A eletrocirurgia é uma técnica cirúrgica que utiliza o bisturi elétrico para a realização do corte, dessecação e coagulação do tecido orgânico, diminuindo dessa forma os riscos de hemorragia. O bisturi elétrico usa o processo da faiscância para a realização do trabalho. Esse processo provoca, entre outras coisas, o aquecimento da água intracelular e, consequentemente, o rompimento da célula do tecido. Embora se saiba a quantidade de energia entregue pelo bisturi elétrico, pouco se sabe sobre as parcelas de energia envolvidas nos vários fenômenos do processo eletrocirúrgico, principalmente no corte, onde as células sofrem ablação por vaporização. Com base neste problema, foi desenvolvida esta pesquisa, que teve o objetivo de determinar a energia necessária para o corte eletrocirúrgico, através dos parâmetros elétricos envolvidos e da energia utilizada para a vaporização da água do tecido orgânico. O método desenvolvido foi testado em três experimentos, com várias séries de cortes específicos em cada. Demonstrou-se que da energia total que é entregue pelo bisturi, menos de 10% é utilizada para o corte, ou especificamente, para a vaporização da água do tecido. O restante da energia acaba sendo utilizada em outros processos que começarão a ser analisados em outros trabalhos. / Electrosurgery is a surgical technique that uses an electrosurgical device for cutting, drying (desiccation), and coagulation of organic tissue, thereby reducing the risk of bleeding. Electrosurgical device uses sparking phenomena for this purpose. This process causes heating of intracellular water and, consequently, the rupture of the cell in the organic tissue. Although the amount of energy delivered by the electrosurgical device is easy to know, little is known about the exactly amount of energy involved in the various phenomena of electrosurgical procedure, especially in cutting, where cells suffer ablation by vaporization Based on this was developed this research, which objective is to determine the energy required for the electrosurgical cutting through the electrical parameters involved and the energy used for the vaporization of water of organic tissue. The method developed was corted in three experiments, with a series of specific tests in each. It has been show that only about 10% of total energy is used for cutting, or specifically, for the vaporization of water of organic tissue. The rest of the energy is used in other processes that need more investigation to be understood.

A eletrocirurgia é uma técnica cirúrgica que utiliza o bisturi elétrico para a realização do corte, dessecação e coagulação do tecido orgânico, diminuindo dessa forma os riscos de hemorragia. O bisturi elétrico usa o processo da faiscância para a realização do trabalho. Esse processo provoca, entre outras coisas, o aquecimento da água intracelular e, consequentemente, o rompimento da célula do tecido. Embora se saiba a quantidade de energia entregue pelo bisturi elétrico, pouco se sabe sobre as parcelas de energia envolvidas nos vários fenômenos do processo eletrocirúrgico, principalmente no corte, onde as células sofrem ablação por vaporização. Com base neste problema, foi desenvolvida esta pesquisa, que teve o objetivo de determinar a energia necessária para o corte eletrocirúrgico, através dos parâmetros elétricos envolvidos e da energia utilizada para a vaporização da água do tecido orgânico. O método desenvolvido foi testado em três experimentos, com várias séries de cortes específicos em cada. Demonstrou-se que da energia total que é entregue pelo bisturi, menos de 10% é utilizada para o corte, ou especificamente, para a vaporização da água do tecido. O restante da energia acaba sendo utilizada em outros processos que começarão a ser analisados em outros trabalhos. / Electrosurgery is a surgical technique that uses an electrosurgical device for cutting, drying (desiccation), and coagulation of organic tissue, thereby reducing the risk of bleeding. Electrosurgical device uses sparking phenomena for this purpose. This process causes heating of intracellular water and, consequently, the rupture of the cell in the organic tissue. Although the amount of energy delivered by the electrosurgical device is easy to know, little is known about the exactly amount of energy involved in the various phenomena of electrosurgical procedure, especially in cutting, where cells suffer ablation by vaporization Based on this was developed this research, which objective is to determine the energy required for the electrosurgical cutting through the electrical parameters involved and the energy used for the vaporization of water of organic tissue. The method developed was corted in three experiments, with a series of specific tests in each. It has been show that only about 10% of total energy is used for cutting, or specifically, for the vaporization of water of organic tissue. The rest of the energy is used in other processes that need more investigation to be understood.

INTRODUÇÃO: A clonidina é um agonista seletivo do receptor adrenérgico alfa2 com propriedades sedativas, analgésicas e possibilita a redução do consumo de outros anestésicos. Suas ações podem mitigar o impacto hemodinâmico e psíquico da S+ Cetamina. Os grandes queimados são de difícil manejo e ainda não existe uma técnica anestésica padrão para estes pacientes, sendo a cetamina amplamente utilizada nestes pacientes em regimes muito variados, apresentando várias vantagens. Os objetivos do estudo foram avaliar os efeitos hemodinâmicos e psíquicos da interação da clonidina e da S+ cetamina e propor uma técnica anestésica para grandes queimados. MÉTODOS: O estudo foi prospectivo, duplo encoberto, aleatório e placebo controlado, planejado para 48 pacientes adultos grandes queimados, estado físico ASA II ou III, que foram agendados para trocas de curativos ou debridamentos cirúrgicos. Para a anestesia foi usado midazolam 0,07mg/kg e duas doses de 1 mg/kg de S+ cetamina. No Grupo Clonidina foi usada a dose de 2 mcg/kg e soro fisiológico no Grupo Placebo. Foram avaliadas as alterações hemodinâmicas durante o intra-operatório. Durante as duas primeiras horas foram avaliadas detalhadamente as alterações psíquicas utilizando 13 variáveis, o retorno da consciência, a analgesia e a ocorrência de complicações. Após 24 horas foram avaliadas a analgesia, a ocorrência de sonhos e delírios. RESULTADOS: O Grupo Clonidina apresentou redução estatisticamente significativa nas pressões arteriais durante o procedimento. Dentre as 13 variáveis psíquicas analisadas, 5 foram menores com significância estatística no Grupo Clonidina durante a avaliação de 30 minutos, incluindo Corpo, Arredores, Pensamento, Sonolento e Ansioso. Na avaliação de duas horas, apenas a variável Ansioso teve redução estatisticamente significativa no Grupo Clonidina. A frequência cardíaca, a ocorrência de delírio e sonhos e a analgesia pós-operatória foram similares nos dois grupos. Não houve diferença entre os grupos na ocorrência de complicações. CONCLUSÃO: O uso de Clonidina em anestesia para pacientes grandes queimados, com S+ cetamina e midazolam reduz as pressões arteriais durante o procedimento e os efeitos psíquicos, sem aumentar a ocorrência de complicações / Abstract: Clonidine is a selective alpha2-adrenoceptor agonist with sedative, analgesic and anesthetic sparing properties. Because of its sympathoinhibitory activity, it may reduce the hemodynamic and psychic effects of S+ ketamine and improve analgesia. The ketamine is commonly used in burned patients worldwide. The objectives of this study were to evaluate the interactions between clonidine and ketamine in hemodynamic and psychic effects and also to propose an anesthetic technique for major burned patients. Method: A prospective, double-blind, placebo controlled study designed for 48 patients with major burns, aged 18-60 years, physical status ASA II or III, that were scheduled for dressing changes and wound debridements. For the anesthesia was used midazolam 0,07mg/kg, two doses of S+ ketamine 1 mg/kg, placebo or clonidine 2mcg/kg. Intraoperative hemodynamic alterations over time were assessed. During the first two hours after the procedures were evaluated, psychic effects in detail using 13 variables, the return of conscience, analgesia, dreaming and delirium and after 24 hours, analgesia, dreaming and delirium. Results: The Clonidine Group had low arterial pressure during the procedure. At the 30 minute evaluation of the psychic variables 5 out of 13 were lower in the Clonidine Group with statistically significance, these being Body, Surroundings, Thoughts, Drowsy and Anxious. At the 2 hour evaluation only the Anxious variable was lower in the Clonidine Group with statistically significance. Cardiac frequency, postoperative analgesia, occurrence of delirium and dreaming weren\'t different between both groups. There wasn\'t any difference in complication rates between both groups. Conclusion: We concluded that the use of Clonidine in S+ ketamine plus midazolam anesthesia in patients with major burns reduces the arterial pressures and the postoperative psychic effects, without increasing the complications

This thesis aims to engage with the poetry of Scotland and Greek-speaking Cyprus, and examine the relationship between poetry defined as high culture and articulations of national identity in the two places. Scotland and Cyprus share characteristics that make the establishment of a single, coherent national identity with the appearance of permanence challenging, including their relationships with culturally dominant neighbours, competition between local and official languages, and the insecurity of their status as nations. Both Scotland and Cyprus have historically had hybrid identities; in Scotland, British identity is made problematic by England's cultural dominance, while in Cyprus Greek-speakers have a conflicted relationship with Greece. This is made more complex by the fact that Scotland's political union with England may be ending, while Cyprus is divided in half as a result of tensions between Christian and Muslim populations and the unsubtle past involvement of Greece and Turkey in the island's affairs. This thesis aims to locate trends of national identity through the analysis of poetry and its reception in three distinct contexts. Part 1 analyses the evolution of Scottish and Greek-speaking Cypriot 'national character' through the poetry of national poets Robert Burns and Vasilis Michailidis, and the poets Walter Scott and Dimitris Lipertis. Part 2 explores the effects of modernity on the expression of national identities in literature through the lens of the Modernist movement, and how this was adopted and modified in Scotland and Cyprus. This is discussed with reference to three poets, Hugh MacDiarmid, Kostas Montis and Edwin Morgan, and their treatment of the national past and search for a national literary language. Finally, Part 3 analyses deliberate engagements of poets with national identity and issues of national importance, using Seamus Heaney's idea of 'adequate' poetry as a guide. Two functions of poetry are considered: the role it can play in transforming the landscape into the national homeland, and its potential to address communal trauma, and transform it into a unifying experience.

No description available.

In Valencia region (SE Spain), many post-fire communities are dominated by non-resprouting (seeder) species, because of the long history of land exploitation and subsequent abandonment during the last half of 20th century. These communities accumulate fine dry biomass and, therefore, can burn again easily. In fact, Mediterranean forests are suffering from an increase in wildfire frequency since the early 1970s. Wildfires shape the composition and functioning of Mediterranean ecosystems, but we do not know how these ecosystems respond to both the higher fire recurrence and shorter recovery times expected for future climatic scenarios. In this sense, Aleppo pine forest (Pinus halepensis) is one of the most fire affected vegetation of this type in the Mediterranean Basin and to know how it respond to fire is fundamental to design management plans. After fire, regeneration of this forest can be highly variable, and it can go from extremely dense tree stands (overstocked pine) to treeless shrublands dominated by seeder species. All these regenerated stands are fire prone with limited ability to deliver multiple ecosystem services. Although several management techniques are applied to redirect these post-fire ecosystems towards less vulnerable and more functional communities, we do not know yet which amongst them could serve to foster more diverse and multifunctional landscapes. Therefore, the general objective of this thesis is to investigate the functioning of these Mediterranean ecosystems as consequence of shifts in fire regime and forest management application, using different techniques, in different post-fire regenerated ecosystems (overstocked pine forests and dense shrublands). To do so, we calculate, within Mediterranean Pinus halepensis forests affected by wildfires, the supply of multiple ecosystem services (biodiversity conservation, carbon sequestration, disturbance regulation, food production, supporting services, and multifunctionality), through up to 25 aboveground and belowground attributes. Our main findings are (1) High fire recurrence and time since last fire interacted to determine ecosystem services but did not affect their synergies and trade-offs between them. Their combined effects reduced carbon sequestration and multifunctionality. Disturbance regulation diminished drastically with the first fire, with no effect of further fires. However, their effects dampened, and even became positive, for biodiversity conservation and food production services if provided enough time to recover. (2) Thinning in overstocked pine stands enhances ecosystem attributes associated with biodiversity conservation without compromising the provision of carbon sequestration. After 10 years, two levels of thinning, (600 and 1200 trees·ha-1), similarly affected ecosystem attributes, which suggest that 1200 trees·ha-1 suffice to enhance individual ecosystem attributes. (3) Clearing within dense shrubland dominated by seeder species enhances ecosystem attributes associated with biodiversity conservation without compromising the capacity of ecosystem to sequester carbon. (4) Plantation of resprouting species combined with thinning and clearing, in overstocked pine forests and dense shrublands respectively, can enhance the provision of ecosystem services of disturbance regulation, food production and ecosystem multifunctionality. (5) Prescribed burning reduces the amount of dead fuel, increases biodiversity conservation, and improves food production. However, these effects become negative, in addition to the decline in disturbance regulation and multifunctionality, if prescribed burning is applied frequently. (6) Combining different management activities can enhance the supply of multiple ecosystem services simultaneously by reducing the trade-offs in between them and therefore, establish multifunctional Mediterranean landscapes.

Les blessures de brûlures entrainent des conséquences importantes qui affectent grandement tous les aspects de la vie des personnes qui en sont victime. Par conséquent, le processus de guérison des survivants peut s'avérer long, complexe et particulièrement éprouvant. En ce sens, le soutien par les pairs semble constituer une source d'aide significative pour les personnes victimes de brûlures et participer positivement à plusieurs étapes clés du processus de guérison. À l'Unité des Grands brûlés du Centre Hospitalier Universitaire de l'Université de Montréal, ces pairs sont nommés « patients ressources accompagnateurs » et ceux-ci sont amenés à rencontrer des patients ayant récemment vécu un évènement de brûlures afin de répondre à leurs questions et partager avec eux les différents savoirs expérientiels qu'ils ont acquis au fil de leur vécu de survivant. Le but de la présente étude consiste à explorer les perceptions des patients ressources accompagnateurs en interrogeant ceux-ci quant à leurs rôles auprès de patients victimes de brûlures graves. Cette étude a été conduite selon un devis qualitatif en s'inspirant de la méthodologie de théorisation ancrée proposée par Corbin et Strauss (2015). Suivant la constitution d'un échantillon théorique, deux entrevues de groupe ont été réalisées avec les patients ressources accompagnateurs (n=3 et n=7) œuvrant auprès des patients de l'Unité des Grands Brûlés du Centre Hospitalier Universitaire de l'Université de Montréal. L'analyse des données a également été réalisée en suivant certaines des étapes de la méthodologie proposées par Corbin et Strauss (2015). L'exploration de la perception de patients ressources accompagnateurs de l'Unité des Grands Brûlés quant à leur rôle au sein de l'unité de soins contribue à la bonification du travail entrepris par une des co-directrices de ce mémoire quant à l’accompagnement des patients hospitalisés. De plus, les résultats de cette étude permettent de préciser plusieurs enjeux vécus par les personnes victimes de brûlures, apportant des éléments de réflexions pertinents quant à la manière dont ceux-ci font l'expérience des différentes étapes de leur trajectoire de soins et des difficultés que certaines de ces étapes peuvent entraîner dans le processus de guérison des survivants. L'ensemble des thématiques captées liées à la perception qu'ont les patients ressources accompagnateurs vis-à-vis leur rôle, permet de saisir la pluralité des enjeux à considérer et la diversité des éléments à intégrer dans les réflexions visant à tendre vers une amélioration des programmes d'interventions patients ressources accompagnateurs existants ou dans le développement de ceux à venir. / Burn injuries lead to major complications and consequences that affect the entire lives of those who are injured. Therefore, the healing process for survivors can be long, complex, and particularly challenging. In this sense, peer support seems to constitute a significant source of help for burn victims and positively participate in several key stages of the healing process. At the Burn Unit of the Université de Montréal Hospital Center, these peers are called "patient resource companions" who are trained and are brought in to meet with patients who have recently experienced a burn injury to answer their questions and share with them the different experiential knowledges they have gained through their experience as survivors. The purpose of this study is to explore the perceptions of patient resource companions on their roles with patients suffering from severe burns. This study was conducted using a qualitative design inspired by the grounded theory methodology proposed by Corbin and Strauss (2015). Following the formation of a theoretical sample, two group interviews were conducted with patient resource companions (n=ti and n=7) working with patients at the Burn Unit of the Université de Montréal Hospital Center. Data analysis was also conducted following some of the different stages of the methodology proposed by Corbin and Strauss (2015). The exploration of the perception of patient resource companions at the Burn Unit regarding their role in the care unit contributes to the documentation and integration of a new dimension in the general framework of reference, of one of the co-supervisor’s research program on patient resource companions. In addition, the results of this study make it possible to specify several issues experienced by burn victims, providing relevant elements of reflection as to the way in which they experience the different stages of their care trajectory and the difficulties that some of these steps can entail in the healing process of survivors. All themes related to the perception that patient resource companions have of their role, makes it possible to grasp the plurality of issues to be considered and the diversity of elements to be integrated into the reflections aimed at tending towards an improvement of existing patient resource support intervention programs or in the development of future ones.

Pacientes vítimas de queimaduras convivem com seqüelas que podem diminuir sua auto-estima e qualidade de vida. Vítimas de queimaduras faciais são excluídos social e profissionalmente solicitando ao cirurgião plástico tratamentos complementares aos cirúrgicos para melhoria da aparência e qualidade da pele. Quinze pacientes do sexo feminino, vítimas de queimadura facial por álcool com mais de dois anos de evolução, foram submetidas a tratamento tópico com tretinoína 0,05% durante um ano, com exceção da região pré-auricular. Após este período, duas biópsias faciais, uma na região pré-auricular e outra um centímetro abaixo do lóbulo da orelha, foram realizadas para comparar áreas não tratadas e tratadas. Os fragmentos biopsiados foram submetidos à análise mecânica e histológica. Medidas de resistência e elastância foram significativamente menores nas áreas tratadas (resistência p=0,03 e elastância p<0,05). Não houve diferença estatística entre as densidades de fibras colágenas totais e de colágeno tipo III, fibras elásticas e versicam nas áreas tratadas e não tratadas / Patients that are victims of burns live with sequelae that may decrease their self-esteem and quality of life. Victims of facial burns are excluded from social and professional life. They request the plastic surgeon to provide complementary treatment to the surgical one, so as to improve their appearance and the quality of the skin. Fifteen female patients, victims of facial burns caused by alcohol with more than two years of evolution, underwent topical treatment with 0.05% tretinoin during one year. During this period, a small area at the pre-auricular region was spared from the treatment. After this period two facial biopsies, one in the pre-auricular area and the other one, 1 cm below the ear lobe, were performed to compare treated and non treated areas. Skin strips underwent a mechanical and histological analysis. Measurements of resistance and elasticity were significantly lower in the treated skin as compared with non-treated skin (resistance, p=0.03 and elasticity, p<0.05). The density of collagen and collagen type III fibers, elastic fibers and versican was not significantly different between treated and non-treated skins

Bound Together elucidates how gay and lesbian leather communities, in the years between 1966 and 1984, contested and expanded fungible notions of sex, community, and history, mostly through material and visual cultural systems: dress codes such as the hanky code, architectural spaces (bars, bathhouses, private clubs), garments, posters, advertisements, newsletters, films, and performances. In examining visual and material cultures, procedures of archival research, as well as the physical states of key archives associated with historic gay and lesbian leather communities, this dissertation opens out a discussion of a set of visual documents and terms rarely considered within the discipline of art history, or academia at large. Through rigorous rhetorical experimentation Bound Together seeks to propose new ways of writing histories. Long and short chapters are interpolated, telescoping between historical leather communities and key works of contemporary art which reformat 1970s documents and visual sources. Jean Luc-Nancy’s conception of “being-with,” a state of coterminous existence that lies at the foundation of being and subjecthood, provides an ideal framework for coming to terms with the challenges of writing leather histories. Nancy’s notion is one that privileges mutual and relational difference. The structure of Bound Together works similarly, building a set of differential modes of viewing, analyzing and writing. In this way I wish to, in the words of Tilottama Rajan, use “history as the condition for an internal distanciation and for self-reflection on what we do,” and to furthermore present alternatives to a discipline’s often “routinized, even commodified […] repeatable techniques.” / text

Pacientes vítimas de queimaduras convivem com seqüelas que podem diminuir sua auto-estima e qualidade de vida. Vítimas de queimaduras faciais são excluídos social e profissionalmente solicitando ao cirurgião plástico tratamentos complementares aos cirúrgicos para melhoria da aparência e qualidade da pele. Quinze pacientes do sexo feminino, vítimas de queimadura facial por álcool com mais de dois anos de evolução, foram submetidas a tratamento tópico com tretinoína 0,05% durante um ano, com exceção da região pré-auricular. Após este período, duas biópsias faciais, uma na região pré-auricular e outra um centímetro abaixo do lóbulo da orelha, foram realizadas para comparar áreas não tratadas e tratadas. Os fragmentos biopsiados foram submetidos à análise mecânica e histológica. Medidas de resistência e elastância foram significativamente menores nas áreas tratadas (resistência p=0,03 e elastância p<0,05). Não houve diferença estatística entre as densidades de fibras colágenas totais e de colágeno tipo III, fibras elásticas e versicam nas áreas tratadas e não tratadas / Patients that are victims of burns live with sequelae that may decrease their self-esteem and quality of life. Victims of facial burns are excluded from social and professional life. They request the plastic surgeon to provide complementary treatment to the surgical one, so as to improve their appearance and the quality of the skin. Fifteen female patients, victims of facial burns caused by alcohol with more than two years of evolution, underwent topical treatment with 0.05% tretinoin during one year. During this period, a small area at the pre-auricular region was spared from the treatment. After this period two facial biopsies, one in the pre-auricular area and the other one, 1 cm below the ear lobe, were performed to compare treated and non treated areas. Skin strips underwent a mechanical and histological analysis. Measurements of resistance and elasticity were significantly lower in the treated skin as compared with non-treated skin (resistance, p=0.03 and elasticity, p<0.05). The density of collagen and collagen type III fibers, elastic fibers and versican was not significantly different between treated and non-treated skins