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The Healthy Cities process uses action research to empower communities to take action for health. Five concepts that link community empowerment and action research are: focus on community, citizen participation, information and problem solving, sharing of power, and quality of life. Two city examples from Healthy Cities Indiana, a pilot program of CITYNET Healthy Cities, provide illustrations of these concepts. The dynamics of community participation in action research and the successes and barriers to community participation are presented. Outcomes that empowered the community are suggested: the extent to which Healthy City projects are initiated, their progress monitored, continued action in health supported, resources obtained, and policies promoted that contribute equity in health.

This study was an investigation of the effects of physiologically-oriented mental imagery on immune functioning. College students with normal medical histories were randomly selected to one of three groups. Subjects in Group 1 participated in short educational training on the production of secretory immunoglobulin A. They were then tested on salivary IgA, skin temperature, and the Profile of Mood States (POMS) before and after listening to a 17-minute tape of imagery instructions with specially composed background "entrainment" music designed to enhance imagery. Subjects in Group 2 (placebo controls) listened to the same music but received nor formal training on the immune system. Group 3 acted as a control and subjects were tested before and after 17 minutes of no activity. Treatment groups listened to their tapes at home on a bi-daily basis for six weeks. All groups were again tested at Weeks 3 and 6. Secretory IgA was analyzed using standard radial immunodiffusion techniques. Repeated measures analyses of variance with planned orthogonal contrasts were used to evaluate the data. Significant overall increases (p less than 0.05) were found between pre- and posttests for all three trials. Groups 1 and 2 combined (treatment groups) yielded significantly greater increases in sIgA over Group 3 (control) for all three trials. Group 1 (imagery) was significantly higher than Group 2 (music) in antibody production for Trials 2 and 3. Symptomatology, recorded by subjects at Weeks 3 and 6, was significantly lower for three symptoms (rapid heartbeat, breathing difficulty, and jaw clenching), favoring both treatment groups over the control group.

Measured the efficacy of music, progressive muscle relaxation, and a combination of both variables on tension reduction. Ss were three sections (N = 76) of an introductory music class. Each section received either sedative music (M), progressive muscle relaxation (PMR), or both (M + PMR) as treatment. Vasoconstriction, or finger temperature, was used to measure stress level prior to and after the intervention. All three groups evidenced significant increases in finger temperature. There was no significant difference among treatment groups, although the M + PMR group's mean increase was greater than the grand mean, while the M and PMR groups' increases were below the grand mean.

The purpose of this study was to measure the effects of music, progressive muscle relaxation (PMR), and guided imagery (GI) on the adrenal corticosteroids, or "stress hormones." Hypotheses were designed to evaluate the effect of a taped induction of music/PMR/GI on the mean level (1), circadian amplitude (2), and circadian re-entrainment with body temperature (3) of urinary corticosteroids. Urine collections and body temperature were recorded in shift-working nurses during three 4-5 day intervals over a 1-month period. The nurses listened to the tape on a daily basis, commencing after the first recording period. Results indicated that circadian amplitude decreased significantly (p = .007), and corticosteroid and temperature rhythms were significantly (p less than .01) more entrained during the tape conditions. The mean corticosteroid level also declined during tape listening, but nonsignificantly (p = .15). Because of the close relationship between corticosteroids and the immune system, these data suggest a relationship between music/relaxation techniques and physical health.

The purpose of this study was to determine the effects of cell-specific mental imagery on neutrophil and lymphocyte cell counts. Subjects (N = 30) were randomly assigned to one of two experimental groups that underwent a 6-week training program focusing on images of morphology, location, and movement of either neutrophils or lymphocytes. Music was used to enhance the imagery of the subjects. Peripheral white blood cell and differential counts were determined before and after the final 20-minute imagery session. Results indicated that neutrophils decreased significantly (p less than .04) in the neutrophil-change group while lymphocytes did not. The reverse occurred in the lymphocyte-change group, with only the lymphocytes decreasing significantly (p less than .03). The authors concluded that under the conditions of the present study, cell-specific imagery was associated with decreases in peripheral blood cell counts of lymphocytes and neutrophils.