Relaxation Therapy for Irritable Bowel Syndrome: A Systematic Review

PURPOSE: This study investigated evidence for the use of relaxation therapies as interventions to decrease irritable bowel syndrome (IBS) symptoms and severity as well as reduce anxiety and improve quality of life in IBS patients. METHODS: A search of electronic bibliographic databases (e.g., Medline Ovid, Embase, KoreaMed, and National Discovery for Science Leaders) was conducted to identify randomized controlled trials that included relaxation exercise programs for adults (>18 years old) with IBS. Of the 486 publications identified, 8 studies met inclusion and exclusion criteria, and all studies were used in the meta-analysis. We used Cochrane's risk of bias to assess study quality. RESULTS: The results showed that IBS symptoms decreased significantly, 6.19 (95% confidence interval [2.74, 14.02]) and there was no heterogeneity. Symptom severity and anxiety decreased by 0.38 (95% confidence interval [-1.41, 0.65]) and -0.08 (95% confidence interval [-0.38, 0.23]) due to relaxation therapies, but theses scores were not statistically significant. CONCLUSION: This review revealed positive effects of relaxation therapy on IBS symptoms in adult patients with IBS. However, these results should be interpreted with caution due to the small number of studies examined and the associated methodological problems. Further studies are needed to ascertain the longterm effects of relaxation therapy and the underlying psychosocial mechanisms leading to anxiety reduction and improved quality of life.

Effect of Kegel Exercise to Prevent Urinary and Fecal Incontinence in Antenatal and Postnatal Women: Systematic Review

PURPOSE: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. METHODS: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. RESULTS: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. CONCLUSION: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

Systematic Review and Meta-Analyses of Diagnostic Accuracy of Infrared Thermometer when Identifying Fever in Children

PURPOSE: Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children. METHODS: Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. RESULTS: Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low. CONCLUSION: The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.

Effects of an Exercise Program on Depression Symptom, Self-esteem and Stress in Adolescents: A Systematic Review / 정신간호학회지

PURPOSE: This study was done to investigate evidence of exercise programs as interventions to decrease depression, anxiety symptoms and stress as well as to improve physical status and self-esteem in adolescents. METHODS: A search of electronic bibliographic database of Medline Ovid, Embase, KoreaMed and NDSL etc. was carried out to identify studies of randomized controlled trials that included exercise programs for adolescent. Of 679 publications identified, 10 studies met inclusion and exclusion criteria, and all studies were used in the meta-analysis. For Quality assessment of studies, Cochrane's Risk of Bias was used. RESULTS: The effectiveness of exercise therapy in adolescents showed that depression symptoms and stress decreased significantly, -0.50 (95% CI: -0.73~-0.27), -1.65 (95% CI: -3.19~-0.12) respectively, but there were some heterogeneity. Self-esteem increased 0.19 (95% CI: -0.22~0.60) due to exercise therapy but theses scores were not statistically significant. CONCLUSION: Based on these findings, there is evidence that exercise programs in adolescents are effective in improving depression symptoms, stress, and self-esteem. Therefore, the priority task is to develop tailored exercise programs for Korean adolescents and make efficient use of these programs.

Health Promotion Researches Supported by the Korean Government

BACKGROUND: This study was carried out to examine the trends of government-supported health promotion research projects conducted in Korea over the past 12 years. METHODS: Research type, area of interest, organization, and expense of 726 research projects conducted from 1998 to 2009 were examined and the health promotion content analyzed. RESULTS: In Korea, 361 health policy researches (HPR) and 365 general health researches (GHR) were supported by the government during the defined time period. A total of 60.5 health promotion research were conducted annually with a total amount of 27.1 billion won provided (2.26 billion won per year). With the average research project lasting 8.5 months, HPR (7.7 months) projects were completed sooner than GHR (9.2 months). Those who majored in preventive medicine completed 177 research (24.4%), the most number of research projects, followed by public health (22.5%), and family medicine (15.6%). There were 641 health promotion research projects done mostly on policies, legal systems, and grasping current conditions, and only 85 (11.7%) clinical test research on the development or effects of health promotion programs. CONCLUSIONS: HPR have been increasing annually. However, our study could not be certain of how close the studies were to the government's health promotion policies. Furthermore, the main health promotion area, 'healthy living', was not researched as often as should be. Additionally, to improve applicability of the research projects, interdisciplinary cooperation should be promoted.

Effect of Postpartum Outcomes in Mother's Upright Position During the Second Stage of Labor: Systematic Review

PURPOSE: The purpose of this study was to determine whether upright position is effective in labor through systematic review in randomized controlled trials. METHODS: We established the PICO (Patient-Intervention-Comparator-Outcome) strategy, and reviewed 282 literatures from national and international electronic databases, and finally selected 9 references based on inclusion and exclusion criteria. We evaluated the quality of references and carried out a meta-analysis. RESULTS: The maternal outcomes showed that the duration of their second-stage labor was 2.29 minutes shorter than that of the women in the recumbent position, and were less likely to have episiotomy. The other outcomes, including the mode of delivery, blood loss, hemoglobin level, use of oxytocin, use of analgesics, and perineal laceration, did not differ between the groups. The fetal heart rate abnormality occurred less than in the control group. The Apgar scores of the groups did not differ. CONCLUSION: There is evidence that an upright position in the second stage of labor reduces the duration of the second stage of labor, the incidence of episiotomy, and an abnormal fetal heart rate.