Sociological explanations for human conduct usually place major ontological and epistemological emphasis upon either discursive or material relations without ever establishing or adequately specifying the validity of this dichotomy. Early texts by the Critical Realist philosopher Roy Bhaskar address this forced separation by creating an integrated ontological and epistemological field that provides a more detailed and precise theoretical ordering to agents, objects, and entities. Undertaking a developmental critique of Bhaskar’s arguments, this thesis extends Critical Realism’s role as theoretical ‘underlabourer’ and creates an expanded theoretical framework that balances discursive and material accounts. Utilising the sophisticated analyses of the structure and operation of discourses found in the work of Michel Foucault alongside the innovative arguments for aleatory materialism developed by Louis Althusser, a critique is established that shows discursive, material, and social relations to be complex, immanent, and, importantly, mutually constitutive. In each theory three core concepts of events, emergence, and the extra-discursive are shown to not only be present but also to operate as the main means of explaining social change. The result of integrating Critical Realism, Foucault, and Althusser in this sympathetic but non-syncretic form is the generation of a non-reductionist materialism combined with discursive relations. On this basis, social change is shown to be the result of restructured discursive and material relations of which human agents are only one part. The thesis provides an illustration of the theoretical argument with an empirical component which examines the formation and decline of the British nuclear industry between its inception in the early 1950s to the year 2000. The conclusion is that the form taken by nuclear energy is not entirely determined by any single one of political, economic, or scientific forces but is, instead, the product of multiple and complex interactions of immanent discursive and material relations that are, importantly, mutually reinforcing. / Thesis (Ph.D, Sociology) -- Queen's University, 2012-09-27 12:38:25.909

Tyrimo tikslas: įvertinti slaugos poreikį asmenims po klubo sąnario endoprotezavimo operacijos tolimuoju pooperaciniu laikotarpiu. Metodai. Tyrimas kiekybinis, atlikta anoniminė anketinė pacientų ir slaugytojų apklausa. Anketos pacientams dalintos gydymo įstaigoje, o pildomos namuose. Pacientams išdalintos 152 anketos. Bendruomenės slaugytojams anketos dalintos jų darbo vietoje ir pildomos iš karto. Viso slaugytojams išdalintos 220 anketų. Tyrimo duomenų statistinė analizė atlikta naudojant SPSS 17.0 programinį paketą. Rezultatai: Daugiau nei pusė pacientų savo būklę namuose vertina patenkinamai, daugumai (77 proc.) sunku nuvykti pas šeimos gydytoją, 15 proc. naudojosi slaugytojo teikiamomis slaugos paslaugomis namuose, pacientus namuose dažniausiai slaugo šeimos nariai (91proc.). Pacientams mažiausiai pakito fiziologinių poreikių tenkinimas. Pusė tiriamųjų pripažino (51 proc.), kad jautėsi priklausomi nuo kitų. Tyrimo pacientai dažnai norėtų iš slaugytojo bendravimo (26 proc.), pacientų mokymo (26 proc.), injekcijų į raumenis (21 proc.) ar į veną (26 proc.) paslaugų. Slaugytojų nuomone, pacientams vienodai svarbu patenkinti savimonės, vaidmens funkcijos bei abipusės (tarpusavio) priklausomybės poreikius. Tyrimo slaugytojai nurodo, kad jie dažnai įvertina paciento būklę namuose, aptaria slaugos tikslus (54proc.) ir sudaro slaugos planą (53 proc.). Priežastys trukdančios slaugytojui bendradarbiauti su pacientu namuose - per didelis darbo krūvis (83 proc.). Išvados: 1)... [toliau žr. visą tekstą] / The objective of the research: to evaluate the need of a care for the persons after hip replacement surgery in the remote postoperative period. Methods. The study is quantitative; anonymous questionnaire survey of patients and nurses has been conducted. The questionnaires were served to the patients at the medical institutions and they were filled at home. 152 questionnaires were distributed to the patients. The questionnaires were distributed to community nurses at their workplaces and filled immediately. In total 220 questionnaires were distributed to the nurses. The statistical analysis of research data was performed using SPSS 17.0 program package. Results: More than half of the patients evaluate their condition at home as satisfactory, the majority of them (77 percent) find difficulties to get to a family doctor, 15 percent used the home nursing services provided by the nurses, the patients at home are often being nursed by their family members (91 percent). Satisfaction of physiological needs is the least that changed to the patients. Half of the patients (51 percent) admitted they were feeling dependent on others. The patients of the research would often like to communicate with the nurses (26 percent), services of patients training (26 percent), injections to the muscles (21 percent) or vein (26 percent). The nurses believe that for the patients it is equally important to satisfy the needs of self-awareness, role function and reciprocal (mutual) dependence. The nurses... [to full text]

Thèses (M.A.)--Université de Sherbrooke (Canada), 2006. / In ProQuest dissertations and theses. Titre de l'écran-titre (visionné le 16 oct. 2007). Publié aussi en version papier.

Thesis (M.A.)--University of Delaware, 2005. / Principal faculty advisor: Nina Athanassoglou-Kallmyer, Dept. of Art History. Includes bibliographical references.

abstract: In the deregulated power system, locational marginal prices are used in transmission engineering predominantly as near real-time pricing signals. This work extends this concept to distribution engineering so that a distribution class locational marginal price might be used for real-time pricing and control of advanced control systems in distribution circuits. A formulation for the distribution locational marginal price signal is presented that is based on power flow sensitivities in a distribution system. A Jacobian-based sensitivity analysis has been developed for application in the distribution pricing method. Increasing deployment of distributed energy sources is being seen at the distribution level and this trend is expected to continue. To facilitate an optimal use of the distributed infrastructure, the control of the energy demand on a feeder node in the distribution system has been formulated as a multiobjective optimization problem and a solution algorithm has been developed. In multiobjective problems the Pareto optimality criterion is generally applied, and commonly used solution algorithms are decision-based and heuristic. In contrast, a mathematically-robust technique called normal boundary intersection has been modeled for use in this work, and the control variable is solved via separable programming. The Roy Billinton Test System (RBTS) has predominantly been used to demonstrate the application of the formulation in distribution system control. A parallel processing environment has been used to replicate the distributed nature of controls at many points in the distribution system. Interactions between the real-time prices in a distribution feeder and the nodal prices at the aggregated load bus have been investigated. The application of the formulations in an islanded operating condition has also been demonstrated. The DLMP formulation has been validated using the test bed systems and a practical framework for its application in distribution engineering has been presented. The multiobjective optimization yields excellent results and is found to be robust for finer time resolutions. The work shown in this report is applicable to, and has been researched under the aegis of the Future Renewable Electric Energy Delivery and Management (FREEDM) center, which is a generation III National Science Foundation engineering research center headquartered at North Carolina State University. / Dissertation/Thesis / Ph.D. Electrical Engineering 2012

The conceptual models in nursing care provide healthcare workers with a comprehensive philosophical-theoretical framework for provision of care to both healthy and ill individuals. They also contribute to develop nursing as a self-standing scientific discipline, supply a common language, an opportunity to make communication more efficient, to improve the provided care, they constitute a tool to evaluate the intervention results and last but not least, they support the education and the development of practice. The Calliste Roy's model, developed in the 1970s already and called "Adaptation model", understands the human as a holistic being that is in permanent interaction with the internal and external environment. According to the Roy's model, nursing is aimed at influencing the individuals' health in health, but also in illness, and at achieving their efficient adaptive behaviour. Our goal consisted in finding out the particularities of nursing care in clinical and community practice in the 50+ generation, under application of Calliste Roy's Adaptation model. Six hypotheses were formulated in collection with the set goal. Quantitative investigation under use of a non-standardized questionnaire was performed in order to get the data needed for processing of the research part of the work. The results of the investigation allowed confirming five out of the six hypotheses set. It was proved that with increasing age, 50+ people experience serious changes at 26 of the changes under evaluation. However, it was not confirmed that the life changes of the 50+ generation directly depend on gender, as no statistically significant connection between all changes tested and the gender was proved. It further applies that with increasing age, the percentage of individuals assessing the attitude to changes as negative rises significantly. It was also found out that the attitude of men towards changes is significantly more positive than the women's attitude. With increasing age, it is more and more difficult for the respondents to adapt to changes in their lives. However, men state significantly more often to be able to adapt to changes without difficulties, while women state difficulties significantly more often. A recommendation for practice consists in applying Calliste Roy's Adaptation model not only to assess the needs of the 50+ generation, but primarily in applying modified nursing case history in practice to support comprehensive assessment of the patient/client. The work brings stimuli for further research investigations, among other things.

Introdução. Cuidar de uma pessoa com doença crônica pode afetar significativamente o bem-estar de quem cuida, assim como perturbar ou deteriorar sua saúde física e emocional, sua dinâmica familiar e social e seus recursos econômicos. Infelizmente na América Latina, o sistema de saúde não responde às demandas e necessidades dos cuidadores familiares. Dispor de evidências oriundas de pesquisas rigorosamente delineadas e conduzidas com cuidadores com o diagnóstico de Tensão do Papel Cuidador contribui para o desenvolvimento de intervenções para melhorar o bem estar e qualidade de vida dessa população. Objetivos. Desenvolver um programa de intervenção de enfermagem que promova a adaptação dos cuidadores familiares com tensão do papel de cuidador; determinar a efetividade de um programa de intervenção aplicado por telefone para promover a adaptação de cuidadores familiares colombianos e brasileiros com Tensão do Papel de Cuidador. Método. Para o primeiro objetivo proposto foi seguida a proposta do UK Medical Research Council para o desenvolvimento e avaliação de intervenções complexas. O programa de intervenção foi desenvolvido em três passos. No primeiro foi estabelecida a evidência existente sobre intervenções para cuidadores familiares. No segundo passo foi desenvolvida a concepção teórica do cuidador familiar visto como individuo adaptável e do programa de intervenção como estímulo contextual sob a perspectiva do modelo de Adaptação de Roy. No terceiro passo, foi modelada a primeira versão do programa de intervenção e refinada em um estudo piloto. Para atingir o segundo objetivo, foi realizado um ensaio clínico randomizado em que 208 cuidadores familiares (104 colombianos e 104 brasileiros) foram randomizados para cinco sessões de intervenção psicoeducativa aplicadas com uso de telefone (Grupo intervenção) ou o cuidado usual (Grupo controle). Na coleta de dados foram aplicados os instrumentos de caracterização do cuidador, do receptor de cuidados e do cuidado oferecido pelo cuidador, a escala de apoio social (MOS), a Escala de Tensão do Papel de Cuidador, a Escala de Bem-estar do Cuidador Familiar e a escala de avaliação da qualidade de vida WHOQol-Bref. Os participantes foram avaliados na linha de base e na 6ª e 9ª semanas de seguimento. As variáveis de desfecho foram analisadas por equações de estimação generalizada (EEG) considerando interação entre tempo e grupo. Resultados. Os dois grupos estudados apresentaram diminuição estatisticamente significante da tensão do papel ao longo do tempo (Fator tempo, p <0.01). Não houve diferenças significativas nos dois grupos ao nível das variáveis bem estar do cuidador familiar e qualidade de vida. Conclusão. O programa de intervenção aplicado com uso de telefone não foi efetivo para promover a adaptação de cuidadores familiares com tensão do papel de cuidador. Apesar dos achados deste estudo, a teoria da adaptação do cuidador familiar derivada do modelo conceptual proposto por Roy foi consistente para compreender o impacto do cuidado no cuidador familiar, além de proporcionar uma estrutura para testar a efetividade do programa. / Introduction. Caring for a person with chronic disease can significantly affect the well-being of carers, as well as disrupt or deteriorate their physical and emotional health, their family, social dynamics, and their economic resources. In Latin America, the health system does not respond to the demands and needs of familiar caregivers. Having evidence from research rigorously delineated and conducted to inform the care of caregivers with the diagnosis of caregiver role strain will contribute to the development of programs capable of meeting the needs and demands of this population. Objectives. To develop a nursing intervention program that promotes the adaptation of family caregivers with caregiver role strain; to determine the effectiveness of nursing interventions applied by telephone to promote adaptation of Colombian and Brazilian family caregivers with caregiver role strain. Method. For the first objective, the UK Medical Research Council guidelines for the development and evaluation of complex interventions were applied. The intervention program was developed in three main steps. In the first one we identified previously published data regarding interventions for family caregivers; in the second step we developed a theoretical understanding of caregiver seen an adaptive individual, and the intervention program was conceived as a contextual stimulus from the perspective of the Roy Adaptation Model. In the third step, a preliminary intervention program was modeled based on literature findings, and then it was refined in a pilot study. To achieve the second objective, a clinical trial with 208 family caregivers (104 Colombians and 104 Brazilians) randomized to five psychoeducational intervention sessions applied using telephone (intervention group) or usual care (control group) was conducted. During data collection, an instrument for caregiver, care receiver and care characteristics, the Social Support scale (MOS), the Caregiver Role Strain scale, the Caregiver Wellbeing scale, and the The World Health Organization Quality of Life (WHOQOL) scale were applied. The participants were assessed at baseline and at the 6th and 9th week of follow-up. The outcome variables were analyzed by generalized estimating equations (GEE) considering interaction between time and group. Results. The two groups had statistically significant decrease of the caregiver role strain over time (Time factor, p <0.01). There were no significant differences between groups for wellbeing of caregivers, neither for quality of life. Conclusion. The intervention program applied using telephone was not effective to promote adaptation of family caregivers with caregiver role strain. Despite the findings, the theory of adaptation of caregivers derived from the conceptual model proposed by Roy was consistent to understand the impact of care on family caregivers, as well as provided a framework to test the effectiveness of the program.

Bakgrund: Idag drabbas många av cancersjukdom men tack vare tidig upptäckt botas många. Under sjukdomstiden påverkas även patientens maka/make/partner av cancersjukdomen. Anhöriga som stöttar sin partner kan ha en ökad risk att drabbas av egna hälsorelaterade problem.  Syfte: Syftet var att belysa anhörigas upplevelser av att stötta en partner i kurativt skede av cancersjukdom.  Metod: Resultatet består av tolv vetenskapliga artiklar som analyserades och delades in i sju teman. Roys Adaptationsmodell har använts för att diskutera resultatet. Artiklarna samlades in via databaserna CINAHL och PUBMED med urvalet 2007-2017.   Resultat: Resultatet visade på att anhörigas behov blev åsidosatta under partnerns sjukdomstid.  Deras identitet påverkades då de anpassade tillvaron för att kunna fokusera på sin partners vård. Rollfördelningen i parrelationen förändrades och anhöriga fick ta mer ansvar. En för stor börda på de anhöriga kunde ha stor påverkan på deras hälsa men många anhöriga upplevde att de kom sin partner närmare under sjukdomstiden.                    Diskussion: De fyra anpassningslägena i Roys modell påverkar varandra och är svåra att separera. Detta visar på att det är viktigt att ha en helhetssyn på människan. Vi anser att det är viktigt att vården uppmärksammar anhörigas behov och situation och erbjuder stöd för att undvika framtida ohälsa. / Background: A large number of individuals are affected by cancer disease every year, but due to improved treatment and early discovery many are cured. The illness, also affect the patient´s significant other and may increase their risk of own health-related problems. Aim: The aim was to describe significant others´ experiences when supporting a partner in curative phase of cancer disease. Method: The results are based on twelve scientific articles and categorized in seven themes. The Roy Adaptation model was used to discuss the result. Data were collected from the CINAHL and PUBMED databases, including articles from the years 2007-2017. Results: The results show that significant others´ own needs were put aside during their partner´s illness. Their identities were affected as they were adapting their everyday life to be able to support their partner. A partner´s illness also changed the couple’s roles as the couples responsibility changed within the relationship. If the significant other experienced the support as burdensome their health could be negatively affected. Significant others´ experienced their relationship to their partner to improve during the illness. Discussion: The four adaptation modes by Roy are related to each other and are hard to distinguish and the holistic view of each person is important. We conclude that it is important that the health care system also acknowledges the significant other´s needs and situations and thereby provide support needed to elude future health issues.

Les récits autobiographiques modernes se distinguent par leur hétérogénéité non seulement entre eux rnais à l’intérieur de chaque texte. Trois textes, de facture autobiographique équivoque, ont été choisis comme objets de cette étude parce qu’ils illustrent cette hétérogénéité inter/intra-textuelle. La Détresse et l’enchantement, de Gabrielle Roy, représente le récit autobiographique supposérnent conventionnel, garantissant la ‘véracité’ de son discours narratif par un certain pacte de lecture; pourtant ce texte révèle une dimension romanesque. Les Mots pour le dire, par contre, récit à saveur de confidence de Marie Cardinal, est ambivalent dès le départ quant à son statut: ii bascule entre des éléments romancés et les souvenirs vérifiables, “événements vécus”, selon l’auteure. Enfin, Les Samourals, roman à clefs de Julia Kristeva, s’éloigne du récit-mémoires, rnais est lu comme une autobiographie à peine voilée à cause des éléments correspondant à la vie de l’auteure. La juxtaposition de ces trois récits montre que chaque texte se situe à un point mobile sur un spectrum entre deux pôles également impossibles à circonscrire—la fiction ou la ‘vérité’ pure. La fonction plutôt que la structure ou le style du texte importe ici; esthétique dans le cas de Roy, thérapeutique chez Cardinal et critique pour Kristeva. L’autobiographie romancée, genre hybride ou “métissé”, est privilégiée par ces écrivaines, toutes les trois déplacées géographiquement et linguistiquement, ayant vécu un “métissage” culturel. Le déplacement, associé à l’étrangeté, intervient dans le récit et dans la narration pour engendrer un rnouvement discursif où la différence entre le même et l’autre, entre l’ici et l’ailleurs, étoffe la structure du texte. Les trois écrivaines choisissent d’écrire en français, mais se considèrent étrangères à la France. Pour ces femmes, leur ‘féminité’ (aussi bien que leur exil) entre en jeu dans leur projet autobiographique, cette double altérité se prolongeant dans l’aliénation du moi/elle que produit la dimension fictive du récit. L’analyse de ces trois récits montrera d’abord comment la fiction s’immisce nécessairement dans le discours du ‘moi’ dédoublé et finit par imposer une texture/un métissage inhérent et essentiel à sa facture. Par ailleurs, l’altérité, envisagée sous le jour de l’étrangeté des autres et de soi—même, prend une importance capitale dans le projet identitaire de ces auteures expatriées. Enfin, l’écriture de ces trois femrnes conscientes de leur féminité s’avère aussi individuelle que celle des autobiographes masculins. Les trois parlent de leur rapport à la mère/la maternité, mais leurs récits révélent des divergences marquées par leur milieu, leur contexte socio—historique et leur relation à la psychanalyse. Le passé qu’elles évoquent est simple, imparfait ou composé, selon la fonction gui prime dans le texte. Ce que les trois auteures partagent, cest un désir de se raconter et une foi dans le texte écrit comme moyen d’atteindre l’autre à travers soi—même et soi—même à travers l’autre. / Arts, Faculty of / French, Hispanic, and Italian Studies, Department of / Graduate

Many anthropological studies have shown the prevalence of the sacred in primitive societies, manifested primarily in significant gestures such as exchanges, rituals, festivals, and the use of time and space. Some studies, in particular those of Roger Caillois and Mircea Eliade, have demonstrated that traces of the sacred, though seemingly displaced, remain present in modern and secular societies. This thesis will examine and bring to light these remnants of sacred behavior in the contemporary settings of the stories of Gabrielle Roy, focusing primarily on food-sharing, gift-giving, and festivals. Each analysis presented will detail how different aspects of the sacred are manifested in contemporary, though fictional, society, and each will permit individuals to identify ways in which modern man, whether religious or secular, is still very connected to sacred practices.