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"complex adaptive system"

Katherine Rouleau, Monique Bourget, Patrick Chege, Francois Couturier, Paula Godoy-Ruiz, Paul H Grand'Maison, Melanie Henry, Kerling Israel, Videsh Kapoor, Hendra Kurniawan, Louella Lobo, Mahamane Maiga, Samantha Pereira Franca, Lynda Redwood-Campbell, Jamie Rodas, Raman Sohal, Dawit Wondimagegn, Robert Woolard
BACKGROUND AND OBJECTIVES: There is a limited evidentiary base on the development of family medicine in different contexts and countries. The lack of evidence impedes our ability to compare and characterize family medicine models and identify areas of success that have led to the effective provision of care. This paper offers a comparative compilation and analysis of the development of family medicine training programs in seven countries: Brazil, Canada, Ethiopia, Haiti, Indonesia, Kenya, and Mali...
March 8, 2018: Family Medicine
Heng Chen, Xinying Chen, Haitao Liu
Language is a complex adaptive system, but how does it change? For investigating this process, four diachronic Chinese word co-occurrence networks have been built based on texts that were written during the last 2,000 years. By comparing the network indicators that are associated with the hierarchical features in language networks, we learn that the hierarchy of Chinese lexical networks has indeed evolved over time at three different levels. The connections of words at the micro level are continually weakening; the number of words in the meso-level communities has increased significantly; and the network is expanding at the macro level...
2018: PloS One
C Robert Cloninger, Igor Zwir
There is fundamental doubt about whether the natural unit of measurement for temperament and personality corresponds to single traits or to multi-trait profiles that describe the functioning of a whole person. Biogenetic researchers of temperament usually assume they need to focus on individual traits that differ between individuals. Recent research indicates that a shift of emphasis to understand processes within the individual is crucial for identifying the natural building blocks of temperament. Evolution and development operate on adaptation of whole organisms or persons, not on individual traits or categories...
April 19, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
Rafael Pérez-Escamilla, Amber J Hromi-Fiedler, Muriel Bauermann Gubert, Katie Doucet, Sara Meyers, Gabriela Dos Santos Buccini
Global efforts to further improve exclusive breastfeeding rates have not been successful, in part because effective scaling-up frameworks and roadmaps have not been developed. The Becoming Breastfeeding Friendly (BBF) toolbox includes an evidence-based index, the BBF Index (BBFI), to guide the development and tracking of large scale, well-coordinated, multisector national breastfeeding promotion programmes. This paper describes the development of the BBFI, which is grounded in the Breastfeeding Gear Model complex adaptive systems framework...
February 22, 2018: Maternal & Child Nutrition
Agathe Lorthios-Guilledroit, Lucie Richard, Johanne Filiatrault
Peer education is growing in popularity as a useful health promotion strategy. However, optimal conditions for implementing peer-led health promotion programs (HPPs) remain unclear. This scoping review aimed to describe factors that can influence implementation of peer-led HPPs targeting adult populations. Five databases were searched using the keywords "health promotion/prevention", "implementation", "peers", and related terms. Studies were included if they reported at least one factor associated with the implementation of community-based peer-led HPPs...
February 3, 2018: Evaluation and Program Planning
Ellen Taylor, Alan J Card, Melissa Piatkowski
AIM: Our review evaluated both the effects of single-occupancy patient rooms (SPRs) on patient outcomes for hospitalized adults and user opinion related to SPRs. BACKGROUND: In 2006, a requirement for SPRs in hospitals was instituted in the United States. This systematic literature review evaluates research published since that time to evaluate the impact of SPRs. METHODS: The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement...
January 2018: HERD
F N Morgado, L M V de Carvalho, J Leite-Silva, A J Seba, M I F Pimentel, A Fagundes, M F Madeira, M R Lyra, M M Oliveira, A O Schubach, F Conceição-Silva
The clinical presentations of skin diseases produced by different pathogens, as American tegumentary leishmaniasis (ATL) and sporotrichosis can be similar and possibly influenced by the skin immune system (SIS). The aim of the study was to understand the underlying mechanisms of skin inflammation produced by different pathogens. We used immunohistochemistry to analyze 96 patients: a- localized cutaneous leishmaniasis (LCL-ATL); b- sporotrichoid cutaneous leishmaniasis (SCL-ATL); c-lymphocutaneous (LC-SP); d- fixed (F-SP) sporotrichosis...
February 13, 2018: Scientific Reports
Evan Rusoja, Deson Haynie, Jessica Sievers, Navonil Mustafee, Fred Nelson, Martin Reynolds, Eric Sarriot, Robert Chad Swanson, Bob Williams
RATIONALE, AIMS, AND OBJECTIVES: As the Sustainable Development Goals are rolled out worldwide, development leaders will be looking to the experiences of the past to improve implementation in the future. Systems thinking and complexity science (ST/CS) propose that health and the health system are composed of dynamic actors constantly evolving in response to each other and their context. While offering practical guidance for steering the next development agenda, there is no consensus as to how these important ideas are discussed in relation to health...
January 30, 2018: Journal of Evaluation in Clinical Practice
Catherine A Gehring, Nancy C Johnson
This report reviews important advances in mycorrhizal research that occurred during the past 2 years. We highlight major advancements both within and across levels of biological organization and describe areas where greater integration has led to unique insights. Particularly active areas of research include exploration of the mechanisms underpinning the development of the mycorrhizal symbiosis, the mycorrhizal microbiome, comparisons among types of mycorrhizas from molecular to ecosystem scales, the extent and function of mycorrhizal networks and enhanced understanding of the role of mycorrhizas in carbon dynamics from local to global scales...
December 30, 2017: Mycorrhiza
Paul Plsek
Front-line ownership (FLO) is an approach to change that is consistent with what we know about complex adaptive systems (CAS), such as a healthcare organization. Traditional change approaches can fail because they are based in the "organization as a machine" metaphor of traditional, scientific management. Both metaphors have their application. It depends on how closely the work naturally resembles a predictable machine. Often, the drive for detailed standardization is a misguided effort to make a human CAS behave more like a machine, so that our traditional approaches to change will work...
2017: HealthcarePapers
Amy M Ross, Kelley Ilic, Hiroko Kiyoshi-Teo, Christopher S Lee
AIM: The purpose of this study was to establish the psychometric properties of the new 16-item leadership environment scale. BACKGROUND: The leadership environment scale was based on complexity science concepts relevant to complex adaptive health care systems. METHODS: A workforce survey of direct-care nurses was conducted (n = 1,443) in Oregon. Confirmatory factor analysis, exploratory factor analysis, concordant validity test and reliability tests were conducted to establish the structure and internal consistency of the leadership environment scale...
December 26, 2017: Journal of Nursing Management
R Pérez-Escamilla, V Cavallera, M Tomlinson, T Dua
BACKGROUND: There is still limited knowledge regarding the translation of early child development (ECD) knowledge into effective policies and large-scale programmes. A variety of frameworks that outline the key steps in scaling up exist, but we argue that taking a complex adaptive systems (CAS) approach assists in understanding the complex, dynamic processes that result in programmes being taken to scale. OBJECTIVES: The objective of this study is to examine the process of scaling up four major country-level ECD programmes through the application of a CAS framework...
January 2018: Child: Care, Health and Development
A Torres, F Lopez Boo, V Parra, C Vazquez, S Segura-Pérez, Z Cetin, R Pérez-Escamilla
BACKGROUND: Chile Crece Contigo (ChCC) is defined as a comprehensive, intersectoral, and multicomponent policy that aims to help all children reach their full potential for development, regardless of their socio-economic status. METHODS: This case study was developed on the basis of grey literature review and key informants' interviews. RESULTS: ChCC behaves as a complex adaptive system that combines universal and targeted benefits for the more vulnerable starting since gestation and until the children are 4 years old...
January 2018: Child: Care, Health and Development
Kathleen P Conte, Sisse Groen, Victoria Loblay, Amanda Green, Andrew Milat, Lina Persson, Christine Innes-Hughes, Jo Mitchell, Sarah Thackway, Mandy Williams, Penelope Hawe
BACKGROUND: The effectiveness of many interventions to promote health and prevent disease has been well established. The imperative has therefore shifted from amassing evidence about efficacy to scale-up to maximise population-level health gains. Electronic implementation monitoring, or 'e-monitoring', systems have been designed to assist and track the delivery of preventive policies and programs. However, there is little evidence on whether e-monitoring systems improve the dissemination, adoption, and ongoing delivery of evidence-based preventive programs...
December 6, 2017: Implementation Science: IS
Kathy A Scott, Janice Pringle
Health care leaders are responsible for oversight of multiple and competing change interventions. These interventions regularly fail to achieve the desired outcomes and/or sustainable results. This often occurs because of the mental models and approaches that are used to plan, design, implement, and evaluate the system. These do not account for inherent characteristics that determine the system's likely ability to innovate while maintaining operational effectiveness. Theories exist on how to assess a system's readiness to change, but the definitions, constructs, and assessments are diverse and often look at facets of systems in isolation...
January 2018: Nursing Administration Quarterly
Jessica Wilkinson, Morgan Goff, Evan Rusoja, Carl Hanson, Robert Chad Swanson
OBJECTIVES: This review of systems thinking (ST) case studies seeks to compile and analyse cases from ST literature and provide practitioners with a reference for ST in health practice. Particular attention was given to (1) reviewing the frequency and use of key ST terms, methods, and tools in the context of health, and (2) extracting and analysing longitudinal themes across cases. METHODS: A systematic search of databases was conducted, and a total of 36 case studies were identified...
November 20, 2017: Journal of Evaluation in Clinical Practice
Emanuele Bigagli
•This paper evaluates the implementation of the MSFD in the Adriatic Sea.•The MSFD is the first policy for marine complex adaptive systems in the EU.•Ecological and jurisdictional boundaries overlap and cross-border cooperation is low.•Integrative assessments of marine systems may be impossible to achieve.•Relative isolation of theoretical approaches and management practices.
November 15, 2017: Ocean & Coastal Management
Edwine W Barasa, Keith Cloete, Lucy Gilson
Recent health system shocks such as the Ebola disease outbreak have focused global health attention on the notion of resilient health systems. In this commentary, we reflect on the current framing of the concept of resilience in health systems discourse and propose a reframing. Specifically, we propose that: (1) in addition to sudden shocks, health systems face the ongoing strain of multiple factors. Health systems need the capacity to continue to deliver services of good quality and respond effectively to wider health challenges...
November 1, 2017: Health Policy and Planning
Trenholme Junghans
Responding to this issue's invitation to bring new disciplinary insights to the field of improvement science, this article takes as its starting point one of the field's guiding metaphors: the imperative to "mind the gap". Drawing on insights from anthropology, history, and philosophy, the article reflects on the origins and implications of this metaphoric imperative, and suggests some ways in which it might be in tension with the means and ends of improvement. If the industrial origins of improvement science in the twentieth century inform a metaphor of gaps, chasms, and spaces of misalignment as invariably imperfect and potentially dangerous, and therefore requiring bridging or closure, other currents that feed the discipline of improvement science suggest the potential value and uses of spaces of openness and ambiguity...
November 17, 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
Julii Suzanne Brainard, Enana Al Assaf, Judith Omasete, Steve Leach, Charlotte C Hammer, Paul R Hunter
Plain English summary: The UK's National Institute for Health Research (NIHR) Health Protection Research Unit in Emergency Preparedness and Response was asked to undertake research on how to reduce the impact of complex national/international emergencies on public health. How to focus the research and decide on priority topics was challenging, given the nature of complex events. Using a type of structured brain-storming, the researchers identified the ongoing UK, European and international migration crisis as both complex and worthy of deeper research...
2017: Research Involvement and Engagement
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