Support provided by non-professional family members is generally believed to be beneficial to the recovery of critically ill patients. Nursing researchers have conducted a number of studies about the experiences of critically ill patients and the needs of their families. However, few have investigated the experiences and interactions of both this group of patients and their main informal carers (principal lay support persons) simultaneously. This study has sought to rectify this situation by capturing and undertaking a theoretical analysis of the perceptions and experiences of both critically ill patients and their principal lay support persons. As a result a substantive theory has been developed through the use of grounded theory method in the Study. This theory identifies and explains the actions and interactions between critically ill patients and their principal lay support persons who participated in the Study, whom the researcher observed and interviewed during the data collection period. Data were collected during the critically ill participant¡¦s hospitalisation and three months following his/her discharge from hospital. Implications of the study concern nursing practice as well as outcomes of the Study as these are described and explained through the substantive theory developed from it. Testing of this theory in the context of critically ill patients and their lay support persons provides opportunities for further research, as does the overall phenomenon of lay person support for critically ill patients. Grounded theory was the method used in the Study. Data for the Study were collected by participant observation of, and face-to-face interviews with patients who had a critical illness and their principal lay support persons. Two interviews were conducted with each of these participants. Patients and their principal lay support persons were initially interviewed separately to obtain information about their individual perspectives of what support meant to them during an episode of critical illness. A second interview was conducted three months later to facilitate the researcher¡¦s understanding of both patients¡¦ and principal lay support persons¡¦ experiences during the recovery process. A total of sixteen (16) interviews were conducted in this study from eleven (11) participants before data saturation occurred. The data collected were analysed by constant comparative analysis integral to the grounded theory approach. Data analysis was also facilitated by a computer-aided qualitative data analysis software NUD*IST 4 (Non-numerical Unstructured Data Indexing, Searching, and Theorizing Version 4). This software aided the analysis to the extent that it provided an efficient data management system. Three categories, 1) being-there-with, 2) independing, and 3) coping were discovered from the data. Being-there-with is an essential and mutual need between the patients and their principal lay support persons during the episode of critical illness and later recovery. Independing on the other hand is the process through which these patients experiment with regaining their independence. It involves their experiences of making decisions and re-building confidence. Coping is the process whereby the principal lay support persons and patients manage their stress during the critical illness and later recovery. During the coping process, there is an uncertainty in principal lay support persons about their loved ones¡¦ situation. They experience ¡¥coping with each day as it comes¡¦ and ¡¥learn to adjust¡¦ to the stress arising from the changing and unpredictable condition of the patients. Being-there-with is also a major coping strategy for both the principal lay support persons and patients to manage their stress. The three categories of being-there-with, independing, and coping arising from this Study provided the basis from which to identify its core category, ¡¥mutually being-there-with each other¡¦, and to theorize the core process that represents the substantive theory about experiences and interactions of principal lay support persons and their loved ones during a critical illness situation. The core process that represents the developed substantive theory is ¡¥surviving a critical illness through mutually being-there-with each other¡¦. This theory explains the complex, dynamic, and interactive nature of principal lay person support which both patients and principal lay support persons experienced during an episode of critical illness and later recovery. An understanding of this dynamic, complex and interdependent relationship between patients and lay support persons will better enable nurses to consider both these parties as the focus of their care. Furthermore, because the substantive theory emerging from this Study captures the process of patients¡¦ and lay support persons¡¦ recovery from an episode of critical illness it provides a conceptual map of how this process may progress. In this Study the theory enables nurses to gauge both patients¡¦ and lay support persons¡¦ progress along the road to recovery and to consider this in their plan of care. Several implications for nursing practice emerged from this study. These relate to the needs of critically ill patients and their principal lay support persons during the process of being critically ill and recovering which they experienced together. Because this Study identified the importance to both patients and principal lay support persons being-there-with each other, a key implication of the study is the need for intensive care units to adopt flexible visiting hours to maximise opportunities for this to occur. Nevertheless, at the same time nurses need to be vigilant that flexible visiting does not prove onerous and overtire patients or their principal lay support persons. A further implication of the Study for nursing practice closely related to its finding of the importance of the core category ¡¥mutually being-there-with each other¡¦ to patients and their lay support persons in the context of critical illness and recovery, is the need for nurses (and other health professionals) to be willing to care for both parties as an inseparable dyadic unit. This Study also has implications relating to the care of critically ill patients following their discharge home. The experience of participants in this Study revealed the importance of careful discharge planning, post-ICU follow-up, and continuity of care in the community to enhance recovery of the patients and to address the special needs of their principal lay support persons. From a researcher¡¦s perspective the process of recruitment for this study demonstrated that recruitment of vulnerable populations (like ICU patients) is a challenge to the researcher in terms of ethical considerations, particularly when the researcher is attempting to meet the expectation of primary selection for theoretical sampling in grounded theory method. Suggestions are made in this thesis about how to tackle this challenge in future studies. At the conclusion of the Study, a number of suggestions for further research are made relating to the findings. These include the recommendation that the substantive theory developed in this Study be tested with a larger population. It is also suggested that a longitudinal follow-up study, which extends beyond a three months recovery period, be conducted to further understand the experiences and support needs of post-ICU patients and their principal lay support persons. In addition, more research is required to identify best practice regarding discharge planning, post-ICU follow-up care, and continuity of care in the community for critically ill patients and their principal lay carers. / PhD Doctorate

This thesis focuses on systems for mediated communication that run on mobile technology. The aim has been to give an answer to the question about what require- ments there are for situation awareness for domain experts when communication is secondary and supports the primary task. This thesis originated in a critical approach to the common practice of design- ing mediated communication systems with the face-to-face meeting as a guiding scenario. Instead, this thesis explores a design process that is based on the task and the strength of the technology itself. Different tasks do, of course, make different de- mands on a system, and a task that is strongly connected to the face-to-face meeting will probably be best served by a system that is designed from that perspective. Three cases that are presented in this thesis share three common themes that have characteristics that set them apart from the face-to-face meeting. The first theme is that the communication is a secondary task that is used to support a primary task. The second theme is that the cases involve domain experts active in the primary task. The use of experts implies that communication will be task- centered and also that the need for information to sustain a valuable situation awareness may be different from a person with less experience in the domain. The third theme is that all cases and the corresponding tasks benefit from some kind of situation awareness among the participants for optimal execution of the task. The three cases are based on: Wearable computers using mediated communication with wearable computers and how to handle interruptions for users of such computers Multidisciplinary team meetings improving access to patient information and enabling individual and group interaction with this information Trauma resuscitation giving a remote trauma expert’s correct and valuable in- formation while minimizing disturbance when supporting a local trauma re- suscitation team Prototypes are central in all three cases, and different prototypes have been designed and evaluated to validate the benefit of designing tools for communication that do not try to replicate the face-to-face meeting. The main findings in this thesis show that the shift of focus to the primary task when designing mediated communication systems has been beneficial in all three cases. A conflict between the secondary communication that is used to support sit- uation awareness and the primary task has been identified. Full situation awareness should therefore not be a goal in these designs but communication should support enough situation awareness to benefit the primary task with minimal disturbance to it. / <p>QC 20140221</p>

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / O presente trabalho possui como objetivo central investigar a teoria acerca da origem da significação, presente na obra Ser e tempo, de Martin Heidegger, procurando mostrar em que medida a significação dos entes traz consigo a interpretação do conhecimento teórico como sendo uma transformação modal da relação semântica em que se movimenta medianamente o existente humano. Para tanto, procuraremos mostrar a partir da idéia de que existem dois extremos de um mesmo movimento de transformação semântica que caracterizam um processo de objetivação ou perda de sentido que a origem de sentido ou instância de produção de todos os conceitos e enunciados filosóficos reside no próprio ser-aí não como um sujeito cognoscente ou representacional, mas como um eu no sentido do si-mesmo próprio que, ao assumir a responsabilidade por seu ser, se mostra como sendo o ponto de vista modal a partir do qual é possível recorrer o sentido indo de encontro com sua própria atividade fundamental. / This work aims to investigate the theory of the origin of meaning, present in Being and Time, Martin Heidegger, trying to show to what extent the significance of loved brings the interpretation of theoretical knowledge as a modal transformation of the relationship semantics which moves in the medium human existent. For that, we show - from the idea that there are two extremes of the same movement of processing semantics that characterize an objective process or loss of sense - the sense of origin or production instance of all concepts and points of philosophy lies in their being-there not as a knowing subject or representational, but as an "I" in the sense of the self itself that, by taking responsibility for his being shown as the modal point of view from which is possible to appeal the order by meeting with its own fundamental activity.

Fundação de Amparo a Pesquisa no Estado do Rio Grande do Sul / The classical physical science distinguishes itself as a previous project, consisting of the fundamental concepts of elements such as calculation, time, space, motion, matter, force and directed to capture all the nature phenomena supposedly unified. Quantum mechanics advances beyond these postulates, evidencing the inevitable interference of the subject in the search results , in which a reference to an ontological theory with material objects should be able to capture for regularities calculation, it becomes impossible, leaving the core concepts and field for the previous innovative project. As a result, the uncertainty principle that is expressed in a state of motion is identified only as to the statistical calculation or position, or the magnitude of the movement. After the development the existential concept of science that emphasizes the being-there as being-in-the-world to find certain beings as objects by the previous project of the scientific perspective, Heidegger subsequently comes to the conclusion that quantum physics incorporating the classical physics keeps unchangeable in terms of the previous science project of all: the nature disposes in advance a way of securing the meeting proposed by the existing human scientific achievement in theory terms . Science is only an access way to nature in its inexhaustible plenitude, so that it makes it unavoidable and unattainable with the scientificity resources. The com-position is the essence of the technique using scientific results and, by its vortex, enabling it to the final co-existing human. It remains to the being-there the mercy of a thought as to question the destitute condition of his own danger in forgetting that the cooption may be victim of their own decision. / A física clássica distingue-se como ciência por um projeto prévio, composto pelos conceitos fundamentais de elementos como cálculo, tempo, espaço, movimento, matéria, força e direcionado a captar todos os fenômenos da natureza supostamente unificada. A mecânica quântica avança além desses postulados, evidenciando a inevitável interferência do sujeito nos resultados de sua pesquisa, em que a referência a uma teoria ontológica com objetos materiais, devendo ser captáveis para fins de cálculo de regularidades, tornase impossível, restando os conceitos de núcleo e campo para o projeto prévio inovador. Em decorrência, o princípio de incerteza se expressa em que um estado de movimento se identifica somente quanto à calculabilidade estatística ou da posição, ou da grandeza do movimento. Após a elaboração do conceito existencial de ciência, que ressalta o seraí como ser-no-mundo a encontrar entes determinados como objetos pelo projeto prévio da perspectiva científica, Heidegger posteriormente chega à conclusão de que a física quântica incorporando a física clássica permanece imutável no que concerne ao projeto prévio da ciência de sempre: a natureza se dispõe de antemão a um encontro ao modo de asseguramento proposto pelo existente humano numa realização científica em termos de teoria. A ciência permanece apenas como um dos modos de acesso à natureza em sua plenitude inesgotável, o que faz com que ela seja incontornável e inacessível com os recursos da cientificidade. A com-posição é a essência da técnica utilizando resultados científicos e, pela sua voragem, habilitando-se para a cooptação definitiva do existente humano. Resta ao ser-aí a piedade de um pensamento indigente enquanto questionar a sua própria condição de perigo no esquecimento da cooptação de que pode ser vítima por própria decisão.

Fundação Carlos Chagas Filho de Amparo a Pesquisa do Estado do Rio de Janeiro / O presente trabalho possui como objetivo central investigar a teoria acerca da origem da significação, presente na obra Ser e tempo, de Martin Heidegger, procurando mostrar em que medida a significação dos entes traz consigo a interpretação do conhecimento teórico como sendo uma transformação modal da relação semântica em que se movimenta medianamente o existente humano. Para tanto, procuraremos mostrar a partir da idéia de que existem dois extremos de um mesmo movimento de transformação semântica que caracterizam um processo de objetivação ou perda de sentido que a origem de sentido ou instância de produção de todos os conceitos e enunciados filosóficos reside no próprio ser-aí não como um sujeito cognoscente ou representacional, mas como um eu no sentido do si-mesmo próprio que, ao assumir a responsabilidade por seu ser, se mostra como sendo o ponto de vista modal a partir do qual é possível recorrer o sentido indo de encontro com sua própria atividade fundamental. / This work aims to investigate the theory of the origin of meaning, present in Being and Time, Martin Heidegger, trying to show to what extent the significance of loved brings the interpretation of theoretical knowledge as a modal transformation of the relationship semantics which moves in the medium human existent. For that, we show - from the idea that there are two extremes of the same movement of processing semantics that characterize an objective process or loss of sense - the sense of origin or production instance of all concepts and points of philosophy lies in their being-there not as a knowing subject or representational, but as an "I" in the sense of the self itself that, by taking responsibility for his being shown as the modal point of view from which is possible to appeal the order by meeting with its own fundamental activity.

Résumé : « Wege, nitch Werke ». L’exergue de la Gesamtausgabe donne une indication précieuse pour quiconque souhaite lire et comprendre la pensée de Heidegger. Son œuvre se distingue des classiques de la tradition philosophique par le fait qu’elle ne cherche pas à établir une doctrine. Elle vise plutôt à reprendre à bras-le-corps une seule et même question : la Seinsfrage. Heidegger l’a retournée de maintes façons, parfois en puisant dans les préjugés au sujet de l’Être, parfois en empruntant des chemins de pensée plutôt inexplorés, mais à chaque fois il étonne. Le lecteur habitué à la rigidité conceptuelle, aux évidences cartésiennes et aux règles logiques de l'esprit, trouve peut-être en Heidegger son plus grand défi parce qu’il adhérait à une pensée-en-chemin (Zu Denken Wege) qui accueille l'errance et la pause, le silence et le tournant. Il invite le lecteur à prendre le pas, à risquer les chemins qui ne mènent nulle part ― Holzwege ―, à ne pas hésiter à faire un pas en arrière (Schritt zurück). La Gesamtausgabe oblige un certain inconfort pour la pensée. Ce mémoire de maîtrise est consacré à l’examen de la fonction phénoménologique des humeurs (Stimmungen) et à l’importance que leur accorde Heidegger, à partir d’une lecture de Sein und Zeit, tout particulièrement. La recherche a pour hypothèse de travail qu’on y retrouve une théorie des humeurs appréciable, bien que ne lui soit pas réservée une analyse systématique dans l’œuvre. Malgré cela, ce mémoire fait la démonstration, en quelques chapitres, que Sein und Zeit contient des éléments théoriques qui permettent de fonder cette théorie. Au final, le mémoire explore brièvement les humeurs analysées par Heidegger. C’est l’occasion de voir comment la théorie des humeurs s’inscrit véritablement dans la pensée du philosophe. La thèse défendue dans ce mémoire pourrait être reprise et approfondie par une étude doctorale, ce qui donnerait peut-être une clef supplémentaire pour contribuer à l'élaboration d'une lecture intégrale de la Gesamtausgabe. / Abstract : The highlight of the Gesamtausgabe gives a valuable indication for anyone who wants to read and understand Heidegger's thought. His work part from the philosophical tradition in that does not seek to establish a doctrine. Rather, it is intended to tackle the question of Being (Seinsfrage). Heidegger has posed it in many ways, sometimes by challenging our common sense about the “Being”, sometimes by exploring new paths of thinking, each time surprising us. Someone familiar with rational assertion, methodological pattern and logical rule, may find Heidegger really hard to understand because he assumes what he calls a « thought-in-way » (Wege Zu Denken), which welcomes silence and wandering. Heidegger invites the reader to try pathways that lead nowhere at first sight — Holzwege —, and sometimes to take a step back (Schritt zurück) from what he thinks. The Gesamtausgabe is definitively a challenge for the thought. The main goal of this master’s thesis is to examine the phenomenological function of moods (Stimmungen) and the importance we should give to them, from a reading of Sein und Zeit, especially. The aim is to find in it a theory of moods, even if Heidegger did not analyze them systematically. Nevertheless, this essay outlines, in just a few chapters, the reasons why we can pretend there is a such theory and why the moods have a significant phenomenological function. Finally, we explore the moods analyzed by Heidegger so we can see how his theory is truly embodied. This research could be taken further in a doctoral study, which would perhaps contribute to a more comprehensive interpretation of the Gesamtausgabe.

In the thesis a methodology of understanding and explicating Christian faith consistent with the mystery of the simultaneous close connection and radical difference of God, human beings and the physical-organic cosmos environment is been mapped out. The theanthropocosmic principle as an expression of the mystery functions as the heuristic key in opening up the notion of kenosis (and incarnation) of Jesus Christ and the Holy Spirit within the scope of the enduring interaction of . The Spirit in the kenotic sense of the word connects and differentiates the overall processes of being and becoming, here and there, now and then of the mystery of the `presences' of God, human beings and the natural cosmic world in being there (Dasein), being thus and thus (Sosein) and being dynamically actual (Aktsein). God acts in terms of the Spirit's operational kenotic presence within the margins of the creatureliness of people and the natural cosmic world as the kenotic clothing of God. A dynamic interpretation of the integral and differential character of being and becoming suggests that making sense of the dynamics of the formation of identities and identification is an ever ongoing endeavour. It implies a continuous process of negotiation whilst experiencing various continuums, remaining open-ended in an ever-increasing sense of wonder and mystery of "exitus a Deo-reditus in Deum". / Systematic Theology and theological Ethics / D. Th. (Systematic Theology)

In the thesis a methodology of understanding and explicating Christian faith consistent with the mystery of the simultaneous close connection and radical difference of God, human beings and the physical-organic cosmos environment is been mapped out. The theanthropocosmic principle as an expression of the mystery functions as the heuristic key in opening up the notion of kenosis (and incarnation) of Jesus Christ and the Holy Spirit within the scope of the enduring interaction of . The Spirit in the kenotic sense of the word connects and differentiates the overall processes of being and becoming, here and there, now and then of the mystery of the `presences' of God, human beings and the natural cosmic world in being there (Dasein), being thus and thus (Sosein) and being dynamically actual (Aktsein). God acts in terms of the Spirit's operational kenotic presence within the margins of the creatureliness of people and the natural cosmic world as the kenotic clothing of God. A dynamic interpretation of the integral and differential character of being and becoming suggests that making sense of the dynamics of the formation of identities and identification is an ever ongoing endeavour. It implies a continuous process of negotiation whilst experiencing various continuums, remaining open-ended in an ever-increasing sense of wonder and mystery of "exitus a Deo-reditus in Deum". / Systematic Theology and theological Ethics / D. Th. (Systematic Theology)