Lightning mapping observation of a terrestrial gamma-ray flash

We report the observation with the North Alabama Lightning Mapping Array (LMA) related to a terrestrial gamma-ray flash (TGF) detected by RHESSI on 26 July 2008. The LMA data explicitly show the TGF was produced during the initial development of a compact intracloud (IC) lightning flash between a negative charge region centered at about 8.5 km above sea level (-22C temperature level) a higher positive region centered at 13 km, both confined to the convective core of an isolated storm in close proximity to the RHESSI footprint. After the occurrence of an LMA source with a high peak power (26 kW), the initial lightning evolution caused an unusually large IC current moment that became detectable 2 ms after the first LMA source and increased for another 2 ms, during which the burst of gamma-rays was produced. This slowly building current moment was most likely associated with the upward leader progression, which produced an uncommonly large IC charge moment change (+90 Ckm) in 3 ms while being punctuated by a sequence of fast discharge. These observations suggest that the leader development may be involved in the TGF production. Copyright © 2010 by the American Geophysical Union.

Toward the development of national telehealth services: the role of Veterans Health Administration and future directions for research.

The Veterans Health Administration (VHA) in the Department of Veteran Affairs (VA) has emerged as a national and international leader in the delivery and research of telehealth-based treatment. Several unique characteristics of care in VA settings intersect to create an ideal environment for telehealth modalities and research. However, the value of telehealth experience and initiatives in VA settings is limited if telehealth strategies cannot be widely exported to other public or private systems. Whereas a hierarchical organization, such as VA, can innovate and fund change relatively quickly based on provider and patient preferences and a growing knowledge base, other health provider organizations and third-party payers may likely require replicable scientific findings over time before incremental investments will be made to create infrastructure, reform regulatory barriers, and amend laws to accommodate expansion of telehealth modalities. Accordingly, large-scale scientifically rigorous telehealth research in VHA settings is essential not only to investigate the efficacy of existing and future telehealth practices in VHA, but also to hasten the development of telehealth infrastructure in private and other public health settings. We propose an expanded partnership between the VA, NIH, and other funding agencies to investigate creative and pragmatic uses of telehealth technology. To this end, we identify six specific areas of research we believe to be particularly relevant to the efficient development of telehealth modalities in civilian and military contexts outside VHA.