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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 | Electrocardiographic manifestations of cardiac infectious-inflammatory disorders显示文摘 | Mohan Punja Dustin G. Mark Jonathan V. McCoy Ramin Javan Jesse M. Pines William Brady | 2010 | American Journal of Emergency Medicine2010，，3： | 1 |
| 3 | A sensitive and rapid ultra HPLC–MS/MS method for the simultaneous detection of clopidogrel and its derivatized active thiol metabolite in human plasma显示文摘 | Cody J. Peer Shawn D. Spencer Dustin A.H. VanDenBerg Michael A. Pacanowski Richard B. Horenstein William D. Figg | 2011 | Journal of Chromatography B2011，，： | 1 |
| 4 | Postconcussive Symptoms Are Associated With Compensatory Cortical Recruitment During a Working Memory Task显示文摘 | Jamie E Pardini Dustin A Pardini James T Becker Kathryn L Dunfee William F Eddy Mark R Lovell Joel S Welling | 2010 | Neurosurgery2010，，4： | 1 |
| 5 | Robot-aided neurorehabilitation:a novel robot for ankle rehabiliration显示文摘 | Krebs Hermano Igo Williams Dustin J Bever Christopher T | 2009 | obofics Tmmacfions on2009，25，3： | 1 |
| 6 | The structure and infrastructure of the global nanotechnology literature显示文摘 | Ronald N. Kostoff Jesse A. Stump Dustin Johnson James S. Murday Clifford G.Y. Lau William M. Tolles | 2006 | Journal of Nanoparticle Research (-)2006，，3： | 1 |
| 7 | The structure and infrastructure of the global nanotechnology literature显示文摘 | Ronald N. Kostoff Jesse A. Stump Dustin Johnson James S. Murday Clifford G.Y. Lau William M. Tolles | 2006 | Journal of Nanoparticle Research (-)2006，，3： | 1 |
| 8 | A Wrist Extension for Mit-Manus显示文摘 | Hermano Ego Krebs James Celestino Dustin Williams | 2004 | Advanced in Rehabilitation Ro- botics2004，306，24： | 1 |
| 9 | Robot-Aided Neurorehabilitation : A Robot for Wrist Rehabilitation 显示文摘 | Hermano lgo Krebs Bruce T Volpe Dustin Williams | 2007 | IEEE Transactions on Neural Systems and Rehabilitation Engineer- ing2007，15，3： | 1 |
| 10 | Comparison of Visual Acuity in Macular Degeneration Patients Measured with Snellen and Early Treatment Diabetic Retinopathy Study Charts显示文摘 | Iryna A. Falkenstein Denine E. Cochran Stanley P. Azen Laurie Dustin Ajay M. Tammewar Igor Kozak William R. Freeman | 2008 | Ophthalmology2008，，2： | 1 |
| 11 | In situ measurement of ECM rheology and microheterogeneity in embedded and overlaid 3D pancreatic tumor stroma co-cultures via passive particle tracking显示文摘Tumor growth is regulated by a diverse set of extraellular infuences,including paracrine crosstalk with stromal partners,and biophysical interactions with surrounding cells and tissues.Studies elucidating the role of physical force and the mechanical properties of the extracellular matrix(ECM)itself as regulators of tumor growth and invasion have been greatly catalyzed by the use of in ritro three-dimensional(3D)tumor models.These systems provide the ability to systematically isolate,manipulate,and evaluate impact of stromal components and extracellular mechanics in a platform that is both conducive to imaging and biologically relevant.However,recognizing that mechanoregulatory crosstalk is bi-directional and fully utilizing these models requires complementary methods for in situ measurements of the local mechanical environment.Here,in 3D tumor/fbroblast co-culture models of pancreatic canocer,a discase characterized by its prominent stromal involvement,we evaluate the use of particle-tracking microrhoology to probe dynamic mechanical changes.Using videos of fuorescently labeled polystyrene micro-spheres embedded in ollagen I ECM,we measure spatiotemporal changes in the Brownian motion of probes to report local ECM shear modulus and microheterogeneity.This approach reveals st ffening of collagen in fibroblast co-cultures relative to cultures with cancer cells only,which exhibit degraded ECM with heterogeneous microstructure.We further show that these effects are dependent on culture geometry with contrast ing behavior for embedded and overlay cultures.In addition to potential application to screening stroma targeted therapeutics,this work also provides insight into how the compoition and plating geometry impact the mechanical propertios of 3D cell cultures that are increasingly widey used in cancer biology. | Dustin P.Jones William Hanna Gwendolyn M.Cramer Jonathan P.Celli | 2017 | Journal of Innovative Optical Health Sciences2017，，6： | 0 |
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