To date, patients with bony metastases were only a small fraction of the samples studied, or they were entirely excluded. Patients with metastatic cancers, such as bone metastases, are more likely to report pain, compared to patients without metastatic cancer (50-74% and 15%, respectively). Their cancer pain results in substantial morbidity and disrupted quality of life in 34-45% of cancer patients. Massage therapy (MT) appears to have positive effects in patients with cancer; however, the benefits of MT, specifically in patients with metastatic bone pain, remains unknown. The purpose of this randomized clinical trial was to compare the efficacy of MT to a social attention control condition on pain intensity, mood status, muscle relaxation, and sleep quality in a sample (n=72) of Taiwanese cancer patients with bone metastases. In this investigation, MT was shown to have beneficial within- or between-subjects effects on pain, mood, muscle relaxation, and sleep quality. Results from repeated-measures analysis of covariance demonstrated that massage resulted in a linear trend of improvements in mood and relaxation over time. More importantly, the reduction in pain with massage was both statistically and clinically significant, and the massage-related effects on relaxation were sustained for at least 16-18 hours postintervention. Furthermore, massage-related effects on sleep were associated with within-subjects effects. Future studies are suggested with increased sample sizes, a longer interventional period duration, and an objective and sensitive measure of sleep. Overall, results from this study support employing MT as an adjuvant to other therapies in improving bone pain management.

Factors contributing to maternal sleep when infants are 4 to 10 weeks of age were examined. Twenty-four-hour sleep-wake diaries collected from 37 mother-infant dyads in the home environment were summarized to describe total, longest, and mean sleep period; synchrony of maternal and infant sleep; and feeding frequency and duration. Regression and post hoc analysis of variance were used to examine factors contributing to maternal and infant sleep. Maternal sleep is driven by infant sleep and feeding pattern. The minimum and maximum numbers of infant sleep episodes per day were 6 and 15, respectively, and mean infant total sleep was 13.47 hours (SD 1.73). Mean maternal total sleep was 7.18 hours (SD 1.51), with half of the mothers reporting less than 7 hours of sleep per 24 hours. Mean number of infant feedings was 11.14 (SD 3.27), with 11 infants (29.7%) receiving 13 or more feedings per 24 hours; minimum and maximum times per feeding were 15 and 41.7 minutes, respectively. Male infants had more sleep episodes, shorter sleep periods, and less sleep than females, and these gender differences resulted in shorter and more fragmented sleep for mothers. Findings suggest there is continued need for interventions to improve maternal sleep following childbearing.

Objective-To further understand state development of preterm infants throughout hospitalization and the effects of selected infant characteristics on state development.Design-Secondary data analysis of a two-group, experimental design study. Setting-Two nurseries in a Northwest medical center.Participants-Ninety-seven (97) hospitalized, medically stable, preterm infants. Fifty one (51) subjects were females.Methods-Two hundred eighty five (285) real-time video recordings of infants performed during 4-hour interfeeding intervals. Sleep-wake states were coded at 15-second intervals.Results-Active sleep was the dominant state across postmenstrual ages. Although not statistically significant, preterm infants showed developmental changes in state organization with increased quiet sleep, drowsy, and awake, decreased active sleep, and more defined and less diffuse states over age. A significant gender effect was found, with males having less active sleep (p = .012), more drowsy (p = .03), more awake (p = 0.43), less defined (p = .002), and more diffuse (p = .001) states compared with females.Conclusion-The predominance of active sleep during the preterm period reflects level of brain maturation. The results emphasize individual variations in state organization influenced by endogenous and environmental factors. Gender differences are potential sources of individual variation.