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Background Shift work is a necessary part of many industries; however, it can have detrimental effects on health over time. Purpose This study investigated the effect of a massage intervention on the cardiac autonomic activity and blood inflammatory markers of healthy medical residents working night shifts. Setting This trial was conducted at British Columbia Children’s and Women’s Hospital between February 2014 and June 2016. Participants Included participants were generally healthy medical residents and were working rotating night shifts on a regular basis. Research Design This was a randomized, controlled, crossover, open-label trial (NCT02247089). Interventions Participants received either a 30-min massage intervention or reading control after consecutive periods of night shift. Main Outcome Measures The primary outcome was high frequency, a proxy for the cardiac parasympathetic activity, measured via heart rate variability. Secondary outcomes included other heart rate variability measures, blood markers of inflammation, and blood pressure. Results Twelve participants were recruited (nine female) with median age of 28 years. There was no significant difference between the massage intervention and the reading control for the primary outcome, (median relative change between pre- and postmassage [interquartile range]: 62% [−1 to 150], pre- and postreading: 14% [−10 to 51], p = .16). Similarly, there was no difference with respect to blood inflammatory markers and blood pressure. Median high frequency significantly increased between pre- and postmassage (185 vs. 358 ms2, p = .04). Conclusion This pilot study found no statistically significant difference between the massage intervention and the reading control; however, we did observe a significant increase in median high frequency from before massage to after massage, indicative of increased parasympathetic activity. This study may help inform planning of larger trials evaluating massage interventions on the activity of the autonomic nervous system and managing shift work stress.

Objective. We aim to broaden understanding of the perspectives of persons with arthritis on their use of wearables to self-monitor physical activity, through a synthesis of evidence from qualitative studies. Methods. We conducted a systematic search of 5 databases (including Medline, CINAHL, and Embase) from inception to 2018. Eligible studies qualitatively examined the use of wearables from the perspectives of persons with arthritis. All relevant data were extracted and coded inductively in a thematic synthesis. Results. Of 4358 records retrieved, 7 articles were included. Participants used a wearable during research participation in 3 studies and as part of usual self-management in 2 studies. In remaining studies, participants were shown a prototype they did not use. Themes identified were: 1) Potential to change dynamics in patient-health professional communication: Articles reported a common opinion that sharing wearable data could possibly enable them to improve communication with health professionals; 2) Wearable-enabled self-awareness; a benefit or downside?: There was agreement that wearables could increase self-awareness of physical activity levels, but perspectives were mixed on whether this increased self-awareness motivated more physical activity; 3) Designing a wearable for everyday life: Participants generally felt the technology was not obtrusive in their everyday lives, but it was speculated certain prototypes may embarrass or stigmatize persons with arthritis. Conclusion. Themes hint toward an ethical dimension, as participants perceive their use of wearables may positively or negatively influence their capacity to shape their everyday selfmanagement. We suggest ethical questions pertinent to the use of wearables in arthritis selfmanagement for further exploration.

Supplemental material, sj-pdf-1-amd-10.1177_11795441211028751 for Cardiovascular Disease in Rheumatoid Arthritis: Risk Factors, Autoantibodies, and the Effect of Antirheumatic Therapies by Mir Sohail Fazeli, Vadim Khaychuk, Keith Wittstock, Boris Breznen, Grace Crocket, Mir-Masoud Pourrahmat and Leticia Ferri in Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders