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The term telemedicine is broadly defined as the use of information and communication technology to deliver health care at a distance. However, the concept of ‘telemedicine’ still lacks consensus both in the literature and in practice. Generation of telemedicine knowledge and evidence for clinical practice is still controversial within the telemedicine scholarship and among decision-makers as telemedicine objectives remain ill-defined and outcomes vary in time. In Ontario, despite the fast pace of information and communication technology change and the increased interest in its health applications, telemedicine is not a mainstream model of care delivery within the medical system. This study empirically investigates the social construction of telemedicine technologies to understand how telemedicine expectations shaped telemedicine in Ontario (Canada) from 1993 to 2017. Drawing from the Social Construction of Technologies framework (SCOT) and historical narrative analytical techniques, it identifies the shared understandings of what telemedicine is (and is not) and what role telemedicine plays in the health care system. I used grounded theory methodology to develop a narrative theory of how the future of telemedicine in Ontario has been constructed over the last 24 years from national newspaper articles, stakeholder documents, service provider websites, and semi-structured interviews with relevant telemedicine stakeholders. Findings show that the development of telemedicine narratives in Ontario is a multi-storied process of conflicting and overlapping visions and expectations among stakeholders and interests. Telemedicine expectations focus mostly on the process of innovation, the provideroriented approach to telemedicine, and the advantages and risks of adopting consumercontrolled telemedicine in a publicly insured health care system. The telemedicine visions result fragmented among different stakeholders and practices, overall inhibiting telemedicine’s future agenda. These findings intend to help researchers, policy makers, private vendors, and health care providers to create a vision of telemedicine that accommodates competing expectations among the clinical, technical, political, and commercial worlds. / Thesis / Doctor of Science (PhD) / Telemedicine delivers health care at a distance by letting doctors talk to patients or other doctors via video, email, or text messages. However, as simple as this idea is, researchers, physicians, policy-makers, and entrepreneurs have speculative, overlapping, and conflicting views about what it should be. These differing views create ambiguity and often confuse the aims of health policy decision-makers and end-users limiting telemedicine’s development. I intend to clarify telemedicine’s shared and diverging understandings of what telemedicine should be by analyzing how stakeholders in Ontario have told and tell stories about telemedicine’s future over the last three decades. I view stories of the technology’s future as persuasive policy arguments that stakeholders adopt to shape and use telemedicine according to their visions and goals. These findings will help researchers, policy-makers, doctors, and businesspeople understand what telemedicine is (and is not) to help them define policies and guidelines for its adoption and implementation.

Disordered eating in men is said to be uncommon with men forming less than ten per cent of reported cases. Yet it has been suggested that the number of males with eating disorders is beginning to increase, affecting more men than ever before. This presents problems for healthcare services that have created previous models of support around women. Current research offers pathological and epidemiological data, including information about testing men for eating disorders using male-centred instruments. However, understanding is aetiolated due to a focus on medical accounts of male disordered eating, rather than focusing on the stories that men themselves have to tell. This exploratory qualitative study addresses this problem by focusing on men’s stories of disordered eating. Four men share their accounts of living with an eating disorder and these are analysed using a hermeneutic approach, in order to glean insights into their experiences with food, body and self. These insights include an examination of the meaning of fat male bodies, analysis of the phenomenon of gender ambivalence that prevails in men with disordered eating and the fragmented and colonised nature of the male eating disordered self. These represent an original contribution to understanding as they have not been considered elsewhere in the literature to date. Additionally, an extensive analysis of the male eating disorder literature, use of a hermeneutic methodology and the positioning of male eating disorders within the context of masculinities studies further add to the novel value of this research.

The goal of my project is a detailed analysis of the technological culture of the United States Air Force from a Science and Technology Studies (STS) perspective. In particular, using the metaphor of the Air Force as religion helps in understanding a culture built on matters of life-and-death. This religious narrative—with the organizational roles of actors such as priests, prophets, and laity, and the institutional connotations of theological terms such as sacredness—is a unique approach to the Air Force. An analysis of how the Air Force interacts with technology—the very thing that gives it meaning—from the social construction of technology approach will provide a broader understanding of this relationship. Mitcham's dichotomy of the engineering philosophy of technology (EPT) and the humanities philosophy of technology (HPT) perspectives provides a methodology for analyzing Air Force decisions and priorities. I examine the overarching discourse and metaphor—consisting of techniques, technologies, experiences, language, and religion—in a range of historical case studies describing the sociological and philosophical issues of the Air Force. As the Air Force is the offspring of the U.S. Army, these examples begin with the Civil War era and the invention of the Gatling gun before moving to the interwar period's Air Corps Tactical School and its seminal organizational thinking about the aircraft. Moving to the more modern times after the birth of the Air Force, I describe and compare the Advanced Airlift Tactics Training Center and the Air Mobility Warfare Center, two organizations interacting with technology from different organizational archetypes. The final example is the Department of Defense Readiness Reporting System, an information technology application at the focal point of cultural change affecting not just the Air Force but the entire Department of Defense. Finally, I will conclude with a chapter on policy considerations and recommendations for the Air Force based on the Air Force religion, a balance of both people and technology, and with an eye toward the future of U.S. military operations. The primary goal is to answer three questions: is the U.S. Air Force truly a religion? If so, how should that affect its approach to technology and technological change? With an eye toward consciously building the future, how has the Air Force religion shaped the organization in the past? [The attached document is cleared by the Department of Defense for public release (OSR Case 09-S-0496).] / Ph. D.