Integration of Building into Nature for the Valles Caldera National Preserve Visitor Center

Valles Caldera National Preserve, located in northern New Mexico, has an opportunity to implement sustainable design concepts while demonstrating long-term financial sustainability in the design of its new visitor center. This building can be designed to use natural systems to provide energy and water, and to blend in with the setting‰Ûªs unique historical and natural landscape. Structures can be integrated into nature by incorporating common techniques, features, and materials of a particular period, area, or people. This analysis identified capital costs for both traditional and sustainable construction techniques, as well as long-term operational costs. The results demonstrate that capital costs of sustainable design that is integrated into the landscape can be comparable to conventional costs and provide long-term operational costs savings.

Psychosocial Distress Screening in a Community Cancer Center: An Exploratory Study of Distress Screening Across the Cancer Treatment Continuum

Purpose: The primary goal of this exploratory study is to demonstrate that distress screening across the course of cancer treatment is possible and provides valuable information about patient needs over time. Distress screening is aligned with guidelines from national accrediting organizations and may lead to improved health-related quality of life, satisfaction with medical care, and possibly survival.Methods: Medical, surgical, and radiation oncology patients completed a screening instrument before their appointments during a six-month period. Patients indicated their level of distress on four domains (practical, emotional, health and social concerns). De-identified data was collected, aggregated and descriptive statistics were analyzed.Results: Approximately 3000 screens were collected and 1500 cancer patients were screened. Of patients who indicated distress, 54% demonstrated a distress level of five or greater. Distress level eight was the most frequent level of distress indicated. The Cancer Dietitian was the most commonly requested healthcare team provider. The Health Concern domain was most frequently endorsed.Conclusion: NCCN, IOM and COC guidelines recommend distress screening in all cancer treatment centers, however implementation has proven difficult. This study adds to the literature about distress in cancer patients, demonstrates the feasibility of repeated distress screening and provides a model program demonstrating the implementation of repeated distress screening at a community cancer center. Findings highlight the importance of supportive oncology services due to the prevalence of high levels of distress. Findings demonstrate the importance of the Cancer Dietitian in supportive cancer care. Additionally, the research reveals a potential perceived stigma in seeking psychosocial oncology services.