Telepathology is the process of diagnostic histopathology performed on digital images viewed on a display screen rather than by conventional glass slide light microscopy. The technology of telepathology has radically improved over the past 5 years so that it is no longer the limiting factor in the diagnostic process. This review looks at the resources needed for dynamic and static telepathology, including image quality, computers and software interfaces, means of transmission and human resources. It critically analyses 32 published trials of telepathology, including some large prospective studies, in all areas of diagnostic histopathology including intraoperative frozen sections, routine and referral cases. New developments, including internet solutions and virtual microscopy, are described and there is analysis of the economics of telepathology within health care systems. The review concludes that all the necessary technology for telepathology is available, there is strong published evidence for a diagnostic accuracy comparable with glass slide diagnosis, in many contexts there is a clear-cut economic argument in favour of telepathology, and that the technique should now be integrated into mainstream diagnostic histopathology.

Aims:To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology.Methods:A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK.Results:There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings.Conclusions:There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings.

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The trend toward increasing numbers of working women may alter the ways both men and women physicians structure their professional lives. The 1987 graduates of residency and fellowship programs at the University of Minnesota Medical School--Minneapolis were surveyed in June 1987 about professional plans and factors that led to their decisions. The women expected that their spouses would contribute half of their family's income, whereas the men expected that they would be largely responsible for their family's income. The married women with children planned on working fewer hours than did other physicians. Family structure may play an important role in preventing the convergence of men and women physicians' personal incomes or working hours.

PUBLIC HEALTH BRIEFS posttest counseling in this study, diverse forms of information and social support were given by the nurses who maintained contact with the participants. Testing was voluntary, with informed consent and under the strict condition of confidentiality. Because ethical and practical considerations prohibit experimenting with the factors mentioned above, their individual contribution to the effect of testing cannot be distinguished. ACKNOWLEDGMENTSThe authors wish to acknowledge with appreciation the helpful assistance APPENDIXThe relative importance of a sexual technique was determined by the computation of so called deviation contrasts, or deviations from the grand means.'02 A practical description of this procedure is found in the SPSSX Users Guide,'2 pp 494-495. New variables were computed for each individual and each sexual technique on pretest, posttest, and follow-up, by subtracting from the number of partners on a specific technique, the mean of the number of partners with whom the remaining techniques were performed. An example may clarify this procedure: if an individual performs masturbation with two partners, orogenital intercourse with six partners, and anogenital intercourse with eight partners, the relative importance of masturbation is 2-(6+8)/2= -5, of orogenital intercourse 6-(8+2)/2= 1, and of anogenital intercourse 8422+6)/ 2=4. Twelve months later, if this individual practices masturbation with eight partners, orogenital intercourse with two partners, and anogenital intercourse with zero partners, the relative importance of masturbation has increased to 8-(2+0)/2=7, of orogenital intercourse has decreased to 2-(8+0)/2=-2, and of anogenital intercourse has decreased to 0-(8+2)/2= -5. It is concluded that a shift has occurred in the pattern of practiced sexual techniques from orogenital and anogenital intercourse in the direction of masturbation. Sexual techniques included in this procedure were : oral, manual, orogenital, anogenital, oroanal, anobrachial, anodigital, dildo use, rectal