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.

<p> The implementation of telehealth applications is resource intensive and fraught with challenges unique to the people and places involved. The use of telehealth to provide clinical care to patients, educate patients and providers, and conduct research studies to advance medical science has been shown to positively affect issues of access and the quality of care. Previous research has focused on the use of specific technologies, known barriers to adoption and diffusion, and the general efficacy of these applications. Few studies have researched the role champions play in the deployment and operation of telehealth networks. The researcher proposed conducting an interpretative phenomenological analysis (IPA) of clinicians, educators and technical professionals within a successful telehealth network to determine the lived experiences that identify them as champions in the field. </p><p> Three research questions were studied: 1) What do telehealth champions believe to be the human elements necessary to advance telehealth systems?; 2) How do these telehealth champions explain their empowerment during the creation and use of telehealth networks?; and 3) How do these champions use shared processes and experiences to help spur engagement? Semi-structured interviews with 16 champions from the three disciplines were conducted to explore their lived experiences as part of a telehealth network. Seven champion themes&mdash;<i>modern pioneers; champion teams; agents of change; knowledge brokers; supported by management; advocates, not champions; and well-prepared visionaries</i>&mdash;emerged from the iterative review and analysis of data. Findings suggest that telehealth champions are not born but instead created. They are modern pioneers who function as part of innovative telehealth teams. Champions also serve as agents of change who utilize their knowledge of disruptive technologies to advocate for improvement in established healthcare systems. They are problem solvers who serve as resources for their colleagues, organizations and collaborative networks. Telehealth champions channel the universal goals of improving patient care and expanding healthcare access to overcome adoption barriers. Applying the ideals of what it means to be champions and how they overcome barriers to new telehealth applications could prove to be very beneficial for those tasked with developing new networks. </p>

<p>Medical education helps ensure doctors acquire skills and knowledge needed to care for patients. However, resident duty hour restrictions have impacted time residents have for medical education, leaving resident educators searching for innovative options for effective medical education. Classroom situated e-learning, a blended learning delivery method, was created to find an effective option for medical education. Research has been conducted on the use of e-learning with residents. More limited research has been reported on the use of blended learning with residents. Research is needed regarding the use of classroom situated e-learning for resident education. Qualitative phenomenological research was used to understand residents' perceptions of the effectiveness of, and interactions in, classroom situated e-learning and traditional lectures. In-depth interviews were used for data collection. Research participants were nine residents who had participated in classroom situated e-learning and lecture based learning. Analysis of the data revealed all participants found classroom situated e-learning effective because it was problem based, provided access to an expert, was interactive, and conducted in a small group. Six of the nine participants provided an example of an effective lecture, which they found effective due to the inclusion of practical or applicable content and an engaging educator. Residents were asked to describe their interactions with the content, the educator, and other learners for classroom situated e-learning and traditional lectures. Their responses were analyzed and themes identified. The themes identified for interaction in classroom situated e-learning were, through the computer for interaction with the content; providing real world content, asking questions of the educator, and feedback for interaction with the educator; and discussion for interaction with other learners. The theme identified for traditional lectures was asking questions of the educator for interaction with the educator. The findings from this study demonstrated that participants' perceived classroom situated e-learning to be effective, and had a preference for interaction that included discussion with the educator and other learners. Recommendations for future research include a replication of this study with residents in other residency programs, and quantitative research comparing the learning outcomes of classroom situated e-learning with traditional lecture based learning. </p>

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 (M.P.H.)--University of Michigan, 1944. / Also issued in print.

Thesis (M.S.P.H.)--University of Michigan, 1933.

Thesis (M.S.P.H.)--University of Michigan, 1942.

Thesis (M.P.H.)--University of Michigan, 1945.

Thesis (M.P.H.)--University of Michigan, 1946.