Orientador: Luiz Benedicto Lacerda Orlandi / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas / Made available in DSpace on 2018-08-19T16:26:55Z (GMT). No. of bitstreams: 1 Nascimento_RobertoDuarteSantana_D.pdf: 1381311 bytes, checksum: 205a9c0aba147eb9daf666f0c3bf0f8c (MD5) Previous issue date: 2012 / Resumo: O conceito de signo em Deleuze aparece ao longo de toda a sua obra, ligando-se em cada um de seus livros e artigos ao desenvolvimento de diferentes problemas em pauta. Tais variações por que passa este conceito não comprometem sua consistência no pensamento deleuziano; ao contrário, elas afirmam a complexidade de uma teoria dos signos que insiste virtualmente em seus livros e artigos. Pode-se dizer mesmo que as diferentes problemáticas às quais se dedica Deleuze se enriquecem quando apreendidas tendo em consideração a experiência do signo. Nesta teoria, o signo é afecto, ou seja, é um sentir diferentemente nos encontros, e corresponde à variação de nossa potência de existir. Isto ocorre porque o signo envolve uma diferença de nível constitutiva, uma heterogeneidade irredutível aos dispositivos que seguram a diferença pela analogia no juízo, pela semelhança no objeto, pela identidade no conceito e pela oposição no predicado. Um dos aspectos mais inovadores desta teoria é que, nela, o signo deixa de ser definido pelo imperialismo do significante. Este passa a caracterizar apenas um dos regimes de signos, que não é nem o mais aberto nem o mais importante. Além disso, nesta teoria o pensamento deixa de ser um ato de boa vontade de uma consciência soberana, como ocorre nas imagens tradicionais do pensamento, pois, para Deleuze, pensar implica um pathos, ou seja, é uma atividade disparada involuntariamente pela força de um signo, pela violência de tal encontro / Abstract: The concept of sign in Deleuze appears in all of his works, being linked in every one of his books and articles to the development of different problems. Such variations undergone by this concept do not compromise its consistency in the Deleuzian thought: on the contrary, they affirm the complexity of a theory of signs that virtually persists throughout his books and articles. It could even be said that the different problems to which Deleuze dedicates himself enrich when understood with regards to the experience of the sign. In this theory, signs are affects, i.e. are a variation of feelings in encounters, and correspond to a variation of our power of existence. This occurs as the sign involves a constitutive difference of level, a heterogeneity which cannot be reduced to the devices that secure the difference through the analogy in judgment, through the resemblance in the object, through the identity in the concept and through the opposition in the predicate. One of the most innovative aspects of this theory is that the sign is no longer defined by the imperialism of the signifier, which now characterizes only one of the regimes of signs (neither the most open, nor the most important). More than that, in this theory, thinking is no longer the act of will of a sovereign consciousness, as it was the case in the traditional image of thought, for, according to Deleuze, thinking implies a pathos, i.e., is the unvoluntary activity triggered by the force of a sign, by the violence of such an encounter / Doutorado / Filosofia / Doutor em Filosofia

SAMMANFATTNING Bakgrund: I Sverige uppskattas att 2–6 procent av befolkningen identifierar sig som homosexuella, bisexuella, transpersoner, queera och intersexpersoner (HBTQI). HBTQI-personer som upplevt kränkande bemötande eller diskriminering i hälso- och sjukvården avstår från att söka vård. Erfarenheter av diskriminering kan leda till psykisk och fysisk ohälsa. Det är ett stort problem då hälso- och sjukvården är en plats där alla ska känna sig respekterade och rättvist behandlade.  Syfte: Att undersöka HBTQI-personers erfarenheter och önskemål av bemötande från hälso- och sjukvårdspersonal. Metod: Litteraturöversikt med beskrivande design och analys av kvalitativa studier. Studiens resultat baseras på 12 kvalitativa studier från databaserna PubMed, CINAHL och PsycInfo. Artiklarna kvalitetsgranskades enligt Statens beredning för medicinsk och social utvärdering (SBU:s) mall.  Resultat: Två kategorier och sju underkategorier identifierades. En kategori var Erfarenheter med följande underkategorier: Diskriminering, Heteronormativitet, Kunskapsbrist hos vårdpersonal och Bekräftelse. Den andra kategorin var Önskemål som innefattade följande underkategorier: Behandlad med respekt, Inkludering och Personcentrerad vård. Slutsats: Diskriminering av HBTQI-personer är vanligt förekommande inom vården. Det är ett allvarligt problem som leder till att HBTQI-personers förtroende för vården minskar samt att de undviker att söka vård trots att behov finns. Därmed belyses behovet av ökad kunskap hos hälso- och sjukvårdspersonal kring HBTQI-personers rättigheter. / ABSTRACT Background: In Sweden, it is estimated that 2-6 percent of the population identify themselves as lesbian, gay, bisexual, trans, queer or intersexpersons (LGBTQI). LGBTQI persons who have experienced abusive treatment or discrimination in health care refrain from seeking care. Experiences of discrimination can lead to mental and psyical ill-health. This is a major problem as health care is a place where everyone should feel respected and treated fairly.  Aim: To examine LGBTQI individuals' experiences and desires of encounters with health care professionals. Method: Qualitative descriptive design. The results of the study are based on 12 qualitative studies from the databases PubMed, CINAHL and PsycInfo. The articles were quality audited according to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU's) checklist. Result: Two main categories and seven subcategories were identified. The first category was Experiences, with the following subcategories: Discrimination, Heteronormativity, Lack of knowledge among healthcare professionals and Affirmation. The second category was Desire which included the following subcategories: Treated with respect, Inclusion and Person-centered care.  Conclusion: Discrimination against LGBTQI people is common in healthcare. This is a severe problem that leads to LGBTQI people's trust in care decreasing and that they avoid seeking care despite experienced need. This highlights the need for increased knowledge among health care professionals about the rights of LGBTQI persons.

Introduktion: Vistelsen på akutmottagningen präglas av möten med flera olika vårdprofessioner. När vårdpersonalen engagerar patienten i en öppen dialog ökar patienternas delaktighet samt patientsäkerheten. Bristande bemötande kan leda till att patientsäkerheten äventyras samt onödiga kostnader då obefogade åtgärder genomförs. Missnöjda patienter till följd av bristande bemötande är mindre benägna att följa vårdens rekommendationer vilket kan leda till att de återkommer till vården i sämre skick.  Syfte: Att undersöka patienters upplevelser av vårdpersonalens bemötande på akutmottagningen. Metod: En deskriptiv kvalitativ litteraturstudie användes som metod. Elva vetenskapliga artiklar med kvalitativ ansats kvalitetsgranskades och analyserades.  Resultat: Fem huvudkategorier framträdde: Information, Kommunikation, Delaktighet, Personcentrerad vård och Personalens handlingar. Att vara tillräckligt informerad, erhålla individanpassad information samt regelbundet kommunicera med vårdpersonal bidrog till en positiv upplevelse av vårdpersonalens bemötande. Även möjligheten att delta i sin vård samt vårdas ur ett personcentrerat förhållningssätt bidrog till positiva upplevelser. När informationen och kommunikationen brast upplevde patienterna oroskänslor.  Slutsats: Mötet präglas av olika faktorer som bidrar till upplevelsen av bemötandet. Varje persons upplevelse är individuell och det är sjuksköterskans ansvar att bemöta personen utifrån dennes individuella behov och önskemål. Ett gott bemötande bidrar till en positiv vårdupplevelse hos den sjuke. När personen inte upplever att bemötandet är tillfredsställande bidrar detta till en negativ vårdupplevelse. / Introduction: Visiting the emergency department is characterized by encounters with different healthcare professions. When the staff engages the patient in an open dialogue patient participation and patient safety increases. Inadequate treatment can lead to patient safety being compromised as well as unnecessary costs when unjustified measures are carried out. Dissatisfied patients, due to poor treatment, are less likely to follow recommendations, leading to them later returning to the hospitals in worse conditions.  Aim: To investigate patients’ experiences of the encounter with the staff in the emergency department.  Method: A descriptive qualitative literature study where eleven scientific articles with a qualitative approach were quality reviewed and analyzed.  Result: Five main categories emerged: Information, Communication, Participation, Person-centered care, and Staff actions. Being sufficiently informed, receiving individually tailored information and regular communication with healthcare staff contributed to a positive experience of the treatment. To be involved in their care and to be cared for from a person-centered approach also contributed to positive experiences. When information and communication was insufficient patients experienced negative emotions.  Conclusion: Being cared for in an emergency department implies an encounter between a patient and staff. The encounter is characterized by various factors that contribute to the experience of being treated at the emergency department. Each persons’ situation is individual, and it is the nurses’ responsibility to respond to the person based on their individual needs. A good encounter contributes to a positive experience for the patient. When the encounter is unsatisfactory it contributes to a negative experience.

Thesis advisor: ORFILIO E. VALIENTE / Uganda’s fragmented ethnic reality comprises the reconstruction of ethnic identities into rival categories of difference and otherness. From a historical perspective, under the ‘divide and rule’ British colonial policy, colonial anthropology, political, and economic systems polarized and mobilized native nations into oppositional and competing configurations of embodied otherness. The resultant antagonistic social ethos, ingrained in the consciousness of persons and groups, foments a legacy of sociopolitical oppression and economic alienation and instigates religious and spiritual fragmentation within the body of Christ. From a Christian perspective, this project proposes an incarnational mission of mercy centered on the event of encounter as a hermeneutical and praxis-based criterion toward social reconciliation. It offers a way of interpreting conflicted reality by transforming ethnic attitudes, social structures, practices, and new habits of relation among persons of different ethnic groups and institutions. Based on Christian values, human agency, and God’s grace, it envisions transformed human relations and the establishment of a renewed social fabric. Christian faith, hope, and love lived out in a concrete praxis of mercy inspire this proposed new way of being, relation, and practice so that Uganda may become a reconciling society that anticipates an eschatological communion in God’s Kingdom. / Thesis (STD) — Boston College, 2022. / Submitted to: Boston College. School of Theology and Ministry. / Discipline: Sacred Theology.

Hospitality management and service positions have been moving from a purely vocational field of work to a scientific and inter-disciplinary supported area of professional development. This exploratory study aims to contribute to this quest by introducing the sociological concept of Dramaturgy to the service encounter as a way of understanding and improving upon present employee behaviors. A review of existing literature illustrates that Dramaturgy has only been used to develop an analogy of service, but has not yet been applied as a tool for further understanding behaviors and interactions during service encounters. The present study identified common concepts between Service Interactions and Dramaturgical Interactions, and used them to create a survey to measure Dramaturgical Awareness. It was proposed that four factors are used to create the structure of Dramaturgy in service encounters. A likert-type survey was distributed to 464 students studying at the Rosen College of Hospitality Management. The responses were subjected to a Principal Component Analysis, and the results introduced two unexpected factors. The original structure of four underlying factors emerged as a five-factor structure, including the two new factors and one factor that combined two former concepts. In response to the given survey, the surviving structure of dramaturgical awareness in service encounters (as measured by hospitality students) includes the following concepts: Interpersonal Communication; Improvisation Techniques; and Acting and Stage Behaviors. Further research can use these findings to understand service encounter behaviors from practitioners from specific areas of work in service, and to also develop a better understanding of the two unexpected factors, dramaturgical behaviors and role theory.

Background: The emergency department is available all hours of the day for patients who have suffered an acute injury or illness. The nurses' experience work in the emergency department as hectic and stressful. Heavy workloads and overcrowding make the nurses feel anxious and frustrated that they cannot provide optimal care to the patients. According to chosen nursing scientific theory, care can be experienced as caring or uncaring. Laws and governing documents that the health and medical care must comply with and the nurses' area of responsibility appear. Aim: To describe patients’ experiences of care in the emergency department. Method: General literature review based on eleven articles with a qualitative approach and four articles with a quantitative approach. Results: Six categories were identified in the analysis; The importance of communication, The importance of information, The importance of the encounter, The importance of security, the importance of time spent waiting and the importance of surroundings. It emerged that the patients' experiences of being cared for in the emergency department varied. The patients experienced a lack of communication and information. The patients experienced different encounters, long waiting times and a hectic environment. These experiences resulted in anxiety and discomfort. When the nurses were well versed in their work, the patients felt more secure and trusted the nurses. Conclusion: Positive and negative experiences are identified by patients in the emergency department. The healthcare staff needs continuous training, improvement of the environment is required to improve the patients' experience of care.

Today we have many alternative medicines, not a few of which connect back to aboriginal cultures. Some of these alternative medicines were born under the influence of European imperialism, as they were not "alternative" until modern empires and modern medicine came to these distant regions. The present study begins with a broad question: how did conceptions of the relationship between modern Western medicine and traditional local non-Western medicine come to be? To explore the historical origins of these two conceptions, I focus herein on Japanese colonial Taiwan (1895–1945), where modern medicine became dominant while traditional medicine also flourished. My research finds that the historical realities of colonial Taiwan were not reflected in the progressive narrative of medicine. According to this narrative, modern medicine became dominant around the world while traditional medicines were swept into the ash heap of history because only modern medicine was the true, effective science of preventing, diagnosing, and treating physical ailments. The history of colonial Taiwan teaches us a much different lesson: practitioners of traditional medicine there were a significant part of the public health system during the colonial period. For example, they rallied against the plague in the late 19th century, diagnosing and treating patients when antibiotics had yet to be developed. Even so, the island witnessed an institutional medical shift, in which licensed practitioners of modern medicine deified modern medicine and denigrated traditional medicine, labeling the latter "primitive" and "non-medicine." In response, practitioners of traditional medicine produced new narratives aiming to challenge this colonial boundary between medicine and non-medicine. These practitioners' fundamental argument was that traditional medicine, though epistemologically different from modern medicine, was still legitimate medicine. From this effort, we now have the widely held belief today that both modern medicine and traditional medicine are legitimate, but distinct, medicines. This historical outcome of colonial resistance occurred worldwide. In my study, I identify the social, political, and colonial contexts of medical resistance in Japanese Taiwan, revealing their roots in issues related to inequality, distrust, economic affordability, and conceptions of body and health care. / Doctor of Philosophy / In this study, I explore conceptions of modern and traditional medicine through a historical lens, and break down two related myths: the first myth is the progressive narrative of modern medicine, which holds that modern medicine became dominant because of its medical superiority; and the second myth is the narrative held by extremist supporters of traditional medicine, who insist that only millennia-old traditional medicine can resolve human ailments without giving rise to untoward side effects and exorbitant costs. I show that, in the case of Japanese colonial Taiwan (1895–1945), both modern and traditional medicine flourished. The history of colonial Taiwan shows us that modern medicine on the island became dominant for two main reasons: first, the public health system successfully dealt with epidemics, which were the most significant threat to life at that time; and second, the colonial government recognized only modern medicine and labeled traditional medicine a non-medicine despite relying on its practitioners in the pre-antibiotic age. The history of colonial Taiwan also shows us that traditional medicine is not "old wisdom" unchanged for thousands of years. Beginning in the 19th century, practitioners of Taiwanese traditional medicine re-constituted it for colonial consumption, arguing that traditional medicine was also true medicine, though epistemologically distinct from modern medicine. This conception of traditional medicine has since informed many current views of traditional medicine. In 2018, the World Health Organization (WHO) published the eleventh revision of the International Classification of Diseases (ICD-11), which, for the first time, featured a chapter on traditional Chinese medicine covering such topics as diagnostic techniques for Qi, blood, and fluid disorders. This inclusion of traditional medicine into the ICD-11 is a major step forward in this process of medical integration and may help resolve the historical confrontation between modern and traditional medicine. However, the WHO decision limits recognition of traditional medicine to Chinese medicine, excluding all other kinds of traditional medicine. Thus, the historical question of whether or not traditional medicine is a true medicine remains ultimately unanswered.

This dissertation explores both the evolving nature of the public encounter--where state and citizen meet--and the virtual civic space in which the meeting occurs through an examination of selected state and federal web sites. The examination uses multiple qualitative measures and an architectural perspective to bridge the gap between traditional physical-space based government and the virtual-space of e-government. The research focuses on identifying salient e-government issues and explicating their implications for public encounters, public administration practitioners and scholars, and traditional government institutions. The implications of e-government on the exercise of administrative discretion, the digital divide, and policy making are explored. Select prescriptions are offered for public administration education, practitioners and scholars. E-government architecture is conceptualized along two dimensions: the normative and the aesthetic. The normative dimension refers to the extent to which certain key norms or values are fulfilled or emphasized in web site architecture while the aesthetic dimension refers to whether certain technical features of what is considered good message design or high message quality are present. The normative tradition of public administration in combination with prior e-government research is used to construct evaluation criteria for assessing latent public values contained in government web site features and content. Information architecture, information presentation, and instructional message design literature are used to construct aesthetic criteria for determining the message character of web sites. Focus groups and a survey questionnaire are used to both challenge and triangulate the web site data analysis. An argument is made for eliminating the distinction or dichotomy between the two modes of government action--traditional and that of e-government. A unification of the two is proposed as part of an overall strategy for addressing the restructuring and reorganization of extant institutional arrangements necessary to support an integrated approach to e-government and traditional service delivery. Caution is urged with respect to proposals for embedding government services and information within existing commercial and entertainment web sites lest democratic values be subordinated to financial interests. / Ph. D.

Bakgrund Kommunikation är utbytet av information, tankar och känslor mellan individer och något som används dagligen inom sjukvården. Hälso- och sjukvårdslagen samt patientsäkerhetslagen redogör för hur sjuksköterskan är skyldig att i samråd med patienten utföra omsorgsfull vård med respekt och omtanke. En vårdteori som används generiskt är den personcentrerade vården som bygger på att främja patientens självbestämmande och autonomi genom att göra denne delaktig i beslut samt att lyssna på vad denne har att säga. Genom att respektera patientens autonomi ökar dess självbestämmande och upplevelse av trygghet och tillit till vården.  Syfte Syftet är att belysa hur kommunikation mellan patient och sjuksköterska kan påverka patientens självbestämmande och autonomi.  Metod Studien är en icke-systematisk litteraturöversikt baserad på 15 vetenskapliga originalartiklar. Utvalda artiklar består av kvalitativa och kvantitativa ansatser och är insamlade från databasernas PubMed och CINAHL med hjälp av sökord. Efter urval har artiklarna granskats utifrån Sophiahemmet Högskolas bedömningsunderlag för att vetenskapligt klassificeras och kvalitetsgranskas. Sammanställning och analys av studiens resultat har gjorts med integrerad dataanalys.  Resultat Föreliggande studies resultat beskriver betydelsen av att bygga en god relation mellan patient och sjuksköterska. Detta kräver ett personcentrerat förhållningssätt där kommunikationen anpassas till patientens personliga kunskapsnivå för att minska kunskapsklyftorna gällande sjukdomsstatus för att självbestämmande ska vara möjligt. Omtänksamhet, respekt och förtroende mellan parterna gynnar patientens autonomi och självbestämmanderätt. Relationsbyggandet och utbildandet kräver tid vilket är en bristvara inom delar av vården, detta trots bevisning om att vårdtiderna blir kortare vid högre självbestämmande.  Slutsats Större resurser på ökad utbildning av sjuksköterskor inom ämnet kommunikation, patient-sjuksköterska skulle gynna patientens självkänsla, autonomi och självbestämmande. Ett varmt bemötande och intresse för patienten som helhet utan tidspress kan även korta vårdtiderna. / Background Communication is the exchange of information, thoughts, and emotions between individuals and is used daily in healthcare. The Swedish Health and Medical Services Act, as well as the Swedish Patient Safety Act, specify that nurses are obligated to provide careful care in consultation with the patient, with respect and compassion. A commonly used nursing theory is person-centered care, which aims to promote the patient's selfdetermination and autonomy by involving them in decision-making and listening to their perspectives. By respecting the patient's autonomy, their self-determination and sense of security and trust in healthcare are increased. Aim The purpose is to highlight how communication between patients and nurses can impact patients' self-determination and autonomy. Method The study is a non-systematic literature review based on 15 scientific original articles. The selected articles consist of qualitative and quantitative approaches and were gathered from the PubMed and CINAHL databases using search terms. After selection, the articles were reviewed based on the assessment criteria of Sophiahemmet University to be classified and quality-assessed scientifically. Compilation and analysis of the study's results were conducted using integrated data analysis. Results The results of the underlying studies point towards the significance of building a good relationship between the patient and nurse. This requires a person centered approach where communication is adapted to the individual knowledge level of the patient, in order to lessen the disease status knowledge gap, and in order to make self-determination possible. Thoughtfulness, respect and trust between the parties is beneficial for the autonomy of the patient, and the patients right to self-determination. Relationship building and education in healthcare requires time, which is of short supply within parts of healthcare, even though there is evidence that the period of care is shorter with higher self-determination. Conclusions Larger resources invested in education of nurses within the subject of communication, patient-nurse, would increase the patients level of self-determination, autonomy and selfesteem. A warm treatment in healthcare, and interest in the patient holistically without time pressure would even shorten the period of care.

Arab countries strive toward the modernization and feminization of the Arab culture; however, some of these countries (i.e., Saudi Arabia) are culturally and legally governed by "sharia law", and have maintained cultural norms regarding segregation of the sexes. In order to have a better understanding of the Arab travelers to the U.S., this research focuses on the gender dynamics between the service providers and Arab customers during a service encounter. Specifically, this research examines how the same and opposite genders of service-provider and customer influence Arab customers’ emotional response (comfort), consequently their service encounter evaluation (satisfaction), and behavioral intentions (feedback willingness). This research also examines how the employees’ efforts to solicit feedback from Arab customers may intensify the effect of gender dynamics on Arab customers’ responses. Scenario-based online surveys are created and distributed to respondents of Arab descent in Saudi Arabia, Bahrain, and United Arab Emirates by using snowball sampling. The results based on 326 respondents show potential differences determined by gender interaction. Arab customers were more comfortable, more satisfied with the service encounter, and more willing to provide feedback, if the employee was the same gender as the customer, as opposed to the employee being the opposite gender from the customer. However, results showed that employee efforts to solicit feedback did not intensify the gender interaction effect. Additionally, through the service encounter, the Arab customers’ comfort influenced their service encounter satisfaction and their willingness to provide feedback. The findings of this research provide valuable implications for hospitality managers to better cater to the needs of Arab customers by examining the dimensions of gender boundaries in an intercultural service encounter.