This paper investigates the multiskilled health practitioner (i.e., imaging specialist) how they are trained for what they do and the way their traditional role as a generalist in radiologic technology has been impacted by advancing technologies. This dissertation consists of multiple case studies, which is primarily qualitative and exploratory in nature. It does not test a hypothesis in a strict sense and is grounded in analytical categories and theories derived from the literature on technology, work, occupations, and organizations. The data analysis section consists of four sections: perceptions of the MSHPs' work, the impact of technology (i.e., incentive structures, wages, issues of autonomy/authority, task difficulty/responsibility and patterns of interaction), the enskilling/deskilling findings for all MSHPs in general and each hospital subgroup, and the MSHPs perceptions about the effectiveness of their formal education programs. With regards to a cultural examination of the workplace, the most significant sociological perspective identified were in the patterns of interaction. Specifically, three primary stylistic differences are noted. In relation to the effects of technology, an institutionalized practice of the incentive structure and the homogeneity of three broad skills were noted among our cohort. Additionally, three contextual factors that condition social action and thereby affect a technology's tendency to enskill or deskill are revealed. In light of the attributes and deficiencies noted by the interviewees regarding their formal educational programs and skills required for their new roles, the researcher provides five recommendations for strengthening technology transfer programs in which to better prepare the MSHP.

The purpose of this study was to determine if a relationship exists between the knowledge and application of a writing scoring rubric to writing performance. Participants in a Minority Medical Education Program were given intense instruction in the use of the Medical Colleges Admissions Test Writing Sample scoring rubric. Scores from the participants' pretest and posttest were compared.

Despite a 70-year long call for reform of the structure of medical education, the process by which one becomes a physician has remained remarkedly unchanged since the early 1900s. This case study was undertaken to identify the factors the facilitated and inhibited attempts at curricular reform in a state College of Medicine at a Research I institution in the southwest. The theoretical lenses of resource dependency, academic capitalism, professionalism/jurisdiction, power, and leadership were used to identify and understand the interrelatedness of the internal and external factors influencing change in medical education. Based on the theoretical constructs underlying the study, several propositions were outlined a priori. The findings indicated support for the propositions: the dean's support of reform initiatives was a key factor in the success of the initiatives; and conversely, those initiatives that were not actively and verbally supported by the dean did not tend to be approved; the dean influenced the agenda by taking key proposals for reform off the agenda; faculty were most resistant to those proposals that would have required them to relinquish their curricular jurisdiction to a central curriculum authority; faculty further maintained jurisdiction over their courses by simply choosing not to use materials made available to them through educational grants; the tenuous financial situation of the institution at the time affected the dean's and the faculty members' willingness to be involved in and support curricular reform efforts as they were under increasing pressure to increase their income-generating activities; and furthermore, the resource allocation patterns of the institution did not support reform initiatives. The findings highlighted two themes that were not accounted for in the propositions. The first indicated that the quality of the working relationship transcended jurisdictional boundaries that would have been expected from the professionalism/jurisdiction framework underlying the study. The second indicated that the efforts of a single individual could transcend all of the theoretical constructs underlying the study. Lastly, based on the findings of the study, several strategies were developed that may be useful to consider when attempting curricular reform.

The main objective of this dissertation was to analyze the role of psychosocial variables, especially positive affect, on health outcomes and health care services utilization (HCSU) in arthritis. The identification of additional psychological variables as predictive or mediating factors is critical for gaining a better understanding of the dynamics of treatment response, especially in the setting of interventions that focus on behavioral changes, and health care seeking behavior. The analyses performed were based on a theoretical model that assumed affective status as a direct effector on the use of specific coping strategies and patients' perception of control over their health, which would, in turn, influence health outcomes and health resources utilization. Using random effects modeling, we found positive affect (PA) to have a negative (β = -4.27; p < 0.001) and negative affect (NA) a positive (β = 5.33; p < 0.001) longitudinal association with levels of perceived pain, adjusted for other covariates. The final, most parsimonious, model explained 22% of the overall variance and 28% of the between-subjects variance of the level of pain perceived by subjects with osteoarthritis. Subjects with high PA levels were more likely to achieve minimal clinically important differences in pain (OR = 7.1; 95% CI, 1.4 to 36.2), global assessment of disease activity (OR = 6.1; 95% CI, 1.7 to 21.8), and physical function (OR = 13.27; 95% CI, 1.7 to 102.1) than subjects with low PA. Finally, in a multivariate stepwise linear regression model, higher levels of positive affect significantly predicted less HCSU (B = -0.29; p = 0.04). The final model also included social support and anxiety and explained slightly over 17% of the variance of long term HCSU (R = 0.51; Adjusted R-square = 0.217).

A sensitive method measuring indium levels >1 ppb (ng/ml) in biological tissues was developed using graphite furnace atomic absorption spectrophotometry. Single oral and pulmonary exposure of uniformly sized indium phosphide particles (mean count diameter = 1.73 ± 0.85 μm) to rats at three dose levels. Indium was deposited throughout tissues after 4 days. Bone, hair, skin, liver and kidney contained the largest indium concentrations (ng Indium/gram tissue) in both studies. Total percent dose found in tissues by either route resulted in an estimated absorption of <0.5% (not including lung for pulmonary study) except in the oral low dose group. Here the percent dose found in tissues was about 5.0% of the administered dose. The lung retained >50% of the administered dose four days following intratracheal instillation. The major route of indium elimination for both oral and pulmonary studies was in the feces; >78% of the administered dose by two days following oral gavage and >26% of the administered dose following intratracheal instillation.

Ethnographic interviews with four adult children revealed four domains: "Quality of Life"; "Doing the Right Thing"; "Staying Strong"; and "Impact of Decision" they used to create meaning for their decision to withdraw life support from an ill parent. The domains were analyzed and eight cultural themes were discovered: The decision is much easier when the family know what the person would want; the decision should include family input; health care providers can be/are a source of support and information for the family; doing the right thing is important for the family; as death approaches, the family needs extra support from others, when death is imminent the family has difficulty "letting go" and "staying strong"; feelings of guilt; and the impact of life patterns associated with loss. The significance of this data can be used by nursing in assisting families faced with the decision to withdraw life support towards healthy grieving patterns.

The advent of the Virtual Reality Modeling Language (VRML) as a portable file format for describing three-dimensional (3-D) scenes has created the ability for researchers, educators and students to share anatomical models on the WWW. The implication for medical teaching is that students can interactively examine anatomical structures and their 3-D spatial relationships, using current personal computer (PC) technology. The work of this thesis creates, for the first time, a high-resolution middle-ear model that is accessible on the World Wide Web (WWW). The 3-D model is created by automated aligning of the source images (histological sections), interactive segmentation, and 3-D surface reconstruction. The resulting model is translated into VRML format. Images of the histological sections can be superimposed on the model, allowing students to view a section in its 3-D context. To enhance the viewing of these scenes, a VRML browser is modified to support transparent rendering of surfaces. Finally, a WWW interface is designed to allow users to selectively choose the model structures, section images and associated viewing parameters, in order to build their own 3-D scene.

Thesis (Ph.D.)--Indiana University, Dept. of Higher Education, 2007. / Source: Dissertation Abstracts International, Volume: 68-09, Section: A, page: 3756. Adviser: Nancy Chism. Title from dissertation home page (viewed May 8, 2008).

Thesis (Ph.D.)--Lehigh University, 2008.

Thesis (Ph.D.)--University of California, San Francisco, 2008. / Source: Dissertation Abstracts International, Volume: 69-09, Section: B, page: 5320. Adviser: Patricia Benner.