"uma casa e uma sanfona para sonhar": grupo multifamiliar musicoterapêutico na comunidade / "una casa y un acordeón para soñar": grupo de musicoterapia multifamiliar en la comunidad / "a house and an accordion to dream": multifamily music therapy group in a community

RESUMO. Esta pesquisa tem por objetivo investigar o uso do Grupo Multifamiliar Musicoterapêutico (GMM) junto a famílias socialmente vulneráveis. Trata-se de uma pesquisa-intervenção realizada em uma região administrativa do Distrito Federal. Participaram do estudo 30 famílias inscritas no Cadastro Único do governo federal e atendidas no Centro de Referência em Assistência Social. Os instrumentos de coleta de dados foram as visitas domiciliares, as entrevistas semiestruturadas e os registros dos encontros e das supervisões. O GMM foi realizado em seis encontros, com duração de 03 horas cada, com periodicidade quinzenal, intercalados com as supervisões da equipe, formada por 15 profissionais das áreas de psicologia, pedagogia, assistência social e musicoterapia. Após a análise foram identificados dois temas: 1) música, afetos e reminiscências; 2) música e sonhos. Percebeu-se que as experiências musicais auxiliaram as famílias na conscientização das formas violentas de comunicação e na transformação por meio de expressões afetuosas mediadas pela música e seu potencial de evocar memórias e sonhos. A capacidade imaginativa das famílias foi uma estratégia de enfrentamento às adversidades e se constituiu como ponte entre o real e o imaginário, nutrindo a esperança de uma vida melhor. Destaca-se o valor da música que, com rapidez e emocionalidade, acessa e comunica com o tal público, por favorecer intervenções musicoterapêuticas comunitárias.

RESUMEN. Este trabajo tiene como objetivo investigar el uso del Grupo Musicoterapéutico Multifamiliar (GMM) con familias socialmente vulnerables. Se trata de una intervención-investigación realizada en una Región Administrativa del Distrito Federal. Participaron del estudio 30 familias que se encuentran inscritas en el Registro Único del Gobierno Federal y que son atendidas en el Centro de Referencia de Asistencia Social. Los instrumentos de recolección de datos fueron: visitas domiciliarias, entrevistas semiestructuradas y registros de reuniones y supervisiones. El GMM fue realizado en seis encuentros, con una duración de tres horas cada uno. Los encuentros se realizaron cada dos semanas, intercalados con la supervisión del equipo, formado por 15 profesionales en las áreas de psicología, pedagogía, asistencia social y musicoterapia. Después del análisis temático, se identificaron dos temas: 1) música, afectos y reminiscencias; 2) y música y sueños. Se observó que las experiencias musicales ayudaron a las familias en la concientización de las formas violentas de comunicación y en la transformación por medio de expresiones afectuosas mediadas por la música y su potencial para evocar recuerdos y sueños. La capacidad imaginativa de las familias fue una estrategia para enfrentar las adversidades y se constituye como un puente entre lo real y lo imaginario, alimentando la esperanza de una vida mejor. Se destaca el valor de la música que, con rapidez y emotividad, accede en y se comunica con esa población, favoreciendo las intervenciones de musicoterapia comunitaria.

ABSTRACT: This research aims to investigate the use of Multi-family Music Therapy Group (MMG) with socially vulnerable families. This is an intervention research carried out in an Administrative Region in the Federal District of Brazil. The study included 30 families enrolled in the Federal Government's Single Registry and assisted at the Social Assistance Reference Center. The data collection instruments were: home visits, semi-structured interviews, and records of meetings and supervisions. The MMG was carried out in six meetings, lasting three hours each, every two weeks, interspersed with the supervision of the team, which was formed by 15 professionals from the fields of psychology, pedagogy, social assistance, and music therapy. After the thematic analysis, two themes were identified: 1) music, affections, and reminiscences; and 2) music and dreams. It was noticed that the musical experiences helped the families in the awareness of violent forms of communication and in the transformation through expressions of affection mediated by music and its potential to evoke memories and dreams. The families imaginative capacity was a strategy to face adversities and constitutes a bridge between the real and the imaginary, nurturing the hope of a better life. The value of music is highlighted, which quickly and emotionally accesses and communicates with that audience, favoring community music therapy interventions.

Music Intervention to Orthopedic Patients: A Possible Alternative Solution to Control Pain.

Aims and Objective. Pain is a common problem associated with postoperative orthopedic patients; the current study is aimed at evaluating music intervention as an alternative method to control pain. Methodology. The experimental design of the current study was comparative, descriptive, and quasi-experimental. 38 postoperative orthopedic patients were equipped with pocket-size MP3 players with prerecorded music tracks (instrumental and lyrical) in Hindi, English, and Urdu. After that, pre-post-pain scores were recorded with the help of designed brief patient logs. Ultimately, a satisfactory survey was completed at discharge. Major Findings. It was found that during the intervention of music, the pain was significantly reduced from 5.40 to 2.98. There was a slight relationship between listening time and pain relief. It was also found that the feedback was extremely positive and each patient suggested the use of music to others with 96.6% recommendation. Conclusion. From the current study, it was found that music intervention can be beneficial to postoperative patient pain control. Further, it is hoped that the findings of the current experimental work will lead to improvements in the care of postoperative patients.

Development and evaluation of a novel music-based therapeutic device for upper extremity movement training: A pre-clinical, single-arm trial.

Restoration of upper limb motor function and patient functional independence are crucial treatment targets in neurological rehabilitation. Growing evidence indicates that music-based intervention is a promising therapeutic approach for the restoration of upper extremity functional abilities in neurologic conditions such as cerebral palsy, stroke, and Parkinson's Disease. In this context, music technology may be particularly useful to increase the availability and accessibility of music-based therapy and assist therapists in the implementation and assessment of targeted therapeutic goals. In the present study, we conducted a pre-clinical, single-arm trial to evaluate a novel music-based therapeutic device (SONATA) for upper limb extremity movement training. The device consists of a graphical user interface generated by a single-board computer displayed on a 32" touchscreen with built-in speakers controlled wirelessly by a computer tablet. The system includes two operational modes that allow users to play musical melodies on a virtual keyboard or draw figures/shapes whereby every action input results in controllable sensory feedback. Four motor tasks involving hand/finger movement were performed with 21 healthy individuals (13 males, aged 26.4 ± 3.5 years) to evaluate the device's operational modes and main features. The results of the functional tests suggest that the device is a reliable system to present pre-defined sequences of audiovisual stimuli and shapes and to record response and movement data. This preliminary study also suggests that the device is feasible and adequate for use with healthy individuals. These findings open new avenues for future clinical research to further investigate the feasibility and usability of the SONATA as a tool for upper extremity motor function training in neurological rehabilitation. Directions for future clinical research are discussed.

A Music-Based Digital Therapeutic: Proof-of-Concept Automation of a Progressive and Individualized Rhythm-Based Walking Training Program After Stroke.

BACKGROUND: The rhythm of music can entrain neurons in motor cortex by way of direct connections between auditory and motor brain regions. OBJECTIVE: We sought to automate an individualized and progressive music-based, walking rehabilitation program using real-time sensor data in combination with decision algorithms. METHODS: A music-based digital therapeutic was developed to maintain high sound quality while modulating, in real-time, the tempo (ie, beats per minute, or bpm) of music based on a user's ability to entrain to the tempo and progress to faster walking cadences in-sync with the progression of the tempo. Eleven individuals with chronic hemiparesis completed one automated 30-minute training visit. Seven returned for 2 additional visits. Safety, feasibility, and rehabilitative potential (ie, changes in walking speed relative to clinically meaningful change scores) were evaluated. RESULTS: A single, fully automated training visit resulted in increased usual (∆ 0.085 ± 0.027 m/s, P = .011) and fast (∆ 0.093 ± 0.032 m/s, P = .016) walking speeds. The 7 participants who completed additional training visits increased their usual walking speed by 0.12 ± 0.03 m/s after only 3 days of training. Changes in walking speed were highly related to changes in walking cadence (R2 > 0.70). No trips or falls were noted during training, all users reported that the device helped them walk faster, and 70% indicated that they would use it most or all of the time at home. CONCLUSIONS: In this proof-of-concept study, we show that a sensor-automated, progressive, and individualized rhythmic locomotor training program can be implemented safely and effectively to train walking speed after stroke. Music-based digital therapeutics have the potential to facilitate salient, community-based rehabilitation.

A protocol of systematic review and meta-analysis of Mozart's Music for drug-resistant epilepsy.

BACKGROUND: This study will aim to assess the effectiveness of Mozart's Music (MM) for the management of patients with drug-resistant epilepsy (DRE). METHODS: In this study, we will search MEDLINE, EMBASE, Cochrane Library, Web of Science, CINAHL, Chinese Scientific Journal Database Information, WANGFANG, and China National Knowledge Infrastructure from their inauguration to March 1, 2020 without language and publication time restrictions. We will also identify other literature resources, such as reference lists of any related reviews. Trial quality will be examined by Cochrane risk of bias tool; reporting bias will be identified by a funnel plot and Egger test; and statistical analysis will be undertaken by RevMan 5.3 software. RESULTS: This study will summarize high quality randomized controlled trials to appraise the effectiveness and safety of MM for the treatment of patients with DRE. CONCLUSIONS: The findings of this study will supply evidence to judge whether MM is effective on DRE at evidence-based medicine level. STUDY REGISTRATION NUMBER: CRD42020170512.

The human health effects of singing bowls: A systematic review.

OBJECTIVE: The objective of this study was to determine the human health effects (beneficial or adverse) of any singing bowl therapies. DESIGN: A systematic review was conducted. SETTING: The setting was not specified, so it could include clinical and non-clinical settings. INTERVENTION: Studies of any intervention predominantly involving singing bowls (e.g. playing singing bowls, listening to singing bowls) were eligible for inclusion. The comparison interventions were not specified, and studies without comparisons (e.g. pre-post studies) were also considered potentially relevant. MAIN OUTCOME MEASURES: Any human health outcome was investigated. RESULTS: The effects of singing bowls on human health were investigated in four peer-reviewed studies, one of which investigated patients with metastatic cancer, and another those with chronic spinal pain. Low-level designs were used in two studies. Improvements in distress, positive and negative affect, anxiety, depression, fatigue, tension, anger, confusion and vigour were reported, as were improvements in blood pressure, heart rate, respiratory rate, peripheral capillary oxygen saturation, cutaneous conductance, and anterior-frontal alpha values. CONCLUSIONS: Given there were few studies and the potential risk of methodological bias, we cannot recommend singing bowl therapies at this stage. As the evidence suggests positive health effects, we recommend that future studies consider the effect of singing bowl therapies using more robust study methods, allowing for evidence-based recommendations to be made to reduce the disease burden.

EMS-effect of Exercises with Music on Fatness and Biomarkers of Obese Elderly Women.

Background and objectives: Electromyostimulation (EMS) has been shown to improve body composition, but what biomarkers it affects has not been investigated. The purpose of this study was to compare the EMS-effect of exercises with music on fatness and biomarker levels in obese elderly. Materials and Methods: Twenty-five women were randomly classified into a control group (CON) and EMS group (EMSG). EMS suits used in this study enabled the simultaneous activation of eight pairs with selectable intensities. Program sessions of EMS were combined with exercises of listening to music three times a week for eight weeks. Although both groups received the same program, CON did not receive electrical stimuli. Results: Compared with CON, a significant effect of the EMS intervention concerning decreased fatness, as well as an increased skeletal muscle mass and basal metabolic rate, were evident. Tumor necrosis factor-a, C-reactive protein, resistin, and carcinoembryonic antigen of biomarkers were significantly different in the groups by time interaction. Similarly, the positive changes caused by EMS were represented in lipoprotein-cholesterols. Conclusions: The results indicate that a significant effect due to the EMS intervention was found concerning body composition and biomarkers in obese elderly women.

Musical educational technology for lactation physiology learning: knowledge translation.

OBJECTIVE: create and validate a musical educational technology for lactation physiology learning for professional training in health. METHOD: methodological study with application of a conceptual framework of Knowledge Translation. In the creation cycle, the knowledge of the physiology of lactation was synthetized in key points to create the lyrics and the melody. In the action cycle, the content of the musical educational technology was validated by judges experts in breast feeding, in the period from September to December 2017. RESULTS: 18 judges from all Brazilian regions participated in the validation. The content of the technology obtained a global Content Validity Index of 0.94 with one round of validation. CONCLUSION: the musical educational technology is validated to introduce the content of the physiology of lactation in the learning process of students, mediated by the teacher.

Didgeridoo Health Promotion Method Improves Mood, Mental Stress, and Stability of Autonomic Nervous System.

A potential method of health promotion using the traditional wooden brass instrument the didgeridoo was examined, especially in terms of mood, stress, and autonomic nerve stabilization. Twenty Japanese healthy subjects undertook 10 lessons of the Didgeridoo Health Promotion Method (DHPM) and a moods questionnaire, blood pressure, salivary amylase (sAmy) as a stress marker, pulse rate and autonomic balance expressed by Ln[low frequency (LF)/High frequency (HF) were examined twice before the entire lessons and once before and after each lesson. The subjects had improved total mood disturbance (TMD: overall mood disorder degree) as measured by the Japanese version of the Profile of Mood States 2nd Edition (POMS2) as a result of taking the lessons. The pulse of the subjects decreased after the lessons, which correlated with a reduction in sAmy. Additionally, it was found that sAmy decreased after the lessons with increasing age of the subject, subjects with higher TMD before the lessons, or subjects with higher sAmy values before the lessons. With autonomic balance measured by Ln[LF/HF], subjects who had parasympathetic dominance as a result of the lesson were significantly more frequent. Additionally, it has been shown that Ln[LF/HF] decreased over 10 weeks, and it is also clear that the effect is sustained. Health promotion is an important concern for societies as a whole. In this study, it became clear that the DHPM affected mood, stress, and autonomic stability. Future studies should focus on monitoring the effects of continuing the lessons for a longer period of time. Additionally, physical effects such as strength of respiratory muscles should be examined. DHPM may be employed in the work place to promote the mental health of workers as well as in regional neighborhood associations/communities.

Sonotherapy in the reduction of anxiety and postoperative pain in patients with regional anesthesia as a sole technique: randomized, controlled clinical trial.

OBJECTIVE: To determine if sonotherapy reduces the anxiety level and postoperative pain in adults undergoing outpatient orthopedic surgery under regional anesthesia. METHOD: A randomized, double-blind, placebo-controlled study in 80 adult patients undergoing orthopedic surgery, 40 received intervention with sonotherapy and 40 did not receive it. Pain, anxiety in the preoperative period, immediate postoperative, high, 24 and 48 hours later were measured. Hemodynamic parameters were measured in four moments. RESULTS: No significant differences were found between the two groups in the pain scales neither anxiety. A significant reduction of the systolic blood pressure was observed after the application of sonotherapy and in recovery. There was no difference in other hemodynamic variables such as heart rate, respiratory rate, arterial oxygen saturation or diastolic blood pressure between groups, however, the observed changes in some of them occurred faster in the intervention group. CONCLUSIONS: In adult patients undergoing outpatient orthopaedic surgery under regional anaesthesia, sound therapy is a novel strategy that significantly reduces systolic blood pressure, considered as an indicator of decreased anxiety. However, in our study, no difference could be demonstrated in terms of pain control or the need for additional sedation or analgesia.

OBJETIVO: Evaluar la eficacia de la sonoterapia en la diminución de la ansiedad y el dolor posoperatorio en adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional. MÉTODO: estudio aleatorizado, doble ciego, controlado con placebo, en 80 pacientes adultos sometidos a cirugía ortopédica; 40 recibieron intervención con sonoterapia y 40 no la recibieron. Se midieron el dolor y la ansiedad en el preoperatorio, en el posoperatorio inmediato, al alta, y 24 y 48 horas después. Se midieron parámetros hemodinámicos en cuatro momentos. RESULTADOS: No se encontraron diferencias significativas entre ambos grupos en las escalas de dolor ni ansiedad. Se observó una reducción significativa de la presión arterial sistólica luego de la aplicación de la intervención y en recuperación. No se observaron diferencias en otras variables hemodinámicas entre los grupos, pero la reducción de algunas ocurre de forma más rápida en el grupo de intervención. CONCLUSIONES: En pacientes adultos llevados a cirugía ambulatoria de ortopedia bajo anestesia regional, la sonoterapia es una estrategia novedosa que reduce la presión arterial sistólica, y esto puede considerarse como un indicador de disminución de la ansiedad. En nuestro estudio no se pudo demostrar diferencia en términos de control del dolor ni de requerimiento de sedación o analgesia adicional.

Standardized music therapy with and without acclimatization, to improve EEG data acquisition in young children with and without disability.

INTRODUCTION: In young children, EEG data acquisition during stimulation tasks is difficult due to anxiety, movement and behaviorally-related interruptions, especially in those with disabilities. NEW METHOD: We used standardized music therapy (MT) protocols with and without acclimatization, during and prior to time-locked EEG with a published tactile testing protocol. Our prospective study leveraged a larger trial in children with/without cerebral palsy aged 7-27 months. Group1 received no preparation, Group2 received 15-minute MT prior to the EEG session, Group3 received the same as Group2 plus a rubber cap for home practice. All groups received MT procedural support during the EEG session. Sessions were stopped/started to acquire a full dataset. Trials were reviewed using a two-step artifact detection strategy by specialists masked to group allocation. RESULTS: 64 patients were included, 20 each in Groups 2 and 3, and 24 in Group1. Average age was 16.08 ± 6.33 months. All (100%) of children had data of sufficient quality and quantity for outcomes measurement without a second testing visit. There were no differences in useable trials by procedural group, disability status, age or stimulus condition. EEG recording time was shorter in Group3 vs. 1 (p = 0.02) and more patients in Group1 required repeat trials compared to Groups2 and 3 (p = 0.04 for both). COMPARISON WITH OLD METHOD: Our new methods resulted in no attrition from data loss, an improvement compared to published similar studies with data loss 30-55%. Acclimatization had minimal effects. CONCLUSION: In children under 3, MT protocols result in high rates of EEG data acquisition, decrease behaviorally-related interruptions and session acquisition time. This method is successful for typically developing children and those with cerebral palsy.

Efficacy and Outcomes of a Music-Based Emotion Regulation Mobile App in Distressed Young People: Randomized Controlled Trial.

BACKGROUND: Emotion dysregulation increases the risk of depression, anxiety, and substance use disorders. Music can help regulate emotions, and mobile phones provide constant access to it. The Music eScape mobile app teaches young people how to identify and manage emotions using music. OBJECTIVE: This study aimed to examine the effects of using Music eScape on emotion regulation, distress, and well-being at 1, 2, 3, and 6 months. Moderators of outcomes and user ratings of app quality were also examined. METHODS: A randomized controlled trial compared immediate versus 1-month delayed access to Music eScape in 169 young people (aged 16 to 25 years) with at least mild levels of mental distress (Kessler 10 score>17). RESULTS: No significant differences between immediate and delayed groups on emotion regulation, distress, or well-being were found at 1 month. Both groups achieved significant improvements in 5 of the 6 emotion regulation skills, mental distress, and well-being at 2, 3, and 6 months. Unhealthy music use moderated improvements on 3 emotion regulation skills. Users gave the app a high mean quality rating (mean 3.8 [SD 0.6]) out of 5. CONCLUSIONS: Music eScape has the potential to provide a highly accessible way of improving young people's emotion regulation skills, but further testing is required to determine its efficacy. Targeting unhealthy music use in distressed young people may improve their emotion regulation skills. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12615000051549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365974.

Music in Seclusion Rooms-Development, Implementation, and Initial Testing of a Music Listening Device.

Although presented as a care measure, the use of seclusion rooms (SR) is controversial for both ethical and therapeutic reasons. Given that music seems to have a positive impact on psychiatric patients, offering them the possibility of listening to music might help to improve the care dimension of SR use. This study aimed to develop, implement, and test a musical listening device that would be completely at patients' disposal, easy to use and beneficial to the quality of care provided in SRs. Over a 12-week period, interviews were conducted with nurses (N = 6) caring for patients placed in an equipped SR. The music player was user friendly, encouraged patients to make choices and decisions, helping them to regain control over themselves and their behavior, and elicited various patient-nurse interactions, thus contributing to the establishment of a caring relation. Further research is warranted to examine whether the systematic use of the music player has an impact on the subjective experience of both patients and caregivers, and on daily ward routine.

Musical educational technology for lactation physiology learning: knowledge translation / Tecnología educativa musical para el aprendizaje de la fisiología de la lactancia: traducción del conocimiento / Tecnologia educativa musical para aprendizagem da fisiologia da lactação: tradução do conhecimento

ABSTRACT Objective: create and validate a musical educational technology for lactation physiology learning for professional training in health. Method: methodological study with application of a conceptual framework of Knowledge Translation. In the creation cycle, the knowledge of the physiology of lactation was synthetized in key points to create the lyrics and the melody. In the action cycle, the content of the musical educational technology was validated by judges experts in breast feeding, in the period from September to December 2017. Results: 18 judges from all Brazilian regions participated in the validation. The content of the technology obtained a global Content Validity Index of 0.94 with one round of validation. Conclusion: the musical educational technology is validated to introduce the content of the physiology of lactation in the learning process of students, mediated by the teacher.

RESUMEN Objetivo: crear y validar una tecnología educativa musical para el aprendizaje de la fisiología de la lactancia en la formación profesional en salud. Método: estudio metodológico con aplicación del Modelo Conceptual de Traducción del Conocimiento. En el ciclo de creación, el conocimiento de la fisiología de la lactancia fue sintetizado en puntos clave con los que se crearon la letra y la melodía. En el ciclo de acción, el contenido de la tecnología educativa musical fue validado por jueces expertos en lactancia materna, en el período de septiembre a diciembre de 2017. Resultados: 18 jueces de todas las regiones brasileñas participaron de la validación. El contenido de la tecnología obtuvo un Índice de Validez de Contenido global de 0.94 con una ronda de evaluación. Conclusión: se validó la tecnología educativa musical para introducir el contenido de la fisiología de la lactancia en el proceso de aprendizaje del alumno, mediado por el profesor.

RESUMO Objetivo: criar e validar uma tecnologia educativa musical para a aprendizagem da fisiologia da lactação na formação profissional em saúde. Método: estudo metodológico com aplicação de Modelo Conceitual de Tradução do Conhecimento. No ciclo de criação foi sintetizado o conhecimento da fisiologia da lactação em pontos-chave, com os quais foram criadas a letra e a melodia. No ciclo de ação foi validado o conteúdo da tecnologia educativa musical por juízes experts em aleitamento materno, no período de setembro a dezembro de 2017. Resultados: 18 juízes de todas as regiões brasileiras participaram da validação. O conteúdo da tecnologia obteve Índice de Validade de Conteúdo global de 0,94 com uma rodada de avaliação. Conclusão: a tecnologia educativa musical está validada para introduzir o conteúdo da fisiologia da lactação no processo de aprendizagem de estudantes, mediado pelo docente.

[Medicine 4.0: examples of applications of electronics, information technology and microsystems in modern medicine]. / « Médecine 4.0 ¼ - Exemples d'application de l'électronique, de la technologie de l'information et des microsystèmes dans la médecine moderne.

The electronic advances of the last hundred years have made enormous contributions to medical research and the development of new therapeutic methods. In recent years in particular, it has been demonstrated that intelligent sensors, with appropriate radio interfaces, will soon allow diagnostic and therapeutic processes in medicine to be linked to one another - this will enable the development of completely new forms of therapy [1]. This new "Medicine 4.0" was the subject of a first article in the series, which presented the progress achieved through the merging of microsensor technology, microelectronics, information and communication technologies, with a particular focus on the case of personalized chemotherapy. The purpose of this new article is to present more practical applications of these new therapeutic methods.

Decreasing Delirium through Music (DDM) in critically ill, mechanically ventilated patients in the intensive care unit: study protocol for a pilot randomized controlled trial.

BACKGROUND: Delirium is a highly prevalent and morbid syndrome in intensive care units (ICUs). Changing the stressful environment within the ICU via music may be an effective and a scalable way to reduce the burden of delirium. METHODS/DESIGN: The Decreasing Delirium through Music (DDM) study is a three-arm, single-blind, randomized controlled feasibility trial. Sixty patients admitted to the ICU with respiratory failure requiring mechanical ventilation will be randomized to one of three arms (20 participants per arm): (1) personalized music, (2) non-personalized relaxing music, or (3) attention-control. Music preferences will be obtained from all enrolled participants or their family caregivers. Participants will receive two 1-h audio sessions a day through noise-cancelling headphones and mp3 players. Our primary aim is to determine the feasibility of the trial design (recruitment, adherence, participant retention, design and delivery of the music intervention). Our secondary aim is to estimate the potential effect size of patient-preferred music listening in reducing delirium, as measured by the Confusion Assessment Method for the ICU (CAM-ICU). Participants will receive twice daily assessments for level of sedation and presence of delirium. Enrolled participants will be followed in the hospital until death, discharge, or up to 28 days, and seen in the Critical Care Recovery Clinic at 90 days. DISCUSSION: DDM is a feasibility trial to provide personalized and non-personalized music interventions for critically ill, mechanically ventilated patients. Our trial will also estimate the preliminary efficacy of music interventions on reducing delirium incidence and severity. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT03095443 . Registered on 23 March 2017.

Music as an Adjunct to Opioid-Based Analgesia.

Epidemic increases in opioid use in the USA and globally highlight the need for effective adjunctive therapies to opioid-based analgesia. Given the shortcomings of behavioral adjuncts to opioid-based pain treatment, an urgent need exists for pain-related behavioral interventions that resonate with broad patient populations, can be delivered confidentially in any environment, and can incorporate new content automatically. Understanding the potential for automated behavioral therapies like music therapy in modulating the experience of pain may unlock methods to transition patients to lower doses of pharmacologic therapy or provide alternatives to opioids during acute exacerbations of pain. This manuscript describes the neurologic mechanism of action, theoretical basis, and potential applications of personalized music as a smartphone-based mHealth intervention for acute and chronic pain management.

[COPD und Klangtherapie: Pilotstudie zur Wirksamkeit einer Behandlung mit Körpertambura bei COPD-Patienten].

Hintergrund: Erkrankungen der Atemorgane treten mit steigendem Alter öfter auf, nehmen weltweit zu und sind häufige Ursachen für Morbidität und Mortalität. In dieser Pilotstudie wurde der Frage nachgegangen, ob eine einmalige 10-minütige Behandlung mit einer Körpertambura eine signifikante und effektive Verbesserung der Lungenfunktion von Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD; GOLD-Stadium A oder B) erbringen kann. Patienten und Methoden: 54 Probanden konnten je zur Hälfte in eine Behandlungsgruppe (Körpertambura) und eine aktive Kontrollgruppe (Atemtherapie) randomisiert werden. Eine Bestimmung der Lungenfunktionsmessparameter «Einsekundenkapazität¼ (FEV1) und «inspiratorische Vitalkapazität¼ (IVC) zu den Zeitpunkten T1 (Baseline), T2 (direkt nach Behandlung) und als Follow-up etwa 3 Wochen nach T1 (T3). Ergebnisse: Die Behandlungsgruppe zeigte sich der Kontrollgruppe in beiden Werten signifikant überlegen. Die Zeit-×-Gruppe-Interaktion (Varianzanalyse) ergab p = 0,001 (FEV1) bzw. p = 0,04 (IVC). Die Behandlungsgruppe zeigte bei beiden Werten eine Verbesserung von klinischer Relevanz. Schlussfolgerung: Diese Ergebnisse zeigen, dass die Klangbehandlung mittels einer Körpertambura - neben den schulmedizinischen, leitliniengerechten Therapien - eine zusätzliche, nebenwirkungsarme, aber durchaus klinisch wirksame Option für die Behandlung von COPD-Patienten darstellen kann, um deren Lebensqualität zu stabilisieren und zu verbessern.

Smartphone-based Music Listening to Reduce Pain and Anxiety Before Coronarography: A Focus on Sex Differences.

Background • Music Care is a smartphone-based application providing a musical intervention for the management of pain and anxiety in a clinical setting. Coronarography is a medical procedure frequently associated with examination anxiety. Objectives • The study intended to perform an initial evaluation of the application for use with patients undergoing a coronarography. Design • The research team performed an uncontrolled, observational study. Setting • The study took place at Nouméa General Hospital in Nouméa, New Caledonia, France. Participants • Participants were 35 patients, 17 women and 18 men, who were undergoing a coronarography between November 2010 and April 2011 at the Nouméa General Hospital. Intervention • Participants listened to a standardized musical sequence of adjustable length by choosing a preferred style of music (eg, classic rock or folk music) from a variety of choices that the research team had chosen to include in the application. Outcome Measures • Before and after listening to the music, all participants were asked to rate their anxiety and pain on an 11-item, visual analogue scale and to complete a questionnaire on their satisfaction with use of the application. Results • The paired sample t test revealed a significant reduction in participants' anxiety (t33 = 4.12, P < .0001) after they had listened to the music. No significant reduction in self-reported pain occurred; however, only a few participants reported pain associated with the procedure. No significant sex differences existed. Women and men both showed reduced anxiety after listening to music as well as reported a high level of satisfaction in using the Music Care application. Conclusions • The smartphone-based Music Care application is an easy-to-use tool to reduce anxiety in patients undergoing coronarography. Future large-scale, controlled trials are necessary to compare its effectiveness with other interventions. Both women and men can benefit from the use of the application.