Concerns over the increasing popularity of wilderness recreation have resulted in attempts to determine the amount of use that different areas can tolerate without adverse affects to the resource. Early attempts to establish recreational carrying capacities focused on managers' assessments of biophysical impacts. The perceptions of wilderness visitors, however, are now considered integral to capacity decisions. This study used a stress appraisal framework to understand wilderness visitors' perceptions of on-site conditions. It was based on the premise that negative appraisals of wilderness conditions produce stress and that individual perceptions vary based on personal and situational characteristics. The purpose of the study was to assess the validity of a wilderness-hassles appraisal scale by testing hypothesized relationships between experience-use history (EUH), place attachment, and stress appraisal. Data collection occurred through a postal survey of hikers (n = 385) contacted in the High Peaks and Pemigewasset Wilderness Areas during the summer of 2004. An exploratory factor analysis indicated that stress appraisal is a multi-dimensional construct. Validity testing procedures were restricted to those dimensions that were consistent between study areas and provided partial support for the hassles scale. As hypothesized, EUH did not influence perceptions of wilderness conditions. Place attachment, on the other hand, was positively correlated with stressful appraisals of social and managerial conditions. Although Kruskall Wallis tests revealed significant differences in visitors' perceptions of managerial conditions between study sites, perceptions of social conditions did not vary significantly. Implications for management and recommendations for further refinement of the wilderness hassles construct are discussed.

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The purpose of this study was to examine predictors of coordinated and comprehensive care within a medical home among children with special health care needs (CSHCN). The latest version of the National Survey of Children with Special Health Care Needs (NS-CSHCN) employed a national random-digit-dial sample whereby US households were screened, resulting in 40,242 eligible respondents. Logistic regression analyses were performed modeling the probability of coordinated, comprehensive care in a medical home based on shared decision-making and other factors. A total of 29,845 cases were selected for inclusion in the model. Of these, 17,390 cases (58.3%) met the criteria for coordinated, comprehensive care in a medical home. Access to a community-based service systems had the greatest positive impact on coordinated, comprehensive care in a medical home. Adequate insurance coverage and being White/Caucasian were also positively associated with the dependent variable. Shared decision-making was reported by 72% of respondents and had a negative, but relatively negligible impact on coordinated, comprehensive care in a medical home. Increasing age, non-traditional family structures, urban residence, and public insurance were more influential, and negatively impacted the dependent variable. Providers and their respective organizations should seek to expand and improve health and support services at the community level.

The preambles of the 1959 Antarctic Treaty and the 1991 Protocol on Environmental Protection to the Antarctic state that Antarctica is to be managed in the interest of all mankind. However, key phrases such as ‘interest of all mankind’ and ‘wilderness and aesthetic values’ are subject to interpretation. The objective of this study is to gain a better understanding of public perceptions of the Antarctic wilderness, proceeding from the assumption that public views should be incorporated into the consultative parties’ decision making process. The study expands on previous research by exploring whether perceptions of the Antarctic environment varied between students at two comparably sized public universities in Spain and the United States. Four hundred undergraduate students were asked about their values, beliefs and attitudes with respect to environmental management practices in Antarctica. After controlling for course type, responses showed little variation based on nationality. A large proportion of students valued Antarctica as a science laboratory for the benefit of mankind, as one of the world's last great wildernesses, and an important component of the climate system. Students did not support an increase in the number of people going to Antarctica, and favoured limitations on infrastructure development.