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https://www.readbyqxmd.com/read/28499742/understanding-constraints-on-sport-performance-from-the-complexity-sciences-paradigm-an-ecological-dynamics-framework
#1
Ludovic Seifert, Duarte Araújo, John Komar, Keith Davids
Glazier's suggestion for the constraints-led approach as a GUT for sport performance is a worthy proposal. What is missing from these preliminary insights is a principled basis, in the form of pillars, for understanding the cornerstones of the sports medicine profession, and this lack of an overarching theoretical framework is also somewhat of a limitation in Glazier's initial ideas, as we argue later. Here we suggest that his preliminary proposal would benefit from considering a more comprehensive ontological positioning within the complexity sciences paradigm to benefit from conceptualising athletes and sports teams as complex adaptive systems...
May 9, 2017: Human Movement Science
https://www.readbyqxmd.com/read/28405531/will-the-meikirch-model-a-new-framework-for-health-induce-a-paradigm-shift-in-healthcare
#2
REVIEW
Johannes Bircher, Eckhart G Hahn
Over the past decades, scientific medicine has realized tremendous advances. Yet, it is felt that the quality, costs, and equity of medicine and public health have not improved correspondingly and, both inside and outside the USA, may even have changed for the worse. An initiative for improving this situation is value-based healthcare, in which value is defined as health outcomes relative to the cost of achieving them. Value-based healthcare was advocated in order to stimulate competition among healthcare providers and thereby reduce costs...
March 6, 2017: Curēus
https://www.readbyqxmd.com/read/28342621/how-nurse-led-practices-perceive-implementation-of-the-patient-centered-medical-home
#3
Rosemary Frasso, A Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-McArthur, Michelle Miller-Day, Robert Gabbay, Peter F Cronholm
PURPOSE: The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. METHODS: Data were collected through in-depth interviews with providers and staff in nurse-led practices...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28340346/the-upsides-and-downsides-of-organelle-interconnectivity
#4
REVIEW
Daniel E Gottschling, Thomas Nyström
Interconnectivity and feedback control are hallmarks of biological systems. This includes communication between organelles, which allows them to function and adapt to changing cellular environments. While the specific mechanisms for all communications remain opaque, unraveling the wiring of organelle networks is critical to understand how biological systems are built and why they might collapse, as occurs in aging. A comprehensive understanding of all the routes involved in inter-organelle communication is still lacking, but important themes are beginning to emerge, primarily in budding yeast...
March 23, 2017: Cell
https://www.readbyqxmd.com/read/28329638/developing-a-continuous-quality-improvement-assessment-using-a-patient-centered-approach-in-optimizing-sle-disease-control
#5
Katelyn Updyke, Brittany Urso, James A Solomon
Systemic lupus erythematous is a multi-organ autoimmune disease in which the patient has "lost" self- tolerance and developed immune-complexes containing self-antigen that cause disease through tissue inflammation and multi-organ damage. Patients often have unpredictable flares in symptoms with poorly identified triggers. However, it has been suggested in other literature that exogenous exposures, including ingested beef, cigarette smoke, UV radiation, metal-complexing agents, and infections can contribute to exacerbations and improvements in SLE symptoms...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28289120/the-challenges-of-measuring-improving-and-reporting-quality-in-primary-care
#6
Richard A Young, Richard G Roberts, Richard J Holden
We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear mechanical systems, such as isolated single-disease care, are inappropriate for nonlinear, complex adaptive systems, such as primary care, because of differences in care processes, outcome goals, and the validity of summative quality scorecards...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28196372/resilience-through-adaptation
#7
Guus A Ten Broeke, George A K van Voorn, Arend Ligtenberg, Jaap Molenaar
Adaptation of agents through learning or evolution is an important component of the resilience of Complex Adaptive Systems (CAS). Without adaptation, the flexibility of such systems to cope with outside pressures would be much lower. To study the capabilities of CAS to adapt, social simulations with agent-based models (ABMs) provide a helpful tool. However, the value of ABMs for studying adaptation depends on the availability of methodologies for sensitivity analysis that can quantify resilience and adaptation in ABMs...
2017: PloS One
https://www.readbyqxmd.com/read/28177175/complex-adaptive-systems-and-their-relevance-for-nursing-an-evolutionary-concept-analysis
#8
Ippolito Notarnicola, Cristina Petrucci, Maria Rosimar De Jesus Barbosa, Fabio Giorgi, Alessandro Stievano, Gennaro Rocco, Loreto Lancia
This study aimed to analyze the concept of "complex adaptive systems." The construct is still nebulous in the literature, and a further explanation of the idea is needed to have a shared knowledge of it. A concept analysis was conducted utilizing Rodgers evolutionary method. The inclusive years of bibliographic search started from 2005 to 2015. The search was conducted at PubMed©, CINAHL© 2017 John Wiley & Sons Australia, Ltd Nursing is a complex adaptive system, and the nursing profession in practice exhibits complex adaptive system characteristics...
February 8, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28167863/biomechanical-cell-regulatory-networks-as-complex-adaptive-systems-in-relation-to-cancer
#9
REVIEW
Liviu Feller, Razia Abdool Gafaar Khammissa, Johan Lemmer
Physiological structure and function of cells are maintained by ongoing complex dynamic adaptive processes in the intracellular molecular pathways controlling the overall profile of gene expression, and by genes in cellular gene regulatory circuits. Cytogenetic mutations and non-genetic factors such as chronic inflammation or repetitive trauma, intrinsic mechanical stresses within extracellular matrix may induce redirection of gene regulatory circuits with abnormal reactivation of embryonic developmental programmes which can now drive cell transformation and cancer initiation, and later cancer progression and metastasis...
2017: Cancer Cell International
https://www.readbyqxmd.com/read/28166826/socio-ecological-dynamics-and-challenges-to-the-governance-of-neglected-tropical-disease-control
#10
REVIEW
Edwin Michael, Shirin Madon
The current global attempts to control the so-called "Neglected Tropical Diseases (NTDs)" have the potential to significantly reduce the morbidity suffered by some of the world's poorest communities. However, the governance of these control programmes is driven by a managerial rationality that assumes predictability of proposed interventions, and which thus primarily seeks to improve the cost-effectiveness of implementation by measuring performance in terms of pre-determined outputs. Here, we argue that this approach has reinforced the narrow normal-science model for controlling parasitic diseases, and in doing so fails to address the complex dynamics, uncertainty and socio-ecological context-specificity that invariably underlie parasite transmission...
February 6, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28120320/culture-and-biology-in-the-origins-of-linguistic-structure
#11
Simon Kirby
Language is systematically structured at all levels of description, arguably setting it apart from all other instances of communication in nature. In this article, I survey work over the last 20 years that emphasises the contributions of individual learning, cultural transmission, and biological evolution to explaining the structural design features of language. These 3 complex adaptive systems exist in a network of interactions: individual learning biases shape the dynamics of cultural evolution; universal features of linguistic structure arise from this cultural process and form the ultimate linguistic phenotype; the nature of this phenotype affects the fitness landscape for the biological evolution of the language faculty; and in turn this determines individuals' learning bias...
February 2017: Psychonomic Bulletin & Review
https://www.readbyqxmd.com/read/28116565/pulling-together-and-pulling-apart-influences-of-convergence-and-divergence-on-distributed-healthcare-teams
#12
L Lingard, C Sue-Chue-Lam, G R Tait, J Bates, J Shadd, V Schulz
Effective healthcare requires both competent individuals and competent teams. With this recognition, health professions education is grappling with how to factor team competence into training and assessment strategies. These efforts are impeded, however, by the absence of a sophisticated understanding of the the relationship between competent individuals and competent teams . Using data from a constructivist grounded theory study of team-based healthcare for patients with advanced heart failure, this paper explores the relationship between individual team members' perceived goals, understandings, values and routines and the collective competence of the team...
January 23, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28116356/tambora-and-the-mackerel-year-phenology-and-fisheries-during-an-extreme-climate-event
#13
Karen E Alexander, William B Leavenworth, Theodore V Willis, Carolyn Hall, Steven Mattocks, Steven M Bittner, Emily Klein, Michelle Staudinger, Alexander Bryan, Julianne Rosset, Benjamin H Carr, Adrian Jordaan
Global warming has increased the frequency of extreme climate events, yet responses of biological and human communities are poorly understood, particularly for aquatic ecosystems and fisheries. Retrospective analysis of known outcomes may provide insights into the nature of adaptations and trajectory of subsequent conditions. We consider the 1815 eruption of the Indonesian volcano Tambora and its impact on Gulf of Maine (GoM) coastal and riparian fisheries in 1816. Applying complex adaptive systems theory with historical methods, we analyzed fish export data and contemporary climate records to disclose human and piscine responses to Tambora's extreme weather at different spatial and temporal scales while also considering sociopolitical influences...
January 2017: Science Advances
https://www.readbyqxmd.com/read/28103786/crh-receptor-signalling-potential-roles-in-pathophysiology
#14
Styliani Ourailidou, Dimitris Grammatopoulos
To maintain homeostatic equilibrium, living organisms have evolved complex adaptation systems that control an array of behavioural, autonomic, neuroendocrine and immune responses. One of the important switches The master switch of this system is the hypothalamic hormone corticotropin-releasing hormone (CRH), which together with a family of related peptides (urocortins, UCNs) orchestrate stress-coping responses that reinstate homeostasis. Persistent disturbances in the homeostatic equilibrium either due to inadequate or persistently uncontrolled responses have been associated with pathogenic mechanisms of disease...
January 10, 2017: Current Molecular Pharmacology
https://www.readbyqxmd.com/read/28069045/improving-nursing-home-care-through-feedback-on-performance-data-inform-protocol-for-a-cluster-randomized-trial
#15
Matthias Hoben, Peter G Norton, Liane R Ginsburg, Ruth A Anderson, Greta G Cummings, Holly J Lanham, Janet E Squires, Deanne Taylor, Adrian S Wagg, Carole A Estabrooks
BACKGROUND: Audit and feedback is effective in improving the quality of care. However, methods and results of international studies are heterogeneous, and studies have been criticized for a lack of systematic use of theory. In TREC (Translating Research in Elder Care), a longitudinal health services research program, we collect comprehensive data from care providers and residents in Canadian nursing homes to improve quality of care and life of residents, and quality of worklife of caregivers...
January 10, 2017: Trials
https://www.readbyqxmd.com/read/28024239/hospitals-as-complex-adaptive-systems-a-case-study-of-factors-influencing-priority-setting-practices-at-the-hospital-level-in-kenya
#16
Edwine W Barasa, Sassy Molyneux, Mike English, Susan Cleary
There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months...
February 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/27965876/implementing-resilience-engineering-for-healthcare-quality-improvement-using-the-care-model-a-feasibility-study-protocol
#17
J E Anderson, A J Ross, J Back, M Duncan, P Snell, K Walsh, P Jaye
BACKGROUND: Resilience engineering (RE) is an emerging perspective on safety in complex adaptive systems that emphasises how outcomes emerge from the complexity of the clinical environment. Complexity creates the need for flexible adaptation to achieve outcomes. RE focuses on understanding the nature of adaptations, learning from success and increasing adaptive capacity. Although the philosophy is clear, progress in applying the ideas to quality improvement has been slow. The aim of this study is to test the feasibility of translating RE concepts into practical methods to improve quality by designing, implementing and evaluating interventions based on RE theory...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27965394/perspectives-on-the-role-of-mobility-behavior-and-time-scales-in-the-spread-of-diseases
#18
Carlos Castillo-Chavez, Derdei Bichara, Benjamin R Morin
The dynamics, control, and evolution of communicable and vector-borne diseases are intimately connected to the joint dynamics of epidemiological, behavioral, and mobility processes that operate across multiple spatial, temporal, and organizational scales. The identification of a theoretical explanatory framework that accounts for the pattern regularity exhibited by a large number of host-parasite systems, including those sustained by host-vector epidemiological dynamics, is but one of the challenges facing the coevolving fields of computational, evolutionary, and theoretical epidemiology...
December 20, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27938873/shaping-the-midwifery-profession-in-nepal-uncovering-actors-connections-using-a-complex-adaptive-systems-framework
#19
Malin Upper Bogren, Marie Berg, Lars Edgren, Edwin van Teijlingen, Helena Wigert
OBJECTIVES: To explore how actors connect in a system aiming at promoting the establishment of a midwifery profession in Nepal. METHODS: A qualitative explorative study based on the framework of Complex Adaptive Systems. Semi-structured interviews were conducted with 17 key people representing eight different organisations (actors) promoting the development of the midwifery profession. RESULTS: The actors' connections can be described with a complex set of facilitators for and barriers to promoting the establishment of a midwifery profession...
December 2016: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/27931219/influences-on-teleconsultation-project-utilization-rates-the-role-of-dominant-logic
#20
David L Paul, Reuben R McDaniel
BACKGROUND: This research analyzes teleconsultation from both a mechanistic and complex adaptive system (CAS) dominant logic in order to further understand the influence of dominant logic on utilization rates of teleconsultation projects. In both dominant logics, the objective of teleconsultation projects is to increase access to and quality of healthcare delivery in a cost efficient manner. A mechanistic dominant logic perceives teleconsultation as closely resembling the traditional service delivery model, while a CAS dominant logic focuses on the system's emergent behavior of learning resulting from the relationships and interactions of participating healthcare providers...
December 8, 2016: BMC Medical Informatics and Decision Making
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