Communities on-line : community-based computer networks

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1995.Includes bibliographical references (p. 163-170).by Anne Beamish.M.C.P

Creating communities of practice : using information technology for learning and communication in automobile dealerships

Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2000.Includes bibliographical references (leaves 202-213).The Ford Motor Company, like many other firms, is concerned with maintaining their competitive advantage in a rapidly changing and somewhat unpredictable business environment. One way of dealing with this new environment is to use information technology to create and support communities of practice-a group that constantly shares knowledge and information. Ford already has Fordstar, a private satellite system for delivering training programs to its dealerships, but would like to expand its use and take advantage of other information and communication technology to increase learning and communication. Dearborn, however, perceives the dealerships as being rather lukewarm in their enthusiasm for information technology (IT). This research shows that there are many problems and obstacles to using IT to create and support communities of practice, but in this particular case, the problems do not lie with the individual dealership employees. These individuals are not modern-day Luddites or acting irrationally. In fact, the dealerships are reacting in a quite reasonable way given the circumstances of their work environment. It is the structure of the industry, business practices, work environment, and culture, rather than the individual, that conspire against creating communities of practice or increased use of IT for learning and communication. The study also demonstrates that dealership employees are not a monolithic group. Technicians, parts employees, service advisors and salespeople all work under different conditions, and consequently react to information technology, learning, and communication in quite different ways. The overall lesson gained from this study is that in order to use information technology to create and support learning and communication within an organization, a very subtle and fine grained understanding of the workplace and its social, technical, economic, organizational and physical environment is required. Only with a thorough understanding of the work practices and environment can technology and policies be crafted to suit the needs and attitudes of a specific community.by Anne Beamish.Ph.D

Architectural grammar for hot humid climates

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Architecture, 1993.Includes bibliographical references (p. 171-177).This thesis considers the viability of an architectural grammar based on traditional Caribbean architecture as an aid to designing climatically responsive architecture in hot humid climates. It argues that since traditional Caribbean architecture is a successful response to the constraints of climate and resources, a grammar based on this architecture would produce designs with similar characteristics and therefore would still be relevant today. The purpose of focusing on the relationship between architectural form and energy use is to help designers understand the consequences of basic design decisions and to help them to use these issues positively to generate form. In order to investigate this issue, a number of questions were addressed in the thesis. They were: What are shape grammars? What is appropriate design in hot humid climates? What is traditional Caribbean architecture and is it climatically appropriate? What would a tropical grammar look like and what would it produce? and How could it be used practically? A grammar was formulated based on a set of 16 traditional Caribbean houses and as a test, two new designs were generated. Shape grammars, in their most basic form, are essentially a set of rules that if followed, will generate designs in the same family as the original set. Typically, they are used to study a particular architect's style or occasionally a building style. This thesis states that shape grammars have two serious limitations which reduce their usefulness to designers. The first is that shape grammars focus only on physical form and the second is that they do not increase the user's understanding of the reasons for the grammar rules. However, it was found that, in contrast, the process of developing or formulating a grammar (as opposed to using one) was exceptionally useful for developing a deep understanding of the architectural style or type. The thesis concludes that architectural grammars can be a very useful and accessible tool for designers: 1. if they are able to go beyond physical form to include other architectural issues and knowledge; 2. if means are developed for presenting grammars which allow users to understand the rules, and not simply follow them; and 3. if methods are developed for analyzing and evaluating the designs that are generated by the grammar. It also concludes that a grammar is a useful tool to familiarize designers with the most successful characteristics of traditional architectural vocabulary. The purpose of this type of grammar is not to copy or duplicate a style, but to learn from its practical solutions in order to create new combinations of form that would be appropriate to the conditions found today.by Anne Beamish.M.S

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Are multispecies models an improvement on single-species models for measuring fishing impacts on marine ecosystems?

We review the application of multispecies models as tools for evaluating impacts of fishing on marine communities. Four types of model are identified: Descriptive multispecies, dynamic multispecies, aggregate system, and dynamic system models. The strengths and weaknesses of multispecies models and their ability to evaluate the causal mechanisms underlying shifts in production are examined. This comparison provides a basis for assessing the benefits of each modelling approach as a tool for evaluating impacts of fishing in marine ecosystems. Benefits of multispecies models include: improved estimates of natural mortality and recruitment; better understanding of spawner-recruit relationships and of variability in growth rates; alternative views on biological reference points; and a framework for evaluating ecosystem properties. Populations are regulated by competition (food limitation), predation, and environmental variability. Each factor may influence different life-history stages, locally or regionally. However, most multispecies models address only a subset of these factors, often aggregated over functionally different species or age groups. Models that incorporate the important interactions at specific stages and scales will be necessary if they are to continue to supplement the information provided by single-species models. (C) 2000 International Council for the Exploration of the Sea