Nurse-driven clinical pathway based on an innovative asthma score reduces admission time for children

Objective: We recently demonstrated that an innovative asthma score independent of auscultation could accurately predict the requirement for bronchodilator nebulization compared to the physician's routine clinical judgment to administer bronchodilators. We aimed to standardize inpatient care for children with acute asthma by implementing a clinical pathway based on this innovative asthma score. Methods: We designed a nurse-driven clinical pathway. This pathway included standardized respiratory assessments and a protocol for the nursing staff to administer bronchodilators without a specific order from the physician. We compared the length of stay and the number of readmissions to a historical cohort. Results: Seventy-nine patients with moderate acute asthma completed the pathway. We obtained a total of 858 Childhood asthma scores in these patients, with a median of 11 scores per patient (interquartile range 8-17). Patients treated according to the nurse-driven protocol were 3.3 times more likely to be discharged earlier (hazard ratio, 3.29; 95% confidence interval, 2.33-4.66; P < 0.05), and length of stay was significantly reduced (median 28 versus 53 h) compared to the historical standard practice. On request, the attending physician assessed the patient's respiratory status 42 times (4.9% of all childhood asthma score assessments). Patient safety was not compromised, and none of the patients were removed from the pathway. In each group, we readmitted two (2.5%) patients within 1 week after discharge. Conclusion: This nurse-driven clinical pathway for children with acute asthma based on an asthma score independent of auscultation findings significantly decreased length of stay without compromising patient safety

Investigation of microwave dielectric relaxation process in the antiferroelectric phase of NaNbO3 ceramics

This letter reports microwave dielectric measurements performed in the antiferroelectric phase of NaNbO3 ceramics from 100 to 450 K. Remarkable dielectric relaxations were found within the antiferroelectric phase and in the vicinity of ferroelectric-antiferroelectric phase transition. Such dielectric relaxation process was associated with relaxations of polar nanoregions with strong relaxor-like characteristic. In addition, the microwave dielectric measurements also revealed an unexpected and unusual anomaly in the relaxation strength, which was related to a disruption of the antiferroelectric order induced by a possible AFE-AFE phase transition.Comment: 4 pages and 4 figures - Paper accepted for publication in the Solid State Communication

Hot-pressed transparent PLZT ceramics from low cost chemical processing

Lanthanum-modified lead zirconate titanate (PLZT) ceramics were obtained with high transmittance in the visible range by a combination of an inexpensive chemical processing and hot pressing. Optical, microstructural, pyroelectric, ferroelectric and dielectric properties characterized in this study attested the applicability of the employed method in the production of PLZT transparent ferroelectric ceramics. In fact, the corresponding analyzed physical parameters are in very good agreement with those obtained in samples traditionally prepared by other methods. Furthermore, due to high sample quality, a phenomenological analysis of the PLZT 10/65/35 relaxor features was performed in these ceramics