The experience of imagery as a post-treatment intervention in patients with breast cancer: program, process, and patient recommendations.

PURPOSE/OBJECTIVES: To better understand the common themes of women participating in an imagery program designed to improve quality of life (QOL). RESEARCH APPROACH: Qualitative. SETTING: Classroom setting at Alaska Regional Hospital in Anchorage. PARTICIPANTS: 10 women with a confirmed diagnosis of breast cancer who had completed conventional care participated in a six-class, eight-week-long imagery program titled Envision the Rhythms of Life (ERL). METHODOLOGIC APPROACH: Focus group audio recordings and notes were interpreted with the Krueger focus group method and confirmed by an outside evaluator. MAIN RESEARCH VARIABLES: Breast cancer survivors' descriptions of imagery practice and experience as they created passive, active, and targeted imagery. FINDINGS: Participants reported the importance of engaging passive and active imagery, letting targeted imagery take on a life of its own, performing homework, understanding the science, practicing, hearing imagery stories, engaging all the senses, trusting imagery, and group interaction. Imagery practice improved mood state. CONCLUSIONS: When delivered by expert imagery trainers in collaboration with oncology nurses, ERL can improve breast cancer survivors' QOL. The present study is one of few reports that evaluated survivors' imagery experiences from a clinical trial and produced significant QOL improvements. INTERPRETATION: The present study provides oncology nurses understanding of the psychological risks faced by breast cancer survivors after completion of primary care and explains the critical need for post-treatment programs for survivors dealing with post-traumatic stress disorder, depression, anxiety, or high levels of stress.

Research with Arctic peoples: unique research opportunities in heart, lung, blood and sleep disorders. Working group summary and recommendations.

Arctic peoples are spread over eight countries and comprise 3.74 million residents, of whom 9% are indigenous. The Arctic countries include Canada, Finland, Greenland (Denmark), Iceland, Norway, Russia, Sweden and the United States. Although Arctic peoples are very diverse, there are a variety of environmental and health issues that are unique to the Arctic regions, and research exploring these issues offers significant opportunities, as well as challenges. On July 28-29, 2004, the National Heart, Lung, and Blood Institute and the Canadian Institutes of Health Research co-sponsored a working group entitled "Research with Arctic Peoples: Unique Research Opportunities in Heart, Lung, Blood and Sleep Disorders". The meeting was international in scope with investigators from Greenland, Iceland and Russia, as well as Canada and the United States. Multiple health agencies from Canada and the United States sent representatives. Also attending were representatives from the International Union for Circumpolar Health (IUCH) and the National Indian Health Board. The working group developed a set of ten recommendations related to research opportunities in heart, lung, blood and sleep disorders; obstacles and solutions to research implementation; and ways to facilitate international comparisons. These recommendations are expected to serve as an agenda for future research.

Arctic telehealth: north to the future.

Over the past thirty years the delivery of health care services in Alaska has gone from Citizen Ban radio transmissions that were relayed through telephone bridges to one of the largest, state of the art telemedicine systems in the world. This transition has been marked by innovative approaches, learning from others, forged partnerships, open relationships with the telecommunication businesses, and a great deal of funding. This transition has required new approaches to health information, relinquishment of sole ownerships, collaboration, cooperation, and a unified voice. The system is not standalone. There are components that have influenced other endeavors. Health Aids now must be trained to make use of the electronic tools that they have at their remote clinics. Upgraded components for airborne medical evacuations need to match the overall system. Health professionals doing rotations and contracts in Alaska must learn how to interface with the telemedicine system. New administrators are being trained through a Master of Public Health program within the University of Alaska Anchorage that is taught entirely over the "Blackboard" computer-based system for distant delivery. The telehealth systems in Alaska and other Arctic nations are becoming the models to be replicated throughout the world. Excelsior.