"i Went To The Woods Because I Wished To Live Deliberately": How A College-Level Academic Course Can Influence A Lifetime

This study, using the portraiture methodology, provides an analysis of the lifelong significance of an undergraduate program that integrates literature with an outdoor experiential platform. With limited research on long-term effects of an academic outdoor experiential course on one's life, there is space to wonder about the prospect and nature of the long-term significance of an academic course that may offer technical skill, intrapersonal and interpersonal development, and also the delivery of subject matter related to a traditional or mainstream academic area of study. Utilizing an academic skills-oriented lens as well as a character strengths lens, portraits were crafted of four former participants of the University of Michigan's New England Literature Program (NELP) to shed light on the long-term influence of this type of course, crucial participant characteristics that contribute to the program's impact, and specific components of the program that are particularly integral to the course's efficacy. Since 1975, each spring term a small contingent of students and educators has lived in the woods in the New England region as a community of learners, artists and explorers. NELP is an exemplar of a longstanding undergraduate academic English course that integrates the literature of New England writers, exploratory writing and student experiences relating to regional literature and the land. Emergent themes of this course's long-term influence on former participants include increased collaborative skills, increased self-confidence and self-knowledge, a reinforcement of lifelong relationships with the outdoors, and nurtured creativity. For participants to reap benefit from this course, it was important for them to enter with maturity to conduct themselves with openness to new experiences, relationships, and extensive reflection. Findings relating to the integral components of such a program include that of being place-based, oriented towards process, and being an intentional, collaborative community.

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.