This issue of the journal guest edited by Paola Mosconi and Cinzia Colombo of the Mario Negri Institute of Milan, Italy, focuses on patient involvement in all aspects of the health care delivery system. I am confident that the research articles that Dr Mosconi and Colombo had collected for this issue will be of significant interest and, in fact, will be surprising to many.

We conclude this issue of the journal with a report from the Republic of Texas (as some readers no doubt know that there are political leaders from Texas who are advocating secession-in part related to the just passed health reform bill). Finally, Dr Goodspeed brings us back to the United States and grounds us all with our regular ambulatory management column.

Norbert I. Goldfield, MD

Editor