Reproductive performance in female common hamsters.

We monitored individual reproductive timing and output in a common hamster population in Vienna over a 3-year period. Animals were live-trapped, weighed, individually marked, and reproductive status was determined at capture. Costs of reproduction were investigated by measuring body condition shortly before hibernation and overwinter survival. Our results indicated that early emerging females had more litters and weaned more offspring per season. Body mass throughout the active season did not differ significantly between females with high and low reproductive output. High reproductive output seemed to affect the duration of the active season. Successful females had a longer postreproduction period before hibernation than less successful ones, probably serving to balance the costs of reproductive effort by extended preparation for hibernation. Also, females that had emerged early in spring and had high reproductive success were more likely to survive the subsequent winter. Hence, we found female common hamsters to vary strongly in maternal investment capacity and to tailor reproductive strategies accordingly.

Telemedicine for delivery of health care in Parkinson's disease.

We have used telemedicine at the Seattle Veterans Administration Medical Center to deliver follow-up care to patients with Parkinson's disease (PD). Patients were located at eight facilities which were 67-2400 km from the medical centre. Each facility had videoconferencing equipment (connected by Internet Protocol at 384 kbit/s), and computer terminals that could access the patient's electronic medical record. Over a three-year period, we used telemedicine for 100 follow-up visits on 34 PD patients. Visits lasted 30-60 min. Patients and providers were satisfied with the use of the technology. Savings amounted to approximately 1500 attendant travel hours, 100,000 travel kilometres, and US 37,000 dollars in travel and lodging costs. For the first 82 telemedicine visits, the video quality was inadequate for scoring all components of the motor Unified Parkinson Disease Rating Scale (UPDRS). For the last 18 visits, a different videoconferencing unit produced better video quality, which was satisfactory for motor UPDRS measurements, except for components that required physical contact with the patient (rigidity and retropulsion testing). Our experience shows that telemedicine can be used effectively for follow-up visits with selected PD patients who are unable to travel.

The development of a telemedical cancer center within the Veterans Affairs Health Care System: a report of preliminary clinical results.

In order to optimize the delivery of multidisciplinary cancer care to veterans, our institution has developed a regional cancer center with a telemedical outreach program. The objectives of this report are to describe the organization and function of the telemedical cancer center and to report our early clinical results. The Veterans Affairs Health Care System is organized into a series of integrated service networks that serve veterans within different areas throughout the United States. Within Veterans Integrated Service Network 20 (Washington, Alaska, Idaho, Oregon) we have developed a regional cancer center with telemedicine links to four outlying facilities within the service area. The telemedical outreach effort functions through the use of a multidisciplinary telemedicine tumor board. The tumor board serves patients in outlying facilities by providing comprehensive, multidisciplinary consultation for the complete range of malignancies. For individuals who do require referral to the cancer center, the tumor board serves to coordinate the logistical and clinical details of the referral process. This program has been in existence for 1 year. During that time 85 patients have been evaluated in the telemedicine tumor board. Sixty-two percent of the patients were treated at their closest facility; 38% were referred to the cancer center for treatment and/or additional diagnostic studies. The patients' diagnoses included the entire clinical spectrum of malignant disease. Preliminary clinical results demonstrate the program is feasible and it improves access to multidisciplinary cancer care. Potential benefits include improved referral coordination and minimization of patient travel and treatment delays.