrictions on smoking in their businesses (84%-91%). Barriers to voluntary policy change included the lack of legal requirement (39%) and fear of the loss of business (53%). This study used self-report data from business owners and managers; the accuracy of the business smoking policy, customer and employee exposure time, and number of complaints may vary across respondents. It is also possible some participants were influenced by factors of social desirability of responses. Continued progress in establishing 100% smoke-free indoor environments may depend on successful advocacy in instituting legislation mandating the elimination of secondhand smoke in all public places. Advocacy efforts should include education around addressing economic concerns of businesses.

RareCryptosporidium hominisSubtype Associated with Aquatic Center Use

To the Editor: Cryptosporidiosis is the most frequently reported gastrointestinal illness in outbreaks associated with treated (disinfected) recreational water venues in the United States (1). In 2003, an increased number of cryptosporidiosis cases occurred in the Tri-Cities area of the Lower Mainland region (near Vancouver), in British Columbia, Canada. Although all cases were associated with the use of a community aquatic center, their onset dates were spread over a 3-month period, and the link between cases was unclear. The aim of this study was to determine if the cases in this disease cluster were related. Although suitable molecular markers had yet to be defined at the time of the outbreak, recent reports on the use of the gp60 gene for subtyping in molecular epidemiologic studies (2,3) have enabled us to reanalyze the isolates and report these results. Fifteen laboratory-confirmed cases were identified from October 15 to December 5, 2003. This number was in excess of the anticipated incidence rate for this community, which averaged 5 reported cryptosporidiosis cases per year. During the period of investigation, an incident of fecal contamination at the aquatic center on October 10, 2003, was documented and remediation involved increasing the free chlorine concentration. Because the regional health authority was concerned about the increased number of cases, the facility closed voluntarily on December 5 for further remediation. However, recorded free chlorine concentrations did not exceed 2.0 ppm at any time during the investigative period (October 5–December 31). The health authority released a public advisory encouraging those who used the facility to submit fecal specimens for laboratory testing. The health authority also sent letters to family physicians in the area, informing them of the disease cluster and requesting that unpreserved stool specimens be collected, in addition to the formalin-fixed specimens, for routine diagnostic testing. Nine fecal specimens were collected from clinically symptomatic case-patients with histories of exposure to the implicated aquatic center. Five specimens were selected by using the criteria that they were from patients with laboratory-confirmed cryptosporidiosis cases from 5 separate households. The specimens were then coded for anonymity before subsequent molecular analysis. Genomic DNA was extracted from purified Cryptosporidium oocysts by freeze-thawing, and the species was determined by PCR amplification and sequencing of the 18S rRNA gene as described previously (4). The gp60 gene was also amplified by PCR by using primers described by Ong and Isaac-Renton (5). DNA sequences of amplicons were determined by cycle sequencing and assembled as described previously (4,5). The gp60 allele and subtype were identified by multiple sequence alignment with GenBank reference sequences and phylogenetic analysis that used ClustalX version 1.8 (www.clustal.org) as well as manual quantification of microsatellite repeats. The 18S rRNA and gp60 genes were amplified successfully from 4 specimens. On the basis of the 18S rRNA gene sequence, all case-patients were infected with Cryptosporidium hominis, a species associated primarily with human-to-human transmission. The gp60 sequences from all 4 case-patients were identical and were subtype IdA19, a rarely reported subtype of C. hominis. Globally, most reports of the gp60 Id allele, such as 9 reported cases from Australia, have identified the IdA15G1 subtype (3). Another subtype, IdA18, was isolated from 5 case-patients in a 1997 foodborne outbreak in Spokane, Washington (6). To date, the IdA19 subtype has been identified in only 1 sporadic case, in northern Ontario (7), and a subset of cases (seven 1dA19 and 2 mixed IdA19 and IbA10G2) in the 2001 waterborne outbreak in North Battleford, Saskatchewan (5,8). The IdA19 subtype is identical in sequence to the IdA18 subtype except for 1 extra TCA repeat in the microsatellite region. Neither subtype has been reported anywhere in the world except in Canada and the Pacific Northwest. Because cases from all previous C. hominis outbreaks of cryptosporidiosis in British Columbia have been caused by the IbA10G2 subtype, the most prevalent subtype in sporadic and outbreak cases around the world (2,5,9,10), our results indicate the presence of a new subpopulation of C. hominis parasites that could cause future disease outbreaks. The identification of the same subtype in all 4 case-patients with cryptosporidiosis associated with the use of a community aquatic center was consistent with their exposure history and confirmed that all cases were linked epidemiologically. However, the association between the single northern Ontario sporadic case and the larger number of Saskatchewan and British Columbia outbreak cases is uncertain. The association with the IdA18 subtype in the Washington foodborne outbreak is also unknown. Further research is needed to determine the distribution and prevalence of gp60 subtypes in Canada as well as other parts of the world before we can more clearly understand the transmission of the IdA19 subtype.

Inactivation of Cryptosporidium parvum under chlorinated recreational water conditions

Cryptosporidium is a chlorine-resistant protozoan parasite and the etiological agent in many disinfected recreational water outbreaks. While previous studies have reported disinfection Ct values for Cryptosporidium parvum using sodium hypochlorite, these studies have employed conditions and procedures which are not ideal for establishing public health remediation recommendations for chlorinated recreational water venues. In the present study, free chlorine Ct values were measured at pH 7.5 using young oocysts (<1 month old) and tissue culture to determine oocyst viability. Two different oocyst isolates were used: one originating from Iowa and one from Maine (USA). This study determined that the Ct values for a 3-log reduction in oocyst viability were 10,400 (Iowa) and 15,300 (Maine) at pH 7.5. These Ct values are higher than the Centers for Disease Control and Prevention (USA) currently recommends (Ct = 9,600) for achieving a 3.0-log inactivation of Cryptosporidium oocysts during remediation of recreational water venues following fecal diarrhea accidents.

Cryptosporidiosis Outbreaks Associated With Recreational Water Use — Five States, 2006

Cryptosporidiosis is a gastrointestinal illness caused by parasitic protozoa of the genus Cryptosporidium and can produce watery diarrhea lasting 1-3 weeks; one or two cases per 100,000 population are reported annually in the United States. Fecal-oral transmission of Cryptosporidium oocysts occurs through ingestion of contaminated drinking or recreational water, consumption of contaminated food, and contact with infected persons or animals (e.g., cattle or sheep). Unlike bacterial pathogens, Cryptosporidium oocysts are resistant to chlorine disinfection and can survive for days in treated recreational water venues (e.g., public and residential swimming pools and community and commercial water parks) despite adherence to recommended residual chlorine levels (1-3 ppm). For 2006, a total of 18 cryptosporidiosis outbreaks have been reported (as of July 24, 2007) to CDC's U.S. Waterborne Disease and Outbreak Surveillance System, compared with five outbreaks reported for 2003 and seven for 2004; data for 2005 and 2006 are not yet final. This report describes five laboratory-confirmed cryptosporidiosis outbreaks in 2006 that involved public recreational water use. The popularity of recreational water venues, the number and geographic distribution of recent cryptosporidiosis outbreaks, and the resistance of Cryptosporidium to chlorination suggest that treatment strategies for recreational water facilities need to be improved.

42. PILOT OF NON-INVASIVE (ORAL FLUID) TESTING FOR HIV WITHIN A COMMUNITY SETTING

An anonymous HIV surveillance study was conducted to determine the prevalence of HIV amongst patrons attending gay recreational venues, the level of undiagnosed HIV infection and to identify sexual risk behaviour associated with HIV positive, HIV negative and unknown serostatus. 427 men who have sex with men were recruited over a period of one week in various sex on premises venues and gay bars within the inner city of Brisbane. Oral fluid testing for HIV antibodies was undertaken using the Orasure collection system and assay. Each participant was invited to complete a brief behaviour questionnaire and submit an oral fluid specimen. Participants were also asked their HIV status. Surveys and specimens were linked using an anonymous numerical code. Surveys were analysed using Epi-Info. Oral swabs were tested for the presence of HIV antibodies and any reactive specimens were confirmed using an Orasure western Blot. Confirmed serology results were linked to reported sexual behaviours, testing patterns and HIV status. The results of this study - sexual and testing behaviour correlated with serostatus- and implications for HIV prevention programs will be presented. As well as that, discussions will be held regarding the community response to the project.

Reducing illness transmission from disinfected recreational water venues: swimming, diarrhea and the emergence of a new public health concern.

Recreational water-related illnesses are associated with swimming in contaminated water venues. The transmission of diarrheal illness in disinfected settings is influenced by several factors which include: chlorine resistance in waterborne pathogens; poor facility maintenance of disinfectant levels; and lack of healthy swimming habits. Health care providers can help to disseminate healthy swimming messages to their patients and help to prevent and control this emerging public health concern.

Health and safety problems in recreational nightlife in the Island of Mallorca

Objective: To examine data on public health problems in recreational life, particularly those associated with conditions of clubs and bars in Mallorca. The hypothesis is that context creates conditions that promote and/or prevent the problems that can arise with drug use. Methods: Data related to emergency healthcare provided during weekends were examined, complemented by qualitative research to evaluate the environmental conditions in the most popular clubs in Mallorca and to assess their possible relationship with public health problems. Results: A systematic epidemiological study of health and safety problems was difficult because of the lack of systematic information collected by health services about their intervention in emergency situations. However, direct observation in the clubs has highlighted a lack of public transport operating to recreational venues, overcrowding, broken glass on the floor, lack of first aid management, high price of drinking water, excessive heat, obstructed emergency exits, the general consumption of alcohol and other drugs and poor availability of contraceptives. The emergency health services reported attending to traffic accidents, drug overdose, aggressions, traumas and drunkenness. A preventive policy is urgently required to reduce the incidence of such problems.

Rivers as urban landscapes: renaissance of the Waterfront

The Lake Ontario Waterfront Trail, currently stretching 350 kilometres along the shore of Lake Ontario, Canada, links 26 communities, 184 natural areas, 161 parks and promenades, 84 marinas and yacht clubs, hundreds of historic places, fairs, museums, art galleries and festivals. The Waterfront Trail is a catalyst for a new attitude and way of thinking towards the Lake Ontario waterfront and its watersheds - one that integrates ecological health, economic vitality and a sense of community. Since it was launched in 1995, the Trail has accompanied the protection of the most valued elements of the waterfront, and the transformation of under-utilized and environmentally degraded lands to vibrant places with businesses and jobs, parks and recreational facilities, green spaces, natural habitats and cultural venues and attractions. It is through the Trail that people have been mobilized to improve the waterfront as they have rediscovered the shoreline and understood the interconnections, both natural and cultural, that are so vital to its health and vitality. The Waterfront Regeneration Trust is the not-for-profit charitable organization that has been leading this large-scale greenway initiative over the past 10 years. While much has been accomplished, there remains much to do to enhance and expand the greenway. This presentation will focus on the lessons we have learned over the past decade in our involvement with more than 100 projects and what those lessons mean for the next decade of waterfront regeneration.

Responding to Fecal Accidents in Disinfected Swimming Venues

These recommendations are solely for management of fecal accidents in disinfected recreational water venues. The recommendations do not address use of other nonchlorine disinfectants because there is limited pathogen inactivation data for many of these compounds. Because improper handling of chlorinated disinfectants could cause injury, appropriate occupational safety and health requirements should be followed.

Evaluating projects funded by the Western Australian Health Promotion Foundation: first results

SUMMARY The paper describes output measures of performance of the Western Australian Health Promotion Foundation (Healthway), using a system known as graduated project evaluation (GPE). Results are reported at the basic and process levels of evaluation on 588 health and sponsorship projects, and at the impact level based on surveys of 5710 spectators and participants at 53 sport, arts and racing events sponsored by Healthway funds. At the basic and process levels the average Healthway project reached 7449 people directly and generated media coverage of health messages on 27.3 occasions. It secured, on average, 0.99 healthy structural reforms in recreational or cultural venues, involved the participation of local community members in project administration in 38% of instances, and provided 1596 person-hours of health education. Non-smoking, safe drinking, nutrition, exercise, sun protection, safe sex and injury prevention health messages were promoted using 24 different types of sponsor benefits. Of the 5710 respondents surveyed post-event, 67% were aware of the promoted health message and 82% of these understood what the message meant. Four per cent of all respondents intended to take action ranging from seeking information to adopting the health behaviour. A comparison of the cost-effectiveness of small and large sponsorship projects is given to illustrate the use of GPE to inform funding decisions. Smaller projects outperformed larger projects on all available indicators. We discuss the peculiar features of the health promotion foundation concept, methods to improve its performance and implications for future research.