Valence asymmetries in attitude ambivalence.

Existing models of ambivalence suggest that as the number of conflicting reactions (e.g., attitude components) increases, so too does the experience of ambivalence.

Case Report: What is Your Differential Diagnosis for Bilateral Cerebellar Infarct?

Neurovascular variants are not frequently described outside of specialty literature. Infarction involving these atypical neurovascular structures present with unusual clinical findings and radiologic imaging. A 63-year-old man with hypertension, diabetes, and former tobacco use presented from the Department of Corrections with global headache, nausea, vomiting, and double vision.

Autosplenectomy Causing Catastrophic Pneumococcal Meningitis in a Patient with Lupus/Antiphospholipid Antibody Syndrome.

We present the case ofa26-year-old female who presented to the hospital with pneumococcal meningitis. A review of her records showed atrophic spleen, and a hypercoagulable workup was positive for Systemic Lupus Erythematous (SLE)/Antiphospholipid Antibody Syndrome (APS). An autosplenectomy from thrombotic occlusion of the splenic artery made her susceptible to pneumococcal meningitis.

Brachial artery injuries in children.

Treatment of brachial artery injuries in children, particularly those resulting from supracondylar humeral fractures, is controversial when distal pulses are absent yet the hand remains warm and pink. This article presents a retrospective study of eight children, ages 3 to 13, who underwent brachial arterial exploration because of absent distal pulses following arm trauma. Absent pulses indicate diminished blood flow, and in all eight cases brachial artery obstruction or severance was confirmed at surgery.

Telemonitoring with case management for seniors with heart failure.

Objective: To assess the impact of supplementing nurse case management with Internet-connected telemonitoring on clinical outcomes in an elderly heart failure (HF) population.

Study Design: Randomized clinical trial allocating high-risk HF subjects to the telehealth system with case management (THCM) versus case management (CM) alone.

Methods: Medicare Advantage members with HF and recent hospitalization were randomized to THCM or CM.

Computerized alert reduced D-dimer testing in the elderly.

Objective: To assess the effect of a targeted age-specific computerized alert to reduce D-dimer testing in elderly patients.

Study Design: A single-crossover cluster randomized trial of computerized alerts during physician order entry involving 8 ambulatory care clinics in a group-model integrated care delivery system.

Methods: The rate of completed D-dimer tests per 1000 patient visits, ratio of completed venous ultrasonography to completed D-dimer tests, and rate of completed venous ultrasonography per 1000 patient visits.

Mountain pine beetle attack associated with low levels of 4-allylanisole in ponderosa pine.

Mountain pine beetle (Dendroctonus ponderosae) is the most important insect pest in southern Rocky Mountain ponderosa pine (Pinus ponderosa) forests. Tree mortality is hastened by the various fungal pathogens that are symbiotic with the beetles. The phenylpropanoid 4-allylanisole is an antifungal and semiochemical for some pine beetle species.

Kaiser Permanente's Convergent Medical Terminology.

This paper describes Kaiser Permanente's (KP) enterprise-wide medical terminology solution, referred to as our Convergent Medical Terminology (CMT). Initially developed to serve the needs of a regional electronic health record, CMT has evolved into a core KP asset, serving as the common terminology across all applications. CMT serves as the definitive source of concept definitions for the organization, provides a consistent structure and access method to all codes used by the organization, and is KP's language of interoperability, with cross-mappings to regional ancillary systems and administrative billing codes.