Objective Chronic pain is common in military veterans with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Neurofeedback, or electroencephalograph (EEG) biofeedback, has been associated with lower pain but requires frequent travel to a clinic. The current study examined feasibility and explored effectiveness of neurofeedback delivered with a portable EEG headset linked to an application on a mobile device. Design Open-label, single-arm clinical trial. Setting Home, outside of clinic. Subjects N = 41 veterans with chronic pain, TBI, and PTSD. Method Veterans were instructed to perform “mobile neurofeedback” on their own for three months. Clinical research staff conducted two home visits and two phone calls to provide technical assistance and troubleshoot difficulties. Results N = 36 veterans returned for follow-up at three months (88% retention). During this time, subjects completed a mean of 33.09 neurofeedback sessions (10 minutes each). Analyses revealed that veterans reported lower pain intensity, pain interference, depression, PTSD symptoms, anger, sleep disturbance, and suicidal ideation after the three-month intervention compared with baseline. Comparing pain ratings before and after individual neurofeedback sessions, veterans reported reduced pain intensity 67% of the time immediately following mobile neurofeedback. There were no serious adverse events reported. Conclusions This preliminary study found that veterans with chronic pain, TBI, and PTSD were able to use neurofeedback with mobile devices independently after modest training and support. While a double-blind randomized controlled trial is needed for confirmation, the results show promise of a portable, technology-based neuromodulatory approach for pain management with minimal side effects.

Many breast cancer survivors may be at increased risk for physical and psychological complications from cancer treatments. Research has shown that regular exercise can help ameliorate some of the lingering side effects of breast cancer treatments and improve health-related quality of life (HRQOL). Additionally, certain stress management techniques have helped increase HRQOL in breast cancer survivors. Few educational programs exist which address both the promotion of physical activity and use of mindfulness-based strategies to improve the health of breast cancer survivors. Community-based wellness workshops were designed to promote regular exercise and use of mindfulness-based techniques. There was an increase in physical activity and improvements on several HRQOL domains 1 month following the exercise workshops; although the results were not significant, they are encouraging.

Background: Symptoms of psychological distress, including fear of cancer recurrence (FCR) and quality of life (QOL) deficits are common along the hematopoietic stem cell transplantation (HCT) survivorship trajectory. Identifying patterns over time could contribute to timely interventions. Materials and Methods: HCT recipients completed the Distress Thermometer (DT), the Center for Epidemiologic Studies-Depression scale (CES-D), the Fear of Relapse and Recurrence Scale, and the Functional Assessment of Cancer Therapy (FACT-BMT) at hospital admission, discharge, 3, 6, 12, and 24 months post-HCT. Demographic data and performance status (PS) were collected at baseline. Mean scores (standard deviation) and frequencies were calculated. We utilized a linear mixed model approach on the repeated measures data (outcome of FCR, with predictors of distress, depressive symptoms and QOL). A multivariate repeated measures regression was constructed to assess what variables were associated with FCR. Results: A total of 198 patients completed questionnaires at admission. A total of 144 patients were deceased or lost to follow-up at 2 years. Both CES-D (P = .006) and DT (P = .0019) scores changed significantly over time and were higher at hospital discharge. FCR did not change significantly (P = .28). QOL was most impaired at hospital discharge. FCR did not correlate with actual recurrence. A significant percentage of recipients were afraid of cancer recurrence; however, a much greater percentage did not feel that fear of recurrence got in the way of enjoying life. QOL (P < .0001) and PS (P = .014) were significant predictors of FCR. A substantial percentage of patients reported significant (>16) depressive symptoms and distress levels (≥4) during the 2-year study period. Conclusions: Depressive symptoms and distress were highest at discharge, whereas overall QOL was lowest. FCR was prominent; yet for the majority, it was not an impediment to enjoying life. A psychosocial intervention may be most useful if introduced at hospital discharge and initiated during the first 3 months following HCT when distress is high.

This article examines the feasibility and effectiveness of delivering a community-based health education workshop to promote positive health behaviors for breast cancer survivors in a predominately rural 13-county region in North Carolina. Curriculum was based on an existing 20-week center-based exercise and recreation therapy program for breast cancer survivors, and it relied on interagency cooperation for promotion and delivery of the intervention. Evaluation of success was based on attendance, ability of participants to demonstrate appropriate health behaviors, and self-reported changes in health behaviors. Challenges and strategies related to partnering with community agencies and generating attendance are discussed. The authors contend that a community-based workshop supported by multiple agencies can be effective in enhancing health-related knowledge and behaviors for breast cancer survivors.