International Journal of Contemporary Hospitality Management
Purpose Green hospitality studies have not adequately focused on the diffusion of eco-innovative ... more Purpose Green hospitality studies have not adequately focused on the diffusion of eco-innovative hotels amongst visitors. This study aims to fill this gap by identifying green hotel attributes that influence visitors’ adoption of eco-friendly hotel and their intentions to partake in green initiatives. Design/methodology/approach The paper uses a mixed-method approach to explore the drivers of customers’ green hotel adoption and consumption. In the qualitative phase, data were collected via 20 open-ended interviews and analyzed to derive a measurement scale. The scale was then tested through a survey comprising 500 respondents using structural equation modelling. Findings The study results elucidate how guests’ visit intentions and green consumption behavior is built through their perception of newness and uniqueness of eco-innovative attributes. Findings shed light on how green hotel’s sustainable communication and corporate social responsibility outreach efforts positively influenc...
SCHOLE: A Journal of Leisure Studies and Recreation Education
Abstract The purpose of this study was to validate a problem-based learning (PBL) approach in tea... more Abstract The purpose of this study was to validate a problem-based learning (PBL) approach in teaching legal aspects of recreational sport to college students, and to examine students' abilities to acquire well-structured knowledge and knowledge use flexibility as learning outcomes of the PBL process. Student satisfaction in learning about the law related to recreational sport was also investigated. A total of 282 undergraduate college students completed a questionnaire after completion of a semester-long mock court project. The study included a four-fold cross-sectional design employing four-time data collection points in assessing the PBL learning process. The results indicated that students attained well-structured knowledge and knowledge use flexibility in law and legal issues through their involvement in the mock court project. Students were also satisfied with learning law and legal issues related to recreational sport through the project. Finally, students perceived the project as having an effective level of quality. Results from the study supported the mock court project as a success and as an effective use of PBL.
International Journal of Aquatic Research and Education, 2017
In 2014 the U.S. Centers for Disease Control and Prevention (CDC) published the first edition of ... more In 2014 the U.S. Centers for Disease Control and Prevention (CDC) published the first edition of the Model Aquatic Health Code (MAHC). This document represented the inaugural introduction of a federal policy guideline with a direct focus in the area of aquatic venue operation and maintenance with the sole purpose of improving the nature of public health in the field. The Indiana State Department of Health (ISDH) began the review and adoption process soon after the policy's release. The ISDH process is proposed as one method for others to consider. The background and history of the MAHC are presented in this manuscript along with an overview of the adoption process to date that has been employed by the State of Indiana. In addition, information is provided on the Diffusion of Innovations Theory (DIT) as a possible method for assessing the long-term adoption of the MAHC on a national level.
International Journal of Sustainability in Higher Education, 2021
Purpose This study aims to examine the organizational citizenship behaviors toward the environmen... more Purpose This study aims to examine the organizational citizenship behaviors toward the environment among US-based faculty members, in social sciences, natural sciences, the humanities and engineering. Potential barriers that may stop academia from being more sustainable are examined but also the opportunities for academics to be involved in environmental sustainability are explored. Design/methodology/approach The authors followed a sequential explanatory mixed methods approach using online surveys (n = 633) followed by open-ended phone interviews (n = 28). Findings Results suggest that there are certain power dynamics that force young faculty members in anti-environmental behaviors, although they are cognizant of the negative impacts on the environment. Many faculty members engage in environmental-related actions outside their service requirements, but this is mostly the case for tenured faculty members. Originality/value The originality of this study lies in the fact that it explo...
The purpose of this study was to examine the initiatives that current aquatic managers in campus ... more The purpose of this study was to examine the initiatives that current aquatic managers in campus recreation are implementing to create environments that are inclusive to lesbian, gay, bisexual, transgender, and queer (LGBTQ) participation and to assess the barriers to such initiatives. The study utilized in-depth semistructured interviews with nine campus recreation aquatic managers to examine steps that are currently being taken when it comes to creating environments that are perceived to be open, or closed, to LGBTQ participants. A grounded theory–based process of data collection and analysis resulted in emergent themes. These themes included (a) “I am not an expert but…,” (b) reactive programming and management, (c) inclusion as a general practice, and (d) the importance of gender-inclusive practices. Management strategies and implications for campus recreation aquatic managers around these emergent themes are discussed regarding the creating of inclusive environments for LGBTQ p...
Introduction:The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from... more Introduction:The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from a perception that lay rescuers may be less likely to perform mouth-to-mouth ventilations during an emergency. This study hopes to describe the efficacy of bystander compressions and ventilations cardiopulmonary resuscitation (CV-CPR) in cardiac arrest following drowning.Hypothesis/Problem:The aim of this investigation is to test the hypothesis that bystander cardiopulmonary resuscitation (CPR) utilizing compressions and ventilations results in improved survival for cases of cardiac arrest following drowning compared to CPR involving compressions only.Methods:The Cardiac Arrest Registry for Enhanced Survival (CARES) was queried for patients who suffered cardiac arrest following drowning from January 1, 2013 through December 31, 2017, and in whom data were available on type of bystander CPR delivered (ie, CV-CPR CO-CPR). The primary outcome of interest was neurologically favorable surviva...
Background: Cardiac arrest associated with drowning is a major public health concern with limited... more Background: Cardiac arrest associated with drowning is a major public health concern with limited research available on outcome. This investigation aims to define the population at risk, and identify factors associated with neurologically favourable survival. Methods: The Cardiac Arrest Registry for Enhanced Survival (CARES) database was queried for patients who had suffered cardiac arrest following drowning between January 1, 2013 and December 31, 2015. The primary outcomes of interest were for favourable or unfavourable neurological outcome at hospital discharge, as defined by Cerebral Performance Category (CPC). Results: A total of 919 drowning patients were identified. Neurological outcome data was available in 908 patients. Neurologically favourable survival was significantly associated with bystander CPR (Odds Ratio (OR) = 2.94; 95% Confidence Interval (CI) 1.86-4.64; p < 0.001), witnessed drowning (OR = 2.6; 95% CI 1.69-4.01; p < 0.001) and younger age (OR = 0.97, 95% CI 0.96-0.98; p < 0.001). Public location of drowning (OR = 1.17; 95% CI 0.77-1.79; p = 0.47), male gender (OR = 0.9, 95% CI 0.57-1.43; p = 0.66), and shockable rhythm (OR = 1.54; 95% CI 0.76-3.12; p = 0.23), were not associated with favourable neurological survival. AED application prior to EMS was associated with a decreased likelihood of favourable neurological outcome (OR = 0.38; 95% CI 0.28-0.66; p < 0.001). In multivariate analysis, bystander CPR (adjusted OR 3.02, 95% CI 1.85-4.92, p < 0.001), witnessed drowning (adjusted OR 3.27, 95% CI 2.0-5.36, p < 0.001) and younger age (adjusted OR 0.97, 95% CI 0.96-0.98, p < 0.001) remained associated with neurologically favourable survival. Conclusions: Neurologically favourable survival after drowning remains low but is improved by bystander CPR. Shockable rhythms were uncommon and not associated with improved outcomes.
Purpose This study aims to define the concept of slow tourism, describe tourists’ slow food exper... more Purpose This study aims to define the concept of slow tourism, describe tourists’ slow food experiences and examine the relationship between the tourists’ slow food experience and their quality of life (QOL). Design/methodology/approach An online survey distributed through the Amazon MTurk platform yields 453 valid questionnaires. Confirmatory factor analysis and structure equational modeling are used to analyze the data. Findings The results reveal that authenticity and slowness significantly affect tourists’ slow food experience, while environmental consciousness does not influence tourists’ slow food experiences. Further, the slow food experience elicits a positive impact on the tourists’ QOL. Originality/value This study contributes to delineating the scope of slow food experiences, which remains unexplored in previous studies and gives further insight into how they impact life quality. This paper expands the body of knowledge by establishing three factors influencing slow food ...
The concept of health-related quality of life (HRQoL) considers patient's perspective as an e... more The concept of health-related quality of life (HRQoL) considers patient's perspective as an essential component of the health care relationship. HRQoL is often assimilated to a set of existing tools aimed at measuring the perspective of patient, more particularly the consequences of ill-health condition on patient's everyday life. Patients' reports of their health is however diverse, as social factors such as age, gender, professional status are likely to impact on health self-perception and reporting. Social aspects of HRQoL are somehow underexplored. This paper presents a secondary analysis of epidemiological HRQoL data issued from two national surveys (Baromètre Santé 2005; Enquête Décennale Santé 2002-2003). The data analysis showed the existence of social determinants of HRQoL. It more specifically demonstrated that four social indicators are determinants of HRQoL namely living in couple, level of education, occupational status and net income per household, independ...
International Journal of Environmental Research and Public Health, 2021
Drowning is a leading cause of fatality among children in the United States, and pool/spa aquatic... more Drowning is a leading cause of fatality among children in the United States, and pool/spa aquatic structures represent common locations of submersion incidents. This study employed narrative case review to understand characteristics related to permission, supervision, and precipitating events in childhood submersion incidents. Retroactive analysis of 1537 fatal and non-fatal submersion incidents among children age 13 years old and younger was conducted using the U.S. Consumer Products Safety Commission In-Depth Investigations dataset from 2000–2017. Narrative descriptions were coded according to the themes of permission, supervision, and precipitating events. In most (86%) incidents, the child did not have permitted water access, and 80% of narratives indicated the child was alone at time of incident. These attributes were significantly associated with a fatal outcome (No permission: OR 11.98, 95% CI 7.97–18.06; Alone: OR 34.93, 95% CI 19.69–61.96). The average length of inactive su...
Journal of Preventive Medicine and Public Health, 2021
In spite of the importance of green space for reducing obesity-related problems, there has been l... more In spite of the importance of green space for reducing obesity-related problems, there has been little exploration of whether access to green space (e.g., parks and recreational facilities) influences the obesity rate of adults in the United States. The purpose of the study was to investigate the relationships among accessibility of green space, obesity rates, and socioeconomic and demographic variables among adults living in the State of Indiana, United States. Methods: We conducted a secondary data analysis to investigate the relationships among accessibility to green space, obesity rates, and socio-demographic variables with employing Geographic Information System in order to measure the accessibility of green space. Results: This study found that accessibility of green space served as a strong predictor of reduced obesity rates among adults (β=-2.478; p<0.10). In addition, adults with higher education levels, as well as better access to green space, were found to have even lower obesity rates (β=-0.188; p<0.05). Other control variables such as unemployment rates, food security, and physical inactivity are additional factors that influence obesity rates among adults. Conclusions: Accessibility of green space may play an important role in facilitating physical activity participation and reducing obesity rates.
International Journal of Aquatic Research and Education, 2022
Drowning represents a leading cause of unintentional deaths among children. Concomitantly, while ... more Drowning represents a leading cause of unintentional deaths among children. Concomitantly, while formal swim instruction often incorporates water safety practices, the efficacy of these messages remains largely unexplored. This qualitative-based study sought to evaluate how youth apply learned water safety concepts when posed with a hypothetical aquatic scenario. Semi-structured interviews, augmented by use of a visual illustration prompt, were conducted with 29 participants of a youth Learn-to-Swim (LTS) program. Interviews assessed participants’ expressed water safety behaviors and were coded based on emergent themes. Findings indicated that most participants were able to identify a “struggling” swimmer in the dramatized illustration. When questioned regarding their hypothetical behavioral response to that swimmer in trouble, participants ultimately yielded appropriate behaviors (e.g., extending one’s reach) with prompting, revealing they would eventually enter the water. Addition...
International Journal of Aquatic Research and Education, 2013
This study examined patterns and levels of physical activity of youth participants at an indoor w... more This study examined patterns and levels of physical activity of youth participants at an indoor waterpark in rural southern Indiana. The System for Observing Play and Recreation in Communities (SOPARC) was the instrument used to guide data collection for the study to determine youth physical activity postures coded as sedentary, walking, or vigorous. Participants consisted of youths, ages 4 to18, who attended the park during the data collection. Results converged into seven main target areas representing data for age groupings, gender, and physical activity postures. Frequencies were calculated for variables involving counts and moderatevigorous physical activity (MVPA). A series of one-way analysis of variance (ANOVA) were performed using total metabolic equivalents (METs). Physical activity in the waterpark was shown to have the capability to produce moderate and vigorous levels of physical activity overall and to also generate a variety of differences among individuals and activity areas at the facility.
International Journal of Aquatic Research and Education, 2021
Several water safety organizations have attempted to improve reporting regarding lifeguard action... more Several water safety organizations have attempted to improve reporting regarding lifeguard actions in order to better understand the characteristics of successful, non-fatal rescues. In 2003, a collective effort initiated the Lifeguard Rescue Reporting System, an online survey distributed to lifeguards and facility managers across the United States and Canada to better understand rescue actions performed in pools/spas, water parks, and open water areas. After seven years of data collection, the online survey accumulated data reflecting 1,676 rescue actions, collecting information including location, victim characteristics and outcome, rescuer characteristics and strategies, and other general circumstances. Descriptive results indicated that at least half of victims were 14 years old or younger across all settings. Depths of 0.9-1.5m (3-5 ft) represented the range at which incidents most frequently occurred in pools and spas and waterparks, whereas the depth of incidents was generall...
International Journal of Aquatic Research and Education, 2015
Lifeguards play an important role in the security and safety of those they are hired to protect. ... more Lifeguards play an important role in the security and safety of those they are hired to protect. A performance issue may arise if they succumb to circumstances that cause them to become physically or psychologically compromised. Dehydration is one issue that can result in decreased levels of workplace performance and pose personal health risks. Certified lifeguards 15 years old and older were tested for urine specific gravity (USG) to determine their place within the dehydration spectrum. Participants (N = 55) were recruited from seven test sites offering a variety of designs (indoor/outdoor, traditional/waterpark) and classifications (private, semipublic, public). Testing involved the collection of a urine specimen from participants and immediate recording of specific gravity using a reagent test strip by researchers. A brief survey to collect demographic information from subjects was also administered. The majority of participants were found to reside along the dehydration spectrum (USG ≥ 1.015), several showing results toward the severe end of the scale. The sample provided adequate demographic variability among males and females and facility classification types. No statistically significant differences were found between the demographic variables and USG scores of subjects. Since the majority of lifeguards in the sample showed some level of dehydration, this indicated a need for more information concerning lifeguards and dehydration. Despite the lack of statistically significant differences among the demographic factors within this sample, future studies should incorporate other behavioral factors and dehydration testing methods to investigate the mechanisms for preventing dehydration as well as its impact on lifeguarding performance.
Campus recreational sport programs strive to create an environment that is accessible to diverse ... more Campus recreational sport programs strive to create an environment that is accessible to diverse participants, including LGBTQ population groups. While improvement has been made in promoting resources and workgroups related to diversity management practices, little empirical evidence exists as it relates to the efficacy of diversity trainings for recreational sport employees. This study analyzed the impact of a diversity training program geared toward the development of affirming recreational sport practices for LGBTQ populations and exploring the professional competencies related to LGBTQ inclusion that are practiced within in a collegiate recreational sport setting. Results indicated that the targeted training initiative was effective in statistically improving employee confidence as it relates to LGBTQ professional competencies ( p < .000), while nonattendance at the training showed no statistically significant differences in such competencies. This study serves as a starting ...
International Journal of Environmental Research and Public Health, 2020
Background: The current study sought to understand whether trail users reported better wellness a... more Background: The current study sought to understand whether trail users reported better wellness and health status compared to the non-users, and to recognize the associated factors. Methods: Eight trails from different locations and settings within Indiana were selected to sample trail users for the study. Additionally, areas surrounding these eight trails were included in the study as sample locations for trail non-users. Trail users and non-users were intercepted and asked to participate in a survey including demographics, socioeconomic status, physical activity, mood, smoking, nutrition, and quality of sleep. Information was collected and compared between the trail users and the non-users. Association of self-rated health, age, sex, race, marital status, employment, income, education, smoking, nutrition, sleep, and mood with trail use was evaluated by multivariable linear regression model. Results: The final sample size included 1299 trail users and 228 non-users. Environmental f...
This study evaluated a shallow-water intervention to reduce pain among women age 61 to 81 with kn... more This study evaluated a shallow-water intervention to reduce pain among women age 61 to 81 with knee and/or hip osteoarthritis. The study used a randomized-replicated single-case two-condition crossover design to determine which condition was more effective at relieving pain. One condition was functional movements without the use of a stationary pole; the other condition, identical movements with the pole. Data were collected through repeated pain measures, pre-test-post-test measures, and retrospective pre-test post-test measures. Pain data analysis with Microsoft Excel® ExPRT 2.0 AB program generated pre- and post-crossover charts. Visual analysis findings were substantiated with sensitivity analyses of retrospective pre-test and post-test data, showing no significance between the two conditions (p ≤ 0.05). Results indicated use of a pole might not be more effective than the movement program itself. For the individual and recreation therapist, this finding might translate to cost e...
Recreation, Parks, and Tourism in Public Health, 2017
It's no secret that youth today in the United States (U.S.) and around the world face mounting pu... more It's no secret that youth today in the United States (U.S.) and around the world face mounting public health challenges in their daily lives. Factors such as obesity, alcohol use, and engagement in sexual activity continue to be top of mind for public health professionals, government officials, parents, and most recently; parks and recreation professionals. When administered in an appropriate and professional manner, these programs can help youth develop key life skills such as self-confidence, self-efficacy, and empathy. In addition, if parks and recreation professionals also take on the responsibility of positively impacting public health issues, these same programs can also create change in population well-being. This paper outlines one such program that we believe can serve as a model for using recreational sports programs as the mechanism to intervene in negative youth health behaviors. The Youth Enrichment through Sport (YES) Ghana program was a two-year endeavor funded through the Bureau of Education and Cultural Affairs within the U.S. Department of State to encourage a cultural exchange and provide a sustainable and effective program model to impact public health for the youth in the Cape Coast region of Ghana, Africa. Although developed and implemented thousands of miles away, lessons learned can easily be applied to many regions of the United States toward the development and administration of a recreational sports program. Such programs would have the potential to make an impact on the public health population.
International Journal of Aquatic Research and Education, Oct 1, 2017
Youth drowning remains a primary cause of injury and death in the United States, particularly wit... more Youth drowning remains a primary cause of injury and death in the United States, particularly within demographic disparities involving: (a) sex, (b) ethnicity, (c) socioeconomic status, and (d) geographic location. Research has examined knowledge acquisition for injury prevention, but little has been done to understand impact on future behavior. This study examined a learn-to-swim and water safety education program using the Reasoned Action Approach to predict future behavior in/around the water. Youth participants ages 5 to 11 at summer camp programs completed a 55-question survey designed to test 7 competencies through the lens of attitudes, intentions, perceived norms, and self-efficacy. Results indicated that several safety messages are not predicted to produce the desired behavior. These include actions related to concepts such as "rescue" and "calling for help". Information derived from this study calls for researchers and practitioners to examine water safety programs for efficacy as an injury prevention tool.
International Journal of Contemporary Hospitality Management
Purpose Green hospitality studies have not adequately focused on the diffusion of eco-innovative ... more Purpose Green hospitality studies have not adequately focused on the diffusion of eco-innovative hotels amongst visitors. This study aims to fill this gap by identifying green hotel attributes that influence visitors’ adoption of eco-friendly hotel and their intentions to partake in green initiatives. Design/methodology/approach The paper uses a mixed-method approach to explore the drivers of customers’ green hotel adoption and consumption. In the qualitative phase, data were collected via 20 open-ended interviews and analyzed to derive a measurement scale. The scale was then tested through a survey comprising 500 respondents using structural equation modelling. Findings The study results elucidate how guests’ visit intentions and green consumption behavior is built through their perception of newness and uniqueness of eco-innovative attributes. Findings shed light on how green hotel’s sustainable communication and corporate social responsibility outreach efforts positively influenc...
SCHOLE: A Journal of Leisure Studies and Recreation Education
Abstract The purpose of this study was to validate a problem-based learning (PBL) approach in tea... more Abstract The purpose of this study was to validate a problem-based learning (PBL) approach in teaching legal aspects of recreational sport to college students, and to examine students' abilities to acquire well-structured knowledge and knowledge use flexibility as learning outcomes of the PBL process. Student satisfaction in learning about the law related to recreational sport was also investigated. A total of 282 undergraduate college students completed a questionnaire after completion of a semester-long mock court project. The study included a four-fold cross-sectional design employing four-time data collection points in assessing the PBL learning process. The results indicated that students attained well-structured knowledge and knowledge use flexibility in law and legal issues through their involvement in the mock court project. Students were also satisfied with learning law and legal issues related to recreational sport through the project. Finally, students perceived the project as having an effective level of quality. Results from the study supported the mock court project as a success and as an effective use of PBL.
International Journal of Aquatic Research and Education, 2017
In 2014 the U.S. Centers for Disease Control and Prevention (CDC) published the first edition of ... more In 2014 the U.S. Centers for Disease Control and Prevention (CDC) published the first edition of the Model Aquatic Health Code (MAHC). This document represented the inaugural introduction of a federal policy guideline with a direct focus in the area of aquatic venue operation and maintenance with the sole purpose of improving the nature of public health in the field. The Indiana State Department of Health (ISDH) began the review and adoption process soon after the policy's release. The ISDH process is proposed as one method for others to consider. The background and history of the MAHC are presented in this manuscript along with an overview of the adoption process to date that has been employed by the State of Indiana. In addition, information is provided on the Diffusion of Innovations Theory (DIT) as a possible method for assessing the long-term adoption of the MAHC on a national level.
International Journal of Sustainability in Higher Education, 2021
Purpose This study aims to examine the organizational citizenship behaviors toward the environmen... more Purpose This study aims to examine the organizational citizenship behaviors toward the environment among US-based faculty members, in social sciences, natural sciences, the humanities and engineering. Potential barriers that may stop academia from being more sustainable are examined but also the opportunities for academics to be involved in environmental sustainability are explored. Design/methodology/approach The authors followed a sequential explanatory mixed methods approach using online surveys (n = 633) followed by open-ended phone interviews (n = 28). Findings Results suggest that there are certain power dynamics that force young faculty members in anti-environmental behaviors, although they are cognizant of the negative impacts on the environment. Many faculty members engage in environmental-related actions outside their service requirements, but this is mostly the case for tenured faculty members. Originality/value The originality of this study lies in the fact that it explo...
The purpose of this study was to examine the initiatives that current aquatic managers in campus ... more The purpose of this study was to examine the initiatives that current aquatic managers in campus recreation are implementing to create environments that are inclusive to lesbian, gay, bisexual, transgender, and queer (LGBTQ) participation and to assess the barriers to such initiatives. The study utilized in-depth semistructured interviews with nine campus recreation aquatic managers to examine steps that are currently being taken when it comes to creating environments that are perceived to be open, or closed, to LGBTQ participants. A grounded theory–based process of data collection and analysis resulted in emergent themes. These themes included (a) “I am not an expert but…,” (b) reactive programming and management, (c) inclusion as a general practice, and (d) the importance of gender-inclusive practices. Management strategies and implications for campus recreation aquatic managers around these emergent themes are discussed regarding the creating of inclusive environments for LGBTQ p...
Introduction:The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from... more Introduction:The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from a perception that lay rescuers may be less likely to perform mouth-to-mouth ventilations during an emergency. This study hopes to describe the efficacy of bystander compressions and ventilations cardiopulmonary resuscitation (CV-CPR) in cardiac arrest following drowning.Hypothesis/Problem:The aim of this investigation is to test the hypothesis that bystander cardiopulmonary resuscitation (CPR) utilizing compressions and ventilations results in improved survival for cases of cardiac arrest following drowning compared to CPR involving compressions only.Methods:The Cardiac Arrest Registry for Enhanced Survival (CARES) was queried for patients who suffered cardiac arrest following drowning from January 1, 2013 through December 31, 2017, and in whom data were available on type of bystander CPR delivered (ie, CV-CPR CO-CPR). The primary outcome of interest was neurologically favorable surviva...
Background: Cardiac arrest associated with drowning is a major public health concern with limited... more Background: Cardiac arrest associated with drowning is a major public health concern with limited research available on outcome. This investigation aims to define the population at risk, and identify factors associated with neurologically favourable survival. Methods: The Cardiac Arrest Registry for Enhanced Survival (CARES) database was queried for patients who had suffered cardiac arrest following drowning between January 1, 2013 and December 31, 2015. The primary outcomes of interest were for favourable or unfavourable neurological outcome at hospital discharge, as defined by Cerebral Performance Category (CPC). Results: A total of 919 drowning patients were identified. Neurological outcome data was available in 908 patients. Neurologically favourable survival was significantly associated with bystander CPR (Odds Ratio (OR) = 2.94; 95% Confidence Interval (CI) 1.86-4.64; p < 0.001), witnessed drowning (OR = 2.6; 95% CI 1.69-4.01; p < 0.001) and younger age (OR = 0.97, 95% CI 0.96-0.98; p < 0.001). Public location of drowning (OR = 1.17; 95% CI 0.77-1.79; p = 0.47), male gender (OR = 0.9, 95% CI 0.57-1.43; p = 0.66), and shockable rhythm (OR = 1.54; 95% CI 0.76-3.12; p = 0.23), were not associated with favourable neurological survival. AED application prior to EMS was associated with a decreased likelihood of favourable neurological outcome (OR = 0.38; 95% CI 0.28-0.66; p < 0.001). In multivariate analysis, bystander CPR (adjusted OR 3.02, 95% CI 1.85-4.92, p < 0.001), witnessed drowning (adjusted OR 3.27, 95% CI 2.0-5.36, p < 0.001) and younger age (adjusted OR 0.97, 95% CI 0.96-0.98, p < 0.001) remained associated with neurologically favourable survival. Conclusions: Neurologically favourable survival after drowning remains low but is improved by bystander CPR. Shockable rhythms were uncommon and not associated with improved outcomes.
Purpose This study aims to define the concept of slow tourism, describe tourists’ slow food exper... more Purpose This study aims to define the concept of slow tourism, describe tourists’ slow food experiences and examine the relationship between the tourists’ slow food experience and their quality of life (QOL). Design/methodology/approach An online survey distributed through the Amazon MTurk platform yields 453 valid questionnaires. Confirmatory factor analysis and structure equational modeling are used to analyze the data. Findings The results reveal that authenticity and slowness significantly affect tourists’ slow food experience, while environmental consciousness does not influence tourists’ slow food experiences. Further, the slow food experience elicits a positive impact on the tourists’ QOL. Originality/value This study contributes to delineating the scope of slow food experiences, which remains unexplored in previous studies and gives further insight into how they impact life quality. This paper expands the body of knowledge by establishing three factors influencing slow food ...
The concept of health-related quality of life (HRQoL) considers patient's perspective as an e... more The concept of health-related quality of life (HRQoL) considers patient's perspective as an essential component of the health care relationship. HRQoL is often assimilated to a set of existing tools aimed at measuring the perspective of patient, more particularly the consequences of ill-health condition on patient's everyday life. Patients' reports of their health is however diverse, as social factors such as age, gender, professional status are likely to impact on health self-perception and reporting. Social aspects of HRQoL are somehow underexplored. This paper presents a secondary analysis of epidemiological HRQoL data issued from two national surveys (Baromètre Santé 2005; Enquête Décennale Santé 2002-2003). The data analysis showed the existence of social determinants of HRQoL. It more specifically demonstrated that four social indicators are determinants of HRQoL namely living in couple, level of education, occupational status and net income per household, independ...
International Journal of Environmental Research and Public Health, 2021
Drowning is a leading cause of fatality among children in the United States, and pool/spa aquatic... more Drowning is a leading cause of fatality among children in the United States, and pool/spa aquatic structures represent common locations of submersion incidents. This study employed narrative case review to understand characteristics related to permission, supervision, and precipitating events in childhood submersion incidents. Retroactive analysis of 1537 fatal and non-fatal submersion incidents among children age 13 years old and younger was conducted using the U.S. Consumer Products Safety Commission In-Depth Investigations dataset from 2000–2017. Narrative descriptions were coded according to the themes of permission, supervision, and precipitating events. In most (86%) incidents, the child did not have permitted water access, and 80% of narratives indicated the child was alone at time of incident. These attributes were significantly associated with a fatal outcome (No permission: OR 11.98, 95% CI 7.97–18.06; Alone: OR 34.93, 95% CI 19.69–61.96). The average length of inactive su...
Journal of Preventive Medicine and Public Health, 2021
In spite of the importance of green space for reducing obesity-related problems, there has been l... more In spite of the importance of green space for reducing obesity-related problems, there has been little exploration of whether access to green space (e.g., parks and recreational facilities) influences the obesity rate of adults in the United States. The purpose of the study was to investigate the relationships among accessibility of green space, obesity rates, and socioeconomic and demographic variables among adults living in the State of Indiana, United States. Methods: We conducted a secondary data analysis to investigate the relationships among accessibility to green space, obesity rates, and socio-demographic variables with employing Geographic Information System in order to measure the accessibility of green space. Results: This study found that accessibility of green space served as a strong predictor of reduced obesity rates among adults (β=-2.478; p<0.10). In addition, adults with higher education levels, as well as better access to green space, were found to have even lower obesity rates (β=-0.188; p<0.05). Other control variables such as unemployment rates, food security, and physical inactivity are additional factors that influence obesity rates among adults. Conclusions: Accessibility of green space may play an important role in facilitating physical activity participation and reducing obesity rates.
International Journal of Aquatic Research and Education, 2022
Drowning represents a leading cause of unintentional deaths among children. Concomitantly, while ... more Drowning represents a leading cause of unintentional deaths among children. Concomitantly, while formal swim instruction often incorporates water safety practices, the efficacy of these messages remains largely unexplored. This qualitative-based study sought to evaluate how youth apply learned water safety concepts when posed with a hypothetical aquatic scenario. Semi-structured interviews, augmented by use of a visual illustration prompt, were conducted with 29 participants of a youth Learn-to-Swim (LTS) program. Interviews assessed participants’ expressed water safety behaviors and were coded based on emergent themes. Findings indicated that most participants were able to identify a “struggling” swimmer in the dramatized illustration. When questioned regarding their hypothetical behavioral response to that swimmer in trouble, participants ultimately yielded appropriate behaviors (e.g., extending one’s reach) with prompting, revealing they would eventually enter the water. Addition...
International Journal of Aquatic Research and Education, 2013
This study examined patterns and levels of physical activity of youth participants at an indoor w... more This study examined patterns and levels of physical activity of youth participants at an indoor waterpark in rural southern Indiana. The System for Observing Play and Recreation in Communities (SOPARC) was the instrument used to guide data collection for the study to determine youth physical activity postures coded as sedentary, walking, or vigorous. Participants consisted of youths, ages 4 to18, who attended the park during the data collection. Results converged into seven main target areas representing data for age groupings, gender, and physical activity postures. Frequencies were calculated for variables involving counts and moderatevigorous physical activity (MVPA). A series of one-way analysis of variance (ANOVA) were performed using total metabolic equivalents (METs). Physical activity in the waterpark was shown to have the capability to produce moderate and vigorous levels of physical activity overall and to also generate a variety of differences among individuals and activity areas at the facility.
International Journal of Aquatic Research and Education, 2021
Several water safety organizations have attempted to improve reporting regarding lifeguard action... more Several water safety organizations have attempted to improve reporting regarding lifeguard actions in order to better understand the characteristics of successful, non-fatal rescues. In 2003, a collective effort initiated the Lifeguard Rescue Reporting System, an online survey distributed to lifeguards and facility managers across the United States and Canada to better understand rescue actions performed in pools/spas, water parks, and open water areas. After seven years of data collection, the online survey accumulated data reflecting 1,676 rescue actions, collecting information including location, victim characteristics and outcome, rescuer characteristics and strategies, and other general circumstances. Descriptive results indicated that at least half of victims were 14 years old or younger across all settings. Depths of 0.9-1.5m (3-5 ft) represented the range at which incidents most frequently occurred in pools and spas and waterparks, whereas the depth of incidents was generall...
International Journal of Aquatic Research and Education, 2015
Lifeguards play an important role in the security and safety of those they are hired to protect. ... more Lifeguards play an important role in the security and safety of those they are hired to protect. A performance issue may arise if they succumb to circumstances that cause them to become physically or psychologically compromised. Dehydration is one issue that can result in decreased levels of workplace performance and pose personal health risks. Certified lifeguards 15 years old and older were tested for urine specific gravity (USG) to determine their place within the dehydration spectrum. Participants (N = 55) were recruited from seven test sites offering a variety of designs (indoor/outdoor, traditional/waterpark) and classifications (private, semipublic, public). Testing involved the collection of a urine specimen from participants and immediate recording of specific gravity using a reagent test strip by researchers. A brief survey to collect demographic information from subjects was also administered. The majority of participants were found to reside along the dehydration spectrum (USG ≥ 1.015), several showing results toward the severe end of the scale. The sample provided adequate demographic variability among males and females and facility classification types. No statistically significant differences were found between the demographic variables and USG scores of subjects. Since the majority of lifeguards in the sample showed some level of dehydration, this indicated a need for more information concerning lifeguards and dehydration. Despite the lack of statistically significant differences among the demographic factors within this sample, future studies should incorporate other behavioral factors and dehydration testing methods to investigate the mechanisms for preventing dehydration as well as its impact on lifeguarding performance.
Campus recreational sport programs strive to create an environment that is accessible to diverse ... more Campus recreational sport programs strive to create an environment that is accessible to diverse participants, including LGBTQ population groups. While improvement has been made in promoting resources and workgroups related to diversity management practices, little empirical evidence exists as it relates to the efficacy of diversity trainings for recreational sport employees. This study analyzed the impact of a diversity training program geared toward the development of affirming recreational sport practices for LGBTQ populations and exploring the professional competencies related to LGBTQ inclusion that are practiced within in a collegiate recreational sport setting. Results indicated that the targeted training initiative was effective in statistically improving employee confidence as it relates to LGBTQ professional competencies ( p < .000), while nonattendance at the training showed no statistically significant differences in such competencies. This study serves as a starting ...
International Journal of Environmental Research and Public Health, 2020
Background: The current study sought to understand whether trail users reported better wellness a... more Background: The current study sought to understand whether trail users reported better wellness and health status compared to the non-users, and to recognize the associated factors. Methods: Eight trails from different locations and settings within Indiana were selected to sample trail users for the study. Additionally, areas surrounding these eight trails were included in the study as sample locations for trail non-users. Trail users and non-users were intercepted and asked to participate in a survey including demographics, socioeconomic status, physical activity, mood, smoking, nutrition, and quality of sleep. Information was collected and compared between the trail users and the non-users. Association of self-rated health, age, sex, race, marital status, employment, income, education, smoking, nutrition, sleep, and mood with trail use was evaluated by multivariable linear regression model. Results: The final sample size included 1299 trail users and 228 non-users. Environmental f...
This study evaluated a shallow-water intervention to reduce pain among women age 61 to 81 with kn... more This study evaluated a shallow-water intervention to reduce pain among women age 61 to 81 with knee and/or hip osteoarthritis. The study used a randomized-replicated single-case two-condition crossover design to determine which condition was more effective at relieving pain. One condition was functional movements without the use of a stationary pole; the other condition, identical movements with the pole. Data were collected through repeated pain measures, pre-test-post-test measures, and retrospective pre-test post-test measures. Pain data analysis with Microsoft Excel® ExPRT 2.0 AB program generated pre- and post-crossover charts. Visual analysis findings were substantiated with sensitivity analyses of retrospective pre-test and post-test data, showing no significance between the two conditions (p ≤ 0.05). Results indicated use of a pole might not be more effective than the movement program itself. For the individual and recreation therapist, this finding might translate to cost e...
Recreation, Parks, and Tourism in Public Health, 2017
It's no secret that youth today in the United States (U.S.) and around the world face mounting pu... more It's no secret that youth today in the United States (U.S.) and around the world face mounting public health challenges in their daily lives. Factors such as obesity, alcohol use, and engagement in sexual activity continue to be top of mind for public health professionals, government officials, parents, and most recently; parks and recreation professionals. When administered in an appropriate and professional manner, these programs can help youth develop key life skills such as self-confidence, self-efficacy, and empathy. In addition, if parks and recreation professionals also take on the responsibility of positively impacting public health issues, these same programs can also create change in population well-being. This paper outlines one such program that we believe can serve as a model for using recreational sports programs as the mechanism to intervene in negative youth health behaviors. The Youth Enrichment through Sport (YES) Ghana program was a two-year endeavor funded through the Bureau of Education and Cultural Affairs within the U.S. Department of State to encourage a cultural exchange and provide a sustainable and effective program model to impact public health for the youth in the Cape Coast region of Ghana, Africa. Although developed and implemented thousands of miles away, lessons learned can easily be applied to many regions of the United States toward the development and administration of a recreational sports program. Such programs would have the potential to make an impact on the public health population.
International Journal of Aquatic Research and Education, Oct 1, 2017
Youth drowning remains a primary cause of injury and death in the United States, particularly wit... more Youth drowning remains a primary cause of injury and death in the United States, particularly within demographic disparities involving: (a) sex, (b) ethnicity, (c) socioeconomic status, and (d) geographic location. Research has examined knowledge acquisition for injury prevention, but little has been done to understand impact on future behavior. This study examined a learn-to-swim and water safety education program using the Reasoned Action Approach to predict future behavior in/around the water. Youth participants ages 5 to 11 at summer camp programs completed a 55-question survey designed to test 7 competencies through the lens of attitudes, intentions, perceived norms, and self-efficacy. Results indicated that several safety messages are not predicted to produce the desired behavior. These include actions related to concepts such as "rescue" and "calling for help". Information derived from this study calls for researchers and practitioners to examine water safety programs for efficacy as an injury prevention tool.
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Papers by William Ramos