No capítulo denominado \"Formas de tempo e de cronotopo no romance (Ensaios de poética histórica)\", de sua obra Questões de Literatura e de Estética (A Teoria do Romance), Mikhail Bakhtin utiliza-se do termo cronotopo para referir-se à indissolubilidade de espaço e de tempo na literatura, uma vez que considera este como a quarta dimensão daquele. O presente trabalho tem como objetivo o exame dos cronotopos no romance Ensaio sobre a Cegueira, de José Saramago, desenvolvido mediante o estudo do manicômio, das ruas, das casas, entre outros. Os cronotopos nesta obra subvertem a relação tradicional entre tempo e espaço, constituindo um mundo invertido em sua totalidade. Por meio dos cronotopos poderemos adentrar o campo da autoconsciência das personagens, o qual revela a ampliação do âmbito de visão delas sobre si mesmas e sobre os outros. Tal ampliação implica o dialogismo e a equiparação das vozes dos protagonistas que empreenderão uma jornada rumo à comunhão e à solidariedade. A autoconsciência desemboca na questão da construção da identidade que descortina a imagem do homem contemporâneo, cindido, em conflito com seu tempo e seu espaço. / In the chapter named \"Formas de tempo e de cronotopo no romance (Ensaios de poética histórica)\", which integrates his Questões de Literatura e de Estética (A Teoria do Romance), Mikhail Bakhtin makes use of the term \"Chronotope\" to refer to the indissolubility of time and space in literature, once he considers the latter as the fourth dimension of the first. The present work aims to investigate the chronotope in Saramago\'s Blindness, by means of the study of some of its chronotopes, such as the asylum, the streets and the houses, among others. In this novel, the chronotopes show the subversion between time and space relation, constituting a world inverted in its wholeness. By means of the chronotopes it will be possible to see the inside of the characters\' selfconsciousness process, which emerge in the narrative and broaden the characters\' visual field about themselves and about the other characters. Such broadening implies the dialogism and characters\' voice equalization (in the sense that each of the characters will be independent, owning their independent voices, which will consequently permit them start a journey towards communion and solidarity. In the novel, the theme of selfconsciousness, however, leads to that of the characters\'s identity building, which is present in the novel\'s plot, and which shows the contemporary individual\'s divided self, in conflict with his time and space.

No capítulo denominado \"Formas de tempo e de cronotopo no romance (Ensaios de poética histórica)\", de sua obra Questões de Literatura e de Estética (A Teoria do Romance), Mikhail Bakhtin utiliza-se do termo cronotopo para referir-se à indissolubilidade de espaço e de tempo na literatura, uma vez que considera este como a quarta dimensão daquele. O presente trabalho tem como objetivo o exame dos cronotopos no romance Ensaio sobre a Cegueira, de José Saramago, desenvolvido mediante o estudo do manicômio, das ruas, das casas, entre outros. Os cronotopos nesta obra subvertem a relação tradicional entre tempo e espaço, constituindo um mundo invertido em sua totalidade. Por meio dos cronotopos poderemos adentrar o campo da autoconsciência das personagens, o qual revela a ampliação do âmbito de visão delas sobre si mesmas e sobre os outros. Tal ampliação implica o dialogismo e a equiparação das vozes dos protagonistas que empreenderão uma jornada rumo à comunhão e à solidariedade. A autoconsciência desemboca na questão da construção da identidade que descortina a imagem do homem contemporâneo, cindido, em conflito com seu tempo e seu espaço. / In the chapter named \"Formas de tempo e de cronotopo no romance (Ensaios de poética histórica)\", which integrates his Questões de Literatura e de Estética (A Teoria do Romance), Mikhail Bakhtin makes use of the term \"Chronotope\" to refer to the indissolubility of time and space in literature, once he considers the latter as the fourth dimension of the first. The present work aims to investigate the chronotope in Saramago\'s Blindness, by means of the study of some of its chronotopes, such as the asylum, the streets and the houses, among others. In this novel, the chronotopes show the subversion between time and space relation, constituting a world inverted in its wholeness. By means of the chronotopes it will be possible to see the inside of the characters\' selfconsciousness process, which emerge in the narrative and broaden the characters\' visual field about themselves and about the other characters. Such broadening implies the dialogism and characters\' voice equalization (in the sense that each of the characters will be independent, owning their independent voices, which will consequently permit them start a journey towards communion and solidarity. In the novel, the theme of selfconsciousness, however, leads to that of the characters\'s identity building, which is present in the novel\'s plot, and which shows the contemporary individual\'s divided self, in conflict with his time and space.

La conscience des troubles a un impact important sur la vie quotidienne des personnesatteintes de démence et de leurs proches. Bien qu’il s’agisse d’un élément problématique dans leparcours de soin, un consensus autour des facteurs responsables et de la variation de saprésentation n’a pas pu être établi. Cette thèse cherche à identifier les caractéristiques et lesmécanismes de la conscience des troubles en lien avec la symptomatologie démentielle : lestroubles cognitifs, affectifs et d’autonomie. L’anosognosie est évaluée spécifiquement grâce à laméthode des écarts entre des mesures issues d’auto-évaluations (prédictions de performances etestimations personnelles) et celles issues d’hétéro-évaluations (tests objectifs et proches-aidants).Une première étude avait pour objectif d’expliciter la nature de l’anosognosie cognitive et savariabilité selon le stade de la maladie d’Alzheimer. L’anosognosie pour le fonctionnementcognitif global ainsi que pour tous les processus évalués au travers de la Dementia Rating Scale(DRS) augmente avec la sévérité de la démence. A contrario, l’anosognosie des troubles mnésiquesne suit pas la dégradation cognitive, créant un clivage avec la conscience des troubles des autresprocessus cognitifs. Ces résultats confirment l’hétérogénéité de l’anosognosie et sa variabilitéselon le stade de la maladie. Des outils objectivant des processus plus purs permettraient despécifier les liens entre troubles cognitifs et anosognosie ce que nous avons réalisé dans unedeuxième étude. Des facteurs cognitifs (tests neuropsychologiques) et non cognitifs (anxiété,indépendance fonctionnelle) sont corrélés significativement à tous les scores d’anosognosiecognitive. Chaque score d’anosognosie est prédit par un ensemble de variables qui lui estspécifique : trois scores par un modèle de régression purement cognitif et un score incluant desfacteurs cognitifs et non cognitifs. Nos résultats mettent en évidence le rôle majeur d’un déficitdysexécutif et l’implication de variables non cognitives, confirmant le caractère multifactoriel del’anosognosie. Enfin, une troisième étude investiguait l’anosognosie concernant la perte d’indépendancefonctionnelle via l’échelle ADL. L’intensité de l’anosognosie était significativement comparableentre les groupes vivant à domicile et en EHPAD. La sévérité des troubles cognitifs n’expliquepas directement la présence de cette forme d’anosognosie. De plus, les sous-dimensions del’échelle ADL sont affectées différemment par l’anosognosie, certaines étant préservées etd’autres non. Ces résultats soutiennent l’idée que l’anosognosie est un phénomène à la foismultidimensionnel qui existe hors de la sphère cognitive, et hétérogène qui varie d’une sousdimensionà une autre.Ces travaux vont dans le sens d’une hétérogénéité de l’anosognosie et ce quels que soientl’objet de conscience ou les stades de la démence considérés. L’influence de variables cognitiveset non cognitives suggère une étude plus systématique de leurs rôles respectifs et la nécessitéd’étudier l’anosognosie dans une perspective exhaustive. La conception en tant que phénomènede la conscience de soi en neurologie sera questionnée, puis préférée à celle de symptôme, autravers d’une nouvelle modélisation. Envisager l’anosognosie comme un déficit d’une partie duSelf offre des pistes de remédiation grâce aux éléments non altérés du Self mais également lapossibilité de considérer chaque personne comme un être conscient et en capacité d’agir face à sa maladie. / Awareness of deficits has a significant impact on the daily lives of people with dementia andtheir relatives. While it represents a problematic element in patients’ care path,there is still noconsensus as to its etiological factors and the variability in its presentation. This thesis aims toidentify the cognitive, affective and autonomic mechanisms associated with disorder awarenessimpairment in dementia. This thesis seeks to identify the characteristics and disorder awarenessmechanisms related to the dementia symptomatology: cognitive, affective and autonomicdisorders. Anosognosia is evaluated using the discrepancies method between measurements takenfrom self-assessment (performance predictions and personal estimates) and hetero-evaluationsscales (objective and caregiver tests).A first study aimed to explain the nature of cognitive anosognosia and its variability accordingto Alzheimer's disease stage. Anosognosia for overall cognitive functioning as well as for allprocesses evaluated through the Dementia Rating Scale (DRS) increases with the severity ofdementia. Conversely, anosognosia of memory disorders did not follow cognitive degradation,creating a cleavage with the anosognosia of other cognitive processes. These results confirm theheterogeneity of anosognosia and its variability according to the stage of the disease.The links between cognitive disorders and anosognosia were then quantified in a secondstudy. Cognitive (neuropsychological tests) and non-cognitive factors (anxiety, functionalindependence) turned out to be significantly correlated with all cognitive anosognosia scores.Each anosognosia score was predicted by a specific set of variables: three scores by a purelycognitive regression model and one score by cognitive and non-cognitive factors. Our resultshighlight the major role of dysexecutive deficits and the involvement of non-cognitive variables,confirming anosognosia’s multifactorial character. Finally, a third study investigated anosognosia for the loss of functional independence usingthe ADL scale. The intensity of anosognosia was significantly comparable between the groupsliving at home and in nursing homes. The severity of cognitive disorders did not directly explainthe presence of this form of anosognosia. Additionally, the ADL scale's sub-dimensions weredifferentially affected by anosognosia, some being preserved while others were not. These resultssupport the idea that anosognosia is a multidimensional and heterogeneous phenomenon thatexists outside of the cognitive sphere, and which varies from one subdimension to another.This work suggests that anosognosia is a heterogeneous construct irrespective of the object ofconsciousness or stages of dementia. The influence of cognitive and non-cognitive variablespoints to the need for a more systematic study of their respective roles and the need to studyanosognosia from comprehensive perspective. Anosognosia as self-awareness’ phenomenon inneurology is discussed and a new modelling strategy is proposed to assess its advantages over asymptom-based framework. Considering anosognosia as a deficit of parts of the Self points topossible remedial paths through the unimpaired elements of the Self but also to the possibility ofconsidering each person as a conscious being capable of acting in the face of his disease.

En s’appuyant sur l’hypothèse frontale du vieillissement (West, 1996), ce travail vise à évaluer le vieillissement normal de capacités frontales (contrôle exécutif, prise de décision, énergisation, métacognition ; Stuss, 2008)et à analyser les liens éventuels entre ces habiletés,l’autonomie et la qualité de vie des aînés. Quarante personnes jeunes (26±5 ans), 40 âgées (68,7±3,7 ans)et 30 très âgées (83,4±3,5 ans) en bonne santé ont participé à notre étude. Les aînés ne montraient pas de traits dépressifs/anxieux, ni de déclin cognitif typiques d’un vieillissement pathologique. Ils présentaient une autonomie et une qualité de vie satisfaisantes.Certaines habiletés cognitives semblent se détériorer après 65 ans (flexibilité, énergisation, prise de décision sous risque explicite, théorie de l’esprit, détection de la coopération/tromperie), d’autres après 80 ans (fluence verbale, mémoire épisodique, dénomination, inhibition,prise de décision en situation ambiguë), d’autres encore seraient préservées (lecture, rappel immédiat,réalisation de tâches de flexibilité spontanée et de temps de réaction simple). La conscience que les sujets ont d’eux-mêmes dépendrait de leur âge. Trois profils distincts de fonctionnement frontal ont été décrits pour chaque groupe de participants, montrant une variabilité intra groupe importante. Le niveau d’autonomie des personnes âgées serait associé au contrôle exécutif,celui de qualité de vie à l’énergisation et à la métacognition. Ces résultats vérifient partiellement nos hypothèses et conduisent à envisager le développement de programmes d’entraînement cognitif multidimensionnels, susceptibles d’influencer la sphère personnelle des aînés. / Starting from the “frontal lobe hypothesis of cognitive aging” (West, 1996), the main objective of this work is to study frontal lobe functions (executive control, decision making,energization, metacognition; Stuss, 2008) and their possible associations with levels of autonomy and quality of life in normal aging. Forty young adults (26±5years), forty old adults (68,7±3,7 years) and thirty very old adults (83,4±3,5 years) participated to our study.These healthy subjects didn’t show any depressive/anxious symptoms and global cognitive decline, which are frequently observed in pathologic alaging. They have a good level of autonomy and general satisfaction of life. A number of frontal lobe abilities seem to decrease after 65 years old (flexibility,energization, explicit decision-making, theory of mind,detection of cooperative and deceptive situations).Other functions decline after 80 years old (verbalfluency, episodic memory, naming, inhibition, implicit decision-making). Reading, immediate recall, realization of spontaneous flexibility and simple reaction time tasks are preserved with aging. Self-consciousness seems to depend on individuals’ age. We have described three different clusters of the frontal functioning for each group of participants, showing the existence of animportant intragroup variability. Old adults’ level of autonomy seems to be associated with the executive control, old adults’ quality of life correlated with the energization and metacognitive functions. These resultsconfirm in part our hypothesis and support the development of multidimensional cognitive training programs, which could impact old adults’ personal sphere.

Al hoe meer organisasies in Suid-Afrika gaan tans deur 'n herstruktureringsfase wat meebring dat die totale werksmilieu verander. Die werknemer verkeer onder druk om aan die nuwe eise in die wereld van werk te voldoen. Druk om te presteer en werksuitset te !ewer mag disfunksionele stres en antler psigiese probleme meebring. Organisasies speel 'n belangrike rol in die dinamiese groeiproses van die individuele werknemer en raak toenemend bewus van die werknemer se fisiese en psigiese gesondheid. Talle organisasies het reeds korporatiewe gimnasiums opgerig en sommige bied subsidiering van lidmaatskap aan gesondheidsklubs aan hul werknemers. Sekere mediese skemas begin self gesondheidsplanne ontwerp met behulp van gesondheidsklubs om die gesondheid van die werknemer te bevorder. / M.A. (Bedryfsielkunde)

Al hoe meer organisasies in Suid-Afrika gaan tans deur 'n herstruktureringsfase wat meebring dat die totale werksmilieu verander. Die werknemer verkeer onder druk om aan die nuwe eise in die wereld van werk te voldoen. Druk om te presteer en werksuitset te !ewer mag disfunksionele stres en antler psigiese probleme meebring. Organisasies speel 'n belangrike rol in die dinamiese groeiproses van die individuele werknemer en raak toenemend bewus van die werknemer se fisiese en psigiese gesondheid. Talle organisasies het reeds korporatiewe gimnasiums opgerig en sommige bied subsidiering van lidmaatskap aan gesondheidsklubs aan hul werknemers. Sekere mediese skemas begin self gesondheidsplanne ontwerp met behulp van gesondheidsklubs om die gesondheid van die werknemer te bevorder. / M.A. (Bedryfsielkunde)