Six step approach systematically guides the process of problem identification,needs assessment, writing goals and objectives, educational strategies, implementation process, and getting worthwhile evaluation and feedback. Based upon Johns Hopkins Internal Medicine model but substantial utility for all medical disciplines. I will use it in redesigning curriculum at my institution. Highly recommended!

Paul Evans DO, Associate Dean for Curricular Affairs, Oklahoma State University COM

CENTURY OLD DEBATE ABOUT WHETHER THE ETIOLOGY OF TOURETTE SYNDROME IS ORGANIC OR PSYCHOGENIC

Tourette Syndromes an often misdiagnosed, misunderstood, complicated and visually compelling disorder. In A Cursing Brain? The Histories of Tourette Syndrome, Howard I. Kushner undertakes a compelling deconstruction of the labyrinth that is the discourse surrounding Tourette Syndrome.

Throughout a major portion of the book, Kushner it seems leans towards multifactorial analysis of the syndrome. A collection of manifestations, Tourettes is sometimes not diagnosed as such unless accompanied by a co-morbid condition such as ADHD or OCD. Moreover, complications arising from a differences in perspective and classification make diagnosing and treating the syndrome more difficult. The split that divides runs between an infection/genetic camp and a purist camp whose assertions lie in a solely genetic argument. Lastly, along with such disorders as Syndenhams Chorea and similar manifestations of neurological disorders, it is "in your face" making it such a visually compelling disorder that it should move people to action.

The aim of this book is to examine several perspectives and to explain them well. In an anti-reductionisin mind set Kushner attempts to zero in on the infectious and genetic perspectives. Kushner digs deep, analyzing in a Foucualdian way, the tradition as began by of Jean Marc Gaspard Itard, Jean Martin Charcot, Georges Gilles de la Tourette and George Guinon. In his involvement with Tourette Syndrome, Kushner seems to lean towards a more organic rather than a psychogenic origin. However, he is clear to point out that despite the success of Dr. Arthur Shapiro using Haloperidol to treat his patients, the side effects seem to be harder to live with than the cure.

Kushner briefly introduces the groundbreaking work of both Dr. Louise Kiessling as well as the work of Dr. David Comings - who represents the most thorough and persistent view of the genetic component as alternative perspectives. Dr. Comings theory has broad implications about certain behaviors that most mental health workers have historically attributed to psychological problems. Genetic studies have led Dr. Comings to conclude that Tourette Syndrome is a polygenic disorder, caused by the coming together from both parents of a number of genes affecting dopamine, serotonin and other brain chemicals.

After undertaking this long study, Kushner gives us a broader understanding of the syndrome and leads us to a conclusion relating to the plausibility and viability of each examination, treatment and perspective.

WHERE THE GENETIC AND INFECTIOUS ETIOLOGIES DIVERGE AND CONVERGE

Tourette Syndrome as a behavioral disorder often misdiagnosed and misunderstood. Kushner sought to gain a better understanding of its cause through two etiological models, the genetic and the immunological. Although the two models diverge in their essential constructs, he speculates that a key juncture where they converge is in the role of neurotransmitters.

Whether TS underlying pathology is ultimately genetic or infectious both models point to the chemical interaction of dopamine, serotonin and norepinephrine as a key mechanism of the disorder.

The Cursing Brain? The Histories of Tourette Syndrome examines a large cross section of perspective from the clinical to the historical and with a multinational flavor. As for the models themselves, Kushner found that researchers are far from a definitive understanding of the genetic model because of its extremely complex nature.

In my opinion, it seems like researchers of Tourette Syndrome seem to feel that they can calibrate the effects of serotonin, dopamine and norepinephrine if they can find the genes that are responsible for regulating these neurotransmitters. To complicate things further, the immunological theory proposes that TS can be caused by GABHS, which triggers cross-reaction between GABHS antibodies and the cells of the basal ganglia.

Kushner's hope is to inspire the move to a more cooperative effort in a more systematic attempt at a joint formal standardization of the TS phenotype.

The immunological faction concludes that a prior streptococcal infection could be the cause of tics and ticcing behavior in some TS children. However, the fact that not all children who are infected with GABHS develop into Tourette Syndrome implicates genetic and epigenetic factors.

In the end, in the words of a highly esteemed expert in the field of TS, "theory takes you only so far-and often nowhere helpful." It should not, however, stop us from acting or, more specifically, from trying to relieve the distress of illness.

As we all take steps to fully understand the complex nature of TS, we have to understand that the definitions may be a product of the dominant discourse of the day. However Tourette - the illness, is real. We treat the symptoms even if we don't fully understand the underlying cause. And as science inches closer to a complete explanation of the etiology of TS, we are increasingly hopeful that someday we can confidently say that we've found a cure.

Miguel Llora

Compiled by Howard Waldrop (a renowned writer of deftly researched alternate-history stories and winner of both the Nebula and World Fantasy awards), Custer's Last Jump And Other Collaborations is an enthralling anthology of original short stories in which Howard Waldrop combined his talent with other skilled wordweavers such as George R. R. Martin, Bruce Sterling, and others. From a unique perspective on the saga of Troy; to a distant future in which Mankind is nearly extinct; to an alternate history when Crazy Horse uses Confederate monoplanes against Custer; Custer's Last Jump And Other Collaborations is a dazzling display of literary imagination, and a very strongly recommended read for science fiction fans enthusiasts everywhere.

Vampires, computer chat and vampire hunters. An seemingly innocent encounter on-line brings disaster to a young college student and his friends.

I really enjoyed this tale and the cyber-twist it put on the "Fatal Attraction" Genre.

My husband and I have 3 children who are ADD, this little book has helped us so much that I would highly recommend reading anhd followimg the authors suggestions.

Most academic books about Natives tend to look at a single tribe at a time, completely missing the extraordinary balances struck by tribes moving through each other's lands or competing in hunting or trading. Meredith (Longhair Clan Cherokee) illustrates that, while WAR is the metaphor for human relationships in Anglo-Saxon cultures, DANCE is the metaphor for tribes on the Southern Plains. Illuminating!

This book is a real treasure to those dedicated to the human-historical studies. It's a well-thought, well structured critical analysis and comparative study on the idea of human existence in historical time - in other words, "historicality of human nature" - as seen and developed by the three thinkers. Really easy and joyful reading, supported by an accurate endnotes and quite an impressive bibliography, that covers sources in English, German, Spanish, and French.

This book is a wonerful way to introduce a younger children to the mystical ways of Judaism. The folktales grab you into the short one to three page stories. After that you read the religious teaching and interpretions of each one, and this leaves a classroom open to discussions. This book can be used in any religious setting, whether it be in a classroom or at home with your family. It makes you want to learn more. The Mystical side of Judaism is often left to the Scholars of the the time. However, what surprised me was how many of them were women. Take time in the classroom, or at home with your family, enjoy understand, and discuss this with all who are interested.

I thoroughly enjoyed this mystery. It is one of the best and most entertaining examples of fiction seamlessly blended with historical fact. Anyone interested in the Thomas Edison family and company or MGM during its golden age will find it fascinating. The author has created well-rounded characters in unique situations that keep the reader constantly involved and intrigued.

A unique western involving a cult of saloon girls trying to take over a town. The author weaves a spell of intrique and action and creates characters a modern reader can identify with. A must read. My highest recommendation.