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Background. Acupressure has been shown to improve respiratory parameters. We investigated the effects of acupressure on weaning indices in stable coma patients receiving mechanical ventilation. Methods. Patients were randomly allocated to one of three treatments: standard care with adjunctive acupressure on one (n = 32) or two days (n = 31) and standard care (n = 31). Acupressure in the form of 10 minutes of bilateral stimulation at five acupoints was administered per treatment session. Weaning indices were collected on two days before, right after, and at 0.5 hrs, 1 hr, 1.5 hrs, 2 hrs, 2.5 hrs, 3 hrs, 3.5 hrs, and 4 hrs after the start of treatment. Results. There were statistically significant improvements in tidal volumes and index of rapid shallow breathing in the one-day and two-day adjunctive acupressure study arms compared to the standard care arm immediately after acupressure and persisting until 0.5, 1 hr, and 2 hrs after adjustment for covariates. Conclusions. In the stable ventilated coma patient, adjunctive acupressure contributes to improvements in tidal volumes and the index of rapid shallow breathing, the two indices most critical for weaning patients from mechanical ventilation. These effects tend to be immediate and likely to be sustained for 1 to 2 hours. [ABSTRACT FROM AUTHOR]

Aims and objectives. To investigate the feasibility of a school-based asthma management programme for middle school children. Background. Asthma rates are increasing among school-aged children. Successful asthma treatment in children depends in part on clear communication and effective education. Design. This feasibility study employed a one-group only longitudinal design with four time points over 18 months. Methods. Nineteen female and twelve male ( n = 31) seventh-grade children with asthma (13 SD 0·71 years) were identified using a six-stage asthma case-finding approach. Teachers and school staff were trained in the principles and methods of the proposed school-based asthma management programme. An individualised guided asthma self-management programme was developed for each child by a clinical team at a major academic medical centre. We assisted teachers in implementing the school programme; building a support network and monitoring children’s activities. Outcome measures included lung function tests (at 0, six, 12 and 18 months), disease-related symptoms, psychosocial status and impact of asthma on learning (at 0 and 18 months). School provided data on academic achievement and school absences at 0, six, 12 and 18 months. Results. Significant improvements were noted at six, 12 and 18 months on forced vital capacity (FVC)% of predicted ( p = 0·001, 0·015, 0·015, respectively), forced expiratory volume in one second (FEV1)% of predicted ( p = 0·001, 0·006, 0·088, respectively) and FEV1/FVC% of predicted ( p = 0·001, 0·015, 0·099, respectively). There was a trend towards improved asthma symptoms ( p = 0·050) and a significant decrease in positive perception of curriculum ( p = 0·017) at 18 months after adjustment for covariates. Conclusions. This programme was associated with respiratory benefits on physiological asthma markers commonly, with a trend for symptom control. Academic and psychosocial outcomes are subject of further inquiry. Relevance to clinical practice. School-based asthma management holds promise as a feasible clinical option for middle school children with asthma in the Taiwanese school system. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the feasibility of a school-based asthma management programme for middle school children., Background: Asthma rates are increasing among school-aged children. Successful asthma treatment in children depends in part on clear communication and effective education., Design: This feasibility study employed a one-group only longitudinal design with four time points over 18 months., Methods: Nineteen female and twelve male (n = 31) seventh-grade children with asthma (13 SD 0·71 years) were identified using a six-stage asthma case-finding approach. Teachers and school staff were trained in the principles and methods of the proposed school-based asthma management programme. An individualised guided asthma self-management programme was developed for each child by a clinical team at a major academic medical centre. We assisted teachers in implementing the school programme; building a support network and monitoring children's activities. Outcome measures included lung function tests (at 0, six, 12 and 18 months), disease-related symptoms, psychosocial status and impact of asthma on learning (at 0 and 18 months). School provided data on academic achievement and school absences at 0, six, 12 and 18 months., Results: Significant improvements were noted at six, 12 and 18 months on forced vital capacity (FVC)% of predicted (p = 0·001, 0·015, 0·015, respectively), forced expiratory volume in one second (FEV(1) )% of predicted (p = 0·001, 0·006, 0·088, respectively) and FEV(1) /FVC% of predicted (p = 0·001, 0·015, 0·099, respectively). There was a trend towards improved asthma symptoms (p = 0·050) and a significant decrease in positive perception of curriculum (p = 0·017) at 18 months after adjustment for covariates., Conclusions: This programme was associated with respiratory benefits on physiological asthma markers commonly, with a trend for symptom control. Academic and psychosocial outcomes are subject of further inquiry., Relevance to Clinical Practice: School-based asthma management holds promise as a feasible clinical option for middle school children with asthma in the Taiwanese school system., (© 2010 Blackwell Publishing Ltd.)

We report on 2,688 nosocomial infection episodes involving 3,238 pathogens in Taiwan's only children's hospital. The mean annual incidence density was 4.06 cases per 1,000 patient-days. The relative risk was highest in intensive care units, oncology wards, and neonatal observation wards. Very young, low-birth-weight, critically ill, and oncology patients were most at risk.