Introduction to the practice of telemedicine

Telemedicine is the delivery of health care and the exchange of health-care information across distances. It is not a technology or a separate or new branch of medicine. Telemedicine episodes may be classified on the basis of: (I) the interaction between the client and the expert (i.e. realtime or prerecorded), and (2) the type of information being transmitted (e.g. text, audio, video). Much of the telemedicine which is now practised is performed in industrialized countries, such as the USA, but there is increasing interest in the use of telemedicine in developing countries. There are basically two conditions under which telemedicine should be considered: (I) when there is no alternative (e.g. in emergencies in remote environments), and (2) when it is better than existing conventional services (e.g. teleradiology for rural hospitals). For example, telemedicine can be expected to improve equity of access to health care, the quality of that care, and the efficiency by which it is delivered. Research in telemedicine increased steadily in the late 1990s, although the quality of the research could be improved - there have been few randomized controlled trials to date.

Early and mid Holocene tool-use and processing of taro (Colocasia esculenta), yam (Dioscorea sp.) and other plants at Kuk Swamp in the highlands of Papua New Guinea

Recent multidisciplinary investigations document an independent emergence of agriculture at Kuk Swamp in the highlands of Papua New Guinea. In this paper we report preliminary usewear analysis and details of prehistoric use of stone tools for processing starchy food and other plants at Kuk Swamp. Morphological diagnostics for starch granules are reported for two potentially significant economic species, taro (Colocasia esculenta) and yam (Dioscorea sp.), following comparisons between prehistoric and botanical reference specimens. Usewear and residue analyses of starch granules indicate that both these species were processed on the wetland margin during the early and mid Holocene. We argue that processing of taro and yam commences by at least 10,200 calibrated years before present (cal BP), although the taro and yam starch granules do not permit us to distinguish between wild or cultivated forms. From at least 6950 to 6440 cal BP the processing of taro, yam and other plants indicates that they are likely to have been integrated into cultivation practices on the wetland edge.