Effects of tree species and planting forms on the thermal comfort of campsites in hot and humid areas of China.

Camping has become a popular outdoor activity in China. However, the long and scorching summers in China's hot and humid regions pose challenges for campsites in maintaining thermal comfort. Therefore, we explored the impact of tree species and planting methods on the thermal comfort of urban campsites in hot and humid areas using the ENVI-met model to simulate the conditions of the study area. The reliability of the model was validated by comparing the simulated values of air temperature (Ta) and relative humidity (RH) with field measurements. We conducted an in-depth analysis of common trees in hot and humid areas and analyzed the effects of five tree species and four tree planting forms on the microclimate of campsites in such areas, using the physiological equivalent temperature (PET) as the evaluation index of thermal comfort. The results indicated that: (1) trees with larger crown widths were most effective in improving outdoor thermal comfort. The ability of trees to regulate microclimate was more influenced by crown width than by leaf area index (LAI), and (2) trees planted in patches provided the highest level of thermal comfort, whereas single trees provided the lowest. However, relying solely on tree planting made it difficult to significantly reduce outdoor heat stress. Therefore, other methods such as increasing ventilation or mist spray should be adopted to modify camping area. This study provides a reference for the planting design of outdoor campsites in hot and humid regions of China.

Mitigation measures against Coronavirus Disease 2019 (COVID-19) in overnight faith-based camps: summer 2021.

OBJECTIVE: In this study, we describe community-based nonpharmaceutical interventions (NPIs) incorporated into COVID-19 mitigation protocols, and SARS-CoV-2 incidence at five faith-based summer camps in the US. STUDY DESIGN: Retrospective cohort study. METHODS: Six southeastern states within the United States (13 sites) were assessed from May 30 to August 14, 2021 (13 sites; N = 13,132; May-August 2021). Camp mitigation policies and NPIs (including masking, vaccinations, meal arrangements, physical distancing, pre-arrival testing, symptom screening, quarantine/isolation, and ventilation upgrades), and SARS-CoV-2 infections were tracked at each site. RESULTS: The symptomatic primary case attack rate was 24.7 (range: 0.0-120.0) cases per 100,000 people per week. Fewer infections were observed in camps with greater mitigation protocols. CONCLUSION: These findings suggest that nonpharmaceutical mitigation can promote stable access to youth programs for historically vaccine-hesitant subgroups. Policy recommendations for nonpharmaceutical interventions to prevent respiratory viral transmission in overnight youth faith-based camp settings may include outdoor activities, accessible symptomatic tests, prearrival testing, indoor mask use, small cohorts, physical distancing, and protocols to minimize staff exposures during time off.

Illnesses and Injuries at a Remote American Residential Summer Camp Over 3 Seasons.

INTRODUCTION: Residential and wilderness excursion summer camps are safe, but outdoor activities can lead to injuries. The frequency of various illnesses and injuries at summer camps has been incompletely described. The treatments provided and the need for escalation to higher levels of care are variable. METHODS: A retrospective cohort analysis was conducted for all visits to a camp infirmary over 3 seasons at a residential summer camp in Minnesota. Seventeen descriptive categories of chief complaints and 13 categories of treatment disposition were created for all 695 eligible infirmary visits. The frequency and illness type for which escalation to a higher level of care beyond the camp infirmary was needed were reviewed. RESULTS: Four hundred one campers sought medical care 695 times over 3 seasons. The most common chief complaints were related to skin (35%), musculoskeletal injury (17%), and upper-respiratory symptoms (15%). The most common treatment and dispositions were over-the-counter medications (43%) and simple bandage or dressing (19%). Escalation of care to a clinic or emergency room was uncommon, with 35 (5%) infirmary visits requiring escalation. Musculoskeletal injuries were the most common reason for escalations of care. While overall less common than musculoskeletal injury, dental injury almost always resulted in escalation of care. CONCLUSIONS: An analysis of 3 y of visits to a summer camp infirmary was used by camp medical staff to update protocols and obtain new supplies for diagnosis and treatments. A more complete understanding of the prevalence of injuries and illnesses has the potential to allow better preparation for camp medical staff.

A qualitative investigation of the impact that therapeutic recreational camps have on the psychological wellbeing of siblings of individuals with health conditions.

BACKGROUND: The siblings of individuals with health conditions are often overlooked, despite being at risk of experiencing psychological difficulties. There is a lack of literature investigating interventions which could promote siblings' psychological wellbeing. Therapeutic recreational (TR) camps promote self-perception and self-worth, yet there are currently no UK studies qualitatively investigating siblings' experiences of TR camps. AIMS: This study aims to understand siblings' lived experiences of attending TR camps, providing a greater depth of understanding of whether these camps have a positive impact on siblings' wellbeing. METHOD: Due to the paucity of qualitative research regarding individuals' experiences of TR camps, semi-structured interviews were conducted with eight individuals who had attended TR sibling camps. Verbatim transcripts were analysed using Interpretative Phenomenological Analysis (IPA). RESULTS: Analysis revealed three superordinate themes. The first, an environment that facilitates autonomous challenge, demonstrated the importance of siblings having a place where they felt autonomous in a fun, care-free environment. This encouraged participants to engage in challenges, feeling determined to overcome them. The second, an inclusive and supportive environment, highlighted the importance of connectedness. Facing challenges and reflecting on this within a supportive team, encouraged a sense of belonging. The final superordinate theme, a transformational journey, revealed that siblings gained determination and a positive outlook to facing challenges in daily life. Additionally, they gained self-acceptance and a positive self-image, becoming more confident with, and accepting of, their identity. CONCLUSIONS: This study presents a novel contribution to the existing literature and highlights the importance of camp providers ensuring their TR model incorporates autonomous challenge, success and reflection. These encourage positive youth development and self-determination in young people. In addition, recommendations include implementing teams, promoting positive volunteer-camper relationships and implementing reflective sessions. These recommendations could potentially enhance the positive impact that TR camps have on siblings' psychological wellbeing.

Application of non-pharmaceutical interventions in camps following the onset of COVID-19.

BACKGROUND: As the COVID-19 pandemic emerged in the United States in the spring and summer of 2020, many organizations serving children and youth immediately faced significant operational and healthcare challenges. Centers for Disease Control and Prevention guidance for the safe operation of youth programmes emphasized the importance of non-pharmaceutical interventions (NPIs), yet few studies have examined NPI usage in summer programmes such as camps. METHOD: This sequential explanatory mixed-methods study explored the utilization of NPIs among camp healthcare providers who completed an online questionnaire followed by one-on-one interviews. RESULTS: The study findings indicated that camps consistently used a core set of NPIs to maintain and protect the health of camp participants, including screening, cohorting, hand hygiene, sanitizing practices, ventilation and physical distancing. The study findings further identified specific practices of camp healthcare providers that made NPI utilization possible, as exemplified in the emergent themes of wellness promotion; health awareness and modelling; and camp health service mobilization. CONCLUSION: NPI usage benchmarks from this study, as well as effective practices for NPI utilization, can inform the application of NPIs and other health-promoting practices across diverse formal and informal youth settings.

Using participatory culture-specific consultation to support the mental health needs of summer camp staff.

Nearly 30% of all U.S. youth attend summer camp each year, making it one of the broadest reaching out-of-school-time interventions in the country. Camp provides a space for seasonal employees, who are often emerging adults, to explore work values and identity, engage in mentoring and support opportunities, and stay connected to a community larger than themselves. However, research on camp experiences also suggests camp settings and expectations around emotional and physical care can cause counselors to experience burnout, compassion fatigue, and reduced job satisfaction. Using participatory culture-specific consultation, the current study addressed a gap in the literature about systemic interventions to manage camp counselor mental health by designing, implementing, and evaluating a mental health consultation model at one of the largest YMCA summer camps in the country. Results suggest the intervention effectively addressed certain administrator and staff needs; results also suggest the model could be refined to more effectively respond to the particular contextual challenges of summer camps. Implications and recommendations for other summer camps are discussed.

Camping-related carbon monoxide poisoning: Knowledge and risk behaviours among young Saudi campers.

OBJECTIVE: To evaluate the Saudi campers' knowledge and the applied safety practices regarding carbon monoxide poisoning during camping activities. METHODS: The cross-sectional questionnaire-based study was conducted from December 1, 2018, to February 1, 2019, in Riyadh, Saudi Arabia, and comprised young male campers from recreational camps in the northern parts of the city. Data was collected from the participants regarding socio-demographic characteristics, knowledge regarding carbon monoxide poisoning, the applied safety measures to prevent carbon monoxide poisoning and the dealing with carbon monoxide poisoning during camping activities. Data was analysed using SPSS 22. RESULTS: There were 235 male subjects with mean age 24.47±1.139 years (range: 21-32 years). Of the total, 50(21.3%) participants had received civil defence education or training. Overall, 137(58.3%) participants had a good mean knowledge score, and 157(66.8%) participants had a good mean practice score for applying healthy measures in preventing and managing carbon monoxide poisoning. As a preventive measure against carbon monoxide poisoning, the use of carbon monoxide detectors was valued by 107(45.5%) participants. Having civil defence training, having a monthly income >10,000 Saudi Riyals, and having a good knowledge score were the elements that had significant association with the choice related to carbon monoxide detector usage. CONCLUSIONS: The campers had relatively high knowledge regarding carbon monoxide poisoning, but this knowledge was not fully translated into good health practice.

The Effect of an Overnight Summer Camp on the Quality of Life for Individuals Who Require Ventilatory Support.

PURPOSE: Summer camps are a modality that addresses barriers to social interaction. Although there is a growing amount of evidence supporting camps for individuals with chronic illness, there is no known research on camp experiences for those who require ventilatory support. The purpose of this study was to examine the perceptions of attending camp on self-esteem, social functioning, emotional functioning, and physical functioning for individuals who require ventilatory support. METHODS: Eleven participants completed the Pediatric Camp Outcome Measure via an online survey. RESULTS: This study found positive correlations between the number of years an individual attended the camp and his or her overall Pediatric Camp Outcome Measure score, as well as social functioning and physical functioning subscales. This study found positive correlations with questions in all subscales with the number of years attending camp. CONCLUSION: Findings suggest that attending summer camp may positively impact the quality of life for individuals who require ventilatory support.

Multicomponent Strategies to Prevent SARS-CoV-2 Transmission - Nine Overnight Youth Summer Camps, United States, June-August 2021.

Most U.S. overnight youth camps did not operate during the summer of 2020 because of the COVID-19 pandemic* (1). Several that did operate demonstrated that multiple prevention strategies, including pre- and postarrival testing for SARS-CoV-2, the virus that causes COVID-19, masking, and physical distancing helped prevent the introduction and spread of COVID-19; in contrast, camps that relaxed prevention strategies, such as requiring a single prearrival test without subsequent testing, experienced outbreaks (2-4). The availability of COVID-19 vaccines for persons aged ≥12 years enabled implementation of an additional prevention strategy that was not available in summer 2020. This study assessed the number of COVID-19 cases and potential secondary spread among 7,173 staff members and campers from 50 states, 13 countries, and U.S. military overseas bases at nine independently operated U.S. summer youth camps affiliated with the same organization. The camps implemented multiple prevention strategies including vaccination, testing, podding (cohorting), masking, physical distancing, and hand hygiene during June-August 2021. Vaccination coverage was 93% among eligible persons aged ≥12 years.† All staff members (1,955) and campers (5,218) received site-specific, protocol-defined screening testing, which included prearrival testing and screening tests during the camp session (38,059 tests). Screening testing identified six confirmed COVID-19 cases (one in a staff member and five in campers) by reverse transcription-polymerase chain reaction (RT-PCR) testing (screening test positivity rate = 0.02%). Three additional cases (in two staff members and one camper) were identified based on symptoms and were confirmed by RT-PCR testing. Testing for SARS-CoV-2, isolation, and quarantine in a population with high vaccination coverage resulted in no known secondary transmission of SARS-CoV-2 identified during camp. Implementation of multicomponent strategies is critical for prevention of COVID-19 outbreaks in congregate settings, including overnight youth camps.

COVID-19 Outbreaks at Youth Summer Camps - Louisiana, June-July 2021.

According to sequencing data reported by CDC, the highly transmissible B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, has been the predominant lineage circulating in Louisiana since the week of June 20, 2021 (1). In Louisiana, the increased spread of the Delta variant corresponded with the start of the state's fourth and largest increase in average daily COVID-19 incidence to date (1,2). This report describes COVID-19 outbreaks in Louisiana youth summer camps as the Delta variant became the predominant lineage during June-July 2021. This activity was reviewed by the Louisiana Department of Health (LDH) and was conducted consistent with applicable state law and LDH policy.

Epidemiologically Linked COVID-19 Outbreaks at a Youth Camp and Men's Conference - Illinois, June-July 2021.

On June 30, 2021, the Illinois Department of Public Health (IDPH) contacted CDC concerning COVID-19 outbreaks at two events sponsored by the same organization: a 5-day overnight church camp for persons aged 14-18 years and a 2-day men's conference. Neither COVID-19 vaccination nor COVID-19 testing was required before either event. As of August 13, a total of 180 confirmed and probable cases had been identified among attendees at the two events and their close contacts. Among the 122 cases associated with the camp or the conference (primary cases), 18 were in persons who were fully vaccinated, with 38 close contacts. Eight of these 38 close contacts subsequently became infected with SARS-CoV-2, the virus that causes COVID-19 (secondary cases); among the eight close contacts with secondary cases, one half (four) were fully vaccinated. Among the 180 total persons with outbreak-associated cases, five (2.8%) were hospitalized; no deaths occurred. None of the vaccinated persons with cases were hospitalized. Approximately 1,000 persons across at least four states were exposed to SARS-CoV-2 through attendance at these events or through close contact with a person who had a primary case. This investigation underscores the impact of secondary SARS-CoV-2 transmission during large events, such as camps and conferences, when COVID-19 prevention strategies are not implemented. In Los Angeles County, California, during July 2021, when the SARS-CoV-2 B.1.617.2 (Delta) variant was predominant, unvaccinated residents were five times more likely to be infected and 29 times more likely to be hospitalized from infection than were vaccinated residents (1). Implementation of multiple prevention strategies, including vaccination and nonpharmaceutical interventions such as masking, physical distancing, and screening testing, are critical to preventing SARS-CoV-2 transmission and serious complications from COVID-19.

Assessment of the World Food Programme summer camps in Lebanon: a model of effective interventions for vulnerable adolescents.

The World Food Programme (WFP) offers yearly health and nutrition summer camps hosting vulnerable Syrian and Lebanese children and aiming at improving physical, mental and social well-being while contributing to better social cohesion. The present study aimed to assess the 2019 WFP summer camps' effectiveness in reaching the intended outcomes and to provide recommendations for improvement. A multi-method approach using (1) quantitative student pre-/post-surveys (n 443), (2) focus group discussions and (3) key informant interviews and surveys (n 42) was adopted. Mean test results showed improvements in nutrition (4·79 (sd 1·9) v. 5·34 (sd 2·7); t(269) = 4·51, P = 0·000) and life skills knowledge (4·97 (sd 1·9) v. 5·55 (sd 2); t(294) = 4·52, P = 0·000) but no improvement in health knowledge and social cohesion scores. Qualitative data revealed positive changes in social cohesion and an increase in health knowledge. In addition, there was a positive attitude towards the summer camps from students, instructors and administrators specifically regarding the integrated content, snacks and atmosphere of fun and learning. The main weaknesses identified were the short time to prepare for the camps, shortage in instructor training and short camp duration. There were also points of debate regarding sexual and reproductive health-related topics and how they should be delivered. All in all, the camps were shown to be a commendable initiative for incorporating an integrated and holistic approach in the support of education and development among vulnerable children and adolescents.

Impact of factory-calibrated Freestyle Libre System with new glucose algorithm measurement accuracy and clinical performance in children with type 1 diabetes during summer camp.

BACKGROUND: Factory-calibrated intermittently-scanned Continuous Glucose Monitoring (isCGM) device FreeStyle Libre (FSL) has recently received improvements in its glucose tracking algorithm and calibration procedures, which are claimed to have improved its accuracy. OBJECTIVE: To compare the accuracy of two generations of 14-days FSL devices (A in 2016, B in 2019) to self-monitored blood glucose measurements (SMBG) in children with type 1 diabetes in real-life conditions during a summer camp. MATERIALS AND METHODS: Two largely independent groups of youth with type 1 diabetes took part in summer camps. In 2016 they used FSL-A, in 2019 FSL-B. On scheduled days, participants performed supervised 8-point glucose profiles with FSL and SMBG. The accuracy vs SMBG was assessed with mean absolute relative difference (MARD) and clinical surveillance error grid (SEG). RESULTS: We collected 1655 FSL-SMBG measurement pairs from 78 FSL-A patients (age 13 ± 2.3 years old; HbA1c: 7.6 ± 0.8%) and 1796 from 58 in FSL-B group (age 13.8 ± 2.3 years old, HbA1c: 7.5 ± 1.1%)-in total 3451 measurements. FSL-B displayed lower MARD than FSL-A (11.3 ± 3.1% vs 13.7 ± 4.6%, P = .0003), lower SD of errors (20.2 ± 6.7 mg/dL vs 24.1 ± 9.6 mg/dL, P = .0090) but similar bias (-7.6 ± 11.8 mg/dL vs -6.5 ± 8 mg/dL, P = .5240). Both FSL-A and FSL-B showed significantly higher MARD when glycaemia was decreasing >2 mg/dL/min (FSL-A:22.3 ± 18.5%; FSL-B:17.9 ± 15.8%, P < .0001) compared with stable conditions (FSL-A: 11.4 ± 10.4%, FSL-B:10.1 ± 9.1%) and when the system could not define the glycaemic trend (FSL-A:16.5 ± 16.3%; FSL-B:15.2 ± 14.9%, P < .0001). Both generations demonstrated high percentage of A-class and B-class results in SEG (FSL-A: 96.4%, FSL-B: 97.6%) with a significant shift from B (decrease by 3.7%) to A category (increase by 3.9%) between generations (FSL-A: 16/80.4%; FSL-B:12.3/85.3%, P = .0012). CONCLUSION: FSL-B demonstrated higher accuracy when compared to FSL-A However, when glycemia is decreasing or its trend is uncertain, the verification with a glucose meter is still advisable.

Changes in glycated hemoglobin, diabetes knowledge, quality of life, and anxiety in children and adolescents with type 1 diabetes attending summer camps: A systematic review and meta-analysis.

Diabetes summer camps provide children and adolescents with type 1 diabetes opportunities to learn about the disease and its management in a supportive environment to help improve glycemic control, self-reliance, and quality of life. The objective of this quantitative review was to assess the advantages of attending summer camps and study any adverse psychological effects. Studies with a pre/post study design in children and adolescents attending summer camp were systematically reviewed. Five bibliographic databases were searched and relevant data extracted. Random effects meta-analyses were used to combine the individual study results to derive pooled estimates and meta-regression was used to explore between-study heterogeneity. Studies in the literature report short-term improvements in the glycemic control, diabetes knowledge (DK), quality of life (QOL) anxiety, diabetes self-management, and self-esteem. Thirty-three studies were identified, and those outcomes reported in five or more studies were included in meta-analyses. There were significant benefits with a pooled mean change for glycated hemoglobin (95% CI) of -0.59(-0.95,-0.23)% (-6.4[-10.4,-2.5]mmol/mol), and for standardized DK score of 1.99(1.28,2.70) but corresponding changes for QOL 0.17(-0.06,0.39) and for anxiety -0.32(-0.70, 0.06) were not significant. However, all outcomes showed considerable between-study heterogeneity little of which was explained by study characteristics. The findings suggest short-term benefits of camp on metabolic control, DK, QOL and anxiety in T1D children and adolescents, although the latter two were not statistically significant. Further research is warranted with more methodological rigor and longer-term follow-up to determine if there are long-term benefits associated with camp attendance.

Performance of three different continuous glucose monitoring systems in children with type 1 diabetes during a diabetes summer camp.

The aim of this study was to assess accuracy of the three most commonly used continuous glucose monitoring (CGM) systems in almost real-life situation during a diabetes camp in children with type 1 diabetes (T1D) aged 9-14 years. Data was gathered during a 2-week summer camp under physicians' supervision. Out of 38 participating children with T1D (aged: 11.0 [9.9; 12.1] years; 57% girls, mean HbA1c 7.2 [6.9; 7.7] %,) 37 wore a CGM system (either Abbott FreeStyle Libre (FSL), Dexcom G6 (DEX) or Medtronic Enlite (ENL)) throughout the camp. All concomitantly available data pairs of capillary glucose measurements and sensor values were used for the analysis. Mean absolute relative difference (MARD) was calculated and Parkes Error Grid analyses were done for all three systems used. In total 2079 data pairs were available for analysis. The overall MARDs of CGM systems used at the camp was FSL: 13.3% (6.7;21.6). DEX: 10.3% (5.8; 16.7) and ENL 8.5% (3.6; 15.6). During eu-, hypo- and hyperglycemia MARDs were lowest in ENL. Highest MARDs were seen in hypoglycemia, where all three systems exhibited MARDs above 15%. Overnight MARDs of all systems was higher than during daytime. All sensors performed worst in hypoglycemia. Performance of the adequately calibrated Medtronic system outperformed the factory-calibrated sensors. For clinical practice, it is important to adequately train children with T1D and families in the correct procedures for sensors that require calibrations.

Look-ahead fixations during visuomotor behavior: Evidence from assembling a camping tent.

Eye movements can support ongoing manipulative actions, but a class of so-called look ahead fixations (LAFs) are related to future tasks. We examined LAFs in a complex natural task-assembling a camping tent. Tent assembly is a relatively uncommon task and requires the completion of multiple subtasks in sequence over a 5- to 20-minute duration. Participants wore a head-mounted camera and eye tracker. Subtasks and LAFs were annotated. We document four novel aspects of LAFs. First, LAFs were not random and their frequency was biased to certain objects and subtasks. Second, latencies are larger than previously noted, with 35% of LAFs occurring within 10 seconds before motor manipulation and 75% within 100 seconds. Third, LAF behavior extends far into future subtasks, because only 47% of LAFs are made to objects relevant to the current subtask. Seventy-five percent of LAFs are to objects used within five upcoming steps. Last, LAFs are often directed repeatedly to the target before manipulation, suggesting memory volatility. LAFs with short fixation-action latencies have been hypothesized to benefit future visual search and/or motor manipulation. However, the diversity of LAFs suggest they may also reflect scene exploration and task relevance, as well as longer term problem solving and task planning.

Supporting children and young people with an acquired brain injury (ABI) and their siblings: The experience of a camp for families with a child with an ABI.

Paediatric acquired brain injury (ABI) is associated with long-term negative sequelae, and families must continually adapt to meet the needs of the child with ABI and family members. Condition-specific camps may support families in this process. This study explored the experience of camps for children with ABI and their families from the perspective of children and young people with ABI and their siblings. Semi-structured interviews were conducted with 10 people with ABI (Mage = 23.93, SD = 16.52 years) and 19 siblings of people with ABI (Mage = 14.53, SD = 5.73 years). Using reflexive thematic analysis, the central theme identified was "My safe space," supported by three further themes: "Having fun and relaxing," "Making friends," and "Enjoying choices." Camp was a space where the shared understanding and acceptance of ABI created a sense of safety. This was facilitated by enjoying activities, developing friendships with peers who shared the experience of ABI, and having a sense of control through choice availability. Thus, camps appear to offer opportunities to enjoy typical childhood experiences while restoring a sense of security, increasing understanding of ABI and validating attendees' experiences. Camps may, therefore, offer low-cost interventions to support children with ABI and their families.

Improvements in Psychosocial Outcomes Following a Summer Camp for Youth with Bleeding Disorders and Their Siblings.

PURPOSE: Complications from bleeding episodes from hemophilia can interfere with children's lives and lead to negative psychosocial outcomes. The purpose of this study is to evaluate whether attitude toward illness, hope, perception of illness benefit and/or burden, and/or illness knowledge change for youth with bleeding disorders and their siblings following a five-day education and activity focused summer camp. We hypothesized that youth with bleeding disorders' attitude toward illness, hope, perception of illness benefit, and illness knowledge would improve after camp attendance, and perception of illness burden would decease after camp attendance. We hypothesized that siblings' hope and illness knowledge would improve after camp attendance. DESIGN AND METHODS: A total of 98 youth (M = 10.9, SD = 3.33, 61.2% male) who attended a bleeding disorder summer camp participated in this study. Fifty percent of participants were diagnosed with either Hemophilia A, Hemophilia B (5%), Von Willebrand Disease (VWD) (28.3%), or platelet deficiency (1.7%), with 38 campers consisting of healthy siblings. The camp hosted "Learning about Hemophilia" breakout sessions for campers. Participants completed self-report questionnaires on the first day and last day of camp. RESULTS: Of participants with bleeding disorders, illness knowledge, perception of illness benefit, and attitude toward their illness significantly improved from pre-camp to post-camp. Hope did not significantly improve among youth with bleeding disorders. Healthy siblings' total hope significantly improved while illness knowledge remained constant. CONCLUSIONS: Summer camps are a promising intervention to improve psychosocial outcomes in youth with hemophilia and WVD. CONCLUSIONS: Summer camps are a promising intervention to improve psychosocial outcomes in youth with hemophilia and WVD.

Modeling areal measures of campsite impacts on the Appalachian National Scenic Trail to enhance ecological sustainability.

Campsite impacts in protected natural areas are most effectively minimized by a containment strategy that focuses use on a limited number of sustainable campsites that spatially concentrate camping activities. This research employs spatial autoregressive (SAR) modeling to evaluate the relative influence of use-related, environmental, and managerial factors on two salient measures of campsite impact. Relational analyses examined numerous field-collected and GIS-derived indicators, including several new indicators calculated using high-resolution Light Detection and Ranging (LiDAR) topographic data to evaluate the influence of terrain characteristics on the dependent variables. Chosen variables in the best SAR models explained 35% and 30% of the variation in campsite size and area of vegetation loss on campsites. Results identified three key indicators that managers can manipulate to enhance the sustainability of campsites: campsite type, and terrain characteristics relating to landform slope and topographic roughness. Results support indirect management methods that rely on the location, design, construction, and maintenance of campsites, instead of direct regulations that restrict visitation or visitor freedoms. As visitation pressures continue to increase, this knowledge can be applied to select and promote the use of more ecologically sustainable campsites.

Staff and Parent Perspectives on a Therapeutic Recreation-Based Bereavement Camp for Families Whose Child Has Died From Serious Illness.

This study explores the nature of a therapeutic recreation-based bereavement camp for families whose child has died from serious illness. Open-ended surveys and interviews were conducted with parents attending a three-camp cycle over a 12-month period or a reunion camp. Thirteen parents completed open-ended surveys before and after each camp and six of these also completed interviews after the final camp. Six additional parents completed interviews after the reunion camp. Six staff working with families during the camps were also interviewed. Content analysis of surveys and thematic analysis of interviews revealed the aims, structure, and content of the camp. The findings suggest a model whereby shared experience allows for normalization and offers a nonjudgmental place to share stories, discuss difficulties come together as a family, and create a support network. These findings highlight the value of therapeutic recreation-based bereavement interventions for families whose child has died from serious illness.