PubMed · 7974229
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A M Bohsen. 1994-05-11. [Overcrowding--county problem].. https://pubmed.ncbi.nlm.nih.gov/7974229/
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This paper further examines an individual-based model of a spatially distributed predator-prey population that demonstrates strong spatial structuring in contrast with predictions from its representative analytic formulation. Examination of a small, localized population reveals that extinctions due to demographic stochasticity dominate the dynamics. Local extinction dynamics produce wave pulses and the interactions of these wave pulses constitute global dynamics. The results motivate a population-level cell-based model with each cell representing a local population and parameterized by local extinction probabilities, rather than individual-based interaction rates. A detailed comparison of spatiotemporal plots from the two modelling frameworks shows that the population-level model captures the broad range of dynamics exhibited by the individual-based model. The agreement between these two complementary theoretical frameworks, one formulated at the level of individuals, the other at the level of populations, provides a mechanistic understanding of the dynamics.
BACKGROUND: The clutter of equipment and lines in today's operating room (O.R.) is increasing. Endoscopic surgical procedures are particularly afflicted by this problem because they require additional equipment. Increasing O.R. crowding may present unnecessary hazards to traffic and adversely affect the performance of the surgical team. The purpose of this study is to provide a quantitative summary of the furniture, equipment, cables, and tubes present during open and laparoscopic operations. METHODS: We prospectively studied an unselected series of general surgical open (OP, n = 10) and laparoscopic (LAP, n = 10) operations performed at a major university teaching hospital. We recorded the location of all furniture and equipment as well as the source, course, and destination of all cables and tubes in the O.R. Cables and tubes touching the surgeon or the assistant were particularly noted. Results are expressed as median values for each group. RESULTS: The percent of O.R. space occupied increased from OP = 36% to LAP = 41% (p < 0.002). The median number of cables and tubes present increased from OP = 27 to LAP = 34 (p < 0.0002), with the number of these lines touching a member of the surgical team increasing from OP = 2 to LAP = 6 (p < 0.0003). CONCLUSIONS: We conclude that there is a significant trend toward increasing O.R. crowding during laparoscopic surgery. Innovative designs will be needed to reduce clutter in the O.R. of the future.
OBJECTIVES: To investigate the association between four sociodemographic measures (unemployment, overcrowding, low social class, and the proportion of migrants from areas of high prevalence of tuberculosis) and average level and rate of change of notification rates for tuberculosis. DESIGN: Ecological analysis of both the average and the rate of change of standardised annual notification rates for tuberculosis from 1982-91 and sociodemographic measures from the 1981 and 1991 censuses. SETTING: 32 London boroughs. SUBJECTS AND DATA: Sociodemographic measures from the 1981 and 1991 censuses and tuberculosis notification rates for 1982-91. MAIN OUTCOME MEASURES: A measure of the association between average levels and rate of change in tuberculosis notification rates and four sociodemographic measures in 1981 and between the rate of change in tuberculosis notification rates between 1981 and 1991 and changes in sociodemographic measures between 1981 and 1991. RESULTS: The average level of notifications was correlated with overcrowding and the proportion of migrants but not with unemployment or social class. No significant association was found between the rate of change in notification rates and sociodemographic measures in 1981. An association was found between increases in unemployment and the rate of change in notification rates, but the effect was small. Changes in the levels of unemployment explained 23% of the variation between boroughs in the rate of change in their notification rates. CONCLUSION: The average tuberculosis notification rates were related to overcrowding and the proportion of migrants in 1981. Only increases in unemployment from 1981 to 1991, however, were significantly associated with the rate of change in notifications over the same period.