Telemedicine strategic planning and implementation issues in the Navy Medical Department

Telemedicine is a system of health care delivery which combines image, video, sounds and text, enabling health care providers to consult one another and to examine patients at a distance through the use of telecommunications technology. There are currently a number of telemedicine initiatives within the Department of Defense (DoD) designed to improve the delivery of health care within the military health services system. Telemedicine demonstration projects and consultation sites have been deployed at Army, Navy, and Air Force medical treatment facilities. These initiatives have been driven by recent advances in telecommunications technology, digital imaging technology and video teleconferencing (VTC) technology, coupled with pressures to reduce health care costs and improve access to scarce medical specialist resources. This thesis provides a contextual framework for the analysis of the potential effects of telemedicine on the Navy health care delivery system. The analysis is developed through the review of current telemedicine and telecommunications technology, examination of strategic planning and implementation issues facing Navy telemedicine efforts, and an assessment of the merits and problems associated with implementing a telemedicine pilot project in a Navy medical treatment facility.http://archive.org/details/telemedicinestra1094535124NANAU.S. Navy (U.S.N.) author

Changing criterion design

Journal ArticleThis article describes and illustrates with two case studies a relatively novel form of the multiple-baseline design called the changing criterion design. It also presents the design's formal requirements, and suggests target behaviors and circumstances for which the design might be useful

PROTEASE ACTIVITY IN THE PLASMA OF AMERICAN OYSTERS, \u3cem\u3eCRASSOSTREA VIRGINICA\u3c/em\u3e, EXPERIMENTALLY INFECTED WITH THE PROTOZOAN PARASITE \u3cem\u3ePERKINSUS MARINUS\u3c/em\u3e

Perkinsus marinus is responsible for disease and mortality of the American oyster, Crassostrea virginica. To inves-tigate the interactions between P. marinus and oyster hemocytes, protease activity was measured in plasma of oysters collected 4 hr, 24 hr, 4 days, and 2 mo after experimental infection with P. marinus. A significant increase in protease activity was observed in oyster plasma 4 hr after injection with P. marinus, followed by a sharp decrease within 24 hr. Gelatin-impregnated gel electrophoresis showed the presence of 2 major bands (60 and 112 kDa) and 3 less prevalent bands (35, 92, and 200 kDa) with metalloproteinaselike activity in the plasma of noninfected oysters. Additional bands in the 40- to 60-kDa range, corresponding to P. marinus serine proteases, were observed in oyster plasma at early time points after infection. A transient, but significant, decrease in the activity of oyster metalloproteinases was observed at early time points after infection. Coincubation of oyster plasma with P. marinus extracellular products resulted in a decrease in oyster metalloproteinases and several P. marinus proteases. This study provides insights into the role of proteases in the pathogenesis of Dermo disease