Correlation of electrical conductance in meridian and autonomic nervous activity after auricular acupressure in middle-aged women.

BACKGROUND: This study aimed to examine the correlation of heart rate variability (HRV) and meridian electrical conductance among middle-aged women during an 8-week period of auricular acupressure (AA) treatment for weight reduction. METHODS: Sixty (60) subjects were randomized either to a control group (n=30) or to a treatment group with AA (n=30). Anthropometric parameters, HRV indices, and meridian levels were measured before treatment, at the 5th week, and 1 week after the 8-week treatment period. RESULTS: Although no significant changes were observed in body weight (BW) and body-mass index (BMI) from baseline to 1 week after AA treatment, a significant decrease in Waist Circumference (WC) was observed in the acupressure group. In contrast, the subjects' BW, BMI, and WC were significantly increased from baseline to the 9th week in the control group. With adjustment for baseline low frequencies (LF) of HRV, the LF at the 5th and 9th weeks in the acupressure groups was generally lower than that in the control group, with a p-value=0.027 using the mixed linear model. The meridian levels for Spleen, Bladder, and Gallbladder were significantly lower in the group subjected to acupressure than in the control group at the 5th week. CONCLUSIONS: The results of the present study indicate that AA tends to inactivate the sympathetic nervous activity demonstrated by both HRV and meridian electrical conductance changes. As a result, AA may modulate the autonomic nervous system to exert its physiological effect through the pathway of the meridian system.

Impact of an antimicrobial stewardship program with multidisciplinary cooperation in a community public teaching hospital in Taiwan.

BACKGROUND: Reports of antimicrobial stewardship programs (ASPs) in community hospitals are limited, with the major focus on specific agents, small settings, or short time periods. Here we present the outcomes of cost control, consumption restraint, and quality of care after a 3-year multidisciplinary ASP in a 415-bed community public teaching hospital. METHODS: Three strategies for improving antimicrobial stewardship were implemented: education, clinical pharmacists-based intervention, and regular outcome announcement. The steering panel of the program was a committee composed of infection specialists, attending physicians, clinical pharmacists, nurses, and medical laboratorists. RESULTS: Semiannual data from July 2009 to June 2012 was analyzed. Antibiotic costs declined from $21,464 to $12,146 per 1,000 patient-days (-43.4%). Approximately $2.5 million was saved in 3 years, and estimated labor cost was $3,935 per month. Defined daily dose per 1,000 patient-days were diminished from 906.7 to 717.5 (-20.9%). Significant reductions were found in the consumption of aminoglycosides, first-generation cephalosporins, and aminopenicillins. However, through comprehensive auditing, increasing consumption of fourth-generation cephalosporins and fluoroquinolones was noticed. No significant difference in the quality of care (ie, length of stay, incidence of health care associated infections, and mortality) was observed. CONCLUSIONS: The multidisciplinary ASP was beneficial to reduce antibiotic cost and consumption. The strategies were practical and worthy to be recommended to community health care settings.