Shor-Posner 2004, resumed

(Since we're going to finish the Shor-Posner article, I have moved it up from the original posting below, in order to keep all the parts of the discussion in sequence. In discussions with Dorothy, my editor on the book, I've come to the conclusion that my original way was too scattered, and that an entire "thread", or discussion of a topic, should occur together to make it easier for the readers to follow particular discussions. So I'll move the earlier discussions of Shor-Posner 1998 up here, to recap, and then we'll finish the article before starting any other discussions.)

Our first MJC article is Shor-Posner 1998: Massage treatment in HIV-1 infected Dominican children: a preliminary report on the efficacy of massage therapy to preserve the immune system in children without antiretroviral medication. It appeared in the Journal of Alternative and Complementary Medicine in 2004 Dec;10(6):1093-5.

The authors are

• Gail Shor-Posner, PhD
  
• Maria-Jose Miguez MD, PhD
  
• Maria Hernandez-Reif, PhD
  
• Eddy Perez-Then, MD, MPH
  
• MaryAnn Fletcher, PhD
  

Drs. Shor-Posner, Miguez, and Perez-Then are affiliated with the Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL, and Dr. Perez-Then is also affiliated with CENISMI/Robert Reid Cabral Children's Hospital, Santo Domingo, Dominican Republic.

Dr. Hernandez-Reif is affiliated with the Touch Research Institutes (Tiffany Field's research group), Department of Pediatrics, University of Miami School of Medicine, and Dr. Fletcher is with the Department of Medicine, University of Miami School of Medicine.

In addition to the IMRaD structure we discussed below, research articles also typically have an Abstract at the very beginning (or sometimes at the very end). This abstract is an executive summary, which hits the main points of the article very briefly, so that you can decide whether you want to spend the time to read the article in full.

Here is Shor-Posner 2004's abstract:

OBJECTIVES: More than 1.4 million children are living with HIV and global access to antiretrovirals is not yet readily available. Massage therapy, which has been shown to improve immune function in HIV+ adults and adolescents, may provide an important complementary treatment to boost immune status in young children living with HIV disease, especially those without access to antiretroviral medications. No studies have been conducted, however, that specifically target massage therapy to enhance immune function in HIV+ children.

DESIGN: Clinical trial with eligible, consented HIV+ children randomized to receive either massage therapy or a friendly visit (controls).

SETTINGS/LOCATION: CENISMI/Robert Reid Cabral Hospital, Santo Domingo, Dominican Republic.

SUBJECTS: HIV+ children ages 2-8 years.

INTERVENTION: Massage therapy sessions (20 minutes, twice weekly, for 12 weeks), conducted by trained nurses, following a structured protocol of moderate pressure stroking and kneading of muscles, using a non-scented oil. The friendly visit control group, (reading, talking, playing quiet games), met with the nurse twice weekly for 12 weeks.

OUTCOME MEASURES: At the initial evaluation, and following the 12-week intervention, blood was drawn to determine absolute helper (CD4/T4) and suppressor (CD8/T8) counts.

RESULTS: Children in the control arm had a greater relative risk of CD4 count decline (>20%) than massage-treated children (RR = 5.7, p = 0.03). Lymphocyte loss was also more extensive in the controls (p < 0.02), and more of the control group than the massage group lost >50 CD8 lymphocytes (p = 0.03).

CONCLUSIONS: The efficacy of massage therapy in maintaining immunocompetence may offer a viable alternative to the thousands of children worldwide without antiretroviral access.

Don't worry if there are unfamiliar terms and statistics in the abstract--for now, just read it and decide whether you think this article is interesting enough to spend time reading it in detail. We will cover the important concepts as we come across them, and by the time we have examined this article together, they will be familiar to you.