Music, immunity and cancer

Music and Emotions in Non-Human Animals from Biological and Comparative Perspectives

The effects of sound stimulation as a sensorial environmental enrichment for captive animals have been studied. When appropriately implemented for farm animals, it can improve welfare, health, and productivity. Furthermore, there are indications that music can induce positive emotions in non-human animals, similar to humans. Emotion is a functional state of the organism involving both physiological processes, mediated by neuroendocrine regulation, and changes in behavior, affecting various aspects, including contextual perception and welfare. As there is very limited information on non-human animals, the objective of this review is to highlight what is known about these processes from human biological and comparative perspectives and stimulate future research on using music to improve animal welfare.

Music in the Metaverse: an alternative solution for immune-boosting and mental health maintenance in the post-COVID-19 age

In this article, the author explains more about the other benefits that people can enjoy when listening to music in the Metaverse, significantly boosting immunity and maintaining mental health.

Digital Therapeutics for Improving Effectiveness of Pharmaceutical Drugs and Biological Products: Preclinical and Clinical Studies Supporting Development of Drug + Digital Combination Therapies for Chronic Diseases

Limitations of pharmaceutical drugs and biologics for chronic diseases (e.g., medication non-adherence, adverse effects, toxicity, or inadequate efficacy) can be mitigated by mobile medical apps, known as digital therapeutics (DTx). Authorization of adjunct DTx by the US Food and Drug Administration and draft guidelines on "prescription drug use-related software" illustrate opportunities to create drug + digital combination therapies, ultimately leading towards drug-device combination products (DTx has a status of medical devices). Digital interventions (mobile, web-based, virtual reality, and video game applications) demonstrate clinically meaningful benefits for people living with Alzheimer's disease, dementia, rheumatoid arthritis, cancer, chronic pain, epilepsy, depression, and anxiety. In the respective animal disease models, preclinical studies on environmental enrichment and other non-pharmacological modalities (physical activity, social interactions, learning, and music) as surrogates for DTx "active ingredients" also show improved outcomes. In this narrative review, we discuss how drug + digital combination therapies can impact translational research, drug discovery and development, generic drug repurposing, and gene therapies. Market-driven incentives to create drug-device combination products are illustrated by Humira® (adalimumab) facing a "patent-cliff" competition with cheaper and more effective biosimilars seamlessly integrated with DTx. In conclusion, pharma and biotech companies, patients, and healthcare professionals will benefit from accelerating integration of digital interventions with pharmacotherapies.

Effect of classical music on growth performance, stress level, antioxidant index, immune function and meat quality in broilers at different stocking densities

High-stocking density is one of the factors that can easily cause oxidative stress and inflammatory reaction of broilers. Currently, music therapy has been proposed to help animals relieve stress to some extent. However, it is still unclear whether classical music can alleviate stress in broilers at high stocking densities. Hence, this study aimed to investigate the effects of classical music on growth performance, stress level, antioxidant index, immune function and meat quality of broilers under different stocking densities. A total of 540 one-day-old broilers with similar body weight were randomly divided into 6 treatment groups, with 6 replicates per group, which included two feeding environments (with/without classical music) and three stocking densities (15.5, 17.9, and 20.3 birds/m2), thereby making a 2 × 3 factorial arrangement. The results showed as follows: increasing stocking density decreased the average daily feed intake and average daily gain (ADG), increased feed-to-gain ratio (F/G) and mortality of broilers. Moreover, increased density resulted in an increase in serum corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels. Increasing stocking density decreased spleen and bursal indices, serum immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) levels. Increasing stocking density elevated serum malondialdehyde (MDA) and decreased catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) activities. Increasing stocking density decreased serum total protein (TP) levels and increased total cholesterol (TC) and glucose (GLU) levels. Additionally, increasing stocking density decreased the cooking liss of pectoralis and increased the L*24h value of pectoralis. Meanwhile, playing classical music for broilers increased their ADG and decreased F/G, and decreased serum CORT, ACTH, GLU content. In addition, the bursa of Fabricius index, serum IgA and IgG contents as well as the a*24h value of pectoralis was increased under the music therapy. In conclusion, high-stocking density (20.3 birds/m2) harmed the growth performance and health of broilers, and the classical music stimulus ameliorated the negative effects to some extent.

Aged brain and neuroimmune responses to COVID-19: post-acute sequelae and modulatory effects of behavioral and nutritional interventions

Advanced age is one of the significant risk determinants for coronavirus disease 2019 (COVID-19)-related mortality and for long COVID complications. The contributing factors may include the age-related dynamical remodeling of the immune system, known as immunosenescence and chronic low-grade systemic inflammation. Both of these factors may induce an inflammatory milieu in the aged brain and drive the changes in the microenvironment of neurons and microglia, which are characterized by a general condition of chronic inflammation, so-called neuroinflammation. Emerging evidence reveals that the immune privilege in the aging brain may be compromised. Resident brain cells, such as astrocytes, neurons, oligodendrocytes and microglia, but also infiltrating immune cells, such as monocytes, T cells and macrophages participate in the complex intercellular networks and multiple reciprocal interactions. Especially changes in microglia playing a regulatory role in inflammation, contribute to disturbing of the brain homeostasis and to impairments of the neuroimmune responses. Neuroinflammation may trigger structural damage, diminish regeneration, induce neuronal cell death, modulate synaptic remodeling and in this manner negatively interfere with the brain functions.In this review article, we give insights into neuroimmune interactions in the aged brain and highlight the impact of COVID-19 on the functional systems already modulated by immunosenescence and neuroinflammation. We discuss the potential ways of these interactions with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and review proposed neuroimmune mechanisms and biological factors that may contribute to the development of persisting long COVID conditions. We summarize the potential mechanisms responsible for long COVID, including inflammation, autoimmunity, direct virus-mediated cytotoxicity, hypercoagulation, mitochondrial failure, dysbiosis, and the reactivation of other persisting viruses, such as the Cytomegalovirus (CMV). Finally, we discuss the effects of various interventional options that can decrease the propagation of biological, physiological, and psychosocial stressors that are responsible for neuroimmune activation and which may inhibit the triggering of unbalanced inflammatory responses. We highlight the modulatory effects of bioactive nutritional compounds along with the multimodal benefits of behavioral interventions and moderate exercise, which can be applied as postinfectious interventions in order to improve brain health.

Effects of Music Therapy on Neuroplasticity, Welfare, and Performance of Piglets Exposed to Music Therapy in the Intra- and Extra-Uterine Phases

Simple Summary

Environmental enrichment using music therapy can be used to improve animal welfare. Music, as an enrichment of the environment, is presented as an easy and viable way to remove the sterility of the breeding environment and make it more interesting and attractive. In this study, we aimed to evaluate the effects of auditory environmental enrichment in the pre- and postpartum period of sows on the behavior, performance, and neuro-plasticity of their piglets. Exposure to music in the last 1/3 of pregnancy and farrowing/lactation improved the weight of piglets at birth and weaning. Musical enrichment during pregnancy and lactation was able to cause changes in the piglets’ neuroplasticity and improve their productive performances.

Abstract

The rearing environment of pigs can cause a high level of stress due to the lack of stimuli and the impossibility of carrying out natural behaviors. Music therapy is a way to enrich the environment and promote stress relief. Few studies in swine using environmental enrichers focus on functional benefits, such as stress resilience, improved biological functions, or mental status. The effect of environmental enrichment on neurobiological processes is particularly poorly understood in farm animals. Thus, our study sought to elucidate the influence of music in piglets exposed to music therapy in the intrauterine and extrauterine phase on neuroplasticity, evaluating the levels of brain-derived neurotrophic factor (BDNF). Behavioural responses were also evaluated using fear tests related to stress resilience. The productive performance of these piglets was analysed to relate the possible reduction in stress levels to greater productivity gains. Forty-eight sows were used at 90 days of gestation until the weaning of their piglets. In the gestation phase, the sows were divided into two treatments: control (without music therapy) and music (with music therapy). In the farrowing/lactation phase, the sows were separated into four treatments: control-control (no music in any phase); control-music (music only in farrowing/lactation); music-control (music only during pregnancy); and music-music (music in both reproductive phases). Music therapy did not cause a difference in the BDNF levels of piglets at birth. However, piglets born from sows of the music-music treatment did not show a reduction in BDNF between birth and weaning, unlike the other treatments. Exposure to music in the last 1/3 of pregnancy and farrowing/lactation improved the weight of piglets at birth and at weaning. Musical enrichment during pregnancy and lactation was able to cause changes in the piglets’ neuroplasticity and improve their productive performances.

The Effect of Music on Livestock: Cattle, Poultry and Pigs

Simple Summary

In times of intensified livestock production, the search for methods that reduce stress, which has an adverse impact on the health and welfare of their animals, has become a challenge for breeders and producers. Therefore, the possibility of using various musical genres to alleviate stress in chickens, cattle or pigs was considered. It has turned out that choosing a musical item is extremely important, as it can positively affect the health and production performance of animals by increasing the feeling of relaxation. The time of exposure to sounds and their intensity are important as well, and some authors propose to also pay attention to the frequency of sound waves. Music therapy, which was previously more widely deployed among humans, is increasingly used for farm animals as an element of enriching their living environment. Current research shows the importance of sound waves’ influence in animal production. Proper selection of the music genre, music intensity and tempo can reduce the adverse effects of noise and, thus, reduce the level of stress. It should be remembered, however, that silence is equally important and necessary for the welfare of animals. The paper presents literature findings regarding the influence of music on cattle, poultry and pigs.

Abstract

The welfare of animals, especially those kept in intensive production systems, is a priority for modern agriculture. This stems from the desire to keep animals healthy, to obtain a good-quality final product, and to meet the demands of today’s consumers, who have been increasingly persuaded to buy organic products. As a result, new sound-based methods have been pursued to reduce external stress in livestock. Music therapy has been known for thousands of years, and sounds were believed to improve both body and spirit. Today, they are mostly used to distract patients from their pain, as well as to treat depression and cardiovascular disorders. However, recent studies have suggested that appropriately selected music can confer some health benefits, e.g., by increasing the level and activity of natural killer cells. For use in livestock, the choice of genre, the loudness of the music and the tempo are all important factors. Some music tracks promote relaxation (thus improving yields), while others have the opposite effect. However, there is no doubt that enriching the animals’ environment with music improves their welfare and may also convince consumers to buy products from intensively farmed animals. The present paper explores the effects of music on livestock (cattle, poultry and pigs) on the basis of the available literature.

Providing Comfort through Music to People Amidst the COVID-19 Pandemic as a Humanitarian Disaster

Hopefully, through this article, mental health workers, such as counselors, psychologists, psychiatrists, nurses, doctors, religious leaders, and social workers, can consider music as a good alternative in the midst of this COVID-19 pandemic. It is hoped that mental health workers who are currently struggling to care for everyone's psychological health in their respective countries can provide comfort through collective music activities.

Cancer incidence among musicians: 45 years of follow-up in four Nordic countries

BACKGROUND

There are studies suggesting that participation in musical activities may protect from cancer. On the other hand, some musicians have a lifestyle that might increase the risk of cancer. The objective of this study was to assess the cancer pattern of musicians in four Nordic countries.

MATERIAL AND METHODS

This study combines census and cancer registry data from 1961 to 2005 for 13 million people from Finland, Iceland, Norway, and Sweden. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for entire national populations used as reference rates.

RESULTS

There were 11,401 male and 3105 female musicians with 2039 cancer cases. The SIR for all sites combined was 1.02 (95% confidence interval 0.97-1.07) in men and 1.04 (0.94-1.15) in women. In male musicians, there were statistically significant excesses in oropharyngeal cancer (4.36, 2.73-6.60), esophageal cancer (2.08, 1.51-2.81), liver cancer (1.81, 1.26-2.52), and skin melanoma (1.40, 1.10-1.75). The risk was decreased in lip cancer (0.13, 0.02-0.48), stomach cancer (0.66, 0.50-0.82), and lung cancer (0.77, 0.65-0.90). In female musicians, there were no statistically significant SIRs in any of the cancer types studied, but the risk of breast cancer was significantly elevated in the age category of 70+ (1.52, 1.04-2.15). The overall SIR was stable over the 45 year period of observation, but strong decreases were observed in the SIRs of esophageal cancer, liver cancer, laryngeal cancer, and skin melanoma.

CONCLUSION

Musicians have characteristics of indoor workers such as low incidence of lip cancer and high incidence of skin melanoma. The low incidence of lung cancer suggests that the prevalence of smoking among musicians is lower than in the general population while the elevated risk of alcohol-related cancer types suggest that drinking is likely more common among musicians. The cancer risk for all sites combined is still similar to that of the general population in the four countries studied.

Association of engagement in cultural activities with cause-specific mortality determined through an eight-year follow up: The HUNT Study, Norway

Participation in cultural activities may protect against cause-specific mortality; however, there is limited knowledge regarding this association. The present study examines the association between participation in a range of receptive and creative cultural activities and risk of cardiovascular disease- and cancer-related mortality. We also examined whether participation in such activities and influence by gender have on this association. We followed 35,902 participants of the Nord-Trøndelag Health Study (HUNT3) of Cardiovascular-Disease and Cancer Mortality from 2006-08 to 2016. Cox proportional-hazards regression was used to estimate the risk of specific mortality based on baseline cultural participation. During the eight-year follow-up, there were 563 cardiovascular-disease- and 752 cancer-related deaths among the sample (292,416 person years). Risk of cardiovascular-disease mortality was higher among non-participants in associations/club meetings (22%) and outdoor activities (23%), respectively, as well as non-attendees of art exhibitions (28%). People who engaged in music, singing, and theatre had a 27% reduced risk of cancer-related mortality when compared to non-participants. Among women, participating in associations/club meetings reduced the risk of cardiovascular-disease mortality by 36%. Men who participated in music, singing, and theatre had a 33% reduced risk of cancer mortality. Overall, a reduced risk of cardiovascular-disease mortality was associated with engaging in creative activities on weekly basis to less than twice per week. For both genders, participating in creative activities less than once a week reduced cardiovascular-disease mortality risk by 40% and 33%, respectively. For the overall sample, participating > 2 times per week in combined receptive and creative activities reduced cancer-related mortality by 29%. Participating frequently in both receptive and creative activities cultural activities was associated with lower risks of CVD and cancer-related mortality. Our data suggest that, to counteract the public health burden of cardiovascular disease- and cancer mortality, policies and initiatives to increase citizens' participation in cultural activities should be considered.

The Immune System Can Hear Noise

As a stressor widely existing in daily life, noise can cause great alterations to the immune system and result in many physical and mental disorders, including noise-induced deafness, sleep disorders, cardiovascular diseases, endocrine diseases and other problems. The immune system plays a major role in maintaining homeostasis by recognizing and removing harmful substances in the body. Many studies have shown that noise may play vital roles in the occurrence and development of some immune diseases. In humans, both innate immunity and specific immunity can be influenced by noise, and different exposure durations and intensities of noise may exert various effects on the immune system. Short-term or low-intensity noise can enhance immune function, while long-term or high-intensity noise suppresses it. Noise can lead to the occurrence of noise-induced hearing loss (NIHL) through the production of autoantibodies such as anti-Hsp70 and anti-Hsp60 and exert adverse effects related to other immune-related diseases such as some autoimmune diseases and non-Hodgkin lymphoma. The neuroendocrine system, mainly including the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) system, is involved in the mechanisms of immune-related diseases induced by noise and gut microbiota dysfunction. In addition, noise exposure during pregnancy may be harmful to the immune system of the fetus. On the other hand, some studies have shown that music can improve immune function and alleviate the adverse effects caused by noise.

Impact of Music Played in an Automatic Milking System on Cows’ Milk Yield and Behavior—A Pilot Study

Practical experience suggests that music can have a positive effect on the welfare of dairy cows, which for some other animal species has been shown in earlier studies. Music could, furthermore, be a useful tool to support, for example, daily milking routines. In this pilot study we explored effects of music inside an automatic milking system (AMS) on cows’ milk yield and behavior. The experiment was conducted on a Finnish dairy farm with 56 cows in loose housing. Over two 2-day periods without and with selected music pieces played inside the AMS, data on daily milk yield (DMY), selection gate passing frequency (GP), milking frequency (MF), and milking interval (MI) were recorded. For analyses, data of 17 Holstein-Friesian cows were used. At cow level, mean values over repeated measurements without and with music were calculated, and analyzed by paired t-tests (DMY, MF) or Wilcoxon tests (MI, GP). During intervals with music versus without, cows passed the selection gate more often (15.8 versus 13.8) and had higher MF (3.0 vs. 2.8). No differences were found in MI (07:49:21 vs. 08:37:38) and DMY (36.5 vs. 37.0). The latter might be explained by a ceiling effect. Overall, the results suggest that the investigated sample of cows perceived the selected music as attractive and that playing music might be a practical tool to reduce necessary efforts of driving cows to milking.

Inflammatory and immunological changes caused by noise exposure: A systematic review

Today, due to the growth of industries and spread of the use of various instruments and devices that produce high noise levels, it is necessary to pay more attention to the effects of exposure to noise on organs and tissues in the body. The importance of the immune system in fighting external and pathogenic factors has raised the need to consider external factors (such as harmful physical factors) and make efforts to avoid producing them. In this systematic review, 811 potentially relevant studies were found in Google Scholar, PubMed, and Web of Science databases, of which 32 different English-written articles were included in the study. The method of searching and systematically reviewing articles was based on the assessment tool of the multiple systematic reviews (AMSTAR) method. The results of this study suggested that noise could affect the function of the immune system and its components by affecting other systems and organs of the body, including the central nervous system, auditory system, circulatory system, and endocrine gland. Moreover, it can be hypothesized that noise affects immune system by producing the NADPH oxidase (Nox) and reactive oxygen species (ROS).

Musical Dogs: A Review of the Influence of Auditory Enrichment on Canine Health and Behavior

Simple Summary

Interest in the use of music therapy as a behavioral enrichment tool in veterinary medicine is growing. Indeed, an industry has formed around the development of ‘dog music’, which has been purposely designed to relax dogs. Despite enthusiastic uptake of the idea, there is little empirical evidence supporting the design of such tools. This article summarizes the scientific literature in this emerging domain. It notes that, as a general observation, animals appear less stressed or anxious when exposed to classical music than to control conditions. It also acknowledges that this field is relatively under-researched, and more rigorous studies must be conducted before species-specific recommendations can be made. Such studies must reflect individuals’ and species’ preferences for different genres and songs, taking care to avoid habituation.

Abstract

Music therapy yields many positive health outcomes in humans, but the effects of music on the health and welfare of nonhuman animals vary greatly with the type of music played, the ethology of the species, and the personality and learning history of individual animals. One context in which music therapy may be used to enhance animal welfare is to alleviate stress in domestic environments. Here, we review studies of the effects of music exposure on dogs as a case study for the implementation of music therapy in veterinary medicine. Nine reports of experimental testing for the therapeutic effects of music on dogs were found, with most of these studies focusing on changes in behavior. Overall, exposure to classical music appears to have a calming influence on dogs in stressful environments, with no additional benefit observed from any music purposely designed for dogs (specifically “Through a dog’s ear”). Given the cost effectiveness and ease of implementation, music therapy holds promise in veterinary medicine and animal welfare. However, to address precise research questions, further studies must use clearly defined characteristics of stimulus music in the experimental design, and consider the variability of each individual animal’s physical characteristics and past experience in the selection of candidates.

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Digital therapeutics (software as a medical device) and mobile health (mHealth) technologies offer a means to deliver behavioral, psychosocial, disease self-management and music-based interventions to improve therapy outcomes for chronic diseases, including pain and epilepsy. To explore new translational opportunities in developing digital therapeutics for neurological disorders, and their integration with pharmacotherapies, we examined analgesic and antiseizure effects of specific musical compositions in mouse models of pain and epilepsy. The music playlist was created based on the modular progression of Mozart compositions for which reduction of seizures and epileptiform discharges were previously reported in people with epilepsy. Our results indicated that music-treated mice exhibited significant analgesia and reduction of paw edema in the carrageenan model of inflammatory pain. Among analgesic drugs tested (ibuprofen, cannabidiol (CBD), levetiracetam, and the galanin analog NAX 5055), music intervention significantly decreased paw withdrawal latency difference in ibuprofen-treated mice and reduced paw edema in combination with CBD or NAX 5055. To the best of our knowledge, this is the first animal study on music-enhanced antinociceptive activity of analgesic drugs. In the plantar incision model of surgical pain, music-pretreated mice had significant reduction of mechanical allodynia. In the corneal kindling model of epilepsy, the cumulative seizure burden following kindling acquisition was lower in animals exposed to music. The music-treated group also exhibited significantly improved survival, warranting further research on music interventions for preventing Sudden Unexpected Death in Epilepsy (SUDEP). We propose a working model of how musical elements such as rhythm, sequences, phrases and punctuation found in K.448 and K.545 may exert responses via parasympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Based on our findings, we discuss: (1) how enriched environment (EE) can serve as a preclinical surrogate for testing combinations of non-pharmacological modalities and drugs for the treatment of pain and other chronic diseases, and (2) a new paradigm for preclinical and clinical development of therapies leading to drug-device combination products for neurological disorders, depression and cancer. In summary, our present results encourage translational research on integrating non-pharmacological and pharmacological interventions for pain and epilepsy using digital therapeutics.

Music Affects Rodents: A Systematic Review of Experimental Research

Background: There is rapidly emerging interest in music interventions in healthcare. Music interventions are widely applicable, inexpensive, without side effects, and easy to use. It is not precisely known how they exert positive effects on health outcomes. Experimental studies in animal models might reveal more about the pathophysiological mechanisms of music interventions. Methods: We performed a systematic review of experimental research in rodents. The electronic databases EMBASE, Medline(ovidSP), Web-Of-Science, PsycINFO, Cinahl, PubMed publisher, Cochrane, and Google scholar were searched for publications between January 1st 1960 and April 22nd 2017. Eligible were English-written, full-text publications on experimental research in rodents comparing music vs. a control situation. Outcomes were categorized in four domains: brain structure and neuro-chemistry; behavior; immunology; and physiology. Additionally, an overview was generated representing the effects of various types of music on outcomes. Bias in studies was assessed with the SYRCLE Risk of Bias tool. A meta-analysis was not feasible due to heterogeneous outcomes and lack of original outcome data. Results: Forty-two studies were included. Music-exposed rodents showed statistically significant increases in neuro-chemistry, such as higher BDNF levels, as well as an enhanced propensity for neurogenesis and neuroplasticity. Furthermore, music exposure was linked with statistically significantly improved spatial and auditory learning, reduced anxiety-related behavior, and increased immune responses. Various statistically significant changes occurred in physiological parameters such as blood pressure and (para)sympathetic nerve activity following music interventions. The majority of studies investigated classical music interventions, but other types of music exerted positive effects on outcomes as well. The SYRCLE risk of bias assessment revealed unclear risk of bias in all studies. Conclusions: Music interventions seem to improve brain structure and neuro-chemistry; behavior; immunology; and physiology in rodents. Further research is necessary to explore and optimize the effect of music interventions, and to evaluate its effects in humans.

Exploring the effect of sound and music on health in hospital settings: A narrative review

BACKGROUND

Sound in hospital space has traditionally been considered in negative terms as both intrusive and unwanted, and based mainly on sound levels. However, sound level is only one aspect of the soundscape. There is strong evidence that exploring the positive aspect of sound in a hospital context can evoke positive feelings in both patients and nurses. Music psychology studies have also shown that music intervention in health care can have a positive effect on patient's emotions and recuperating processes. In this way, hospital spaces have the potential to reduce anxiety and stress, and make patients feel comfortable and secure. This paper describes a review of the literature exploring sound perception and its effect on health care.

DATA SOURCES AND REVIEW METHODS

This review sorted the literature and main issues into themes concerning sound in health care spaces; sound, stress and health; positive soundscape; psychological perspective of music and emotion; music as a complementary medicine for improving health care; contradicting arguments concerning the use of music in health care; and implications for clinical practice. Using Web of Science, PubMed, Scopus, ProQuest Central, MEDLINE, and Google, a literature search on sound levels, sound sources and the impression of a soundscape was conducted. The review focused on the role and use of music on health care in clinical environments. In addition, other pertinent related materials in shaping the understanding of the field were retrieved, scanned and added into this review.

RESULTS

The result indicated that not all noises give a negative impression within healthcare soundscapes. Listening to soothing music was shown to reduce stress, blood pressure and post-operative trauma when compared to silence. Much of the sound conveys meaningful information that is positive for both patients and nurses, in terms of soft wind, bird twitter, and ocean sounds.

CONCLUSIONS

Music perception was demonstrated to bring about positive change in patient-reported outcomes such as eliciting positive emotion, and decreasing the levels of stressful conditions. Whilst sound holds both negative and positive aspects of the hospital ecosystem and may be stressful, it also possesses a soothing quality that induces positive feelings in patients. Conceptualizing the nature of sound in the hospital context as a soundscape, rather than merely noise can permit a subtler and socially useful understanding of the role of sound and music in the hospital setting, thereby creating a means for improving the hospital experience for patients and nurses.

Music Interventions in Oncology Settings: A Systematic Literature Review

This paper presents a systematic review of published research investigating therapeutic applications of music in cancer patients. The review focuses on published international research from the USA, Canada, Australia and European countries using four electronic databases: PSYCHINFO, WEB OF SCIENCE, MEDLINE and SCIENCEDIRECT. Twenty four papers were identified and each paper was coded in terms of sample type, basic research question, research design and methodological details, results and implications for future research. Utilising previous work such as Aldridge (2003) as a point of departure, this review provides information on the key areas of interest in the psychology of music therapy and the therapeutic use of music amongst cancer patients and gives an account of the methodological approaches that were adopted. Results provide an overview of reported outcomes of music interventions such as reduction in anxiety, reduction in side effects of chemotherapy, physiological effects, psychological effects, behavioural improvements and communication and expression improvements.

The therapeutic impacts of environmental design interventions on wellness in clinical settings: A narrative review

PURPOSE

The aim of this review is to document the role of physical environmental factors in clinical environments and their impact on patients and staff wellness with a particular focus on physical and mental healthcare.

METHODS

Data sources comprised relevant English language articles and the results of literature search of ISI Web of Knowledge, PubMed, Scopus, ProQuest Central, MEDLINE, and Google.

RESULTS

Incorporating physical environmental factors into hospital design can facilitate better user satisfaction, efficiency and organisational outcomes. Many of the design interventions convey positive distractions for patients and staff, in terms of views of pleasant outside vistas, soothing sound, artwork and music.

CONCLUSIONS

Well-designed physical settings play an important role in the healing process of patients in health care facilities. The challenge then is to fully understand that role in the ecological context of health care. Other contributors are possible and should be explored in further research.

Singing modulates mood, stress, cortisol, cytokine and neuropeptide activity in cancer patients and carers

There is growing evidence that psychosocial interventions can have psychological benefits for people affected by cancer, including improved symptoms of mental health and wellbeing and optimised immune responses. However, despite growing numbers of music interventions, particularly singing, in cancer care, there is less research into their impact. We carried out a multicentre single-arm preliminary study to assess the impact of singing on mood, stress and immune response in three populations affected by cancer: carers (n = 72), bereaved carers (n = 66) and patients (n = 55). Participants were excluded if pregnant or if they were currently being treated with chemotherapy, radiotherapy or oral immunosuppressive drugs. Participants were regular participants in five choirs across South Wales and took part in one hour of group singing. Before and after singing, visual analogue mood scales, stress scales and saliva samples testing for cortisol, beta-endorphin, oxytocin and ten cytokines were taken. Across all five centres and in all four participant groups, singing was associated with significant reductions in negative affect and increases in positive affect (p < .01) alongside significant increases in cytokines including GM-CSF, IL17, IL2, IL4 and sIL-2rα (all p < .01). In addition, singing was associated with reductions in cortisol, beta-endorphin and oxytocin levels. This study provides preliminary evidence that singing improves mood state and modulates components of the immune system. Further work is needed to ascertain how this differs for more specific patient groups and whether repeat exposure could lead to meaningful, longitudinal effects.

A randomized trial comparing live and telemedicine deliveries of an imagery-based behavioral intervention for breast cancer survivors: reducing symptoms and barriers to care

OBJECTIVE

This multi-site randomized trial evaluates the quality of life (QOL) benefits of an imagery-based group intervention titled 'Envision the Rhythms of Life'(ERL).

METHODS

Breast cancer survivors >6 weeks post-treatment were randomized to attend five weekly 4-h group sessions at a community center with therapist present (live delivery (LD), n = 48), therapist streamed via telemedicine (telemedicine delivery (TD), n = 23), or to a waitlist control (WL) group (n = 47). Weekly individual phone calls to encourage at-home practice began at session one and continued until the 3-month follow-up. Seven self-report measures of QOL were examined at baseline, 1-month and 3-month post-treatments including health-related and breast cancer-specific QOL, fatigue, cognitive function, spirituality, distress, and sleep.

RESULTS

The Bonferroni method was used to correct for multiple comparisons, and alpha was adjusted to 0.01. Linear multilevel modeling analyses revealed less fatigue, cognitive dysfunction, and sleep disturbance for LD and TD compared with WL across the follow-up (p's < 0.01). Changes in fatigue, cognitive dysfunction, sleep disturbance, and health-related and breast cancer-related QOL were clinically significant. There were no differences between LD and TD.

CONCLUSIONS

Both the live and telemedicine delivered ERL intervention resulted in improvements in multiple QOL domains for breast cancer survivors compared with WL. Further, there were no significant differences between LD and TD, suggesting telemedicine delivered ERL intervention may represent an effective and viable option for cancer survivors in remote areas.

Cellular and molecular mechanisms of immunomodulation in the brain through environmental enrichment

Recent studies on environmental enrichment (EE) have shown cytokines, cellular immune components [e.g., T lymphocytes, natural killer (NK) cells], and glial cells in causal relationship to EE in bringing out changes to neurobiology and behavior. The purpose of this review is to evaluate these neuroimmune mechanisms associated with neurobiological and behavioral changes in response to different EE methods. We systematically reviewed common research databases. After applying all inclusion and exclusion criteria, 328 articles remained for this review. Physical exercise (PE), a form of EE, elicits anti-inflammatory and neuromodulatory effects through interaction with several immune pathways including interleukin (IL)-6 secretion from muscle fibers, reduced expression of Toll-like receptors on monocytes and macrophages, reduced secretion of adipokines, modulation of hippocampal T cells, priming of microglia, and upregulation of mitogen-activated protein kinase phosphatase-1 in central nervous system. In contrast, immunomodulatory roles of other enrichment methods are not studied extensively. Nonetheless, studies showing reduction in the expression of IL-1β and tumor necrosis factor-α in response to enrichment with novel objects and accessories suggest anti-inflammatory effects of novel environment. Likewise, social enrichment, though considered a necessity for healthy behavior, results in immunosuppression in socially defeated animals. This has been attributed to reduction in T lymphocytes, NK cells and IL-10 in subordinate animals. EE through sensory stimuli has been investigated to a lesser extent and the effect on immune factors has not been evaluated yet. Discovery of this multidimensional relationship between immune system, brain functioning, and EE has paved a way toward formulating environ-immuno therapies for treating psychiatric illnesses with minimal use of pharmacotherapy. While the immunomodulatory role of PE has been evaluated extensively, more research is required to investigate neuroimmune changes associated with other enrichment methods.

The psychoneuroimmunological effects of music: a systematic review and a new model

There has been a growing interest over the past decade into the health benefits of music, in particular examining its psychological and neurological effects. Yet this is the first attempt to systematically review publications on the psychoneuroimmunology of music. Of the selected sixty-three studies published over the past 22 years, a range of effects of music on neurotransmitters, hormones, cytokines, lymphocytes, vital signs and immunoglobulins as well as psychological assessments are cataloged. Research so far points to the pivotal role of stress pathways in linking music to an immune response. However, several challenges to this research are noted: (1) there is very little discussion on the possible mechanisms by which music is achieving its neurological and immunological impact; (2) the studies tend to examine biomarkers in isolation, without taking into consideration the interaction of the biomarkers in question with other physiological or metabolic activities of the body, leading to an unclear understanding of the impact that music may be having; (3) terms are not being defined clearly enough, such as distinctions not being made between different kinds of stress and 'music' being used to encompass a broad spectrum of activities without determining which aspects of musical engagement are responsible for alterations in biomarkers. In light of this, a new model is presented which provides a framework for developing a taxonomy of musical and stress-related variables in research design, and tracing the broad pathways that are involved in its influence on the body.

Effects of music on immunity and physiological responses in healthcare workers: a randomized controlled trial

Research-based evidence supports the effectiveness of soothing music in improving stress-related psycho-physiological indices in a clinical setting. However, there is currently insufficient scientific knowledge of the effects of music on immune markers of stress in humans. Therefore, the aims of the study were to compare the effects of music and quiet rest on the levels of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), interleukin-10 (IL-10), heart rate and mean arterial pressure among healthcare workers. By using a randomized controlled trial design, 60 nurses were randomly assigned to the stimulating or sedating music or rest groups for 30 min. Participants' psychoneuroimmunological parameters were measured using enzyme-linked immunosorbent assays. General estimating equation was used to analyse data. Results revealed that IL-6, TNF-α and IL-10 were not detectable in this population. No significance differences in heart rate were found among the three groups. However, the stimulating music group had significantly higher mean arterial pressure levels than the sedating music group but no differences between the quiet rest group and the sedating music group. Music with different tempi had little effect on mean arterial pressure. Any effect of music on immune markers of stress requires further research.

How do rats respond to playing radio in the animal facility?

In the animal facility, a range of different sounds are present. On the one hand, rats and humans will regard sound and noise differently even within the audible range, but on the other hand mice and rats being very adaptable to the environment may adapt to living in a noisy facility with e.g. a radio playing. It was the aim of the present study to investigate whether two different strains of rats had different preferences for different kinds of sound patterns, including radio, and to get an indication of whether they are able to distinguish between different sound patterns. The present preference study revealed that rats were able to distinguish between different sound patterns. They showed a clear preference for silence to anything else, which may be taken as an indication that they feel disturbed by the sound from the speaker.

Immobilization stress responses in adult rats exposed in utero to immobilization

The present study investigated the influence of immobilization prenatal stress on adult male rats, with the same postnatal stress, on the immune parameters and its relation with plasma corticosterone (COR) and glucose levels. To study the immunity parameters, profiles of the leucocytes, size of spleen and number of the mononuclear cells of this organ were determined. Basal levels of COR and glucose were higher in prenatally stressed animals. When the adult animals were exposed to immobilization stress, COR increased but the increase was less than that for the control group, and glucose was equal in both groups. Although postnatal acute stress decreased the number of leucocytes and lymphocytes and increased the number of neutrophils, the effect was lower in prenatally stressed animals; for that reason, the ratio neutrophil/lymphocyte increased less. The number of mononuclear cells were higher in the spleen of prenatally stressed animals. This effect was probably due to retention of blood lymphocytes in the spleen. There seemed to be an alteration in the redistribution of leucocytes, both in basal conditions and under postnatal stress. The alteration of the immunological function may be partly due to an alteration in the functionality of the hypothalamic–pituitary–adrenal axis, which was hyperactive in basal conditions but appeared to suffer habituation to the same stress.

The impact of light, noise, cage cleaning and in-house transport on welfare and stress of laboratory rats

Human interaction and physical environmental factors are part of the stimuli presented to laboratory animals everyday, influencing their behaviour and physiology and contributing to their welfare. Certain environmental conditions and routine procedures in the animal facility might induce stress responses and when the animal is unable to maintain its homeostasis in the presence of a particular stressor, the animal's wellbeing is threatened. This review article summarizes several published studies on the impact of environmental factors such as light, noise, cage cleaning and in-house transport on welfare and stress of laboratory rats. The behaviour and physiological responses of laboratory rats to different environmental housing conditions and routine procedures are reviewed. Recommendations on the welfare of laboratory rats and refinements in experimental design are discussed and how these can influence and improve the quality of scientific data.

Exposure to music in the perinatal period enhances learning performance and alters BDNF/TrkB signaling in mice as adults

Music has been suggested to have a beneficial effect on various types of performance in humans. However, the physiological and molecular mechanism of this effect remains unclear. We examined the effect of music exposure during the perinatal period on learning behavior in adult mice, and measured the levels of brain-derived neurotrophic factor (BDNF) and its receptor, tyrosine kinase receptor B (TrkB), which play critical roles in synaptic plasticity. In addition, we measured the levels of 3-phosphoinositide-dependent protein kinase-1 (PDK1) and mitogen-activated protein kinase (MAPK), downstream targets of two main pathways in BDNF/TrkB signaling. Music-exposed mice completed a maze learning task with fewer errors than the white noise-exposed mice and had lower levels of BDNF and higher levels of TrkB and PDK1 in the cortex. MAPK levels were unchanged. Furthermore, TrkB and PDK1 protein levels in the cortex showed a significant negative correlation with the number of errors on the maze. These results suggest that perinatal exposure of mice to music has an influence on BDNF/TrkB signaling and its intracellular signaling pathway targets, including PDK1, and thus may induce improved learning and memory functions.

Stress and depression-induced immune dysfunction: implications for the development and progression of cancer

The persistent activation of the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary axes in chronic stress response and in depression impairs the immune response and contributes to the development and progression of some types of cancer. This overview presents results from experimental animal models, human studies, and clinical evidence that various cellular and molecular immunological parameters are compromised in chronic stress and depression. At the cellular level, stressed and depressed patients had overall leukocytosis, high concentrations of circulating neutrophils, reduced mitogen-stimulated lymphocyte proliferation and neutrophil phagocytosis. At the molecular level, high levels of serum basal cortisol, acute phase proteins, specific antibodies against herpes simplex virus type 1 and Epstein Barr virus, plasma concentration of interleukins IL-1, IL-6, and TNF-alpha, and a shift in the balance of Th1 and Th2 immune response were observed. Both stress and depression were associated with the decreased cytotoxic T-cell and natural killer cell activities affecting the processes of the immune surveillance of tumours, and the events that modulate the development and the accumulation of somatic mutations and genomic instability. DNA damage, growth and angiogenic factors, proteases, matrix metalloproteinases, and reactive oxygen species were also related to the chronic stress response and depression. Behavioural strategies, psychological, and psychopharmacotherapeutic interventions that enhance effective coping and reduce affective distress showed beneficial effects in cancer patients. A better understanding of the bidirectional communication between the neuroendocrine and immune systems could contribute to novel clinical and treatment strategies in oncology.