***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Increasing numbers of reports show the beneficial effects of listening to Mozart music in decreasing epileptiform discharges as well as seizure frequency in epileptic children . There has been no effective method to reduce seizure recurrence after the first unprovoked seizure until now . In this study , we investigated the effect of listening to Mozart K.448 in reducing the seizure recurrence rate in children with first unprovoked seizures . Methods Forty-eight children who experienced their first unprovoked seizure with epileptiform discharges were included in the study . They were r and omly placed into treatment ( n = 24 ) and control ( n = 24 ) groups . Children in the treatment group listened to Mozart K.448 daily before bedtime for at least six months . Two patients in the treatment group were excluded from analysis due to discontinuation intervention . Finally , forty-six patients were analyzed . Most of these patients ( 89.1 % ) were idiopathic in etiology . Seizure recurrence rates and reduction of epileptiform discharges were compared . Results The average follow-up duration s in the treatment and control groups were 18.6 ± 6.6 and 20.1 ± 5.1 months , respectively . The seizure recurrence rate was estimated to be significantly lower in the treatment group than the control group over 24 months ( 37.2 % vs. 76.8 % , p = 0.0109 ) . Significant decreases in epileptiform discharges were also observed after 1 , 2 , and 6 months of listening to Mozart K.448 when compared with EEGs before listening to music . There were no significant differences in gender , mentality , seizure type , and etiology between the recurrence and non-recurrence groups . Conclusions Although the case number was limited and control music was not performed in this study , the study revealed that listening to Mozart K.448 reduced the seizure recurrence rate and epileptiform discharges in children with first unprovoked seizures , especially of idiopathic etiology . We believe that Mozart K.448 could be a promising alternative treatment in patients with first unprovoked seizures and abnormal EEGs . Further large-scaled study should be conducted to confirm the effect . Trial registration NCT01892605 , date : June-19 - The number of published systematic review s of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions . Systematic review s are subject to a range of biases and increasingly include non-r and omised studies of interventions . It is important that users can distinguish high quality review s. Many instruments have been design ed to evaluate different aspects of review s , but there are few comprehensive critical appraisal instruments . AMSTAR was developed to evaluate systematic review s of r and omised trials . In this paper , we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic review s that include r and omised or non-r and omised studies of healthcare interventions , or both . With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic review s , including those based on non-r and omised studies of healthcare interventions The purpose of this study was to explore the feasibility and preliminary efficacy of a therapeutic music video ( TMV ) intervention for adolescents and young adults ( AYAs ) undergoing stem-cell transplantation ( SCT ) . Twelve AYAs ( aged 11 - 24 years ) were r and omized to the TMV or an audio-book protocol . The TMV was design ed to diminish symptom distress and improve coping , derived meaning , resilience , and quality of life by supporting AYAs in exploring thoughts and feelings . Six sessions with a board-certified music therapist were held twice a week for 3 weeks . The Adolescent Resilience Model guided the selection of a large , comprehensive battery of outcome measures . Major data collection s occurred before admission , after intervention , and at 100 days after transplantation . Participants completed a brief set of measures at presession/postsessions 2 , 4 , and 6 . Rates of consent , session completion , and question naire completion supported feasibility . Immediate follow-up measures suggest positive trends in the TMV group for hope , spirituality , confidence/mastery , and self-transcendence . Positive trends at 100 days include MOS , symptoms distress , defensive coping , spirituality , and self-transcendence .  Therapeutic music video participants also demonstrated gains in quality of life . The TMV intervention may buffer the immediate after-effects of the stem-cell transplantation experience , and a larger study is warranted This study looked for a relationship between immunity and one 's spirits while investigating the effect musical therapy produces on Immunoglobulina A ( IgA ) found in saliva and a Patient 's Opinion on the Likert Scale ( OPEL ) . There were 30 children as patients , 15 in a control group and 15 in an experimental group . They were 5 or 16 years of age and checked into the Sant Joan de Deu Hospital in Barcelona due to neoplastic illness . Receiving vaccinations is a part of growing up ; however , as necessary as vaccinations are , many children find them to be frightening and painful . Music has been examined as a potential distraction during pediatric medical procedures , but research findings have been mixed , due , in part , to the fact that children were primarily instructed to merely " listen to the music . " The present study sought to determine if a focus of attention activity involving music would affect levels of distress and perceptions of pain in pediatric injection patients . Sixty-four 4- to 6(1/2 ) -year old children receiving routine immunizations  were r and omly assigned to one of three conditions : musical story , spoken story , or st and ard care/control . Children in the two treatment conditions listened to a recorded story and pointed at corresponding pictures throughout the injection process . Observational data on distress and pain were collected , in addition to the child 's self-rating of pain . Participants in the musical story condition tended to be less distressed and report less pain than participants in the other two conditions , although these differences were not statistically significant . Subsequent analysis indicated that children who received more injections tended to benefit more from the music intervention , in terms of their perceived pain A nonpharmacological method can be an alternative or complement to analgesics . The aim of this study was to evaluate if music medicine influences pain and anxiety in children undergoing lumbar punctures .  A r and omized clinical trial was used in 40 children ( aged 7 - 12 years ) with leukemia , followed by interviews in 20 of these participants . The participants were r and omly assigned to a music group ( n = 20 ) or control group ( n = 20 ) . The primary outcome was pain scores and the secondary was heart rate , blood pressure , respiratory rate , and oxygen saturation measured before , during , and after the procedure . Anxiety scores were measured before and after the procedure . Interviews with open-ended questions were conducted in conjunction with the completed procedures . The results showed lower pain scores and heart and respiratory rates in the music group during and after the lumbar puncture . The anxiety scores were lower in the music group both before and after the procedure . The findings from the interviews confirmed the quantity results through descriptions of a positive experience by the children , including less pain and fear AIM The present study has examined whether interactive music may be considered an effective treatment for the attenuation of anxiety in oncological paediatric patients undergoing painful procedures ( lumbar injection , bone marrow aspiration , osteomedullary biopsy and arterial catheter ) . METHODS Thirty-nine tumour patients aged between 2 and 12 were r and omised into 2 groups : Music ( M ) ( N. 20 ) and Controls ( N. 19 ) and were treated by M : conscious sedation and intervention of interactive music and C : sedation . The following factors were assessed : temperament on the Emotivity , Activity , Sociability scale , anxiety on the Yale preoperative anxiety scale ( mYPAS ) , the induction compliance checklist ( ICC ) , parent anxiety by cataloguing the trait-state anxiety inventory , and the degree of satisfaction of children , parents and staff using the Barrera question naires . Data significance was accepted with values of P<0.05 . RESULTS There was a fall in mYPAS values in M compared to C in the four phases of the process : Phase 1 ( P<0.05 ) ; Phase 2 , 3 and 4 ( P<0.01 ) . For the ICC children with a score of < or=1 , ' ' collaborated ' ' , those with a score of > 1 were ' ' non collaborators ' ' ; in the music group the trend was for an increase in the number of collaborating children ( P<0.07 ) . CONCLUSIONS The M group presents a significant effect of attenuation of anticipatory anxiety and a tendency to great induction compliance compared to group C. The parents do not show any significant anxiety attenuation effect . The degree of satisfaction of children , parents and staff point to a positive role and a beneficial effect of interactive music on the occasion of painful procedures The purpose of this study was to assess the effects of music therapy on pain and anxiety in pediatric burn patients during a donor site dressing change . Fourteen subjects were r and omly selected to participate in this study . The experiment was conducted in the Reconstructive Unit of Shriners Burns Hospital-Boston . The experimental group 's intervention consisted of live music and was compared to a control group whose intervention was verbal interaction . Psychological , behavioral , and physiological data were assessed through the Wong Baker FACES Pain Rating Scale , the Fear Thermometer , the Nursing Assessment of Pain Index , heart rate , and respiration rate . Data were analyzed using the ANCOVA , Mann-Whitney U , and regression analysis . The results were mixed and inconclusive . The members of the experimental group reported anecdotal information about the effects of music on pain and anxiety . An exploration of the limitations of the study and suggestions for further study are discussed IMPORTANCE Many medical procedures aim ed at helping children cause them pain and distress , which can have long-lasting negative effects . Music is a form of distraction that may alleviate some of the pain and distress experienced by children while undergoing medical procedures . OBJECTIVE To compare music with st and ard care to manage pain and distress . DESIGN , SETTING , AND PARTICIPANTS R and omized clinical trial conducted in a pediatric emergency department with appropriate sequence generation and adequate allocation concealment from January 1 , 2009 , to March 31 , 2010 . Individuals assessing the primary outcome were blind to treatment allocation . A total of 42 children aged 3 to 11 years undergoing intravenous placement were included . INTERVENTIONS Music ( recordings selected by a music therapist via ambient speakers ) vs st and ard care . MAIN OUTCOMES AND MEASURES The primary outcome was behavioral distress assessed blinded using the Observational Scale of Behavioral Distress-Revised  . The secondary outcomes included child-reported pain , heart rate , parent and health care provider satisfaction , ease of performing the procedure , and parental anxiety . RESULTS With or without controlling for potential confounders , we found no significant difference in the change in behavioral distress from before the procedure to immediately after the procedure . When children who had no distress during the procedure were removed from the analysis , there was a significantly less increase in distress for the music group ( st and ard care group = 2.2 vs music group = 1.1 , P < .05 ) . Pain scores among children in the st and ard care group increased by 2 points , while they remained the same in the music group ( P = .04 ) ; the difference was considered clinical ly important . The pattern of parent satisfaction with the management of children 's pain was different between groups , although not statistically significant ( P = .07 ) . Health care providers reported that it was easier to perform the procedure for children in the music group ( 76 % very easy ) vs the st and ard care group ( 38 % very easy ) ( P = .03 ) . Health care providers were more satisfied with the intravenous placement in the music group ( 86 % very satisfied ) compared with the st and ard care group ( 48 % ) ( P = .02 ) . CONCLUSIONS AND RELEVANCE Music may have a positive impact on pain and distress for children undergoing intravenous placement . Benefits were also observed for the parents and health care providers . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00761033 Distraction has shown to be a helpful pain intervention for children ; however , few investigations have studied the effectiveness of this method with adolescents . The aim of this study was to evaluate the usefulness of an easy and practical musical distraction in reducing  adolescents ' immunization pain . Furthermore , to examine whether musical distraction techniques ( with or without headphones ) used influenced the pain outcome .  Hundred and eighteen 14-year-old adolescents , scheduled for polio immunization , participated . Adolescents were r and omly assigned to one of three research groups ; musical distraction with headphones ( n=38 ) , musical distraction without headphones ( n=41 ) and st and ard care control ( n=39 ) . Results showed adolescents receiving musical distraction were less likely to report pain compared to the control group , controlling for covariates . Comparing musical distraction techniques , eliminating headphone emerged as a significant predictor of no pain . Results suggest that an easy and practical musical distraction intervention , implemented without headphones , can give some pain relief to adolescents during routine vaccination 
    Output:
    
Results : Findings show that there is a growing body of evidence regarding the beneficial effects of  music therapy , music medicine , and other music-based interventions for children and adolescents , although more rigorous research is still needed .
Conclusions : Music therapy can be considered a safe and generally well-accepted intervention in pediatric health care to alleviate symptoms and improve quality of life .