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Outdoor education (OE) takes place within a range of program settings and contexts (e.g., recreational, educational, developmental, or therapeutic). Experiential learning is central to OE and focuses these programs around elements of inquiry, active learning and reflection in the outdoor classroom. The personal, social and environmental benefits of OE have been well documented, however very little attention has been afforded to effective program planning strategies in order to achieve desired OE outcomes. This article describes useful learning-centered program planning strategies in OE. These strategies are transferable to a wide range of alternative physical education and sport coaching programs.

The article discusses holistic learning and the ways it can be put into practice in outdoor education programs. The concept's derivation from literature on multiple intelligences is discussed. Silence and authentic reflection are described as ways to encourage spiritual growth in an outdoor education setting. The concept of spiritual wellness is defined as a sense of life purpose and fulfilment experienced through interactions with self, community, and environment. The article lists several strategies for holistic outdoor education, including learning context strategies, predisposing strategies, and enabling strategies. Reminders for teachers to allow for pluralistic spiritual beliefs and remain grounded in their approaches to spirituality are also addressed.

Purpose: To investigate the longitudinal relationship between chemotherapy-induced peripheral neuropathy (CIPN) symptoms (sx) and brain perfusion changes in patients with breast cancer. Interaction of CIPN-sx perfusion effects with known chemotherapy-associated gray matter density decrease was also assessed to elucidate the relationship between CIPN and previously reported cancer treatment-related brain structural changes., Methods: Patients with breast cancer treated with (n = 24) or without (n = 23) chemotherapy underwent clinical examination and brain magnetic resonance imaging at the following three time points: before treatment (baseline), 1 month after treatment completion, and 1 year after the 1-month assessment. CIPN-sx were evaluated with the self-reported Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity four-item sensory-specific scale. Perfusion and gray matter density were assessed using voxel-based pulsed arterial spin labeling and morphometric analyses and tested for association with CIPN-sx in the patients who received chemotherapy., Results: Patients who received chemotherapy reported significantly increased CIPN-sx from baseline to 1 month, with partial recovery by 1 year (P < .001). CIPN-sx increase from baseline to 1 month was significantly greater for patients who received chemotherapy compared with those who did not (P = .001). At 1 month, neuroimaging showed that for the group that received chemotherapy, CIPN-sx were positively associated with cerebral perfusion in the right superior frontal gyrus and cingulate gyrus, regions associated with pain processing (P < .001). Longitudinal magnetic resonance imaging analysis in the group receiving chemotherapy indicated that CIPN-sx and associated perfusion changes from baseline to 1 month were also positively correlated with gray matter density change (P < .005)., Conclusion: Peripheral neuropathy symptoms after systemic chemotherapy for breast cancer are associated with changes in cerebral perfusion and gray matter. The specific mechanisms warrant further investigation given the potential diagnostic and therapeutic implications., (© 2015 by American Society of Clinical Oncology.)