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| 1 | Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination显示文摘AIM To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.METHODS Specific intervention strategies(i.e.,comfort positioning,nonnutritive sucking and sucrose analgesia,distraction) were identified,selected and introduced in three waves,using a Plan-Do-Study-Act framework.System-wide change was measured from baseline to post-intervention by:(1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and(2) caregiver satisfaction ratings following the visit.Additionally,self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts.RESULTS Significant improvements were noted post-intervention.Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received.Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [t(143) = 2.50,P ≤ 0.05],as well as greater agreement that the pain prevention strategies used helped their children's pain [t(180) = 2.17,P ≤ 0.05] and that they would be willing to use the same strategy again in the future [t(179) = 3.26,P ≤ 0.001] as compared to baseline.Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention.Specifically,staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47 vs 3.10; t(70) =-2.11,P ≤ 0.05],less agreement that pain from vaccinations is 'just part of the process' [3.94 vs 3.23; t(70) = 2.61,P ≤ 0.05],and less agreement that parents expect their children to experience pain during vaccinations [4.81 vs 4.38; t(69) = 2.24,P ≤ 0.05].Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas,including safety,cost,time,and effectiveness,as well as less concern about the pain their children experience with vaccination [4.08 vs 3.26; t(557) = 6.38,P ≤ 0.001],less need for additional pain prevention strategies [3.33 vs 2.81; t(476) = 4.51,P ≤ 0.001],and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40 vs 3.75; t(433) =-2.39,P ≤ 0.05].CONCLUSION Quality improvement methodology can be used to help close the gap in implementing pain prevention strategies during routine vaccination procedures for children. | Jennifer Verrill Schurman Amanda D Deacy Rebecca J Johnson Jolynn Parker Kristi Williams Dustin Wallace Mark Connelly Lynn Anson Kevin Mroczka | 2017 | World Journal of Clinical Pediatrics2017，6，1： | 3 |
| 2 | Subepicardial endothelial cells invade the embryonic ventricle wall to form coronary arteries显示文摘冠的动脉把血流动带到心肌肉。理解冠的动脉的发展程序提供卓见进冠的动脉疾病的治疗。多重来源被描述了为包括 proepicardium,湾穴 venosus (SV ) ,和心内膜贡献冠的动脉。然而,冠的容器的发展起源仍然在强烈学习下面。我们为学习冠的开发生产了一个新基因工具,一只 AplnCreER 老鼠在开发冠的容器明确地衬里 recombinase,它表示可诱导的 Cre。冠的开发和 AplnCreER 命运跟踪的预定正式就职的定量分析证明 subepicardial endothelial 房间(EC ) 的子孙两个都入侵紧缩的心肌层形成冠的动脉并且在表面上留下生产静脉。我们发现这些 subepicardial EC 是 intramyocardial 的主要来源在发展中的心的冠的容器。在 vitro 将生物的活组织移植于培养基中培养,试金显示这些 subepicardial EC 的多数从 SV 和中庭的心内膜,然而并非从室的心内膜产生。Apln 积极的房间的同种细胞的分析显示单个 subepicardial EC 同等地作出贡献到冠的动脉和静脉。一起,这些数据建议 subepicardial EC 是 intramyocardial 的主要来源在室的冠的动脉墙,和那冠的动脉和静脉在发展中的心有普通起源。 | Xueying Tian Tianyuan Hu Hui Zhang Lingjuan He Xiuzhen Huang Qiaozhen Liu Wei Yu Liang He Zhongzhou Yang Zhen Zhang Tao P Zhong Xiao Yang Zhen Yang Yan Yan Antonio Baldini Yunfu Sun Jie Lu Robert J Schwartz Sylvia M Evans Adriana C Gittenberger-de Groot Kristy Red-Horse Bin Zhou | 2013 | Cell Research2013，23，9： | 3 |
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| 19 | Distinguishing between Employees' Perceptions of Person-Job and Person-Organization Fit显示文摘 | Lauver Kristy J Kristof Brown Amy | 2001 | Journal of Vocational Behavior2001，59，3： | 1 |
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