Lee Ann Paradise, Managing Editor, Texas Tech University Health Sciences Center, Lubbock, Texas

When I sat down to write this editorial, I initially intended to give you an overview of the articles contained in this journal, which I will eventually do. However, before I do that, I would like to discuss two things with you. First, we have added a new section to our journal that discusses legal and policy issues relating to rural health. Although we have always published articles of this type, we are now making a commitment to address these issues in every journal. Our intent is to simplify some of the legislation, which is often complicated and misunderstood, and to bring to light new policies that may affect rural communities and the health care providers that serve them.

Secondly, I'd like to encourage you to submit articles on topics that relate to this new section. Please refer to the author instructions for details on how to submit your article. All articles undergo a blind peer review and should deal with current issues that are pertinent to rural health. In addition, we are especially interested in articles on rural health hospitals, primary and emergency care, and border health.

Now here's the overview I promised you. As you know, we always open our journal with a "Notes" article that discusses rural health issues from the field. The best way to describe these articles is to say that they are comprehensive, but brief and are written in easy-to-understand language. The article by McBeath and Kennedy discusses a unique school-based clinic and telemedicine program in Hart, Texas based on a partnership between the Hart Independent School District and the Texas Tech University Health Sciences Center. One of a few programs of its kind in Texas, and indeed the nation, it uniquely combines primary pediatric health care in a school-based clinic and distance health care via telemedicine. Comments from the program's participants as well as from people interested in starting a similar project have been overwhelmingly positive. Other articles on telemedicine in Texas are planned to appear in upcoming issues.

In this issue's legal and policy section, Dr. Keith Mueller takes some of the guesswork out of understanding the changes and consequences associated with the Balanced Budget Act legislation. Focusing on the Medicare program, Dr. Mueller takes a no-nonsense approach to the economics of rural health care. Shining a spotlight on problem areas, he invites us to become involved in the creation of new policies before they become established rather than waiting until its too late.

International in scope, a brief article by Dr. Karunesh Tuli discusses rural health in Texas while also looking at rural health programs across the globe. While focusing on educating health care workers and identifying community needs, this article reminds us that through shared experiences we can learn from each other and also make a difference in our own community. In addition, you might want to check out the reference section to this article, which includes a lot of interesting on-line sites.

An article focusing on border issues by Richard Durbin discusses everything from water resources to hazardous waste to air quality. In an attempt to clarify which agencies are responsible for various environmental health services, Durbin developed a questionnaire and sent it to a variety of state and local agencies. Based on personal accounts as well as in-depth research, Durbin's article is organized into bite-size chunks and seasoned with information gained from a variety of interviews.

In the final installment of the article on family physicians and emergency medicine by Dr. Bullock and her collaborators, we learn about the benefits of utilizing the skills of different specialties to meet the needs of patients in rural settings. Moving away from the idea that a physician should only practice within his or her own specialty, this article discusses ways in which some physicians have combined their education and experience to improve the quality of care in rural and under-served communities.

As a result of the research conducted by Dr. Serey Shum and her team, we learn about the attitudes and behaviors regarding skin cancer prevention among rural Texas farm women. Having conducted 665 surveys, the team was able to identify what influenced prevention practices and plans to tailor educational programs that speak specifically to this often overlooked portion of the population.