A bibliographic snapshot of the telemedicine citation literature

There appear to have been no previous literature-based or literature-oriented studies in telemedicine which have analysed raw citation data. Using a simple search strategy, the Web of Science was analysed up to the end of 2005 to give a snapshot of the field, and to identify matters which would need to be considered in larger scale bibliometric studies. Of the 3673 telemedicine documents retrieved, 2213 (60%) had been cited. Of 56,875 citation records, 32,460 unique citation formats were found. The most-cited paper, and the paper with the greatest annual citation rate, was Perednia and Allen's review article in JAMA, 1995. The two specialist telemedicine journals published 40% of all papers retrieved. In the general literature (i.e. excluding the two specialist journals) there were 1556 citations to their 1374 'citable' articles, apportioned in the ratio 76:24, almost exactly in accordance with the distribution of the articles themselves. However, each of the two specialist telemedicine journals cited itself in a proportion higher than its share of original articles, with an 'excess' of self-citations of 14% in the journal of Telemedicine and Telecare, and 19% in the Telemedicine journal and E-Health. Despite certain technical difficulties, there is considerable scope for bibliometric research in telemedicine.

An editor's view of telemedicine

Should an editor hold a view about telemedicine, or should an editor be entirely disinterested? The editorial role has been defined by the International Committee of Medical journal Editors and a long list of editorial responsibilities has been set out by the World Association of Medical Editors. This represents something of a counsel of perfection, although clearly an editor should not have a personal view, in the sense of promoting telemedicine or dismissing it. Since telemedicine editors are almost bound to be active in research, they should take particular care with manuscripts involving their own work, for example standing aside from the editorial process and delegating editorial decisions to other members of the editorial staff. At the beginning of the 1990s, there were few publications about telemedicine in the peer-reviewed literature. The subsequent years have seen a rapid growth in numbers of articles and the emergence of two specialist journals. These are all healthy signs. However, there have been remarkably few studies of telemedicine's cost-effectiveness, which must represent a sign of its immaturity. On balance, the evidence seems to indicate that telemedicine research is in a healthy state.

Incidence and risk factors associated with exertional rhabdomyolysis syndrome in National Hunt racehorses in Great Britain

A telephone survey of 51 National Hunt racing yards with 1140 horses in training was made in April and May 2003 to establish the incidence of exertional rhabdomyolysis syndrome during the previous year. A case-control study was used to investigate the risk factors for the syndrome in eight yards selected on the basis that cases had been confirmed by the analysis of serum muscle enzymes. The overall incidence of syndrome was 6 center dot 1 cases per 100 horses per year, and 55 per cent of the yards reported at least one case. The risk factors identified were sex, the average length of the training gallop, and the type of horse (steeplechaser, bumper/unraced or hurdler). There were no significant associations with the horses' temperament, age or Timeform rating.

E-health and the Universitas 21 organization: 2. Telemedicine and underserved populations

Telemedicine activities in underserved communities were reviewed as part of the Universitas 21 (U21) e-health project. A SWOT analysis (strengths, weaknesses, opportunities, threats) was conducted on 12 articles identified in a literature review, supplemented by expertise from U21 members. The analysis showed that threats include the reluctance of populations to use telemedicine services, and a general absence of infrastructure and resources to sustain them. Opportunities centre around potential research, including cost-effectiveness analyses and quantitative assessments of existing telemedicine services. The great strength of telemedicine is that it can improve access to health services among those most in need. However, its greatest weakness is the lack of evidence supporting its clinical and cost advantages relative to traditional services. This represents an important opportunity for research on telemedicine initiatives among underserved populations.

Aspergillazines A-E: novel heterocyclic dipeptides from an Australian strain of Aspergillus unilateralis

Biological and chemical pro ling of an Australian strain of the fungus Aspergillus unilateralis (MST-F8675), isolated from a soil sample collected near Mount Isa, Queensland, revealed a complex array of metabolites displaying broad chemotherapeutic properties. Noteworthy among these metabolites were a unique series of highly modified dipeptides aspergillazines A-E, incorporating a selection of unprecedented and yet biosynthetically related heterocyclic systems. Co-occurring with the aspergillazines was the recently described marine-derived fungal metabolite trichodermamide A (cf. penicillazine), whereas re-fermentation of A. unilateralis in NaCl (1%) enriched media resulted in co-production of the only other known example of this structure class, the marine-derived fungal metabolite trichodermamide B. Further investigation of A. unilateralis returned the known terrestrial fungal metabolite viridicatumtoxin as the cytotoxic and antibacterial principle, together with E-2-decenedioic acid, ferulic acid, (7E,7'E)-5,5'-diferulic acid and (7E,7'E)-8,5'-diferulic acid. The aromatic diacids have previously been reported from the chemical and enzymatic (esterase) treatment of plant cell wall material, with their isolation from A. unilateralis being their first apparent reported occurrence as natural products. Structures for all metabolites were determined by detailed spectroscopic analysis and, where appropriate, comparison to literature data and/or authentic samples.

A systematic review of successes and failures in home telehealth: preliminary results

We conducted a systematic review of the literature to identify studies in home telehealth that compared a home telehealth intervention with a non-telehealth standard/usual care alternative in terms of administrative changes, patient management decisions, patient outcomes, caregiver outcomes, economic impact or social impact on patients. A search of various databases produced 6643 references. Of these 769 papers were selected for more detailed investigation. These papers, combined with hand searching of relevant telehealth journals and cross-referencing of citations in identified publications, resulted in 138 papers referring to 130 projects for review. In this preliminary analysis we used a quality appraisal approach that took into account the study design. An additional analysis of patient numbers was then used to calculate a net evidence score. A large proportion of studies (80%) were randomised controlled trials. Only 22 projects (17%) reported economic data deemed to be sufficient for appraisal. Evidence exists for the clinical effectiveness of home telehealth in diabetes, the general area of mental health, high risk pregnancy monitoring, heart failure and cardiac disease.

Learning from the story of a great leader

This paper reports on research findings from a larger study which seeks to understand leadership from the experiences of well-known and well-recognised Australian leaders across a spectrum of endeavours such as the arts, business, science, the law and politics. To date there appears to be limited empirical research that has investigated the insights of Australian leaders regarding their leadership experiences, beliefs and practices. In this paper, the leadership story of a well-respected medical scientist is discussed revealing the contextual factors that influenced her thinking about leadership as well as the key values she embodies as a leader. The paper commences by briefly considering some of the salient leadership literature in the field. In particular, two prominent theoretical frameworks provided by Leavy (2003)and Kouzes and Posner (2002) are explored. While Leavy’s framework construes leadership as consisting of three “C’s” – context , conviction and credibility, Kouzes and Posner (2002)refer to five practices of exemplary leadership. The paper provides a snapshot of the life forces and context that played an important role in shaping the leader’s views and practices. An analytical discussion of these practices is considered in the light of the earlier frameworks identified. Some implications of the findings from this non-education context for those in schools are briefly noted.