Discusses a new test of English language proficiency for international medical graduates. The test, the Clinical Skills Assessment, consists of a series of encounters with "standardized patients" who have been trained to portray various medical conditions. (Author/VWL)

Recognizing possible seizure disorders, medication side-effects, behavioral and cognitive effects of seizures, and their treatments are important skills for school psychologists because they affect 500,000 United States school-aged children attending regular education. A knowledgeable school professional serves a critical role in integrating…

Describes three state-initiated programs that address the challenge of providing access to health care for Appalachia's rural residents: a traveling pediatric diabetes clinic serving eastern Kentucky; a telemedicine program operated out of Knoxville, Tennessee; and a new medical school in Kentucky dedicated to training doctors from Appalachia for…

Wayne Myers, director of the Office of Rural Health Policy, discusses Appalachian rural health and access to health care. The health manpower shortage in Central Appalachia still exists but is less severe than 10 years ago. The needs of underserved areas could be address by training local people in the community and through telemedicine and…

Using an ecological framework, identifies sociodemographic, family, and community predictors of mothers' satisfaction with their children's medical care. Results indicate that demographics exert little influence on satisfaction, whereas family and community stressors do influence satisfaction. Mothers reporting greater perceptions of racism and…

Clients seek genetic counseling to become informed, make better decisions, and to be reassured. Genetic knowledge, however, involves uncertainty. Genetic information conveyed in 30 counseling sessions was studied for its predictability, controllability and novelty (unexpected findings). The interrelationship of unpredictability, uncontrollability,…

Women (N=46) with ultrasound-diagnosed lethal fetal anomaly in late pregnancy were studied. Psychological instability, general psychological distress, depression, and despair were measured over four years and related to normal versus "neurotic" personality dispositions. Findings are presented; the need for medical intervention, emotional support,…

A brief history is provided of extracorporeal membrane oxygenation (ECMO), a treatment option for infants that provides prolonged circulation and reoxgenation of blood outside the body to temporarily support a failing heart or lungs. The University of Kentucky ECMO program is described, along with the positive outcomes of 19 infants. (Contains…

Although generalist physicians have traditionally been defined by their specialties (family, internal, pediatric medicine), this approach may not recognize specific competencies and training needed. A new definition based on functional requirements of generalist practice and the central role of the generalist in comprehensive care is proposed.…

An examination of clinical data from the regional hospital in Cape Town, South Africa, over four years for 538 children with a diagnosis of mental retardation found mild mental retardation referrals were underrepresented in low socioeconomic areas and that paramedical agencies were the primary referral source in these areas. (Author/CR)

This primer on the medical aspects of treating Attention Deficit Hyperactivity Disorder (ADHD) youth will help counselors feel better informed about the types of medications available, possible side effects, and the advantages and disadvantages for use. It also offers a discussion of the consequences for using interventions requiring medication…

Challenges the message of "biopsychiatry," the belief that all mental illness is biologically based, genetic in origin, and incurable, and can only be treated chemically. Suggests that the epidemic drugging of school-age children is an act of despair. Highlights one family's experience in getting appropriate treatment without medication for their…

An interview with the former editor of "The New England Journal of Medicine" examines the impact on medical education of corporatization of the health-care system, including pressures to see more patients, less time spent with each patient, financial pressures limiting medical research, issues related to tenure, and concerns that young doctors are…

This article reviews evidence on the treatment and comorbidity of psychiatric disorders with the purpose of suggesting odds that a child with behavioral disorder may indeed have a disorder that is responsive to psychopharmacologic treatment. Merging the medical and behavioral models is suggested as critical to special education decisions.…

Medical family therapy grew out of the experiences of family therapists working with other professionals to provide comprehensive, integrated healthcare for patients. This is the story of one such patient and provides an account of the experience through quotes from videotaped sessions and electronic mail communications that occurred throughout…