***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 Adjuvant chemotherapy is associated with poor quality of life ( qol ) in breast cancer patients . We tested the effect of listening to music during chemotherapy on quality of life in these patients . MATERIAL / METHODS We tested in a prospect i ve cohort the changes in qol scores as assessed by European Organization for Research and Treatment of Cancer Quality of Life Question naire ( EORTC QLQ-C30 ) , and the influence of listening to non-preferred music at the chemotherapy unit on these parameters in a mixed linear model by repeated measures analysis of variance ( RMANOVA ) . RESULTS For the whole cohort , musical intervention was not associated with a change in any dimension of quality of life . However ; the music effect significantly interacted with patient age ; patients > 45 years old had improved insomnia and appetite loss scores after musical intervention ( F = 6.76 , P = 0.019 and F = 11.22 , P = 0.004 , respectively ) . CONCLUSIONS Our results show that brief , non-preferred music exposure at the time of chemotherapy administration does not improve quality of life in patients with early breast cancer . Nonetheless , there is still a possibility that a subgroup will benefit from this approach as suggested by the interaction of the music effect with patient age The treatment of pain continues to gain in saliency as a component of defining best practice in medical care . Music therapy is an integrative treatment modality that impacts patient outcomes in the treatment of spinal pain . At Mount Sinai Beth Israel , we conducted a mixed- methods study addressing the effects of music therapy interventions on the recovery of patients after spine surgery . The study combined st and ard medical approaches and integrative music therapy .  Sixty patients ( 35 female , 25 male ) ranging in age from 40 to 55 years underwent anterior , posterior , or anterior-posterior spinal fusion and were r and omly assigned to either music therapy plus st and ard care ( medical and nursing care with scheduled pharmacologic pain intervention ) or st and ard care only . Measurements for both groups were completed before and after the intervention . Music therapy involved the use of patient-preferred live music that supported tension release/relaxation through incentive-based clinical improvisation , singing , and /or rhythmic drumming or through active visualization supported by live music that encompasses tension resolution . The control and music groups showed significant differences in degree and direction of change in the visual analog scale ( VAS ) pain ratings from before to after intervention ( P = .01 ) . VAS pain levels increased slightly in the control group ( to 5.87 from 5.20 ) but decreased by more than 1 point in the music group ( to 5.09 from 6.20 ) . The control and music therapy groups did not differ in the rate of change in scores on Hospital Anxiety and Depression Scale ( HADS ) Anxiety ( P = .62 ) , HADS Depression ( P = .85 ) , or Tampa Scale for Kinesiophobia ( P = .93 ) . Both groups had slight increases in HADS Anxiety , comparable decreases in HADS Depression , and minimal changes in fear-related movement ( Tampa scale ) Goals of workPrevention of chemotherapy-induced nausea and vomiting ( CINV ) with st and ard antiemetics has been more difficult to achieve in female patients . Data from two phase III trials of the NK1 antagonist aprepitant were assessed for potential effect of gender on treatment response . Patients and methods 1,044 patients receiving cisplatin ( ≥70 mg/m2 ) were r and omly assigned to control regimen [ ondansetron ( O ) 32 mg i.v . and dexamethasone ( D ) 20 mg p.o . on day 1 ; D 8 mg twice daily on days 2–4 ] or aprepitant ( A ) regimen ( A 125 mg p.o . plus O 32 mg and D 12 mg on day 1 ; A 80 mg and D 8 mg once daily on days 2–3 ; and D 8 mg on day 4 ) . The primary endpoint was overall complete response ( no emesis and no rescue therapy over days 1–5 ) . Data were analyzed by a modified intent-to-treat approach . Between-treatment comparisons for each gender were made using logistic regression . Main results Women comprised 42 and 43 % of the aprepitant and control groups , respectively . In the control group , 41 % of women had overall complete response compared with 53 % of men . In the aprepitant group , 66 % of women had overall complete response compared with 69 % of men . Conclusion The addition of aprepitant may negate the adverse prognostic effect of female gender on the prevention of CINV in patients receiving highly emetogenic chemotherapy PURPOSE To examine the effect of  patient-selected music intervention during daily weaning trials for patients on prolonged mechanical ventilation . METHODS Using a crossover repeated measures design , patients were r and omized to  music vs no music on the first intervention day . Provision of music was alternated for 6 days , result ing in 3 music and 3 no music days . During weaning trials on music days , data were obtained for 30min prior to music listening and continued for 60min while patients listened to selected music ( total 90min ) . On no music days , data were collected for 90min . Outcome measures were heart rate ( HR ) , respiratory rate ( RR ) , oxygen saturation ( SpO2 ) , blood pressure ( BP ) , dyspnea and anxiety assessed with a visual analog scale ( VAS-D , VAS-A ) and weaning duration ( meanh per day on music and non-music days ) . RESULTS Of 31 patients r and omized , 23 completed the 6-day intervention . When comparisons were made between the 3 music and 3 no music days , there were significant decreases in RR and VAS-D and a significant increase in daily weaning duration on music days ( p<0.05 ) . A multivariate mixed-effects model analysis that included patients who completed ≥2 days of the intervention ( n=28 ) demonstrated significant decreases in HR , RR , VAS-A , and VAS-D and a significant increase in daily weaning duration on music days ( p<0.05 ) . CONCLUSIONS Providing patient selected music during daily weaning trials is a simple , low-cost , potentially beneficial intervention for patients on prolonged mechanical ventilation . Further study is indicated to test ability of this intervention to promote weaning success and benefits earlier in the weaning process PURPOSE / OBJECTIVES To test whether use of music as a diversional intervention during high-dose chemotherapy administration would affect perception of nausea and episodes of vomiting . SAMPLE 39 patients undergoing bone marrow transplant . A total of 33 patients were included in the data analysis , with 17 in the control group and 16 in the music intervention group . METHODS Patients were assigned r and omly to a control group ( usual antiemetic protocol ) or the experimental group ( usual antiemetic group plus music intervention during the 48 hours of high-dose cyclophosphamide administered as part of the preparative regimen ) . MAIN RESEARCH VARIABLES Use of a music intervention , perception of nausea , and instances of vomiting . FINDINGS Significant differences were found between group scores on a visual analog scale for nausea and number of episodes of vomiting , demonstrating that the experimental group experienced less nausea and fewer instances of vomiting . CONCLUSION This study found that music is an effective adjunct to a pharmacologic antiemetic regimen for lessening nausea and vomiting , and this study merits further investigation through a larger multi-institutional effort . IMPLICATION S FOR NURSING PRACTICE Using music as a diversional adjunct intervention to antiemetic therapy is helpful in decreasing nausea and vomiting . The intervention can be initiated independently by nurses and individualized for each patient , leading to greater patient comfort and compliance with high-dose chemotherapy Purpose Despite significant advances in antiemetic management , almost 50 % of cancer patients still experience  nausea and vomiting during treatment . The goal of antiemetic therapy is complete prevention of treatment-induced nausea and /or vomiting ( TINV ) ; however , realisation of this goal remains elusive , thus supplementary strategies identifying patients at high risk must be employed in the interim . Consequently , we examined TINV incidence and its risk factors , including patient , clinical and pretreatment quality of life (QOL)/psychological factors . Methods Two hundred newly diagnosed cancer patients beginning combined treatment participated in this prospect i ve , longitudinal , observational study . QOL ( including TINV ) , psychological adjustment , and patient/ clinical characteristics were examined at pretreatment , on-treatment ( 8 weeks ± 1 week ) and post-treatment . Results Overall , 62 % of patients experienced TINV , with TIN incidence ( 60 % ) doubling that of TIV ( 27 % ) . Eight independent risk factors predicted 73 % of TIN incidence : high premorbid/anticipatory NV , moderately/highly emetogenic chemotherapy ( M/HEC ) , longer treatment ( > 3 months ) , female gender , surgery prior to adjuvant chemotherapy ± radiotherapy , private health insurance and low emotional functioning ( pretreatment ) . Six independent risk factors predicted 77 % of TIV incidence : premorbid/anticipatory vomiting , M/HEC , female gender , cancer resection and low role functioning ( pretreatment ) . Conclusions TINV still represents a very major concern for patients . Several pretreatment risk factors for the development of TIN and TIV , respectively , were identified . Patients about to undergo cancer treatment , particularly combined treatment involving emetogenic chemotherapy and surgery , should be screened for these factors with a view to modifying st and ard pretreatment/maintenance antiemetic therapy . Furthermore , and consistent with recent research , it is recommended that more comprehensive interventions combining antiemetics with other effective pharmacological ( e.g. anxiolytics ) and non-pharmacological approaches ( e.g. acupuncture , relaxation techniques ) be considered by clinicians in attempts to improve control of TIN and TIV ( and overall QOL ) for their patients . In this way , optimal holistic care will be ensured for cancer patients by clinicians providing conventional oncology treatment PURPOSE Pharmacological therapy is only partially effective in preventing or treating chemotherapy induced nausea and vomiting ( CINV ) . Therefore , exploring the complementary role of non-pharmacological approaches used in addition to pharmacological agents is important . Nevasic uses specially constructed audio signals hypothesized to generate an antiemetic reaction . The aim of this study was to examine the feasibility of conducting a r and omized controlled trial ( RCT ) to evaluate the effectiveness of Nevasic  to control CINV . METHODS A mixed methods design incorporating an RCT and focus group interviews . For the RCT , female breast cancer patients were r and omized to receive either Nevasic plus usual care , music plus usual care , or usual care only . Data were analysed using descriptive statistics and linear mixed-effects models . Five focus group interviews were conducted to obtain participants ' views regarding the acceptability of the interventions in the trial . RESULTS 99 participants were recruited to the RCT and 15 participated in focus group interviews . Recruitment targets were achieved . Issues of Nevasic acceptability were highlighted as weaknesses of the program . This study did not detect any evidence for the effectiveness of Nevasic ;  however , the results showed statistically significant less use of anti-emetics ( p = 0.003 ) and borderline non-significant improvement in quality of life ( p = 0.06 ) . CONCLUSIONS Conducting a non-pharmacological intervention using such an audio program is feasible , although difficulties and limitations exist with its use . Further studies are required to investigate the effectiveness of Nevasic from perspectives such as anti-emetic use , as well as its overall effect on the levels of nausea and vomiting Goals of workA number of prognostic factors have been identified as risk factors for chemotherapy-induced emesis . This post-hoc analysis addressed whether : ( 1 ) these prognostic factors can identify a low-risk group for whom ondansetron plus dexamethasone alone provide a high level of protection ( ≥80 % no emesis ) ; ( 2 ) the NK1 receptor antagonist aprepitant improves antiemetic outcome regardless of emetic risk . Patients and methods Breast cancer patients in a phase III double-blind , placebo-controlled trial were r and omized to antiemetic regimens including ondansetron and dexamethasone , or aprepitant , ondansetron , and dexamethasone . Multivariate logistic regression models were used to assess the impact on emesis ( but not nausea ) of the regimen with aprepitant , and previously reported risk factors , including age ( < 55 and ≥55 years ) , ethanol use ( 0–4 or ≥5 drinks/week ) , history of pregnancy-related morning sickness , and history of motion sickness , using a modified intent-to-treat approach . Results Treatment with aprepitant ( P < 0.0001 ) , older age ( P = 0.006 ) , ethanol use ( P = 0.0048 ) , and no history of morning sickness ( P = 0.0007 ) were all significantly associated with reduced likelihood of emesis . The proportion of patients with one , two , or three risk factors who remained emesis free was significantly higher with the aprepitant-containing regimen than with the active control ( 70.2–82.8 % vs. 38.6–66.4 % , respectively ) . Conclusions Aprepitant markedly improved control of emesis in patients with one or more risk factors . This analysis did not support using risk factors for modifying the antiemetic approach . A low-risk group with zero risk factors for whom aprepitant provided little benefit was 
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Locus of control for music selection was more often with the investigator rather than the participant .
IMPLICATION S FOR RESEARCH The existing data have been largely generated by nurse scientists , and implication s for nursing practice are many , because music interventions are low-cost , easily accessible , and without known adverse effects .