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PubMed2004

Consulting.

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Ethics, Clinical↗
PubMed2001

Emerging models.

In all these models, the potential of child psychiatrists and other mental health professionals in decreasing student barriers to learning is promising. While expanding the traditional client service model, child psychiatrists can serve as advocates for identifying student's unmet mental health needs, encourage schools to build capacity for effective responses, be vigilant for quality assurance, develop and initiate new programs that systematically respond to needs of the school community, and provide training opportunities that demystify the psychiatric concepts that can help administrators and teachers. Relatively few child psychiatrists are active in the school setting or have developed a presence in the national movement to provide mental health services in schools. In recognition of the fact that traditional models of psychiatric care such as outpatient clinics and hospital-based programs do not reach many children and adolescents, it is hoped that child psychiatrists will be more motivated to have a more active and rewarding presence in the school setting. Even with the variety of responses to the need for increasing mental health services to children, there are a lot of unanswered questions. With only 8000 child psychiatrists in the United States and 80,000 schools, it is clear that we need to be strategic about how best to utilize our resources. The big question is whether there are predictable and alterable characteristics, mechanisms, and interactive processes that enable high-risk students to attain educational and personal success, despite seemingly poor odds. Emerging models have the potential to begin answering this question.

Adolescent↗
PubMed2002

Use of dynamic telepathology in Mohs surgery: a feasibility study.

BACKGROUND: Telepathology is an emerging technology for remote pathology consultation and diagnosis. OBJECTIVE: To assess the diagnostic accuracy and utility of a dynamic telepathology system in the setting of Mohs surgery. METHODS: Using a dynamic telepathology system, a single dermatopathologist at a remote site assessed the following cases: (1) 50 fixed-tissue slides of basal and squamous cell carcinomas for pathologic diagnosis; (2) 40 frozen-section slides from Mohs surgery for the presence or absence of tumor; (3) 20 frozen-section slides from Mohs surgery for intraoperative consultation with the Mohs surgeon. All 110 slides were then randomly reviewed by the same dermatopathologist by conventional light microscopy. Telepathology and conventional light microscopy diagnoses were then compared. RESULTS: There was complete agreement between telepathology and conventional light microscopy diagnoses. CONCLUSION: Dynamic telepathology is a convenient, useful, and accurate system for remote diagnosis and consultation in the setting of Mohs surgery.

Basal Cell Carcinoma↗
PubMed1995

Telemedicine for patient consultation: factors affecting use by rural primary-care physicians in Kansas.

The purpose of our study was to investigate knowledge of, attitudes to, and use of interactive telemedicine for specialist consultation among rural practitioners Kansas. We interviewed 28 rural primary-care practitioners at seven remote health-care facilities in six locations. Content analyses of the interviews showed universal but superficial knowledge of telemedicine, appreciation of the value of the technology, but relatively low usage of the telemedicine service available (32% of subjects). Physicians did not appear to be afraid of change. Telemedicine usage was not related to the professional characteristics of the physicians. Our findings suggest that further growth in the use of telemedicine will depend on efforts directed towards physicians which are aimed at creating a more user-friendly environment and at accommodating the referral practices of potential users.

Health Knowledge, Attitudes, Practice↗