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Hands-on experiential learning: Qualitative evaluation project--Interviewing people about what massage means to them

Submitted by RST on Sun, 05/06/2012 - 11:10
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Introduction

This exercise asks you to collect and record data about the personal and unique meanings that people take from massage.

The purpose is to give you the experience of conducting qualitative research on a very small scale, so that from it, you get a sense of how researchers design and carry out studies to investigate a particular research question.

We're going to use an ethnographic interview, which is a qualitative research method. It's a way of interviewing people, usually one-on-one, to find out basic facts about their lives, how they understand the world around them, and possibly such things as what meaning they derive from it.

 

Designing your project

The research design for this project is fairly straightforward:

Decide on 2 or 3 people whom you would like to interview to learn what they think about massage, and what their experience with massage is.

Decide on the setting where you would like to interview them--invite them to your place, drop by theirs, invite them out for coffee, or whatever other setting works well for you to ask questions and note down their answers.

Invite people to participate in your study. Two or three is enough for this, as it is really a demo more than it is an actual project.

Make sure that before you interview anyone, they have signed and given you a copy of the consent form later in this post.

Meet them for the interview, and record their answers to your questions.

Write up their answers to your questions, and--making sure you observe accepted practices of confidentiality--tell us in the comments below what you wanted to explore, what questions you asked in order to explore that, what their answers are, what you think their answers tell you about the meaning they take from massage, and anything else about the process that strikes you as worth mentioning.

 

Primum non nocere--First, do no harm.

 

Remember that, as a healthcare professional and as a researcher--even in an exercise as small-scale as this one--you have a responsibility and a duty above all to protect the identities of the people you interview.

Before you share information with the rest of us in the POEM community, make sure that you have removed or shielded any information that would help people to figure out the identity of the people you interview.

Perhaps the most obvious thing to do first is to make sure you don't use someone's real name. But by itself, that may not be enough to protect the identity of your participants.

Consider, for example, the following description:

"Mary", an MT originally from Alabama who now lives in the Seattle area, and who speaks Cambodian and works with refugee clients...

 

That description is specific enough for people who know me to figure out that "Mary" is really me; changing the name was not enough to hide that fact.

Consider changing the sex and age of your participants, as well as any other relevant demographic characteristics, that will protect their identity. In a context where it doesn't affect the meaning of the results, a 27-year-old man can become a 50-year-old woman, if necessary for the sake of protecting confidentiality in a research project.

Change details in the interviews that don't affect the meaning of the answers your participants provide. For example, with 1684 residents, Oshoto, WY is small enough that people from there might know each other well enough to recognize each other's stories. So if I interviewed someone who said something like "When I was growing up in Oshoto, ...", then I would either change the name of the town, or I would remove it altogether and just report the person said "When I was growing up, ...".

Although your sample size in this exercise is so small that this may not be practical here, for future projects you might combine two or more people into a composite character, whose identity can't be guessed because that single individual doesn't exist.

 

Does this changing of facts feel somehow deceptive--enough so that you're wondering about the ethics of it all? If you're new to qualitative research, and it does feel that way, then that's a good thing, because it means that you're integrating previous ethical principles with what you're learning now about research, and you're pushing at the boundaries of what you know.

You're right that integrity is at the core of research, and--although this can feel somewhat deceptive--this way of protecting your participants is squarely at the heart of research integrity.

First of all, you are doing it to protect your participants--they do not need to fear embarrassment, financial consequences, or worse, because they shared information with you. Your focus is on the information itself; nothing will happen to the participants as a result of giving you their answers to your questions.

Second, you will be faithful in the information you provide. You will not make up characters that do not exist at all, and you will not make up answers or information that someone did not share with you.

You are not changing the heart of the content of the answers. Changing someone's birthplace from Oshoto, WY to Pinson, AL, for example, or leaving it out entirely, is a detail that does not substantively change what massage means to that person, which is what this exercise is about.

On the other hand, to totally invent a person who you didn't really interview, and then to report an answer that you made up as being from that person--that would be a major ethical breach of integrity. But you're not doing anything like that here--in changing the details of real people who really exist, and who really gave you those answers you are reporting, you're nowhere near that ethical lapse.

 

Think about how you are going to invite your participants to talk to you. You want this to be about them, not about their trying to please you by telling you what they think you want to hear, so give some thought to your questions before you sit down with them for an interview.

Closed-ended questions, where the person being interviewed has a limited set of responses to choose from--"yes" or "no" questions, for example--tend not to be as good for this purpose as open-ended questions.

"Do you think massage benefits you?" does not encourage someone to open up to you as "Tell me about what you think massage does for people."

Decide on the questions you want to ask, and think about what you will do if the discussion goes in very different ways from what you expect. Think about what you will be reporting in future, and keep that in mind as you are deciding on the questions you will ask.

 

Carrying out your project

Informed consent

A core foundational principle of research is that the person you're interviewing should be participating willingly, and should understand why they are participating. If that willingness changes, they are free to stop participating at any time they want to.

This consent form is based on the one available at this link.

You can paste this consent form into a document, and print out two copies--one for your interview participant to keep for themselves, and one to sign and give to you to keep.

 

Participant's Agreement

I am aware that my participation in this interview is voluntary.

If, for any reason, at any time, I wish to stop the interview, I may do so without having to give an explanation.

I understand the intent and purpose of this research, and I understand that I will be asked about my understanding and experiences of massage.

I understand that I am free to expand on the topic or talk about related ideas.

I also understand that if there are any questions I would rather not answer or that I do not feel comfortable answering, then I have the choice of stopping the interview or moving on to the next question, whichever I prefer.

I understand that the information I provide will be used in a general way for a group online discussion of how people understand and experience massage, and that my identity will be kept confidential. Only the interviewer will know my identity; none of the other participants in the discussion of the answers to the interview questions will be aware of who I am.

I have been offered a copy of this consent form that I may keep for my own reference.

I have read the above form and, with the understanding that I can withdraw at any time and for whatever reason, I consent to participate in today's interview.



_________________________________                       ___________________
Participant's signature                                         Date
 

_________________________________
Interviewer's signature
 

 

 

 

Reporting on your project

In the comments to this story, please share your findings, and outline your evaluation of the interview.

Tell us how you approached the task, and what your key findings were.

In addition, think about the kinds of quantitative data you'd like to collect to boost your qualitative findings--what are your qualitative findings, what other processes do they point to, and how would you use quantative methods to investigate those processes?

 

Information sources on ethnographic interviewing

Design4Instruction: The Ethnographic Interview accessed 6 May 2012

Ethnomed: "Collecting Ethnographic Data: The Ethnographic Interview" accessed 6 May 2012

Johns Hopkins Bloomberg School of Public Health Center for Refugee and Disaster Response (CRDR) publication: Training in Qualitative Research Methods for Private Voluntary Organizations and Non-Governmental Organizations accessed 6 May 2012

Sakai Project article: "Ethnographic Interviews - Interviewing and Observing Users" accessed 6 May 2012

Wikipedia article "Ethnography" accessed 6 May 2012

 

 

 

Sue Shekut: Seeking feedback on massage research design

Submitted by RST on Sun, 03/25/2012 - 19:18
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The following is the same text that is contained in the 2 PDFs attached to this page.

This page is searchable text for finding from the POEM home page and for commenting on, but only the PDFs contain the correct and authoritative formatting of the document.

 

March 24, 2012

Fellow POEM Members,

I am submitting my research design, “Massage Therapy Modality Effect on Blood Pressure, Cortisol and Anxiety“ to POEM for feedback from POEM members and suggestions on how to best operationally define the different modalities of massage therapy for research.

My goals in submitting this particular research design to POEM are:

  1. To give other massage therapists (MTs) a template for writing similar studies.
  2. To find like-minded MTs that may want to contribute to this study/elements of this study and perhaps do the actual research.
  3. To show other MTs that writing research designs is not that hard, can be done by an MT, and follows a standard format.
  4. To make sure that the work I put in thus far does not just sit in my computer gathering "dust".

 

The design isn't the best ever, but it addresses some of the issues we all face in design research for massage therapy.

 

My specific questions to fellow POEM members are as follows:

  1. Is the operational definition I include of deep tissue, Swedish and sports massage clear enough for others to replicate? Is it accurate?
  2. Does a specific protocol for each modality need to be defined for the study design?
  3. Does a specific protocol for each modality need to be defined for MTs that provide massage to ensure objective application of the modalities for each research subject?
  4. Are these three modalities the best representation of diverse types of massage for studying effects of BP, cortisol and anxiety? Would including other modalities or breaking down deep tissue into trigger point work and mysofascial release provide more useful data?
  5. Does the study need to operationally define “light, moderate and firm” pressure or is the subjective appraisal of pressure by MTs giving the massage of each level of pressure sufficient? If not, how best to operationally define pressure levels? Who defines pressure levels? The MTs, each research subject?

 

Note that I wrote the bulk of this design in 2010 and had not yet read Christopher Moyer's study on cortisol and massage. However, since Moyer’s study was not an experimental study, but a meta-analysis of previous research, I believe that further experimental research on the effects of massage on cortisol levels is warranted.

I welcome comments, feedback and offers of collaboration for this research project. Even if no one ends up conducting this particular research project, I hope that by reading and reviewing my work, other MTs may be empowered to conduct their own research and further the evidence base of the massage profession.

Warmly,
Sue Shekut, Licensed Massage Therapist
Graduate student in Clinical Professional Psychology at Roosevelt University

 

Massage Therapy Modality Effect on Blood Pressure, Cortisol and Anxiety
Susan J. Shekut
Roosevelt University
© 2012, Sue Shekut

Abstract

Stress management is an important issue in the workplace and for the individual. Massage therapy has been shown to reduce depression and anxiety as well as to reduce levels of cortisol and reduce blood pressure (BP). Massage modality can moderate the effect of onset of BP reduction and may moderate the effect of onset of cortisol reduction as well as self-reported anxiety levels. There are a number of types of massage, but for this study, only deep tissue, sports massage and Swedish massage styles were examined as to their effect on the blood pressure, cortisol and anxiety levels of 90 participants. It is expected that Swedish massage will decrease BP, cortisol and self reported anxiety to the greatest degree immediately following the massage intervention and that deep tissue and sports massage will have greater effects on BP, cortisol and anxiety reduction two days post massage intervention.

Massage Therapy Modality Effect on Blood Pressure, Cortisol and Anxiety

Workplace stress has recently been indicated to be one of the major causes of some of the costliest, most time-robbing health problems for business. According to the 17th World Congress on Health and Safety at Work, 13.4 million working days are lost due to stress, anxiety, and depression (17th World Congress on Health and Safety at Work).

Traditional approaches to stress management include psychological interventions such as cognitive behavioral therapy, mediation, diaphragmatic breathing and similar self-directed techniques (David & McKay, 2008). However, there is a growing trend among consumers to seek massage therapy as a form of stress relief. In a consumer survey published by the American Massage Therapy Association (AMTA) in 2009 found that 32 percent of Americans said they got a massage for stress and/or relaxation in the last five years.

Some believe the mechanism of effect for massage therapy may be primarily psychological (Moyer, Rounds, & Hammum, 2004). Others believe massage has a physiological effect as well. Studies show that massage therapy can be effective for anxiety and depression as well as a host of clinical conditions (Rich, 2010). Additionally, current research findings has shown that a single session of massage therapy reduces state anxiety, blood pressure and heart rate, and multiple sessions of massage reduce delayed onset of pain (Moyer, et al., 2004). Other studies show that participants’ salivary cortisol levels decreased following massage therapy (Field, et all, 1997). Yet none of these studies tested whether a specific massage therapy modality was responsible for producing these affects.

The Touch Research Institute of Miami University, a noted research facility in the field of massage therapy, has conducted a number of studies demonstrating the physiological effects of massage therapy. One of their studies found that healthy adults that received 15-minute chair massages twice per week for five weeks had marked improvement in EEG patterns of alertness and frontal delta power increases, which suggests relaxation (Field, et al., 1996). The massage recipients also showed increased speed and accuracy on math computations, lower anxiety levels, as well as lowered salivary cortisol levels on the first day of treatment. However, BP levels were not tested at all in this study–only anxiety and cortisol levels were tested.

Corporate companies have been using massage therapy as a reward and stress intervention for the past 10-15 years (reference). A 1996 (Shulman & Jones) quasi-experimental field study found significant reductions in anxiety levels for massage recipients as measured by the State-Trait Anxiety Inventory Self-Assessment Questionnaire. Researchers found that residual effects of the massage continued after cessation of the massage intervention and that there was a trend for stress levels to be more greatly reduced for those massage recipients that worked more than 40 hours per week and had higher education levels. However, they did not test the effect of the intervention on BP levels, cortisol levels or participants’ anxiety levels in this study.

Fifteen-minute chair massages on healthcare workers at a major hospital decreased job stress, anxiety and depression as well as decreased in urinary cortisol (Field, Quintino, Henteleff, Wells-Kief, & Delvecchio-Fienerg, 1997). However, chair massages can include a variety of massage modalities depending on the training of the massage therapists providing the massage intervention. Neither the massage modality was addressed nor was the massage intervention operationally defined in this study. Participant BP levels were not investigated either.

Field and her colleagues reviewed various massage studies and overall found that massage therapy decreases cortisol levels and increases urinary serotonin and dopamine levels (Field, Hernandez-Reif, & Diego, 2005). While Field and colleagues claim that the reduction in cortisol suggests that massage had stress-alleviating effects and that increases in urinary serotonin and dopamine suggest that they help reduce depression and the effects of stress, there is no significant relationship between serotonin and dopamine secreted in the urine and the amount of these neurotransmitters in the brain. Research has shown that neurotransmitters do not cross the blood brain barrier. According to a recent study published in the Journal of Urology, urinary serotonin and urinary dopamine do not show levels of serotonin and dopamine that were previously in the central or peripheral nervous system. Urinary serotonin and urinary dopamine are synthesized in the kidneys, not in the central nervous system (Hinz, Stein, Trachte, & Uncini, 2010). Therefore, measuring urinary levels of neurotransmitters is not a definitive test to measure depression or anxiety nor to test the effects of massage therapy on depression or anxiety. However, testing salivary cortisol is an accepted method of testing the changes in unbound cortisol in participants, due to the validity of salivary cortisol reflecting the level of cortisol in the blood and the relative ease with which salivary cortisol may be obtained from participants. Habitual smokers tend to show blunted cortisol responses to psychological stress and therefore should not be included in studies that measure cortisol changes in response to stress effecting interventions (Kirschbaum & Hellhammer, 1993).

Since blood pressure tends to increase with stress and the sympathetic nervous system response, measuring blood pressure changes has been one method researchers use to examine physiological effects of massage (Smith, T. W., Birmingham, W., & Uchino, 2012; Cambron, Dexheimer, & Coe, 2006). This would suggest that measurements of changes in BP may be a good physiological measurement of anxiety levels to assess effects of massage therapy. In a preliminary study, 150 adults with “normal” BP (under 150/95) were given different types of massages to determine the effect on blood pressure. Overall blood pressure decreased for massage recipients of all types of massages. However, those that received Swedish massages had the greatest effect on BP reduction. Trigger point and sports massage styles tended to increase systolic BP. If both sports and trigger point therapy massage were used in one session, then both diastolic and systolic BP increased. However, these results were not statistically significant. Blood pressure was measured using an automatic cuff which may have resulted in less accurate readings but the study authors were not concerned with measuring actual BP changes, but the overall effect of the massages on BP. Another potential threat to internal validity of this study was that the massage therapy students conducting the massages self reported the style of techniques they used. Additionally, the study was a case study and not powered for multiple statistical tests. Future researchers were recommended to use manual BP cuffs and provide for tighter controls on the type of massages used (Cambron, Dexheimer, & Coe, 2006).

Recent studies examined the effects of the level of pressure of massages given to participants to determine if light, moderate pressure, or vibratory massage would have a greater effect on parasympathetic nervous system activity (Diego, Field, Sanders, & Hernandez-Reif, 2004). Massage recipients felt less anxiety following massage sessions no matter what pressure
was used. However, those that received moderate pressure massages reported the greatest decreases in self-reported stress. The moderate massage group showed a significant decrease in heart rate during the massage, which continued into the post massage session.

Field and a colleague followed up this study with research on the effect of moderate pressure massage on EKG readings to determine if a parasympathetic response was the result of moderate pressure massage (Diego, Field, , Sanders, . & Hernandez-Reif, 2004). Results indicated that participants that received the moderate pressure, 15-minute massage showed an increase in high frequency ratio components of heart rate variability. This suggested an increase in parasympathetic nervous system activity. The study contended that the mechanism for action in increasing parasympathetic response was the stimulation of pressure receptors in the skin (Diego & Field, 2009). While yielding useful data as to the effects of the level of pressure, neither of these latter two studies measured BP levels, cortisol levels, or participant anxiety, only the heart rate variability of participants.

Despite the growing volume of research on massage therapy, none of these studies compare modality (type) of massage given to changes in cortisol levels, changes in BP levels or changes in perceived anxiety levels. Since previous studies show that BP increases with massage that produces more painful responses (trigger point therapy, sports massage and deep tissue), it is expected that cortisol levels, a measure of the stress response, will respond similarly to BP on the types of massage interventions. Since psychological stress has been shown to increase cortisol levels, it is expected that self reported anxiety levels will correlate with levels of BP and cortisol.

Swedish massage (which tends to be a more moderate pressure style of massage), deep tissue massage and sports massage tend to be deeper pressure massage modalities (AMTAWashington, 2010). Massage recipients typically report feeling the most relaxing effects of a deep tissue or sports massage a few days after the massage session as the initial effects may include soreness and fatigue. These results would be assessed post massage and then 2 days after the massage session.

Hypothesis 1: Blood pressure levels will be negatively correlated with Swedish massage therapy immediately following the intervention.

Hypothesis 2: Blood pressure levels will be negatively correlated with deep tissue and sports massage two days post intervention.

Hypothesis 3: Salivary cortisol levels will be negatively correlated with Swedish massage therapy immediately following the intervention.

Hypothesis 4: Salivary cortisol levels will be negatively correlated with deep tissue and sports massage two days post intervention.

Hypothesis 5: Self reported anxiety levels will be negatively correlated with Swedish massage therapy immediately following the intervention.

Hypothesis 6: Self reported anxiety levels will be negatively correlated with deep tissue and sports massage two days post intervention.

Method

Participants

The sample would include approximately 90 participants from an large city in the Midwest. They would be recruited from the area via fliers sent to area offices as well as at nearby retail stores. It would be expected that participants would be fairly well educated, both male and female of middle to upper middle socioeconomic status, and be representative of a variety of races and demographics of this area.

Participants would be ages 25-55, of normal health, no hypertension or heart disease (BP under 140/90–the threshold for indicating hypertension), be nonsmokers, not be pregnant and have no history of severe mental illness (e.g., depression, bipolar, schizophrenia). Participants would be screened to ensure that they had previously received massages and have had positive experiences with massage, but had not received massages for at least 6 months prior to the study. Participants would be randomly assigned to Swedish, Deep Tissue. and Sports massage groups. Participants would be blind to the type of massage they are being given. A short questionnaire would be included with their two-day follow up anxiety test to assess whether they knew the type of massage they were given. Participants would be instructed to avoid salty foods between the massage intervention and the two-day follow up. Incentive to return for their two-day follow up would be the receipt of a gift certificate for a 30-minute massage (modality of their choice) to be completed at a later date.

BP Testing Procedures

BP would be measured via a manual BP cuff 5 minutes prior to massage intervention and 5 minutes after the intervention. At two day follow up the BP will again be measured. Recordings of Diastolic and Systolic BP would be made for both pre and posttests. Changes in BP for each participant would be recorded.

Cortisol Testing Procedures

Salivary cortisol testing procedure would be conducted in the following order: Premassage session salivary samples would be taken 3 minutes prior to massage; Post massage, another salivary sample would be taken 3 minutes prior to massage; Two days after the massage intervention, a salivary sample would also be taken.

Anxiety Testing Procedures

The State-Trait Anxiety Inventory Form (STAI) will be used to measure anxiety in participants. The STAI clearly differentiates between the temporary condition of "state anxiety" and the more general and long-standing quality of "trait anxiety." (Spielberger, 1994). Participants will be given the STAI 10 minutes prior to the massage, 10 minutes after the
massage and two days after the massage.

Massage Interventions

Massages would be provided by three Licensed Massage Therapists with at least five years of full-time work experience in massage therapy and with advanced training in the types of massage they are to perform (Swedish, deep tissue and sports massage).

Massage therapists would be instructed to provide either a 30-minute session of Swedish massage on the upper torso, a 30 minute session of deep tissue massage on the back (including infraspinatus, rhomboids, trapezius, erector and quadratus lumborum muscles), or a 30-minute session post-event Sports massage session on the upper torso. Each massage therapist would provide a different type of massage to different participants to avoid experimenter bias from influencing results. Massages would be provided in the same room in the same office to hold environmental differences constant.

Types of massage will be operationally defined per the definition provided by Milady’s Theory and Practice of Therapeutic Massage as follows (Beck, 1994).

Deep tissue message. “The term deep tissue massage refers to various regimens or massage styles that are directed toward the deeper tissue structures of the muscle and fascia…In most deep tissue massage techniques the aim is to affect the various layers of fascia that support muscle tissues and loosen bonds between layers of connective tissues” (Beck, 1994, p. 548).

Sports massage. “Sports massage refers to a method of massage especially designed to prepare an athlete for an upcoming event and to aid in the body’s regenerative and restorative capacities following a rigorous workout or competition. This is achieved through specialized manipulations that stimulate circulation of the blood and lymph. Some sports massage movements are designed to break down lesions and adhesions or reduce fatigue” (Beck, 1994, p.16).

Swedish message. “The Swedish system is based on the Western concepts of anatomy and physiology and employs the traditional manipulative techniques of effleurage, petrissage, vibration, friction and tapotement” (Beck, 1994, p. 15). All three types of massage would be administered using moderate and not light pressure based on previous study findings that moderate pressure massage stimulates parasympathetic NS activity more so than light pressure massage.

Anticipated Results

Based on results of previous research noted in this study, it is expected that recipients of Swedish massage will have the greatest reduction in both BP and cortisol levels immediately following the massage. However, we also expect to find that BP and cortisol levels will be reduced more for the deep tissue and sports massage group than the Swedish massage group two days after receiving the massage intervention. It is expected that recipients of Swedish massage will report the least anxiety immediately posttest and that the recipients of deep tissue and sports massage will report the least anxiety two days post test. Results will be analyzed using one-way ANOVA tests.

References

AMTA-Washington chapter (2010) Retrieved from: http://www.amtawa.org/index.php?src=gendocs&ref=Modalities&category=Reso...

Beck, M. (1994). Milady's theory and practice of therapeutic massage. (2nd ed.). Albany: 1994 Milady Publishing Company.

Calvert, R. N. (2010) A Brief History of Massage. Retrieved from: http://www.massagetherapy.com/media/experiencehistory.php

Cambron, J. A., Dexheimer, J. & Coe, P. (2006) Changes in blood pressure after various forms of therapeutic massage: A preliminary study. The Journal of Alternative and Complimentary Medicine, 12(1), 65-70.

Davis, M., Eshelman, E., & McKay, M. (2008). The relaxation and stress reduction workbook (6th ed.). Oakland, CA US: New Harbinger Publications.

Diego, M. A., & Field, T. (2009) Moderate pressure massage elicits a parasympathetic nervous system response, International Journal of Neuroscience, 119, 630-638.

Diego, A., Field, T., Sanders, C. & Hernandez-Reif, M. (2004). Massage therapy of moderate and light pressure and vibrator effects on EEG and heart rate. International Journal of Neuroscience, 114, 31-45.

Field, T., Hernandez-Reif, (FI?) & Diego, M. (2005) Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal Neuroscience, 115, 1397-1413.

Field, T., Diego, M. & Hernandez-Reif, M. (2010) Moderate pressure is essential for massage therapy effects. International Journal of Neuroscience, 120, 381-385.

Field, T., Ironson, G., Scafidi, F., Nawrocki, T., Goncalves, A., Burman, I., Pickens, J., Fox, N., Schanberg, S., & Kuhn, C. (1996). Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations. International Journal of Neuroscience, 86, 197-205.

Field, Tiffany, Hernandez-Reif, M., Hart, S., Quintine, O., Droase, L. A., Field, T.,… & Schanberg, S. (1997) Effects of sexual abuse are lessened by massage therapy. Journal of Bodywork and Movement Therapies, 1(2), 65-69.

Field, T., Quintino, O., Henteleff, T., Wells-Kief L. & Delvecchio-Fienerg G. (1997). Job Stress reduction therapies. Alternative Therapies in Health and Medicine 3(4), 54-56.

Hinz, M., Stein, A., Trachte, G. & Uncini, T. (2010) Neurotransmitter testing of the urine, a comprehensive analysis. Journal of Urology, 2010(2), 177-183.

Kirschbaum, C. & Hellhammer, D., H. (1993) Salivary cortisol in psychoneuroendocrine research: Recent developments and applications. Psychoneuroendocrinology, 19(4), 313-333.

Kharrazian, D. (2009) Understanding the clinical relevance and non-validity of neurotransmitter testing. AlaimoChiropractic.com. Retrieved from: http://alaimochiropractic.com/urinaryneurotransmitter-testing-valid-or-h...

Moyer, C. A., Rounds, J, & Hannum, J. W. (2004). A meta-analysis of massage therapy research. Psychological Bulletin, 130(1). 3-18.

Ponce, A. N., Lorber, W., Paul, J. J., Esterlis, I., Barzvi, A., Allen, G. J., & Pescatello, L. S. (2008) Comparisons of varying dosages of relaxation in a corporate setting: Effects on stress reduction. International Journal of Stress Management 15(4), 396-407.

Rich, G. J. (2010). Massage therapy: Significance and relevance to professional practice. Professional Psychology: Research and Practice, 41(4). 325-332.

Schulman, K. R., & Jones, G. E. (1996) The effectiveness of massage therapy intervention on reducing anxiety in the workplace. Journal of Applied Behavioral Science, 32(2), 160-173.

Smith, T. W., Birmingham, W., & Uchino, B. N. (2012). Evaluative Threat and Ambulatory Blood Pressure: Cardiovascular Effects of Social Stress in Daily Experience. Health Psychology. Advance online publication. doi: 10.1037/a0026947

Spielberger, C. D., & Sydeman, S. J. (1994). State-Trait Anxiety Inventory and State-Trait Anger Expression Inventory. In M. Maruish, M. Maruish (Eds.) , The use of psychological testing for treatment planning and outcome assessment (pp. 292-321). Hillsdale, NJ England: Lawrence Erlbaum Associates, Inc.

Williams, A. (2005). Work-Related Stress Emerging as Major Global Occupational Health Hazard, National Safety Council press release. Retrieved from:http://www.nsc.org/Pages/Work-RelatedStressEmergingasMajorGlobalOccupationalHealthHazard.aspx

"A very sad dinosaur"

Submitted by RST on Wed, 12/07/2011 - 10:52
Posted in
Cancer is different from other diseases, because cancers are not natural to the Universe. The man-made chemicals that cause cancers are foreign to the Universe. Man created the cancer; Man must treat the cancer, by killing or excising the cancer. Because Man created the cancer: Man must kill it.
 
--variations on this idea have been seen around the net on different MT forums
 
 
This article is an older one, but since we're talking about brains this month, it is still timely. It contains interesting information both about cancer, and about the scientific method--how scientists know about things that happened millions of years before any of us were ever born.
 
 
On October 23, [2003,] a team of paleontologists and pathologists announced that they had discovered a massive, possibly lethal brain tumor in the fossilized skull of a Gorgosaurus,
 

Source: http://upload.wikimedia.org/wikipedia/commons/8/80/Gorgosaurus_BW.jpg accessed 7 December 2011
 
 
a 25-foot-long relative of Tyrannosaurus rex
 
 
 
 
 
 
 
that lived 72 million years ago.
 
You can read this as a clock that starts just past noon at 4.6 billion years ago (4.6 Ga). Continuing clockwise, the formation of the earth takes place 4550 million years ago (= 4550 Ma). At 3 billion years ago (3 Ga), 2 Ga, and 1 Ga, things are happening, but life on Earth doesn't really explode into prominence until about 530 Ma with the Cambrian explosion.
 
The dinosaurs lived alongside early mammals from about 230 Ma to 65 Ma, and humans arrived just before midnight on this clock: around 2 Ma.
 
The Cretaceous period, where this case report happened, follows the Jurassic period of Hollywood fame, and both are part of the green band representing the Mesozoic ("middle-life" or "middle-animal") era. Gorgosaurus roamed what would eventually become North America about 75 Ma or so.
 
 
 
 
 
 
Fossils of dinosaur bones are no surprise, but soft tissue doesn't fossilize the same way bones do, which is why we have so little information on dinosaur viscera. How, then, do we have a fossil sample of brain tumor?
 
A matrix of bone within this dinosaur's brain tumor allowed it to fossilize along with the rest of the animal's skeleton.
 
 
 
 
 
The tumor, possibly an unusual type of bone-forming cancer called an extraskeletal osteosarcoma, filled nearly the entire area formerly occupied by the cerebellum and brainstem and probably impaired the cerebrum, the part of the brain that controls thought and memory.
 
How do we know that dinosaur brains work like ours do--that the cerebellum and brainstem control movement and autonomic functions, and that the cerebrum controls thought and memory?
 
Like us, dinosaurs are vertebrates, and moreover--just like us--they are tetrapods.
 
Understandably, this vocabulary might be confusing: τετρά/tetra is Greek for 4, and quadr- is Latin for 4. πόδ/pod is Greek for foot, and ped is Latin for foot. And we know that quadrupeds are animals who walk on all fours, like dogs, cats, and horses, right?
 
So since tetrapod means the same thing in Greek as quadruped means in Latin, and since we're not quadrupeds (we're bipeds), how can we possibly be tetrapods?
 
It's because--although the meanings of the word roots are the same in their respective languages--they've come to mean different things in biology. Tetrapod refers roughly to structure, while quadruped refers roughly to function. So all animals that descended from the paired-limbed fish who evolved into land vertebrates are tetrapods, either because we all have two pairs of limbs (our arms and our legs), or because we used to have them before they changed a great deal (birds' and bats' wings are modified arms), or because we used to have them before they diminished greatly in size (whales, dolphins) or disappeared altogether (snakes).
 
Quadruped, on the other hand, refers to the action of walking on all fours, whether flat-footed like a bear, or on the toes like dogs and cats, or on the toenail, like horses. All of the animals listed in this paragraph are quadrupeds and tetrapods, because they walk on their pairs of limbs. The animals in the previous paragraph, on the other hand, do not walk on all fours--so although they are tetrapods, they are not quadrupeds.
 
So as different as we look on the outside, you see that there is a deep structural similarity we share.
 
And that structural similarity about vertebrate brains is the basis for how we reason about what effects the tumor must have had on this dinosaur when it began compressing structures in her brain.
 
We know how such a tumor affects other vertebrates, and we reason from that similarity about how it must have affected her vertebrate brain.
“As the tumor grew, the dinosaur—a female perhaps three years old— would have forgotten where she left her last kill, and then she would have forgotten to go to the bathroom,” says paleontologist Peter Larson of the Black Hills Institute in Hill City, South Dakota.
 
Sadly, you can see the same progression in loss of function in people living with the effects of brain tumors or other brain conditions. First, it can affect higher-order cerebral functions like thought and memory, but it can progress to a point where the autonomic functions directed by the cerebellum and the brainstem--the ones we don't consciously think about, like breathing or urinating--can be compromised.
The tumor would also have put pressure on the dinosaur’s cerebellum and brain stem, which regulate motor function and other autonomic functions such as heart rate. “The tumor would have impaired mobility and affected the animal’s balance. She would have fallen down a lot,” says veterinary pathologist Rachel Reams of Eli Lilly & Company, who studied the fossil.
 
Usually, as MTs, we don't see clients in this condition, because they are so compromised that other health issues are of much higher priority at that point.
 
Unfortunately for what the poor dinosaur went through, there is physical evidence to back up Reams' inferences about what happened to her.
Larson and his colleagues found ample evidence confirming that conclusion. Throughout the Gorgosaurus’s skeleton, the researchers saw signs of debilitating injuries: a smashed shoulder blade, a bad infection in the lower jaw, broken ribs, and a torn tendon in the left leg. “The leg eventually healed and became useful again, but for a while she would have been dragging that leg around,” Larson says. The creature never recovered from a badly broken right fibula, the small bone of the lower leg. The fracture had healed for barely two weeks at the time of the animal’s death. That was probably the last injury the she suffered, although scientists do not know exactly what killed her. “She was a very sad dinosaur,” says Larson.
 

 

Nobody likes to think of an animal in distress, even as long ago as this happened, and even as scary a predatory beast as she was. The poor sad dinosaur lived and died alone with her disease, experiencing all the problems it created for her quality of life.

The only possible silver lining to suffering is if we can learn something from it that we can, in turn, use to prevent further suffering.

From what the poor Gorgosaurus has taught us through her brief life and awful death in the Cretaceous, how could you change the quotation at the very top so that MTs could share correct information about cancer with other MTs in public forums?

What do we now know about cancer from this 75-million-year-old "case report"?

 

cheers, to Bab Hambilus!

Notes on McGlashan et al's article, "Embryonic communication in the nest: metabolic responses of reptilian embryos to developmental rates of siblings": Materials and methods

Submitted by RST on Mon, 12/05/2011 - 10:32
Posted in

2. Materials and methods

(a) Study species

Emydura macquarii

Source: http://upload.wikimedia.org/wikipedia/commons/0/00/Pair_of_Emydura_macquarii_-_Warrawong.JPG accessed 5 December 2011

 

Murray Darling Basin in New South Wales and southeast Queensland, Australia

Source: http://upload.wikimedia.org/wikipedia/commons/7/7c/Murray-catchment-map_MJC02.png accessed 5 December 2011

 

terrestrial nests: nests dug in holes in the ground

 

68C = 154.4 degrees Fahrenheit

 

(b) Egg collection

funnel traps: this is the basic idea of a trap where the turtle enters through a funnel, and then can't get out, but don't take this too literally as being the actual trap they used, as I couldn't find a picture of that

Source: http://www.lakeborumba.com/images/Funnel-FishingTrap-lindr-250.gif accessed 5 December 2011

 

 

gravid: pregnant

 

 

subcutaneous intramuscular injection: I think they just mean "intramuscular" here; "subcutaneous intramuscular" doesn't make much sense, as they're two different types of injection.

subcutaneous injections are administered just under the skin, as in 

Source: http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/9954.jpg accessed 5 December 2011

 

By contrast, intramuscular injections are administered into the muscle, as in this image that shows both kinds of injections (ignore the intradermal injection, as that doesn't concern us here):

Source: http://juvenation.org/cfs-filesystemfile.ashx/__key/communityserver-discussions-components-files/130/7356.f0329_2D00_01.jpeg accessed 5 December 2011

 

 

 

oxytocin: a hormone that has many effects, from inducing labor in humans and other mammals to promoting bonding. There's way too much knowledge about oxytocin to go into here, but it's interesting that it has analogous effects (inducing labor, stimulating egg-laying) in animals that appear so different as humans and turtles

 

 

oviposition: laying eggs

 

clutch: all the eggs laid at the same time by one animal

 

(see electronic supplementary material for egg maintenance during incubation): at http://rspb.royalsocietypublishing.org/content/early/2011/11/24/rspb.2011.2074/suppl/DC1 accessed 5 December 2011

 

 

 

(c) Experimental design

hatching synchrony = hatching "same-time" = simultaneously hatching

 

induced = artificially stimulated or begun 

 

developmental asynchrony = developmental "not-same-time" = development at different times from each other

 

 

Experimental treatments were designed to test whether less advanced embryos were either hatching prematurely or potentially adjusting developmental rates throughout the incubation period.

 

They were investigating whether the less advanced embryos sped up development to match the stage where the more advanced ones already were, or whether they kept going at their normal rate and just ran out of time at the end before finishing development.

 

26C: 78.8 degrees Fahrenheit

 

30C: 86 degrees Fahrenheit

 

31C: 87.8 degrees Fahrenheit

 

two-tailed t-tests: a statistical test to determine whether to reject the null hypothesis and consider the study's alternative hypothesis to be confirmed

 

VCO2: volume of carbon dioxide

 

 

(d) Metabolic and heart rates

closed system respirometry: respirometry is the measurement of metabolic rates, and here, they used carbon dioxide breathed out over time as a marker of metabolic rate. Because the system was closed, they knew no carbon dioxide was coming in from outside, so any increase in CO2 had to come from the turtles' breathing it out. Measuring that increase in CO2 over time gave them the rate at which the turtles were producing it, thus, their metabolism.

 

A Qubit (S500) respirometer (Kingston, ON, Canada) was used to measure carbon dioxide production

Source: http://qubitsystems.com/wp-content/uploads/S500%20matobox%20(from%20old%20site).jpg accessed 5 December 2011

 

Heart rates were recorded using the Buddy digital egg monitor system (Avian Biotech, UK), which is a non-intrusive method for measuring heart rates of embryos in eggs.

 

Source: http://i00.i.aliimg.com/photo/v0/214696894/Buddy_Egg_Monitor.jpg accessed 5 December 2011

 

infrared transmitters and sensors:

Source: http://coolcosmos.ipac.caltech.edu/cosmic_classroom/ir_tutorial/images/irbody.jpg accessed 5 December 2011

 

Heart rates (b.p.m.): beats per minute

 

(e) Pipping

Incubation period was measured as the number of days from initial egg collection until pipping. Pipping (when the eggshell is first slit) is better than hatching as an index of the end of the incubation period, because it shows less variability than hatching [28].

 

Another example of trying to cut down on confounds--since pipping is less variable than hatching, there is less opportunity for those variations to create confounds.

 

Source: http://3.bp.blogspot.com/_h-Njfq-hyBM/Sl4FjKu-kdI/AAAAAAAAAeY/rjbL_KcSS5M/s400/Pipping.JPG accessed 5 December 2011

 

 

(f ) Post-hatching development and growth

Righting trials--I think this means they flipped them, and timed how long it took the turtles to right themselves to a standing position, but don't take my word for this. I will look it up when I get to the university and can get behind the paywall to read the Colbert article, and will update at that point.

yolk sac:

a membranous sac attached to an embryo, providing early nourishment in the form of yolk [Wikipedia: Yolk sac]

 

Source: http://www.redfoots.com/pics/esac-s.jpg accessed 5 December 2011

 

The volume of a cube (L x W x H) was used as a crude measure to calculate the volume of yolk.

 

 

 

 

callipers: British spelling of calipers

Source: http://upload.wikimedia.org/wikipedia/commons/9/94/Messschieber.jpg accessed 5 December 2011

 

 

straight carapace: the carapace is the dorsal (back) shell of the turtle, composed of the spine and rib fused with dermal plates. This image shows the components of the carapace.

source: http://upload.wikimedia.org/wikipedia/commons/1/1f/Bojanus_fig9.jpg accessed 5 December 2011

 

plastron: the ventral or abdominal shell of a turtle

Source: http://upload.wikimedia.org/wikipedia/commons/6/6e/Midland_painted_turtle%2C_plastron%2C_young.jpg accessed 5 December 2011

 

marginal scutes on carapace

Source: http://www.turtlejournal.com/terrapindiary/lewis02/gallery/marking1.jpg accessed 5 December 2011

 

 

Notes on Guzzetta et al's article, "Massage Accelerates Brain Development and the Maturation of Visual Function", Introduction

Submitted by RST on Sun, 12/04/2011 - 10:08
Posted in

These notes are intended to serve as a guide to reading the article by Guzzetta et al. There is a great deal of scientific jargon in the article, and the style is telegraphic--factors which make the article less accessible to people who might otherwise like to read the research for themselves.

This post is intended to accompany a reading of that article, to demystify the jargon for a non-specialist reading audience, to expand the telegraphic style, and to make explicit the implicit knowledge contained within.

The article under study is:

Guzzetta A, Baldini S, Bancale A, Baroncelli L, Ciucci F, Ghirri P, Putignano E, Sale A, Viegi A, Berardi N, Boldrini A, Cioni G, Maffei L. Massage accelerates brain development and the maturation of visual function. Journal of Neuroscience. 2009 May 6;29(18):6042-51. PMID: 19420271 Free fulltext PDF of article available here.
 
Abstract: Environmental enrichment (EE) was shown recently to accelerate brain development in rodents. Increased levels of maternal care, and particularly tactile stimulation through licking and grooming, may represent a key component in the early phases of EE. We hypothesized that enriching the environment in terms of body massage may thus accelerate brain development in infants. We explored the effects of body massage in preterm infants and found that massage accelerates the maturation of electroencephalographic activity and of visual function, in particular visual acuity. In massaged infants, we found higher levels of blood IGF-1. Massage accelerated the maturation of visual function also in rat pups and increased the level of IGF-1 in the cortex. Antagonizing IGF-1 action by means of systemic injections of the IGF-1 antagonist JB1 blocked the effects of massage in rat pups. These results demonstrate that massage has an influence on brain development and in particular on visual development and suggest that its effects are mediated by specific endogenous factors such as IGF-1.
 
 

The first paragraph is pretty straightforward and relatively easily readable, although there are a few points worth remarking upon.

When you read their sentence "EE has remarkable effects on adult brain function in several species", this is a good opportunity to remember that we used to think the adult brain was far less plastic than it turns out to be in reality.

Here, I am using the word "plastic" as in "plastic surgery", meaning that it lends itself to being molded or shaped or formed. The fact that the adult brain is somewhat plastic means that negative experiences in the past that influenced the brain have at least a hope of being recovered from.

Let's review how the visual system works, to ensure that we're all on the same page.

  • Action item (AI) 1/Raven: review of the visual system: I'll post it in this discussion, and in the human systems e-Book, when it is finished--most likely, by end of day (EOD) Monday.

 

"Appreciable" means empirically detectable, measurable.

  • AI 2/Raven: put definition of "appreciable" in the wiki.
 
 
For many of us--not all, since massage education in the United States is so variable--one of the first things we learned in anatomy and physiology class was the various levels of analysis that we could look at in an anatomical structure and its physiological function. Even so, those we learned did not represent all possible levels, but just the ones most useful at the beginning, such as the gross anatomical level or the systems level.
 
  • Question 1: Can you give an example of a structure and its function at the behavioral level, at the electrophysiological level, and at the molecular level?
 

There is a lot of technical language in the 2nd paragraph, but it really refers to only a few foundational concepts. Once you know how, for example, a BDNF receptor works, you will understand how an NMDA receptor works when you come across it, because it's the same general idea--the specific molecule involved is the only change.

So don't let a skim of this paragraph discourage you--it's not nearly as hard as it looks at first glance.

  • Question 2: What seems to be the cause-and-effect connection between EE and improved function and behavior in pups?
  • Question 3: Can you think of an analogy in human behavior? Remember, we are not claiming that we know that this is true, but that it could possibly serve as a testable hypothesis for further study.
 
 
"[L]icking and grooming provided by the mother has been shown to influence [here, positive influence is implied]: 

 

Although there remains a lot that we don't know about what the hippocampus does, it is fairly well-established that it plays a major role both in memory and in spatial coding (mental representations of the spatial relations between objects). [1]

 

Guzzetta also states that the level of licking and grooming provided by the mother affects molecules crucial for plasticity, meaning the brain's ability to be shaped or formed in new ways and to form new connections, rather than being frozen and relatively unable to change.

In this context of the brain, this refers to proteins and other molecules that promote the growth and development of brain cells (a process called neurogenesis), since the dynamics governing that growth and development is where plasticity comes from.

BDNF, short for Brain-Derived Neurotrophic Factor, is:

  • is a protein expressed by the BDNF gene;
  • is a growth factor;
  • is involved in neurogenesis;
  • is suppressed in cases of depression;
  • increased by the neurotransmitter glutamate, exercise, caloric restriction, intellectual stimulation
  • active and present in high concentrations in brain areas vital to learning, memory, and higher thinking, such as the hippocampus and cortex. [2]
 
 

NMDA, short for N-Methyl-D-aspartic acid, is a molecule that mimics the action of the neurotransmitter glutamate, so it can stand in for glutamate when investigating the neurotransmitter's action under certain circumstances.

 
 
 
 
 
  • novelty reaction
  • exploratory behavior
 
Exploration is the act of making the unknown known and is a fundamental adaptive behavior across many species. A related adaptive behavior is novelty seeking, defined as a proclivity to approach unfamiliar situations. Abnormal exploratory behavior and novelty seeking are characteristic of many neuropsychiatric conditions, including excessive activity observed in bipolar mania, increased novelty seeking in substance use disorders, and prominent inactivity and withdrawal as observed in schizophrenia. For several decades, numerous animal paradigms of neuropsychiatric illness have assessed the multiple dimensions of exploratory behavior and novelty seeking. These models have been useful in elucidating underlying neurobiological mechanisms and testing novel psychotropic treatments. [3]
 
 
 
  • spatial learning and memory
  • level of glucocorticosteroid receptors in the hippocampus
Glucocorticoids are steroid hormones that play a role in reducing inflammation and in normal brain development. [4]
 
  • feedback control on hypothalamus-pituitary-adrenal axis
The hypothalamic–pituitary–adrenal (HPA) axis is a major system of hormonal control over many functions in the body. Much like a thermostat uses surrounding heat to tell if it needs to continue heating or to turn off the heat, the HPA axis checks blood levels of circulating hormones to determine whether to stimulate or stop stimulating hormone production in the glands in the system.
 
  • spine density and synaptic plasticity in hippocampus
This refers to the structure and plasticity of neurons in the hippocampus.
 
 
negative effects produced by maternal separation/deprivation or prenatal stress on:
  • pup growth
  • growth hormone (GH) secretion

Growth hormone, secreted by the anterior pituitary gland, plays a major role in structure growth and regulation of other hormonal systems in the body, such as the production of IGF-1.

 

 
 
 
 
 
  • HPA axis
  • BDNF expression
  • synaptophysin expression

Synaptophysin is a protein expressed by the SYP gene. The exact function of the protein is unknown...Recent research has shown, however, that elimination of synaptophysin in mice creates behavioral changes such as increased exploratory behavior, impaired object novelty recognition, and reduced spatial learning. [5]

 

 
"rescued": here it means "mitigated", or "alleviated"
 
"Working in preterm infants, Schanberg and Field (1987) found evidence that massage promoted a faster weight gain and a lower level of cortisol in massaged infants."
 
  • Question 4: What's wrong with this sentence?
 
 
Paragraph 3 is relatively straightforward and easy to understand.
 
 
Paragraph 4
 
Visual evoked potentials (VEPs) are measurements of electrical activity in the nervous system after some source of visual stimulation has occurred. For example, an investigator might use VEPs to trace the activity in the brain to see what happens when the subject is watching a flashing light.
 
Visual acuity is the sharpness or clearness of someone's vision--how clearly they can see.
 
Source: http://upload.wikimedia.org/wikipedia/commons/9/9f/Snellen_chart.svg accessed 4 December 2011
 
 
 
Electroencephalography (EEG) is the measurement of the brain's electrical activity
 
 
 
by means of electrodes placed along the scalp.
 
 
 
 
 
 
 

In paragraph 5, Guzzetta states that "IGF-1 mediates EE effects on visual cortical development". To "mediate" means to be in the middle of other things. Let's say the independent variable (roughly, the "cause") in the following figure is EE, and the dependent variable (roughly, the "effect") is visual cortical development.

Path C shows a connection where EE directly causes visual cortical effects. But here, Guzzetta is saying that that is not the case--instead, EE has an effect on IGF-1 (path A), and IGF-1 then has an effect on visual cortical effects (path B). IGF-1, then, mediates (is a mediator variable between) EE effects and visual cortical development.

 
 
 
 
So now that we've established the role that Guzzetta's team proposes it plays in mediating the effects of EE into visual cortex development, let's talk about what IGF-1 is.
 
IGF-1:
  • is a protein molecule, encoded by the IGF1 gene, that functions as a hormone;
  • is named Insulin-like Growth Factor 1:
    • "Insulin-like" because of its structural similarity to insulin;
    • "Growth Factor" because of its lifelong anabolic role;
    • "1" because it is a member of a family of structurally-related proteins, such as IGF-2;
  • is produced mostly by the liver;
  • is a primary mediator of Growth Hormone (GH);
  • appears to play a major role in biological aging and cancer, as well as in normal growth. [6]
 
 
 
How it works:
  1. the anterior pituitary in the brain produces GH, and releases it into the blood;
  2. GH goes to the liver, and stimulates it to produce IGF-1, and release it into the blood;
  3. IGF-1 causes growth in many different kinds of cells in the body, including the ones we're interested in here: the visual cortical cells in the occipital lobe.
     
Guzzetta also states that EE increases the number of IGF-1-positive neurons in the visual cortex; this is an example of neurogenesis.
 
They describe how increasing IGF-1 in the visual cortex of non-EE rats by means of osmotic minipumps mimics EE effects, accelerating visual acuity development.
 
An osmotic minipump is a tiny implantable device that delivers IGF-1, which the rat's cells then take up by osmosis.
  • AI 3/Raven: finish demonstration of diffusion, use that to lead into osmosis
 
 
The visual cortex is the part of the brain that processes information delivered from the eyes. This is the brain of a person whose hair, skin, and skull have been digitally removed from the image.
 
The person is facing away from you, so you are looking at the back of their head: the occipital lobe.
 
A funny thing is that--although the eyes are in the front of the head, the information they deliver has to travel all the way to the back to be processed, and then is projected all the way back up front to the eyes again, which gives the perception that vision is in our eyes.
 
 
The name "visual cortex" tells us that it's in the cortex, or outer layer of the cerebrum--the darker purple in this picture of a slice of brain tissue; the gray matter of the brain, as opposed to the inner layer of white matter.
 
 
 
 
 
Guzzetta observes that blocking IGF-1 action in the visual cortex of EE rats by means of the IGF-1 receptor antagonist JB1 blocks EE action on visual acuity development. JB-I blocks IGF-I signaling; in the following discussion of antagonists, we'll discuss in more detail how it does so.
 
They also observe that massage led to increased levels of blood IGF-1 and IGF1BP3 in human infants. IGFBP-3 is a carrier or a binding protein for IGF-1, preventing the kidney from quickly clearing it from the blood, as it normally would. [6]
 
Guzzetta states that massage led to increased number of IGF-1 positive neurons in the cortex in rat pups.
  • Question 5: Why didn't they test this in human infants?
 
 
Guzzetta also observes that antagonizing IGF-1 action blocked the effects of massage in rat pups. You can think of an antagonist at a molecular level as being both similar to and different from an antagonist at the muscular level.
 
Like a muscular antagonist, a molecular antagonist works against, or opposes, another molecule. But the way in which it opposes that other molecule is not like how an antagonist muscle works.
 
A molecular antagonist is similar enough to the other molecule that it can slip into the "lock-and-key" receptor, and block it off, so that when the other molecule arrives, it cannot find a receptor to take it up.
 
So Guzzetta is saying that they hypothesize that the effects of massage are mediated by IGF-1, and the fact that an IGF-1 antagonist blocked the effects of massage reinforces the hypothesis that massage affects the visual cortical neurons in a way that is mediated by IGF-1.
  • Question 6: Why didn't they test this in human infants?
 
  • Question 7: What is the purpose of Guzzetta's study?
Imagine you're explaining it to someone you just met at a party, or on the bus, not in the lab or clinic--use that level of language, rather than Guzzetta's jargon.
 
  • Question 8: What did they say about their results in this paragraph?
 
 
 

References

[1] Wikipedia: Hippocampus accessed 4 December 2011

[2] Wikipedia: BDNF accessed 4 December 2011

[3] Minassian A, Henry BL, Young JW, Masten V, Geyer MA, Perry W. Repeated assessment of exploration and novelty seeking in the human behavioral pattern monitor in bipolar disorder patients and healthy individuals. PLoS One. 2011;6(8):e24185. PMID: 21912623

[4] Wikipedia: Glucocorticoid accessed 4 December 2011

[5] Wikipedia: Synaptophysin accessed 4 December 2011

[6] Wikipedia: IGF-1 accessed 4 December 2011

 

Notes on McGlashan et al's article, "Embryonic communication in the nest: metabolic responses of reptilian embryos to developmental rates of siblings": Introduction

Submitted by RST on Sat, 12/03/2011 - 12:44
Posted in

Why you might want to know this

  • Anatomy is a foundational discipline in massage therapy, and the embryology/developmental biology of those structures is key to understanding anatomy;
  • You care about the natural world, the environment, and the animals in it, and you want to better understand the threats they face, so that you can take more effective action to protect them from those threats;
  • You want to better understand science in order to be a well-informed citizen, to participate in policy debates and decisions from a position of knowledge and effectiveness.

 

These are my notes on the Introduction to the following article:

Embryonic communication in the nest: metabolic responses of reptilian embryos to developmental rates of siblings

Jessica K. McGlashan, Ricky-John Spencer and Julie M. Old, Water and Wildlife Ecology Group, Native and Pest Animal Unit, School of Natural Sciences, University of Western Sydney, Locked Bag 1797, Penrith South DC, New South Wales 1797, Australia. Proc Biol Sci. 2011 Nov 30. Free fulltext PDF of article available here.

Incubation temperature affects developmental rates and defines many phenotypes and fitness characteristics of reptilian embryos. In turtles, eggs are deposited in layers within the nest, such that thermal gradients create independent developmental conditions for each egg. Despite differences in developmental rate, several studies have revealed unexpected synchronicity in hatching, however, the mechanisms through which synchrony are achieved may be different between species. Here, we examine the phenomenon of synchronous hatching in turtles by assessing proximate mechanisms in an Australian freshwater turtle (Emydura macquarii). We tested whether embryos hatch prematurely or developmentally compensate in response to more advanced embryos in a clutch. We established developmental asynchrony within a clutch of turtle eggs and assessed both metabolic and heart rates throughout incubation in constant and fluctuating temperatures. Turtles appeared to hatch at similar developmental stages, with less-developed embryos in experimental groups responding to the presence of more developed eggs in a clutch by increasing both metabolic and heart rates. Early hatching did not appear to reduce neuromuscular ability at hatching. These results support developmental adjustment mechanisms of the ‘catch-up hypothesis’ for synchronous hatching in E. macquarii and implies some level of embryo–embryo communication. The group environment of a nest strongly supports the development of adaptive communication mechanisms between siblings and the evolution of environmentally cued hatching.

Keywords: synchronous hatching; heart rate; developmental costs; turtle; Emydura macquarii; metabolic compensation

 

 

1. INTRODUCTION

→ Huge importance of incubation environmental temperature in embryonic development in egg-laying species: warmer ==> faster, colder ==> slower

Source: http://www.fowlvisions.com/wp-content/uploads/2009/01/first-baby-chick-incubator.jpg accessed 3 December 2011

 

→ although effect of temp on speed of development is well-known, other environmental factors may actually turn out to be more important

 

→ Animals with many young at one time (like fish, unlike us): timing/synchronization important

Source: http://www.scientificamerican.com/media/inline/life-on-palmyra-reef_1.jpg accessed 3 December 2011

 

→ what makes young in same clutch (set of eggs) vary in timing? Order of ovulation, thermal micro-environments of eggs can have effect

→ despite these differences, many egg-laying animals (including invertebrates, fishes, amphibians, crocodilians, snakes, turtles, and birds) are able to synchronize hatching

→ Freshwater turtles: give us a chance to see how this process actually works

 

→ Eggs ovulated simultaneously, then fertilized, then begin dividing (1 cell → 2, 2 → 4, 4 → 8, ...). At first, the divisions are exactly like each other (“undifferentiated”), but when enough cells have built up into a mass, it begins to differentiate (specialize) into layers (3 in animals like us, and turtles are not that different from us, relatively speaking). The stage at which 3 layers (ectoderm, mesoderm, endoderm) are present, but have not yet begun to form distinct organs, is called “gastrulation”, and the cells themselves form the gastrula.

→ At this point, mama turtle hits the pause button (not literally; the process occurs all by itself--she doesn't have to actively do it), and the embryos are halted at gastrulation until they are safely in the nest, and can pick up developing where they left off

Source: http://celldynamics.org/embryos/images/stichopus_gastrula1.jpg accessed 3 December 2011

 

→ mama comes out of the water and digs hole in ground to build nest. eggs are deposited in the nest in layers, and even though the nest is shallow, there is still room for detectable environmental variation in it. For this reason, we expect the eggs to respond to that temperature variation, and hatch at different speeds in different layers from top to bottom.

Source: YouTube: Turtle digging nest, Dec 2010, Punta Banco, Costa Rica accessed 3 December 2011

 

→ eggs in the top layers can experience temperatures up to 68C higher than eggs in the bottom layers. To know what that means, you can use the exact formula for converting Celsius/Centigrade temperatures to Fahrenheit, but since we don't need to be that exact just to discuss it, we can use the quick and dirty conversion of doubling the C temperature, and then adding 30. So if the temperature can be up to 68C higher in the upper layers than in the lower layers, then that means it can be up to (68 times 2 = 136 degrees Fahrenheit + 30 = ) 166 degrees Fahrenheit hotter in the upper layers. That's quite a big difference, so we expect—as previously discussed—that the eggs exposed to those higher temperatures will hatch quite a bit faster than those in the lower layers. Is what we predict actually what happens in the natural world?

→ Surprisingly, no, it isn't. The temperature difference does not produce the difference in hatching times that we would expect. Both in Australian and North American freshwater turtles, we observe less-developed siblings “catch up” to the more-developed ones in the upper layers. In some cases, they just hatch earlier; in other cases, they actually increase their rates of development in response to biochemical cues from their siblings, regardless of their own actual temperature.

 

→ What would explain this difference between what we predict and what actually happens? Ultimate (“big-picture”) explanation: avoiding predators is a selection pressure (a strong influence) that drives the evolution of synchronous hatching. This is a mindliess process; no one actually “decides” to do something differently to avoid predators. Instead, in a big enough population of turtles, you'll have some that randomly happen to hatch at the same rates, and others that hatch at different rates. If hatching at the same rate gives those turtles a survival advantage compared to the other turtles, then more of them will survive. Surviving longer means they have more chance to pass that trait to their offspring, which means more of those offspring will survive to reproduce, and the cycle continues.

Source: http://informationsentinel.com/resources/Sea_Turtles_zipped%20Kevyn/Sea%20Turtles/assets/so%20many%20babies!.jpg accessed 3 December 2011

 

→ If avoiding predators is a possible explanation of what we observe, then what might be the actual mechanism of that process?

→ Ever seen a bicycle race where cyclists “draft” in the wake of other cyclists to gain a slight advantage of speed without having to spend as much energy on it, or been in a crowd trying to push its way into a concert? There is an analogous energy advantage to being pushed along with the group as everyone leaves the nest at once, rather than having to spend all the energy to dig and pull yourself out individually from the bottom layer.

Source: http://www.cyclingtipsblog.com/wp-content/uploads/2009/06/team-time-trial.jpg accessed 3 December 2011

 

–> If a predator is waiting by the nest, one turtle coming out all by itself is a nice snack. A large group of turtles, on the other hand, may “swamp” and confuse the predator. Even if it doesn't, and the predator does get a turtle or ten, then in a group, any given individual's chances of escaping the predator are better in a crowd than if the individual is totally alone in coming out of the nest.

→ These are potential scenarios where group simultaneous hatching and emergence can reduce the amount of energy an individual spends, and increase an individual's chances of survival. What are the costs required to produce these advantages?

 

→ remember, the predator scenario was the “ultimate” or big-picture cause. Proximate, or “near-by” or “immediate” causes would include detecting sibling hatching or developmental cues, and responding to those cues by changing your own developmental rate (not consciously, but biochemically)

→ perhaps the less-developed siblings have poorer motor sklls, so they are at more risk from predators than the more-developed turtles are

→ perhaps being less-developed makes those turtles more likely to die from natural causes

 

→ what are the possible ways to link hatching times among siblings? The slower ones can speed up, or the faster ones can slow down

→ Hatching out of the eggs can be tightly linked to emergence from the nest, or it can be not tightly linked—the young turtles hang out in the nest for a while before emerging and heading to the water

→ One species of freshwater turtle, Chrysemys picta: the slower ones hatch prematurely rather than the faster ones slowing down, but hatching and emergence are not closely linked. This gives the slower ones a little time after hatching to continue developing before finally emerging.

"Hi! I'm what's called a 'painted turtle', Chrysemys picta. We hang around the nest for a little while after hatching and before emerging into the world."

Source: http://www.herpnet.net/Iowa-Herpetology/images/stories/reptiles/turtles/Chrysemys_picta_Painted_turtle/Chrysemys_picta_Painted_turtle_plastron.jpg accessed 3 December 2011

 

 

→ A different species, Emydura macquarii, emerges very soon after hatching—no hanging around in the nest time for continued development in these turtles. What this means is that the slower ones, in catching up, kind of skimp on the secondary period of development. The primary period (where organs and tissues develop) is pretty much on track, but the speeding up to catch up to their warmer/faster siblings takes a toll during the secondary period (where the neuromuscular system matures).

"Hi! We're Emydura macquarii, the Murray River Turtle. We pretty much hit the road once we hatch."

Source: http://upload.wikimedia.org/wikipedia/commons/0/00/Pair_of_Emydura_macquarii_-_Warrawong.JPG accessed 3 December 2011

 

→ Figure 1: metabolic profile for freshwater turtle eggs during incubation, based on E. macquarii eggs.

→ The plotted lines (black solid, gray solid, black dotted, and gray dashed) begin when incubation begins—remember, we said previously that the embryo is paused at the gastrula stage until mom digs a nest and lays the eggs in it. 

→ 0 on the horizontal line (x-axis) represents the moment she lays them in the nest and incubation starts/the embryo resumes developing. They end when hatching occurs, about 52-67 days later for this species.

→ 0 on the vertical line (y-axis) represents 0% of the peak (top) metabolic rate—the gastrula is not carrying out metabolic processes. Once incubation begins, metabolism also starts, and increases continuously until it reaches peak metabolic rate. Then something interesting happens—notice the lines dropping off when they come into contact with the gray bars. We'll talk about what that is, and what it means, when we talk about those bars.

Source: Figure 1 from article

 

→ The solid black line shows the process that normally-developing eggs follow. This tells us the natural baseline against which we are comparing all the other eggs that have had interventions (some kind of stimulus to promote development).

→ The solid gray line shows eggs that were incubated separately at warmer temperatures for the first week of development before being reunited with the normally-developing eggs. So the line is the same shape, because it follows the same process—it is just shifted left (lower number of days of incubation) because the temperature caused everything to happen faster. So at 5 days, the gray line is already as high (increased percentage of peak metabolic rate) as the black line is normally at 20 days. This tells us about the speed-up effect caused by temperature alone. This group of eggs is called the “stimulus eggs”.

 

→ At about 12 days of incubation, the gray dashed line—which was previously invisible, because it was exactly following the solid black line--breaks away from the black line and starts showing a faster increase in its percentage of peak metabolic rate than it had been showing to that point. That's because it had previously been permitted to develop normally, and then, in early development, they had been stimulated to develop faster. Notice that the gray dashed line eventually joined the gray solid line—it caught up to the “stimulus eggs”, even though it got its own stimulation about 12 days later.

→ At about 35 days of incubation, much later in development, the eggs represented by the black dotted line also received a stimulus. Notice how fast they shot up to also catch up to the “stimulus eggs”. The line is quite steep, because they had a lot of ground to make up before hitting the peak metabolic rate in such a short time, but they succeeded at doing so.

→ What this tells us is that all the stimulated eggs—whether from the beginning, or from 10 days into incubation, or from 35 days into incubation—reached peak metabolic rate at just about the same time. So the eggs that were stimulated later all managed to catch up to the eggs that were stimulated at the very beginning.

 

→ The plain white area of the graph before the bars where the plotted lines hit peak metabolic rate represent the primary developmental period—the period where the organs and tissues are formed in the embryos.

→ The gray bars represent the secondary developmental period, where neuromuscular development takes place. As you would expect, the light gray bar—which represents the secondary developmental period in the stimulated eggs—is shifted left, or occurs about a week before, the dark gray bar, which represents the secondary developmental period in normally-developing eggs.

 

→ Although the light gray bar is time-shifted from the dark gray bar, they each show a similar interaction with their corresponding plotted line. The line hits about 100% peak metabolic rate just as the secondary developmental period starts, and then drops off sharply, going back to about 75% of peak metabolic rate. The article explains what is happening: “Respiration rates in reptiles and precocial birds generally drop by up to 25 per cent before hatching occurs, but hatching can occur at any time after peak metabolism. The fall in metabolism prior to hatching in some species is associated with the secondary development period, which is variable in length.”

→ “Reptiles” here refers to turtles, which seem to many people as though they ought to be amphibians, but they're not. They're really reptiles, based on evolutionary heritage, who enjoy an amphibian (two-life) lifestyle, in the water and out of it.

→ If you've ever heard a child referred to as “precocious”, then you've already got a mnemonic (memory aid) for remembering the difference between precocial species and altricial species. A precocious child is one who is able to carry out activities more advanced than you would expect someone at the child's developmental stage to do—maybe he read early, or she's a math whiz, or they' were able to program computers before even starting school. Similarly, precocial birds are birds whose young hatch at a relatively advanced and independent developmental stage, compared with altricial birds, whose young hatch helpless. Imagine a baby chick, pecking its way out of the egg, and looking about itself with open eyes before taking its first—if hesitating—steps. That's a precocial bird. Now visualize a songbird, whose babies come out of the egg with their eyes closed, and require a great deal of parental care before they develop to a stage where they can begin to leave the nest. That's an example of an altricial bird.

→ So like in precocial birds, the (reptilian) turtles hit peak metabolic rate, and then the secondary developmental stage starts, and their peak metabolic rate drops until they hatch. That's what the upward-sloping lines suddenly beginning to slope downwards means.

 

→ Once the lines begin to slope downward (the peak metabolic rate falls), then the eggs are in the secondary stage of development.

→ Bonus question here: what is cause and what is effect? Does the drop in peak metabolic rate cause the secondary developmental stage to start, or does the onset of the secondary developmental stage cause the peak metabolic rate to drop? Or are there any other possibilities? What does the graph tell us about cause and effect?

 

→ You see the two vertical arrows, one at the right end (final day) of each secondary developmental period. Those arrows indicate the normal hatching times for each group of eggs. These guys pretty much hatch immediately when the secondary developmental period is completed.

–> The horizontal dashed arrow in the secondary developmental period of the normally-developing eggs indicates that this is the only place left at this point in the process where the normal eggs can catch up to the “stimulus eggs”. The other eggs that started out normal, but were then stimulated, had more time to make up ground, but this is, literally, their last chance to get caught up. The only way to catch up is to shorten the time spent on neuromuscular development. And that skimping can have short- and long-term costs, and because they did not spend the full time in that stage, they may be at more risk not to survive later on when they leave the nest. But there is no other way to make up the time difference.

 

–> This study is intended to test the two competing proximate (“immediate”) mechanisms of the catch-up hypothesis, underlying simultaneous or early hatching in freshwater turtles. They will look at how these mechanisms can be linked to environmental temperature changes. 

→ They found a reference to earlier work by Booth, where Booth's team tried transferring freshwater turtle eggs among lower- and higher-temperature environments, but failed to show any linked developmental catching up. They think that perhaps Booth missed subtle changes in temperatures during the day that could have large effects. To avoid falling into this trap that they perceive might have led Booth astray, they will evaluate mechanisms for their hypothesis both in environments with constant temperatures, and in environments where temperatures fluctuate.

 

Citizen science: Want to participate in the development of a research questionnaire for neck and back pain?

Submitted by RST on Fri, 12/02/2011 - 10:35
Posted in

The Clinical Whiplash Intervention and Prognosis Research Group is seeking volunteers who have experienced back or neck pain to provide feedback on the usefulness of a new questionnaire designed to measure recovery from pain or injury in those conditions.

You will be required to provide a valid email address for them to contact you at, and they say that the study should take no more than about 15 minutes of your time. You can also opt in to a voluntary drawing for 2 $50 Amazon gift certificates after you have participated, which will be given to 2 of the participating volunteers chosen at random.

More information on participating in the survey evaluation is available at this link.

Let's read together: A Randomised Controlled Single-Blind Trial of the Efficacy of Reiki at Benefitting Mood and Well-Being--Introduction

Submitted by RST on Mon, 10/03/2011 - 09:27
Posted in

A link to the free fulltext PDF article is here.

 

Introduction

Reiki is a system involving the laying on of hands developed in Japan in the early 20th century [1] and is believed to have the capacity to heal the physical body and mind and bring emotional and spiritual balance.

 

"Is believed" drastically overstates the case--as the claim is written, it implies "believed universally", and Reiki is far from universally accepted. "Is believed by its practitioners" or "is believed by its adherents" would be a far more accurate description of the acceptance of Reiki.

Compare "The gate control theory is believed to provide a physiological explanation for the practice of rubbing a painful area" [A] and "The bear spirit Otso is believed to have been born in the regions of the Moon-land, on the shoulders of Otava, with the daughters of creation" [B].

Which sentence is an accurate statement of an almost universal consensus, and which statement needs modification to make clear that it is not a universal belief, but that of a specific minority of adherents? 

I know that this is their goal in this article--to demonstrate, using scientific methods, that Reiki deserves universal acceptance. But they actually have to do that work of connecting the dots and demonstrating the scientific credibility first, before claiming that it is already true.

This is the heart of science, and is what distinguishes it from philosophy, apologetics, and other pursuits. You have to do the actual work first; you cannot claim it, simply based on possibilities, or what is imaginable. In the upcoming sentence, they say "While the majority of scientific investigations [of Reiki] have suffered from design limitations...". That means that the work has not yet been done correctly, and so it has not yet been done.

If we are going to apply science to this exploration of Reiki, then we have to do it rigorously. Anything less is a waste of all of our time, money, emotional energy, and other resources. And I believe we all have a lot to offer our clients in the way of support, caring presence, and therapeutic alliance, whether or not the specific mechanism of what is offered is scientifically plausible or not. If we're not going to do the science rigorously, then we're wasting time and other resources that, in the long run, are better spent with clients.

This may sound like quibbling--I hear the phrases "mere semantics" and "semantic games" a lot. But semantics is the study of meaning, and what could possibly be more important than the meaning we communicate to ourselves, our clients, and each other?

Along those same lines, what do the expressions "heal the physical body and mind" and "bring emotional and spiritual balance" mean? Those are extremely vague, and that vagueness makes it impossible to pin down to evaluate objectively whether Reiki does what it claims to do or not.

For example, a leg is part of the physical body, so does "heal the physical body" mean restoring an amputated leg? If not, why not? What does it apply to, and why are those parts of the physical body different from the physical leg?

Does "healing the mind" and "bring emotional balance" mean that a schizophrenic receiving Reiki can safely come off of his medications? If not, then similar questions to those about the leg apply here as well. What is spiritual balance, and how do we tell when someone is in or out of it?

If claims are vague enough that they are untestable, then they are not scientific. Which is fine if you want to do something other than science, but for carrying out science, they don't really convey any meaning that we can practically use in evaluating them.

 

While the majority of scientific investigations have suffered from design limitations, however, there is some suggestive evidence that Reiki can influence mood [2–4] and induce physiological change in humans [5–10] and animals [11].

 

"The majority of scientific investigations [of Reiki] have suffered from design limitations" means that most research that claims to support Reiki does not stand up under examination, because the methodology--the most important part of the study--was flawed.

So we'll be looking at this study, and the one it was based on, to see how Bowden and her team avoid falling into those methodological traps.

However, the studies she cites as "suggestive evidence" seem to have methodological problems as well.

Wardell 2001, for example, uses a convenience sample and no control group, and is subject to the within-group measures problem that we discussed in Journal Club last month.

Baldwin 2006 points out that:

In the rat, stress from noise damages the mesenteric microvasculature, leading to leakage of plasma into the surrounding tissue.

 

and then makes the leap that because 4 rats showed less microvascular leakage in the mesentery after 3 treatments, that therefore Reiki minimizes environmental stress in human hospital patients.

It's a huge leap, but perhaps not an impossible one--but to show it's not impossible, you have to actually do the work of connecting the dots and showing how you demonstrated clearly that the effect must be due to Reiki and not something else. You can't just assume it and plow forward, not if we are to do real and rigorous science.

 

The present study employed a similar design to a previous study by the authors [4], where 35 first year undergraduates were randomly assigned to ten 20-minute sessions of Reiki or no-Reiki in conjunction with self-hypnosis/guided relaxation over a period of two and half to twelve weeks. While the Reiki group had a tendency towards a reduction of symptoms of illness following the intervention, a substantive increase in symptoms was seen in the no-Reiki group—leading to a highly significant distinction between them. There was also a trend for the Reiki group to have a greater improvement in overall mood than the no-Reiki group, accompanied by a near-significant comparative reduction in stress. However, the Reiki group had significantly higher baseline illness symptoms and mood scores than the no-Reiki group. The current study sought to replicate the comparatively greater mood and health benefits of the Reiki group in the previous study, while employing a design that ensured that the mean scores of the groups did not differ at baseline. In addition, the inclusion of participants with high depression and/or anxiety permitted the possibility that a greater degree of improvement could occur than was the case with the normally healthy participants of the first study.

 

I find this paragraph confusing--were the undergraduates properly randomly assigned, which would level out variations like higher baseline illness symptoms and mood scores between the two groups? Or were the two groups systematically different from each other, in which case they are, by definition, not properly randomized?

What she is saying sounds contradictory, and I can't be sure of exactly what is going on from the level of detail provided here. But one thing I can be sure of, however, is that if the Reiki group had "significantly" higher illness symptoms and mood scores, then several confounds, including regression to the mean and (UPDATE: corrected my misspelling of "vis") vis medicatrix naturae (the healing power of nature, the tendency for the body to heal itself of many illnesses) can have made an effect for which Reiki then incorrectly got the credit.

We will look in the Methods section next to see how they screened for such confounds, as well as for the fact that--as psychosocial beings--we respond psychologically and socially in ways that can be described as healing body and mind due to presence and caring attention from others. How they teased out Reiki from these effects, and how they determined what was caused by Reiki as opposed to something else, will be a very important part of our analysis.

 

 

References from the original article used in this section

1. Miles P, True G. Reiki—review of a biofield therapy history, theory, practice, and research.Alternative Therapies in Health and Medicine. 2003;9(2):62–72. [PubMed]
2. Dressen LJ, Singg S. Effects of Reiki on pain and selected affective and personality variables of chronically ill patients. Subtle Energy and Energy Medicine. 1998;9:51–82.
3. Shore AG. Long-term effects of energetic healing on symptoms of psychological depression and self-perceived stress. Alternative Therapies in Health and Medicine. 2004;10(3):42–48. [PubMed]
4. Bowden D, Goddard L, Gruzelier J. A randomised controlled single-blind trial of the effects of Reiki and positive imagery on well-being and salivary cortisol. Brain Research Bulletin. 2010;81(1):66–72.[PubMed]
5. Wetzel W. Reiki Healing: a physiologic perspective. Journal of Holistic Nursing. 1989;7(1):47–154.
6. Wirth DP, Chang RJ, Eidelman WS, Paxton JB. Haematological indicators of complementary healing intervention. Complementary Therapies in Medicine. 1996;4(1):14–20.
7. Wirth DP, Brenlan DR, Levine RJ, Rodriguez CM. The effect of complementary healing therapy on postoperative pain after surgical removal of impacted third molar teeth. Complementary Therapies in Medicine. 1993;1(3):133–138.
8. Wardell DW, Engebretson J. Biological correlates of reiki touch(Service mark) healing. Journal of Advanced Nursing. 2001;33(4):439–445. [PubMed]
9. Kumar RA, Kurup PA. Changes in the isoprenoid pathway with transcendental meditation and Reiki healing practices in seizure disorder. Neurology India. 2003;51(2):211–214. [PubMed]
10. Mackay N, Hansen S, McFarlane O. Autonomic nervous system changes during Reiki treatment: a preliminary study. Journal of Alternative and Complementary Medicine. 2004;10(6):1077–1081.
11. Baldwin AL, Schwartz GE. Personal interaction with a Reiki practitioner decreases noise-induced microvascular damage in an animal model. Journal of Alternative and Complementary Medicine.2006;12(1):15–22.
 

References I used in this section

[A] Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–9. PMID 5320816. Free fulltext PDF available at this link.

[B] http://www.sacred-texts.com/neu/kveng/kvrune46.htm accessed 3 October 2011.

 

 

So that's what I've gotten our of the Introduction. Did you get anything else from it?

Please share it with us in the comments, if so, and we'll proceed to the Introduction section shortly.

 

 

Evid Based Complement Alternat Med. 2011; 2011: 381862.
Published online 2011 March 27. doi:  10.1155/2011/381862
PMCID: PMC3092553
Copyright © 2011 Deborah Bowden et al.
 
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
 
Articles from Evidence-based Complementary and Alternative Medicine : eCAM are provided here courtesy of Hindawi Publishing Corporation

Let's read together: A Randomised Controlled Single-Blind Trial of the Efficacy of Reiki at Benefitting Mood and Well-Being

Submitted by RST on Mon, 09/26/2011 - 09:26
Posted in

(UPDATE, 2 October 2011: link to the free fulltext PDF article is here; as well, the text of the article will be posted here at POEM for us to read through together, per their Creative Commons license. Cheers, to rchunco, for the improved suggestion!)

Let's go through this article together, sharing our insights along the way.

A Randomised Controlled Single-Blind Trial of the Efficacy of Reiki at Benefitting Mood and Well-Being

Deborah Bowden, Lorna Goddard, and John Gruzelier

Psychology Department, Goldsmiths, University of London, ITC Builidng[sic], New Cross, London SE14 6NW, UK

 

Abstract: This is a constructive replication of a previous trial conducted by Bowden et al. (2010), where students who had received Reiki demonstrated greater health and mood benefits than those who received no Reiki.

 

In the space of only one sentence in the abstract, a great deal of meaning is contained.

Let's save the first specialized term, "constructive replication", for last, as it is the most-complicated concept in the sentence.

The rest of the sentence is relatively straightforward.

The previous trial (or study) conducted by Bowden et al. (and others) is the following:

D. Bowden, L. Goddard, and J. Gruzelier, “A randomised controlled single-blind trial of the effects of Reiki and positive imagery on well-being and salivary cortisol,” Brain Research Bulletin, vol. 81, no. 1, pp. 66–72, 2010.

 

Unlike the study we're going through now, the 2010 article is behind a paywall, so I can't post it for reference. I can, however, quote relevant parts of it under the Fair Use provision, and so I'll do that as appropriate in discussing this article.

Bowden summarizes the results of the 2010 study as showing that "students who had received Reiki demonstrated greater health and mood benefits than those students who received no Reiki". This study is an attempt to replicate, or reproduce, those results.

Replication of studies has a long history in science. The entire point of an effect being universal, objective, and mind-independent (as opposed to unique, subjective, and mind-dependent) is for anyone to be able to reproduce the effect or outcome in question. Replication is how you demonstrate that anyone can do so.

It's also how you can ethically offer the possibility of specific outcomes to the client. No outcome is ever guaranteed, of course, but a reliably reproducible outcome at least holds the potential of your being able to deliver it to your client. If it can't be reliably reproduced, on the other hand, then how can you promise the client that there is a good chance that you will be able to deliver it?

For these reasons, replication studies are very important in scientific and clinical research in general, and specifically in massage research, as it can help us build our validated knowledge base.

"Constructive replication" is a very specific kind of replication, where researchers try to reproduce a study using methods that are different from the original study. At first, that may sound like a contradiction in terms, but it's actually a technique that has an established history in clinical research.

The primary reason that people carry out constructive replication is to try to demonstrate that--even when the study is carried out in a different way--the treatment is still associated with the desired results. It's like the cause-and-effect connection is so strong that it will come about one way or another; not just in the one way that was demonstrated in the previous study.

So what she's saying is that she's satisfied that the previous study validated the connection strongly enough that a constructive replication will expand and generalize the results from the ones in the first study.

We can add that to our list to check as we read through this one:

How methodologically sound was the 2010 study that this study is trying to generalize from?

 

The next sentence is straightforward:

The current study examined impact on anxiety/depression. 40 university students—half with high depression and/or anxiety and half with low depression and/or anxiety—were randomly assigned to receive Reiki or to a non-Reiki control group.

 

When we're reading the rest of the article, we'll look for an indication of how that number of 40 students was determined to have sufficient power for this study:

How was the number of 40 participants chosen, and what steps did the authors take to ensure that 40 participants made up a sufficiently-sized sample? 

 

The next sentence is somewhat unclear, although I expect the main article will clear up the ambiguity:

Participants experienced six 30-minute sessions over a period of two to eight weeks,

 

Does that mean some people got 6 sessions in 2 weeks, while others got 6 sessions in 8 weeks? That seems like a pretty wide variation in the treatment--such a large variation, in fact, that I would question whether or not we're comparing apples to oranges.

We'll look for a fuller explanation of this difference in the main article:

What is the actual discrepancy in timing of treatments, and what does this mean for the study?

 

The next note is totally one of style, not of substance, and doesn't affect the conclusions we'll draw from this article:

where they were blind

 

The correct word here is "blinded", rather than "blind". As mentioned, this won't affect our assessment of the article itself, but when you are writing research articles, you'll want to make sure you get that detail right.

 

to whether noncontact Reiki was administered as their attention was absorbed in a guided relaxation.

 

This sounds like a standard approach to providing a control for an intervention such as Reiki or massage.

 

The efficacy of the intervention was assessed pre-post intervention and at five-week follow-up by self-report measures of mood, illness symptoms, and sleep.

 

This looks fairly standard for testing for the capacity of the treatment to have an effect on the outcomes measures listed. We'll look at this in more detail in the Methods section.

 

The participants with high anxiety and/or depression who received Reiki showed a progressive improvement in overall mood, which was significantly better at five-week follow-up, while no change was seen in the controls.

 

Bowden is saying here that the students with either high anxiety, high depression, or both, showed an improvement in mood that continued to get better after the end of the study for the 5 weeks leading to the followup assessment. Additionally, she reports that this improvement is statistically significant, which means they've determined that the probability that this is a chance result, rather than a real treatment effect, is less than 5%, or 1 chance out of 20.

 

While the Reiki group did not demonstrate the comparatively greater reduction in symptoms of illness seen in our earlier study, the findings of both studies suggest that Reiki may benefit mood.

 

Bowden reports that the constructive replication did not show the same effects in the Reiki group with regard to reducing illness symptoms, but that both studies suggest that Reiki may benefit mood.

Notice her use of the word "suggest" and "may". This tentativeness is quite correct when drawing conclusions from a study. It is extremely rare to definitively determine cause and effect in this way; much more usual is the slow building of a solid body of evidence, which tends to point in one way or the other.

 

So that's what I've gotten our of the abstract. Did you get anything else from it?

Please share it with us in the comments, if so, and we'll proceed to the Introduction section shortly.

 

 

Evid Based Complement Alternat Med. 2011; 2011: 381862.
Published online 2011 March 27. doi:  10.1155/2011/381862
PMCID: PMC3092553
Copyright © 2011 Deborah Bowden et al.
 
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
 
Articles from Evidence-based Complementary and Alternative Medicine : eCAM are provided here courtesy of Hindawi Publishing Corporation
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