human
***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: OBJECTIVE To measure the effects of parents giving massage therapy to their children with cystic fibrosis to reduce anxiety in parents and their children and to improve the children 's mood and peak air flow readings . METHODS Twenty children ( 5 - 12 years old ) with cystic fibrosis and their parents were r and omly assigned to a massage therapy or a reading control group . Parents in the treatment group were instructed and asked to conduct a 20-minute child massage every night at bedtime for one month . Parents in the reading control group were instructed to read for 20 minutes a night with their child for one month . On days 1 and 30 , parents and children answered questions relating to present anxiety levels and children answered questions relating to mood , and their peak air flow was measured . RESULTS Following the first and last massage session , children and parents reported reduced anxiety . Mood and peak air flow readings also improved for children in the massage therapy group . CONCLUSIONS These findings suggest that parents may reduce anxiety levels by massaging their children with cystic fibrosis and their children may benefit from receiving massage by having less anxiety and improved mood , which in turn may facilitate breathing INTRODUCTION Despite its increasing use as a complementary therapy to treat pain , acupuncture is rarely considered by pediatricians , in part due to perceptions that it will not be acceptable to pediatric patients . We wished to describe pediatric pain patients ' experience with acupuncture treatment for chronic pain . DESIGN Retrospective case series . METHODS Subjects were pediatric pain patients referred by the Pain Treatment Service at Children 's Hospital in Boston , who went to a pediatric acupuncturist .  A research assistant not involved in the patient 's care conducted the survey by telephone . Data were analyzed qualitatively and descriptively . RESULTS Of 50 eligible patients , 47 families were reached by telephone ; all agreed to be interviewed . Patients had a median age of 16 years at the time of referral , 79 % were female , and 96 % were white . The most common three diagnoses were migraine headache ( n = 7 ) , endometriosis ( n = 6 ) , and reflex sympathetic dystrophy ( n = 5 ) . Patients had a median of 8 treatments ( range : 0 - 60 ) within 3 months ( range : 0 - 48 months ) ; 85 % of families paid out-of-pocket . Acupuncture therapies included needle insertion ( 98 % ) , heat/moxa ( 85 % ) , magnets ( 26 % ) , and cupping ( 26 % ) . Most patients and parents rated the therapy as pleasant ( 67 % children/60 % parents ) , and most ( 70 % children/59 % parents ) felt the treatment had helped their symptoms ; only 1 said that treatment made symptoms worse . CONCLUSION Pediatric patients with chronic , severe pain found  acupuncture treatment pleasant and helpful . Additional , prospect i ve studies are needed to quantify the costs and effectiveness of acupuncture treatment for pediatric pain UNLABELLED It has been postulated that sensory stimulation ( acupuncture ) affects the cardiovascular system via the autonomic nervous system . Previously , skin temperature , thermography , plethysmography and blood pressure changes have been used in evaluation of sympathetic nerve activity following acupuncture . By using power spectral analysis , the low frequency and high frequency components of heart rate variability can be calculated reflecting the sympathetic and parasympathetic activity . The purpose of this study was to investigate to what extent acupuncture applied into the thenar muscle and into the cavum concha of the ear induced changes in the sympathetic and /or parasympathetic nervous system in healthy subjects . MATERIAL S AND METHODS Twelve healthy volunteers , six men and six women , mean age 34.4 ( range 23 - 48 ) participated in three balanced , r and omly distributed sessions . At an individual initial visit the 12 volunteers were introduced to the needle sensation by having a needle inserted into the point LI 11 . The needle sensation was evoked and the subject was trained to identify the characteristic needle sensation . The introduction was followed by three test sessions . SESSION A A short acupuncture needle , ( Seirin no 3 , ∅0.20x15 mm ) was inserted perpendicular into the earpoint , Lu 1 , in the left inferior hemi-conchae . SESSION B An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular into the Hegu point ( LI 4 ) in the middle of the right dorsal thenar muscle . SESSION C An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular superficially into the skin overlying the Hegu point on the left h and . Results . Stimulation of the ear induced a significant increase in the parasympathetic activity during the stimulation period of 25 min ( P<0.05 ) and during the post-stimulation period of 60 min ( P<0.05 ) . No significant changes were observed in either the sympathetic activity , blood pressure or heart rate . Stimulation of the thenar muscle result ed in a significant increase in the sympathetic and the parasympathetic activity during the stimulation period ( P<0.01 ) and during the post-stimulation period ( P<0.01 and P<0.001 , respectively ) . A significant decrease in the heart rate frequency ( P<0.05 ) at the end of the post-stimulation period was also demonstrated . The superficial needle insertion into the skin overlaying the right thenar muscle caused a pronounced balanced increase in both the sympathetic and parasympathetic activity during the post stimulation period of 60 min ( P<0.01 ) while no changes were observed during the stimulation period . CONCLUSION It is indicated that sensory stimulation ( acupunctura ) in healthy persons is associated with changed activity in the sympathetic and parasympathetic nervous system depending on site of stimulation and period of observation Goals In this multicenter crossover study , our aim was to evaluate the efficacy and acceptance of acupuncture as a supportive antiemetic approach during highly emetogenic chemotherapy in pediatric oncology . Patients and methods Eleven children receiving several courses of highly emetogenic chemotherapy for treatment of solid tumors were included . R and omization allocated patients to start chemotherapy either with antiemetic medication plus acupuncture or antiemetic medication alone . During all study courses , patients continued to receive their programmed and additional antiemetic medication as needed . Acupuncture was given at day 1 of chemotherapy and at subsequent days on patient ’s dem and . The amount of baseline and additional antiemetic medication during chemotherapy was documented . Patients maintained a daily diary of vomiting episodes and completed an evaluated nausea score at the end of every course . Their body weight was taken before and after a chemotherapy course . Main results Twenty-two courses with or without acupuncture were compared . The benefits of acupuncture in adolescents with respect to the reduction of additional antiemetic medication were observed . Acupuncture enabled patients to experience higher levels of alertness during chemotherapy and reduced nausea and vomiting . Except for needle pain , no side effects were noted . Patient ’s acceptance of acupuncture was high . Conclusion Our data indicate that acupuncture might reduce antiemetic medication and episodes of vomiting in pediatric oncology Objective : To assess the potential clinical use , particularly in modulating stress , of changes in the cardiovascular and respiratory systems induced by music , specifically tempo , rhythm , melodic structure , pause , individual preference , habituation , order effect of presentation , and previous musical training . Design : Measurement of cardiovascular and respiratory variables while patients listened to music . Setting : University research laboratory for the study of cardiorespiratory autonomic function . Patients : 12 practising musicians and 12 age matched controls . Interventions : After a five minute baseline , presentation in r and om order of six different music styles ( first for a two minute , then for a four minute track ) , with a r and omly inserted two minute pause , in either sequence . Main outcome measures : Breathing rate , ventilation , carbon dioxide , RR interval , blood pressure , mid-cerebral artery flow velocity , and baroreflex . Results : Ventilation , blood pressure , and heart rate increased and mid-cerebral artery flow velocity and baroreflex decreased with faster tempi and simpler rhythmic structures compared with baseline . No habituation effect was seen . The pause reduced heart rate , blood pressure , and minute ventilation , even below baseline . An order effect independent of style was evident for mid-cerebral artery flow velocity , indicating a progressive reduction with exposure to music , independent of style . Musicians had greater respiratory sensitivity to the music tempo than did non-musicians . Conclusions : Music induces an arousal effect , predominantly related to the tempo . Slow or meditative music can induce a relaxing effect ; relaxation is particularly evident during a pause . Music , especially in trained subjects , may first concentrate attention during faster rhythms , then induce relaxation during pauses or slower rhythms A prospect i ve controlled trial was conducted to compare the efficacy of an analgesic cream ( eutectic mixture of local anesthetics , or EMLA ) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients ( age 6 - 16 years ) . The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability . Patients were r and omized to 1 of 3 groups : local anesthetic , local anesthetic plus hypnosis , and local anesthetic plus attention . Results confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure . The level of hypnotizability was significantly associated with the magnitude of treatment benefit , and this benefit was maintained when patients used hypnosis independently BACKGROUND Art therapy has been used to help children cope with chronic illness but has not been specifically tested with children who have asthma . OBJECTIVE To test an art therapy intervention in a r and omized controlled trial in children with asthma . METHODS Twenty-two children with asthma were r and omized to an active art therapy or wait-list control group . Those in the active art therapy group participated in 60-minute art therapy sessions once a week for 7 weeks . Sessions included specific art therapy tasks design ed to encourage expression , discussion , and problem-solving in response to the emotional burden of chronic illness . Measures taken at baseline , immediately after , and 6 months after the final art therapy session included the Formal Elements Art Therapy Scale applied to the Person Picking an Apple from a Tree assessment , the parent and child versions of the Pediatric Quality of Life Asthma Module , and the Beck Youth Inventories . Those children assigned to the wait-list control group completed all evaluations at the same intervals as the children receiving art therapy but did not receive the art therapy interventions . RESULTS Score changes from baseline to completion of art therapy indicated ( 1 ) improved problem-solving and affect drawing scores ; ( 2 ) improved worry , communication , and total quality of life scores ; and ( 3 ) improved Beck anxiety and self concept scores in the active group relative to the control group . At 6 months , the active group maintained some positive changes relative to the control group including ( 1 ) drawing affect scores , ( 2 ) the worry and quality of life scores , and ( 3 ) the Beck anxiety score . Frequency of asthma exacerbations before and after the 6-month study interval did not differ between the 2 groups . CONCLUSION This was the first r and omized trial demonstrating that children with asthma receive benefit from art therapy that includes decreased anxiety and increased quality of life Objective : The experience of venipuncture is seen by children as one of the most fearful experiences during hospitalization . Children experience anxiety both before and during the procedure . Therefore , any intervention aim ing to prevent or reduce distress should focus on the entire experience of the procedure , including waiting , actual preparation , and conclusion . This study was design ed to determine whether the presence of musicians , who had attended specific training to work in medical setting s , could reduce distress and pain in children undergoing blood tests . Methods : Our sample population was composed of 108 unpremedicated children ( 4–13 years of age ) undergoing blood tests . They were r and omly assigned to a music group ( n = 54 ) , in which the child underwent the procedure while interacting with the musicians in the presence of a parent or to a control group ( n = 54 ) , in which only the parent provided support to the child during the procedure . The distress experienced by the child before , during and after the blood test was assessed with the Amended Form of the Observation Scale of Behavioral Distress , and pain experience with FACES scale ( Wong Baker Scale ) only after the venipuncture . Results : Our results show that distress and pain intensity was significantly lower ( p < .001 ; p < .05 ) in the music group compared with the control group before , during , and after blood sampling . Conclusions : This controlled study demonstrates that songs and music , performed by “ professional ” musicians , have a beneficial effect in reducing distress before , during , and after blood tests . This study shows , moreover , that the presence of musicians has a minor , but yet significant , effect on pain due to needle insertion This study investigated a behavioral intervention incorporating parent coaching , attentional distraction , and positive reinforcement to control child distress during invasive cancer treatment . Children ( N = 23 ) requiring physical restraint to complete venipuncture were alternately assigned to either a behavioral intervention or an attention control condition .  Child distress behaviors were recorded , and self-reports of parent , child , and nurse distress were obtained . Parent and nurse also rated child distress . Results of planned comparisons indicate that observed child distress , parent-rated child distress , and parent ratings of his/her own distress were significantly reduced by behavioral intervention and were maintained across the course of three intervention trials . The use of physical restraint to 
    Output:
    
agent
***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: OBJECTIVE To measure the effects of parents giving massage therapy to their children with cystic fibrosis to reduce anxiety in parents and their children and to improve the children 's mood and peak air flow readings . METHODS Twenty children ( 5 - 12 years old ) with cystic fibrosis and their parents were r and omly assigned to a massage therapy or a reading control group . Parents in the treatment group were instructed and asked to conduct a 20-minute child massage every night at bedtime for one month . Parents in the reading control group were instructed to read for 20 minutes a night with their child for one month . On days 1 and 30 , parents and children answered questions relating to present anxiety levels and children answered questions relating to mood , and their peak air flow was measured . RESULTS Following the first and last massage session , children and parents reported reduced anxiety . Mood and peak air flow readings also improved for children in the massage therapy group . CONCLUSIONS These findings suggest that parents may reduce anxiety levels by massaging their children with cystic fibrosis and their children may benefit from receiving massage by having less anxiety and improved mood , which in turn may facilitate breathing INTRODUCTION Despite its increasing use as a complementary therapy to treat pain , acupuncture is rarely considered by pediatricians , in part due to perceptions that it will not be acceptable to pediatric patients . We wished to describe pediatric pain patients ' experience with acupuncture treatment for chronic pain . DESIGN Retrospective case series . METHODS Subjects were pediatric pain patients referred by the Pain Treatment Service at Children 's Hospital in Boston , who went to a pediatric acupuncturist .  A research assistant not involved in the patient 's care conducted the survey by telephone . Data were analyzed qualitatively and descriptively . RESULTS Of 50 eligible patients , 47 families were reached by telephone ; all agreed to be interviewed . Patients had a median age of 16 years at the time of referral , 79 % were female , and 96 % were white . The most common three diagnoses were migraine headache ( n = 7 ) , endometriosis ( n = 6 ) , and reflex sympathetic dystrophy ( n = 5 ) . Patients had a median of 8 treatments ( range : 0 - 60 ) within 3 months ( range : 0 - 48 months ) ; 85 % of families paid out-of-pocket . Acupuncture therapies included needle insertion ( 98 % ) , heat/moxa ( 85 % ) , magnets ( 26 % ) , and cupping ( 26 % ) . Most patients and parents rated the therapy as pleasant ( 67 % children/60 % parents ) , and most ( 70 % children/59 % parents ) felt the treatment had helped their symptoms ; only 1 said that treatment made symptoms worse . CONCLUSION Pediatric patients with chronic , severe pain found  acupuncture treatment pleasant and helpful . Additional , prospect i ve studies are needed to quantify the costs and effectiveness of acupuncture treatment for pediatric pain UNLABELLED It has been postulated that sensory stimulation ( acupuncture ) affects the cardiovascular system via the autonomic nervous system . Previously , skin temperature , thermography , plethysmography and blood pressure changes have been used in evaluation of sympathetic nerve activity following acupuncture . By using power spectral analysis , the low frequency and high frequency components of heart rate variability can be calculated reflecting the sympathetic and parasympathetic activity . The purpose of this study was to investigate to what extent acupuncture applied into the thenar muscle and into the cavum concha of the ear induced changes in the sympathetic and /or parasympathetic nervous system in healthy subjects . MATERIAL S AND METHODS Twelve healthy volunteers , six men and six women , mean age 34.4 ( range 23 - 48 ) participated in three balanced , r and omly distributed sessions . At an individual initial visit the 12 volunteers were introduced to the needle sensation by having a needle inserted into the point LI 11 . The needle sensation was evoked and the subject was trained to identify the characteristic needle sensation . The introduction was followed by three test sessions . SESSION A A short acupuncture needle , ( Seirin no 3 , ∅0.20x15 mm ) was inserted perpendicular into the earpoint , Lu 1 , in the left inferior hemi-conchae . SESSION B An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular into the Hegu point ( LI 4 ) in the middle of the right dorsal thenar muscle . SESSION C An acupuncture needle ( Hwato , ∅0.30x30 mm ) was inserted perpendicular superficially into the skin overlying the Hegu point on the left h and . Results . Stimulation of the ear induced a significant increase in the parasympathetic activity during the stimulation period of 25 min ( P<0.05 ) and during the post-stimulation period of 60 min ( P<0.05 ) . No significant changes were observed in either the sympathetic activity , blood pressure or heart rate . Stimulation of the thenar muscle result ed in a significant increase in the sympathetic and the parasympathetic activity during the stimulation period ( P<0.01 ) and during the post-stimulation period ( P<0.01 and P<0.001 , respectively ) . A significant decrease in the heart rate frequency ( P<0.05 ) at the end of the post-stimulation period was also demonstrated . The superficial needle insertion into the skin overlaying the right thenar muscle caused a pronounced balanced increase in both the sympathetic and parasympathetic activity during the post stimulation period of 60 min ( P<0.01 ) while no changes were observed during the stimulation period . CONCLUSION It is indicated that sensory stimulation ( acupunctura ) in healthy persons is associated with changed activity in the sympathetic and parasympathetic nervous system depending on site of stimulation and period of observation Goals In this multicenter crossover study , our aim was to evaluate the efficacy and acceptance of acupuncture as a supportive antiemetic approach during highly emetogenic chemotherapy in pediatric oncology . Patients and methods Eleven children receiving several courses of highly emetogenic chemotherapy for treatment of solid tumors were included . R and omization allocated patients to start chemotherapy either with antiemetic medication plus acupuncture or antiemetic medication alone . During all study courses , patients continued to receive their programmed and additional antiemetic medication as needed . Acupuncture was given at day 1 of chemotherapy and at subsequent days on patient ’s dem and . The amount of baseline and additional antiemetic medication during chemotherapy was documented . Patients maintained a daily diary of vomiting episodes and completed an evaluated nausea score at the end of every course . Their body weight was taken before and after a chemotherapy course . Main results Twenty-two courses with or without acupuncture were compared . The benefits of acupuncture in adolescents with respect to the reduction of additional antiemetic medication were observed . Acupuncture enabled patients to experience higher levels of alertness during chemotherapy and reduced nausea and vomiting . Except for needle pain , no side effects were noted . Patient ’s acceptance of acupuncture was high . Conclusion Our data indicate that acupuncture might reduce antiemetic medication and episodes of vomiting in pediatric oncology Objective : To assess the potential clinical use , particularly in modulating stress , of changes in the cardiovascular and respiratory systems induced by music , specifically tempo , rhythm , melodic structure , pause , individual preference , habituation , order effect of presentation , and previous musical training . Design : Measurement of cardiovascular and respiratory variables while patients listened to music . Setting : University research laboratory for the study of cardiorespiratory autonomic function . Patients : 12 practising musicians and 12 age matched controls . Interventions : After a five minute baseline , presentation in r and om order of six different music styles ( first for a two minute , then for a four minute track ) , with a r and omly inserted two minute pause , in either sequence . Main outcome measures : Breathing rate , ventilation , carbon dioxide , RR interval , blood pressure , mid-cerebral artery flow velocity , and baroreflex . Results : Ventilation , blood pressure , and heart rate increased and mid-cerebral artery flow velocity and baroreflex decreased with faster tempi and simpler rhythmic structures compared with baseline . No habituation effect was seen . The pause reduced heart rate , blood pressure , and minute ventilation , even below baseline . An order effect independent of style was evident for mid-cerebral artery flow velocity , indicating a progressive reduction with exposure to music , independent of style . Musicians had greater respiratory sensitivity to the music tempo than did non-musicians . Conclusions : Music induces an arousal effect , predominantly related to the tempo . Slow or meditative music can induce a relaxing effect ; relaxation is particularly evident during a pause . Music , especially in trained subjects , may first concentrate attention during faster rhythms , then induce relaxation during pauses or slower rhythms A prospect i ve controlled trial was conducted to compare the efficacy of an analgesic cream ( eutectic mixture of local anesthetics , or EMLA ) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients ( age 6 - 16 years ) . The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability . Patients were r and omized to 1 of 3 groups : local anesthetic , local anesthetic plus hypnosis , and local anesthetic plus attention . Results confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure . The level of hypnotizability was significantly associated with the magnitude of treatment benefit , and this benefit was maintained when patients used hypnosis independently BACKGROUND Art therapy has been used to help children cope with chronic illness but has not been specifically tested with children who have asthma . OBJECTIVE To test an art therapy intervention in a r and omized controlled trial in children with asthma . METHODS Twenty-two children with asthma were r and omized to an active art therapy or wait-list control group . Those in the active art therapy group participated in 60-minute art therapy sessions once a week for 7 weeks . Sessions included specific art therapy tasks design ed to encourage expression , discussion , and problem-solving in response to the emotional burden of chronic illness . Measures taken at baseline , immediately after , and 6 months after the final art therapy session included the Formal Elements Art Therapy Scale applied to the Person Picking an Apple from a Tree assessment , the parent and child versions of the Pediatric Quality of Life Asthma Module , and the Beck Youth Inventories . Those children assigned to the wait-list control group completed all evaluations at the same intervals as the children receiving art therapy but did not receive the art therapy interventions . RESULTS Score changes from baseline to completion of art therapy indicated ( 1 ) improved problem-solving and affect drawing scores ; ( 2 ) improved worry , communication , and total quality of life scores ; and ( 3 ) improved Beck anxiety and self concept scores in the active group relative to the control group . At 6 months , the active group maintained some positive changes relative to the control group including ( 1 ) drawing affect scores , ( 2 ) the worry and quality of life scores , and ( 3 ) the Beck anxiety score . Frequency of asthma exacerbations before and after the 6-month study interval did not differ between the 2 groups . CONCLUSION This was the first r and omized trial demonstrating that children with asthma receive benefit from art therapy that includes decreased anxiety and increased quality of life Objective : The experience of venipuncture is seen by children as one of the most fearful experiences during hospitalization . Children experience anxiety both before and during the procedure . Therefore , any intervention aim ing to prevent or reduce distress should focus on the entire experience of the procedure , including waiting , actual preparation , and conclusion . This study was design ed to determine whether the presence of musicians , who had attended specific training to work in medical setting s , could reduce distress and pain in children undergoing blood tests . Methods : Our sample population was composed of 108 unpremedicated children ( 4–13 years of age ) undergoing blood tests . They were r and omly assigned to a music group ( n = 54 ) , in which the child underwent the procedure while interacting with the musicians in the presence of a parent or to a control group ( n = 54 ) , in which only the parent provided support to the child during the procedure . The distress experienced by the child before , during and after the blood test was assessed with the Amended Form of the Observation Scale of Behavioral Distress , and pain experience with FACES scale ( Wong Baker Scale ) only after the venipuncture . Results : Our results show that distress and pain intensity was significantly lower ( p < .001 ; p < .05 ) in the music group compared with the control group before , during , and after blood sampling . Conclusions : This controlled study demonstrates that songs and music , performed by “ professional ” musicians , have a beneficial effect in reducing distress before , during , and after blood tests . This study shows , moreover , that the presence of musicians has a minor , but yet significant , effect on pain due to needle insertion This study investigated a behavioral intervention incorporating parent coaching , attentional distraction , and positive reinforcement to control child distress during invasive cancer treatment . Children ( N = 23 ) requiring physical restraint to complete venipuncture were alternately assigned to either a behavioral intervention or an attention control condition .  Child distress behaviors were recorded , and self-reports of parent , child , and nurse distress were obtained . Parent and nurse also rated child distress . Results of planned comparisons indicate that observed child distress , parent-rated child distress , and parent ratings of his/her own distress were significantly reduced by behavioral intervention and were maintained across the course of three intervention trials . The use of physical restraint to 
    Output:
    