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Search Results: 1 - 10 of 193108 matches for " Loren G. Yamamoto "
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Failure to prevent medication errors: We need smarter nearly error proof systems  [PDF]
Loren G. Yamamoto, Kyle M. Watanabe, Joan E. Kanemori
Open Journal of Pediatrics (OJPed) , 2013, DOI: 10.4236/ojped.2013.32013
Abstract: Purpose: To determine if nurses are able to identify medication errors that have the potential to bypass computer physician order entry (CPOE) and smart ordering systems. Background: Medical care systems employ computer “smart” systems to reduce medication errors by using artificial intelligence (preprogrammed methods of decision support and error reduction). However, these systems are not perfect and they can be bypassed. Nurses who carry out the order represent the last check point in error prevention prior to the administration of medication orders. Methods: A paper exercise was created with 513 physician orders. Nurses were asked to indicate whether they would carry out the order, refuse to carry out the order, consult a pharmacist for clarification, or carry out the order with special precautions. Nurses were given the option of using any nursing or medical reference. Results: The rate of correctly identifying 23 of the contraindicated orders was low. Both experienced and inexperienced nurses had high rates of not identifying the errors despite similar use of references and requests for assistance from pharmacists. Conclusions: This study demonstrates that if an error escapes a smart system, nurses were able to identify most of these errors, but not all of these. The current system features high stress, self-esteem issues, time pressure, high volume, and high risk. The system must change radically to meet the public’s expectations of being nearly error free which can only be achieved with smarter systems that are more resistant to human errors.
Similar erythrocyte sedimentation rate and C-reactive protein sensitivities at the onset of septic arthritis, osteomyelitis, acute rheumatic fever
Jonathan E. Reitzenstein,Loren G. Yamamoto,Hareesh Mavoori
Pediatric Reports , 2010, DOI: 10.4081/pr.2010.e10
Abstract: The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are employed in the evaluation of patients with suspected septic arthritis, osteomyelitis, and acute rheumatic fever. The purpose of this study is to determine if one test has greater sensitivity (rises earlier) than the other. Laboratory data were retrieved for pediatric patients hospitalized with one of the above three conditions, who had both ESR and CRP tests done on or shortly prior to admission. Sensitivity calculations were performed for mild, moderate, and severe degrees of ESR and CRP elevation. Microcytic erythrocytes, as defined by mean corpuscular volume (MCV) less than 80 μL, were identified to see if this affects the ESR. ESR or CRP sensitivities depend on the cutoff value (threshold) chosen as a positive test. The sensitivities were similar for similar degrees of elevation. ESR and CRP discordance was not significantly related to MCV. We concluded that the CRP does not rise earlier than the ESR (their sensitivities are similar). Previously published conclusions are dependent on arbitrary thresholds. We could not find any evidence that MCV affects the ESR.
Limitations of Online Information on Abdominal Aortic Aneurysm
Carolyn G. Goldberg,Loren Berman,Richard J. Gusberg
International Journal of Vascular Medicine , 2010, DOI: 10.1155/2010/789198
Abstract: Background. Patients with AAA face a complex decision, and knowledge of the risks and benefits of each treatment option is essential to informed decision-making. Here we assess the current information on the internet accessible to patients regarding the management of AAA. Study Design. We performed a search on Google using the keywords “abdominal aortic aneurysm” and reviewed the top 50 web sites. We focused on information related to treatment options and alternatives to treatment and the risks of each option. Results. Twenty-seven websites were included in the study. Nearly 30% of websites discussed the risk of mortality and myocardial infarction after open surgery, compared to only 7.4% for both risks after EVAR. Other complications were listed by fewer websites. Fifty-five percent of websites reported that patients had a faster recovery following EVAR, but only 18.5% mentioned the risk of reintervention after EVAR or the need for long-term surveillance with CT scans. Conclusions. While most websites included descriptive information on AAA and mentioned the potential treatment options available to patients, the discussion of the risks of open surgery and EVAR was inadequate. These results suggest that websites frequently accessed by patients lack important information regarding surgical risk. 1. Introduction When diagnosed with an abdominal aortic aneurysm (AAA), patients are confronted with a complex decision: whether or not to undergo invasive treatment for an asymptomatic but potentially fatal condition. If patients elect to pursue surgical treatment, many must further decide between open surgery and endovascular repair (EVAR). Knowledge of the natural history of AAA as well as the risks and benefits of all treatment options is essential for patients to make a well-informed decision. Effective communication of this information during the informed consent process can be challenging because of the volume and complexity of the information involved as well as the emotional impact of the potentially life-changing alternatives being considered. We have previously reported that many patients neither appreciated the scope of their options before AAA repair nor felt adequately informed prior to making a decision [1]. Given the complexity and variability of information, it is not surprising that many patients do not feel well informed about possible outcomes of surgical intervention. It has been well documented that education increases patient satisfaction with decision making [2–5]. The internet has the potential to provide patients with information and
Analyses of Long Lived Slepton NLSP in GMSB Model at Linear Collider
P. G. Mercadante,H. Yamamoto
Physics , 1999,
Abstract: We performed an analysis on the detection of a long lived stau at a linear collider with $\sqrt{s}=500$ GeV. In GMSB models a long lived NLSP is predicted for large value of the supersymmetry breaking scale F. Furthermore in a large portion of the parameter space this particle is a stau. Such heavy charged particles will leave a track in the tracking volume and hit the muon detector. In order to disentangle this signal from the muon background we explore kinematics and particle identification tools: time of flight device, dE/dX and Cerenkov devices.
Stability for some inverse problems for transport equations
Fikret G?lgeleyen,Masahiro Yamamoto
Mathematics , 2015,
Abstract: In this article, we consider inverse problems of determining a source term and a coefficient of a first-order partial differential equation and prove conditional stability estimates with minimum boundary observation data and relaxed condition on the principal part.
Auto-percep??o de aluna de enfermagem ao desenvolver rela??o de ajuda a familiares de crian?a em fase terminal
Loren?on, Marisa;
Revista Latino-Americana de Enfermagem , 1998, DOI: 10.1590/S0104-11691998000400008
Abstract: the present study aims at reporting and analysing the therapeutic approach of children under intensive care and studying the relationship between nurse and mother. facing the illness of a dying child and within a sometimes hostile and emotional environment, the student is trained to help the family and their problems. the student's own anxiety and difficulties in managing these situations are evaluated.
OKLAHOMA BANK BEHAVIOR AND THE PANIC OF 1907
Loren Gatch
Essays in Economic & Business History , 2010,
Abstract: While the Panic of 1907 began in New York City, its effects reverberated throughout the United States. This article examines the response of Oklahoma banks to the nationwide restriction of payments beginning in late October of that year. Despite the widespread support of local communities for their banks, Oklahoma institutions cut back on loans and built up their reserves to a greater degree than did country banks nationwide. Of particular concern for Oklahomans in late 1907 was the financing of the cotton crop. Balance sheet evidence suggests that Oklahoma banks in cotton-growing areas reacted more defensively than did banks in wheat-growing areas, where the harvest had already been completed. A multiple regression model exploring changes in Oklahoma bank reserves before and after the Panic not only confirms the relevance of cotton as a factor but also points to bank size, the use of cash substitutes, and political jurisdiction as variables that influenced the extent to which Oklahoma banks increased their reserves in response to the Panic.
LOCAL MONEY IN THE UNITED STATES DURING THE GREAT DEPRESSION
Loren Gatch
Essays in Economic & Business History , 2008,
Abstract: The Great Depression in the United States produced a great outpouring of local currencies as responses to various aspects of the economic crisis. This article describes the basic types of scrip in use, assesses their legality and theoretical justification, and ventures some generalizations as to what sorts of scrip worked best. It argues that the widespread use of local scrip was not motivated by any systematic analysis of the shortcomings of the national economy, or of its monetary system. Rather, the scrip movement represented eclectic responses to specific economic problems created by the Depression.
Self-fashioning, Freedom, and the Problem of His-story: the return of noir
Scott Loren
European Journal of American Studies , 2008, DOI: 10.4000/ejas.1842
Abstract: With a mix of two patently American film genres - film noir and the western - David Cronenberg’s critically acclaimed A History of Violence (2005) sets up a group of oppositions through the story of a man who leaves a life of crime and violence behind to assume a new identity, start a family, and settle down in the quiet town of Millbrook, Indiana. The oppositions between gangster thug, super-killer and good citizen, family-man are paralleled in another opposition particularly typical to the ...
Examples of DLR states which are not weak limits of finite volume Gibbs measures with deterministic boundary conditions
Loren Coquille
Mathematics , 2014, DOI: 10.1007/s10955-015-1211-3
Abstract: We review what is known about the structure of the set of weak limiting states of the Ising and Potts models at low enough temperature, and in particular we prove that the mixture $\frac12(\mu^\pm+\mu^\mp)$ of two reflection-symmetric Dobrushin states of the 3-dimensional Ising model at low enough temperature is a Gibbs state which is not a limit of finite-volume measures with deterministic boundary conditions. Finally we point out what the issues are in order to extend the analysis to the Potts model, and give a few conjectures.
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