This study measured implicit and explicit attitudes toward major nursing safety violations using ... more This study measured implicit and explicit attitudes toward major nursing safety violations using the Implicit Association Test (IAT) and self-reported questionnaires, respectively. Experiment 1 sampled nursing students (n = 71), and Experiment 2 sampled patient safety nurses (n = 38). Although reaction time to IAT stimuli of major nursing safety violations was quicker than of general nursing behaviors, error trials did not reveal a significant difference between IAT stimuli of major nursing safety violations and of general nursing behaviors in Experiment 1. Explicit attitude was related with intention to violate safety protocols in Experiment 1. In Experiment 2, both reaction time and error trials showed significant differences between IAT stimuli of major nursing safety violations and of general nursing behaviors. This was interpreted in that patient safety nurses had formed a firm implicit attitude, unlike the nursing students; however, the findings suggested that attitudes were n...
We report a Japanese boy with the Walker-Warburg syndrome. He had typical clinical features, incl... more We report a Japanese boy with the Walker-Warburg syndrome. He had typical clinical features, including type II lissencephaly, congenital muscular dystrophy and an ocular abnormality associated with previously undescribed findings, a double cortical layer and an isolated cyst evident on magnetic resonance imaging, and an increased level of serum IgM. We speculate that the inner layer of the cortices in this case represents a layered heterotopia under the cerebral cortex.
A 1-year-old girl was admitted to our University Hospital with a history of fever, vomiting, left... more A 1-year-old girl was admitted to our University Hospital with a history of fever, vomiting, left-sided hemiconvulsion, gait disturbance, and drowsiness. The cerebrospinal fluid (CSF) on the 9th day of illness revealed 157 white blood cells/mm 3 (68 % monocytes), 64 mg/dl of protein, 59 mg/dl of glucose, and 4.2 ng/ml ( < 4.0 ng/ml) of myelin basic protein. Herpes simplex virus (HSV) DNA was detected in the CSF on the 9th day by the use of polymerase chain reaction method [4]. A high Ig M titer against to HSV type I was also detected in the CSE Periodic slow and sharp wave discharges were recorded in the right fronto-temporal region on the electroencephalogram. Intravenous acyclovir was given atadoseofl0 mg/kg8 hourly for 10 days.The T2-weighted MRI on the 15th day showed increased signal intensities in the white matter of the right temporal lobe (Fig. 1 a). No HSV DNA was detected in the CSF on day 23. The patient's symptoms had resolved by day 37. T2-weighted MRI follow-up on day 71 revealed widespread involvement of the right temporal lobe (Fig. 1 b). MRI on day 92 demonstrated no progression of the lesions. A mild left hemiparesis was still present when she was discharged on day 109.
The analysis of medical incident reports is indispensable for patient safety. The cycles between ... more The analysis of medical incident reports is indispensable for patient safety. The cycles between analysis of incident reports and proposals to medical staffs are a key point for improving the patient safety in the hospital. Most incident reports are composed from freely written descriptions, but an analysis of such free descriptions is not sufficient in the medical field. In this study, we aim to accumulate and reinterpret findings using structured incident information, to clarify improvements that should be made to solve the root cause of the accident, and to ensure safe medical treatment through such improvements. We employ natural language processing (NLP) and network analysis to identify effective categories of medical incident reports. Network analysis can find various relationships that are not only direct but also indirect. In addition, we compare bottom-up results obtained by NLP with existing categories based on experts' judgment. By the bottom-up analysis, the class of...
Journal of Hematotherapy & Stem Cell Research, 2000
The present study investigated the kinetics involved in collection CD34+ cells and colony-forming... more The present study investigated the kinetics involved in collection CD34+ cells and colony-forming units-granulocyte-macrophages (CFU-GMs) during large-volume leukapheresis (LVL) in pediatric patients with malignancies and attempted to correlate the number of cells with the processed blood volume. In addition, adult cases were also examined using the same continuous flow blood cell separator to investigate the difference between children and adults. We examined 5 pediatric patients who had undergone chemotherapy before apheresis and 3 adult patients who were scheduled to undergo chemotherapy following apheresis. Collection was performed using a continuous-flow blood cell separator. Patients received granulocyte-colony-stimulating factor (G-CSF) to mobilize peripheral blood stem cells (PBSCs), except in the case of acute myelocytic leukemia. The processed blood volume was set to approximately 300 ml in children and 500 ml/kg of body weight in adults and the leukapheresis component was collected when approximately 50 ml of blood was processed. Six sequential samples were taken from each component in pediatric patients and 10 sequential samples from adults to obtain CD34+ cells and CFU-GMs. Counts of mononuclear cells (MNCs) and CD34+ cells in peripheral blood were measured just before and after each apheresis. Hemoglobin, hematocrit, and platelet counts in peripheral blood were monitored during apheresis. A total of 11 collections were performed for pediatric patients. The mean total CD34+ cells and CFU-GMs in each fractionated yield did not show a remarkable increase with increasing volume of blood processed. In adults, the kinetics of CD34+ cells in each fractionated yield were determined on a continuous basis and CFU-GMs increased during the course of apheresis. In pediatric patients, circulating MNCs and CD34+ cells were stable during apheresis, whereas in adult patients these cells decreased in the peripheral blood after apheresis. In both pediatric and adult patients, the platelet count in the peripheral blood decreased after apheresis. In contrast to adults, in pediatric patients who had been undergone chemotherapy, the collection efficiency did not appear to increase with increased volume of blood processed. Moreover, there was a marked platelet reduction in peripheral blood following apheresis. We conclude that the kinetics of collecting PBSCs by continuous flow blood cell separator is different between pediatric cases and adults cases. The application of LVL may be prudent in some children with malignancies, including those with a low platelet count and low body weight.
Notch1 is indispensable for T cell development. It is anticipated that Notch1 and other Notch rec... more Notch1 is indispensable for T cell development. It is anticipated that Notch1 and other Notch receptors expressed on the surface of thymic T cell precursors are activated by ligands present on environmental cells, including antigen presenting cells (APCs), and involved in positive and negative selections. Notch receptors on peripheral T cells may also be activated by ligands on APCs. Here, we examined the expression pattern of three Notch ligands, Jagged1, 2 and Delta1 in APCs by an immunofluorescence cell staining method and a reverse transcriptase-polymerase chain reaction (RT-PCR) method. Peritoneal macrophages were strongly positive for Jagged1 staining. In contrast, macrophages separated from spleen and dendritic cells (DCs) separated from spleen and thymus showed positive staining for all the three ligands at a similar intensity. An analysis by RT-PCR revealed that peritoneal and splenic macrophages and splenic and thymic DCs, show a distinct pattern in Notch ligand expression...
We performed a cell transplantation study to treat the brain involvement in lysosomal storage dis... more We performed a cell transplantation study to treat the brain involvement in lysosomal storage diseases. We used acid β-galactosidase knock-out mice (BKO) from C57BL/6 as recipients. To minimize immune responses, we used cells derived from transgenic mice of C57BL/6 overexpressing the normal human β-galactosidase. Fetal brain cells (FBC), bone marrow-derived mesenchymal stem cells (MSC), and mixed FBC and MSC cells
2012 Proceedings of Picmet 12 Technology Management For Emerging Technologies, Jul 1, 2012
ABSTRACT The analysis of medical incident reports is indispensable for patient safety management.... more ABSTRACT The analysis of medical incident reports is indispensable for patient safety management. The cycles between analysis of incident reports and proposals to medical staffs are a key point for improving the patient safety management in the hospital. Most of the incident reports include free descriptions, however, the analysis of free descriptions aren&#39;t enough in the medical area. We aimed to accumulate, to interpret information again by structured incident information, and to clarify the point that should be improved for the cause of the accident and safe medical treatment improvements in the present study. We employ the natural language processing and the network analysis for detecting effective categories of Medical Incident Report. The network analysis can find various relationships that are not only direct relationships but also indirect relationships. First, some important characteristic words were extracted in three categories of the accident&#39;s background, details, and solutions using TF-IDF measure. Next, we show the co-occurrence networks using the extracted words. Then, we detect the new categories based on the network analysis and compare between existing categories based on experts&#39; decisions and bottom-up ones. By the network analysis, some of new perceptions for improving the patient safety management are appeared.
Background: Recently, arts and health activities have been introduced into health care, and evide... more Background: Recently, arts and health activities have been introduced into health care, and evidence of their effectiveness has been accumulating. However, few studies have examined this subject in Japan. Methods: In this practice-based report, faculty of a Japanese school of medicine and a university of arts and design collaborated to explore the effectiveness of an arts and health approach in three different patient safety educational programs implemented in different university hospitals in Japan. Results: The results of the programs demonstrated the effectiveness of integrating arts and health into patient safety management. Conclusions: Additional research is required to understand this further.
ObjectivesSerious adverse effects, including arrhythmia and cardiac arrest, result from rapid int... more ObjectivesSerious adverse effects, including arrhythmia and cardiac arrest, result from rapid intravenous high concentration of potassium chloride (KCl). We aimed to eliminate prescription of undiluted KCl and encourage dilution of KCl to 400 mEq/L and 40 mEq/L in the intensive care units (ICUs) and general and outpatient departments, respectively.MethodsBefore the first intervention, we collected data regarding high-concentration KCl and interviewed representatives of physicians prescribing high-concentration KCl. Based on the guidelines in other countries on safely used concentrations of KCl (400 mEq/L), we negotiated with physicians to dilute KCl below 400 mEq/L. In the first intervention, we made rules based on surveys above. In the second intervention, we revised the rules based on opinions from physicians and pharmacists and investigated the change in the number of prescriptions of KCl concentration in each department. Continuing efforts with the safety manager ensured complia...
This study measured implicit and explicit attitudes toward major nursing safety violations using ... more This study measured implicit and explicit attitudes toward major nursing safety violations using the Implicit Association Test (IAT) and self-reported questionnaires, respectively. Experiment 1 sampled nursing students (n = 71), and Experiment 2 sampled patient safety nurses (n = 38). Although reaction time to IAT stimuli of major nursing safety violations was quicker than of general nursing behaviors, error trials did not reveal a significant difference between IAT stimuli of major nursing safety violations and of general nursing behaviors in Experiment 1. Explicit attitude was related with intention to violate safety protocols in Experiment 1. In Experiment 2, both reaction time and error trials showed significant differences between IAT stimuli of major nursing safety violations and of general nursing behaviors. This was interpreted in that patient safety nurses had formed a firm implicit attitude, unlike the nursing students; however, the findings suggested that attitudes were not related to violations in nursing.
This study measured implicit and explicit attitudes toward major nursing safety violations using ... more This study measured implicit and explicit attitudes toward major nursing safety violations using the Implicit Association Test (IAT) and self-reported questionnaires, respectively. Experiment 1 sampled nursing students (n = 71), and Experiment 2 sampled patient safety nurses (n = 38). Although reaction time to IAT stimuli of major nursing safety violations was quicker than of general nursing behaviors, error trials did not reveal a significant difference between IAT stimuli of major nursing safety violations and of general nursing behaviors in Experiment 1. Explicit attitude was related with intention to violate safety protocols in Experiment 1. In Experiment 2, both reaction time and error trials showed significant differences between IAT stimuli of major nursing safety violations and of general nursing behaviors. This was interpreted in that patient safety nurses had formed a firm implicit attitude, unlike the nursing students; however, the findings suggested that attitudes were n...
We report a Japanese boy with the Walker-Warburg syndrome. He had typical clinical features, incl... more We report a Japanese boy with the Walker-Warburg syndrome. He had typical clinical features, including type II lissencephaly, congenital muscular dystrophy and an ocular abnormality associated with previously undescribed findings, a double cortical layer and an isolated cyst evident on magnetic resonance imaging, and an increased level of serum IgM. We speculate that the inner layer of the cortices in this case represents a layered heterotopia under the cerebral cortex.
A 1-year-old girl was admitted to our University Hospital with a history of fever, vomiting, left... more A 1-year-old girl was admitted to our University Hospital with a history of fever, vomiting, left-sided hemiconvulsion, gait disturbance, and drowsiness. The cerebrospinal fluid (CSF) on the 9th day of illness revealed 157 white blood cells/mm 3 (68 % monocytes), 64 mg/dl of protein, 59 mg/dl of glucose, and 4.2 ng/ml ( < 4.0 ng/ml) of myelin basic protein. Herpes simplex virus (HSV) DNA was detected in the CSF on the 9th day by the use of polymerase chain reaction method [4]. A high Ig M titer against to HSV type I was also detected in the CSE Periodic slow and sharp wave discharges were recorded in the right fronto-temporal region on the electroencephalogram. Intravenous acyclovir was given atadoseofl0 mg/kg8 hourly for 10 days.The T2-weighted MRI on the 15th day showed increased signal intensities in the white matter of the right temporal lobe (Fig. 1 a). No HSV DNA was detected in the CSF on day 23. The patient's symptoms had resolved by day 37. T2-weighted MRI follow-up on day 71 revealed widespread involvement of the right temporal lobe (Fig. 1 b). MRI on day 92 demonstrated no progression of the lesions. A mild left hemiparesis was still present when she was discharged on day 109.
The analysis of medical incident reports is indispensable for patient safety. The cycles between ... more The analysis of medical incident reports is indispensable for patient safety. The cycles between analysis of incident reports and proposals to medical staffs are a key point for improving the patient safety in the hospital. Most incident reports are composed from freely written descriptions, but an analysis of such free descriptions is not sufficient in the medical field. In this study, we aim to accumulate and reinterpret findings using structured incident information, to clarify improvements that should be made to solve the root cause of the accident, and to ensure safe medical treatment through such improvements. We employ natural language processing (NLP) and network analysis to identify effective categories of medical incident reports. Network analysis can find various relationships that are not only direct but also indirect. In addition, we compare bottom-up results obtained by NLP with existing categories based on experts' judgment. By the bottom-up analysis, the class of...
Journal of Hematotherapy & Stem Cell Research, 2000
The present study investigated the kinetics involved in collection CD34+ cells and colony-forming... more The present study investigated the kinetics involved in collection CD34+ cells and colony-forming units-granulocyte-macrophages (CFU-GMs) during large-volume leukapheresis (LVL) in pediatric patients with malignancies and attempted to correlate the number of cells with the processed blood volume. In addition, adult cases were also examined using the same continuous flow blood cell separator to investigate the difference between children and adults. We examined 5 pediatric patients who had undergone chemotherapy before apheresis and 3 adult patients who were scheduled to undergo chemotherapy following apheresis. Collection was performed using a continuous-flow blood cell separator. Patients received granulocyte-colony-stimulating factor (G-CSF) to mobilize peripheral blood stem cells (PBSCs), except in the case of acute myelocytic leukemia. The processed blood volume was set to approximately 300 ml in children and 500 ml/kg of body weight in adults and the leukapheresis component was collected when approximately 50 ml of blood was processed. Six sequential samples were taken from each component in pediatric patients and 10 sequential samples from adults to obtain CD34+ cells and CFU-GMs. Counts of mononuclear cells (MNCs) and CD34+ cells in peripheral blood were measured just before and after each apheresis. Hemoglobin, hematocrit, and platelet counts in peripheral blood were monitored during apheresis. A total of 11 collections were performed for pediatric patients. The mean total CD34+ cells and CFU-GMs in each fractionated yield did not show a remarkable increase with increasing volume of blood processed. In adults, the kinetics of CD34+ cells in each fractionated yield were determined on a continuous basis and CFU-GMs increased during the course of apheresis. In pediatric patients, circulating MNCs and CD34+ cells were stable during apheresis, whereas in adult patients these cells decreased in the peripheral blood after apheresis. In both pediatric and adult patients, the platelet count in the peripheral blood decreased after apheresis. In contrast to adults, in pediatric patients who had been undergone chemotherapy, the collection efficiency did not appear to increase with increased volume of blood processed. Moreover, there was a marked platelet reduction in peripheral blood following apheresis. We conclude that the kinetics of collecting PBSCs by continuous flow blood cell separator is different between pediatric cases and adults cases. The application of LVL may be prudent in some children with malignancies, including those with a low platelet count and low body weight.
Notch1 is indispensable for T cell development. It is anticipated that Notch1 and other Notch rec... more Notch1 is indispensable for T cell development. It is anticipated that Notch1 and other Notch receptors expressed on the surface of thymic T cell precursors are activated by ligands present on environmental cells, including antigen presenting cells (APCs), and involved in positive and negative selections. Notch receptors on peripheral T cells may also be activated by ligands on APCs. Here, we examined the expression pattern of three Notch ligands, Jagged1, 2 and Delta1 in APCs by an immunofluorescence cell staining method and a reverse transcriptase-polymerase chain reaction (RT-PCR) method. Peritoneal macrophages were strongly positive for Jagged1 staining. In contrast, macrophages separated from spleen and dendritic cells (DCs) separated from spleen and thymus showed positive staining for all the three ligands at a similar intensity. An analysis by RT-PCR revealed that peritoneal and splenic macrophages and splenic and thymic DCs, show a distinct pattern in Notch ligand expression...
We performed a cell transplantation study to treat the brain involvement in lysosomal storage dis... more We performed a cell transplantation study to treat the brain involvement in lysosomal storage diseases. We used acid β-galactosidase knock-out mice (BKO) from C57BL/6 as recipients. To minimize immune responses, we used cells derived from transgenic mice of C57BL/6 overexpressing the normal human β-galactosidase. Fetal brain cells (FBC), bone marrow-derived mesenchymal stem cells (MSC), and mixed FBC and MSC cells
2012 Proceedings of Picmet 12 Technology Management For Emerging Technologies, Jul 1, 2012
ABSTRACT The analysis of medical incident reports is indispensable for patient safety management.... more ABSTRACT The analysis of medical incident reports is indispensable for patient safety management. The cycles between analysis of incident reports and proposals to medical staffs are a key point for improving the patient safety management in the hospital. Most of the incident reports include free descriptions, however, the analysis of free descriptions aren&#39;t enough in the medical area. We aimed to accumulate, to interpret information again by structured incident information, and to clarify the point that should be improved for the cause of the accident and safe medical treatment improvements in the present study. We employ the natural language processing and the network analysis for detecting effective categories of Medical Incident Report. The network analysis can find various relationships that are not only direct relationships but also indirect relationships. First, some important characteristic words were extracted in three categories of the accident&#39;s background, details, and solutions using TF-IDF measure. Next, we show the co-occurrence networks using the extracted words. Then, we detect the new categories based on the network analysis and compare between existing categories based on experts&#39; decisions and bottom-up ones. By the network analysis, some of new perceptions for improving the patient safety management are appeared.
Background: Recently, arts and health activities have been introduced into health care, and evide... more Background: Recently, arts and health activities have been introduced into health care, and evidence of their effectiveness has been accumulating. However, few studies have examined this subject in Japan. Methods: In this practice-based report, faculty of a Japanese school of medicine and a university of arts and design collaborated to explore the effectiveness of an arts and health approach in three different patient safety educational programs implemented in different university hospitals in Japan. Results: The results of the programs demonstrated the effectiveness of integrating arts and health into patient safety management. Conclusions: Additional research is required to understand this further.
ObjectivesSerious adverse effects, including arrhythmia and cardiac arrest, result from rapid int... more ObjectivesSerious adverse effects, including arrhythmia and cardiac arrest, result from rapid intravenous high concentration of potassium chloride (KCl). We aimed to eliminate prescription of undiluted KCl and encourage dilution of KCl to 400 mEq/L and 40 mEq/L in the intensive care units (ICUs) and general and outpatient departments, respectively.MethodsBefore the first intervention, we collected data regarding high-concentration KCl and interviewed representatives of physicians prescribing high-concentration KCl. Based on the guidelines in other countries on safely used concentrations of KCl (400 mEq/L), we negotiated with physicians to dilute KCl below 400 mEq/L. In the first intervention, we made rules based on surveys above. In the second intervention, we revised the rules based on opinions from physicians and pharmacists and investigated the change in the number of prescriptions of KCl concentration in each department. Continuing efforts with the safety manager ensured complia...
This study measured implicit and explicit attitudes toward major nursing safety violations using ... more This study measured implicit and explicit attitudes toward major nursing safety violations using the Implicit Association Test (IAT) and self-reported questionnaires, respectively. Experiment 1 sampled nursing students (n = 71), and Experiment 2 sampled patient safety nurses (n = 38). Although reaction time to IAT stimuli of major nursing safety violations was quicker than of general nursing behaviors, error trials did not reveal a significant difference between IAT stimuli of major nursing safety violations and of general nursing behaviors in Experiment 1. Explicit attitude was related with intention to violate safety protocols in Experiment 1. In Experiment 2, both reaction time and error trials showed significant differences between IAT stimuli of major nursing safety violations and of general nursing behaviors. This was interpreted in that patient safety nurses had formed a firm implicit attitude, unlike the nursing students; however, the findings suggested that attitudes were not related to violations in nursing.
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Papers by Etsuko Nakagami-Yamaguchi