WorldWideScience

Sample records for complex adaptive health

  1. Understanding global health governance as a complex adaptive system.

    Science.gov (United States)

    Hill, Peter S

    2011-01-01

    The transition from international to global health reflects the rapid growth in the numbers and nature of stakeholders in health, as well as the constant change embodied in the process of globalisation itself. This paper argues that global health governance shares the characteristics of complex adaptive systems, with its multiple and diverse players, and their polyvalent and constantly evolving relationships, and rich and dynamic interactions. The sheer quantum of initiatives, the multiple networks through which stakeholders (re)configure their influence, the range of contexts in which development for health is played out - all compound the complexity of this system. This paper maps out the characteristics of complex adaptive systems as they apply to global health governance, linking them to developments in the past two decades, and the multiple responses to these changes. Examining global health governance through the frame of complexity theory offers insight into the current dynamics of governance, and while providing a framework for making meaning of the whole, opens up ways of accessing this complexity through local points of engagement.

  2. Salud: un sistema complejo adaptativo Health: an adaptive complex system

    Directory of Open Access Journals (Sweden)

    Luis Fernando Toro-Palacio

    2012-02-01

    Full Text Available Este artículo destaca la enorme distancia existente entre el pensamiento complejo de índole intelectual, difundido en nuestro medio, y el pensamiento complejo de índole experimental, que ha permitido lograr los desarrollos científico-tecnológicos que han cambiado radicalmente el mundo. Invita a considerar como sistemas complejos adaptativos entidades tales como la vida, el ser humano, la sociedad global y todo aquello que se llama salud, para lo cual resulta prioritario adoptar un enfoque diferente que amplíe su conocimiento. Al reconocer esta racionalidad, se sustentan las principales características y propiedades emergentes de la salud como sistema complejo adaptativo, siguiendo un modelo de prestación de cuidados y servicios. Finalmente, se plantean algunas preguntas de investigación pertinentes desde esta perspectiva, y se expresan una serie de apreciaciones que se espera sirvan para comprender todo lo que como individuos y como especie hemos llegado a ser. Se propone en este trabajo que la salud y la prestación de servicios de asistencia sanitaria se consideren como sistemas complejos adaptativos.This article points out the enormous gap that exists between complex thinking of an intellectual nature currently present in our environment, and complex experimental thinking that has facilitated the scientific and technological advances that have radically changed the world. The article suggests that life, human beings, global society, and all that constitutes health be considered as adaptive complex systems. This idea, in turn, prioritizes the adoption of a different approach that seeks to expand understanding. When this rationale is recognized, the principal characteristics and emerging properties of health as an adaptive complex system are sustained, following a care and services delivery model. Finally, some pertinent questions from this perspective are put forward in terms of research, and a series of appraisals are expressed that

  3. Using evaluation to adapt health information outreach to the complex environments of community-based organizations.

    Science.gov (United States)

    Olney, Cynthia A

    2005-10-01

    After arguing that most community-based organizations (CBOs) function as complex adaptive systems, this white paper describes the evaluation goals, questions, indicators, and methods most important at different stages of community-based health information outreach. This paper presents the basic characteristics of complex adaptive systems and argues that the typical CBO can be considered this type of system. It then presents evaluation as a tool for helping outreach teams adapt their outreach efforts to the CBO environment and thus maximize success. Finally, it describes the goals, questions, indicators, and methods most important or helpful at each stage of evaluation (community assessment, needs assessment and planning, process evaluation, and outcomes assessment). Literature from complex adaptive systems as applied to health care, business, and evaluation settings is presented. Evaluation models and applications, particularly those based on participatory approaches, are presented as methods for maximizing the effectiveness of evaluation in dynamic CBO environments. If one accepts that CBOs function as complex adaptive systems-characterized by dynamic relationships among many agents, influences, and forces-then effective evaluation at the stages of community assessment, needs assessment and planning, process evaluation, and outcomes assessment is critical to outreach success.

  4. Performance of community health workers:situating their intermediary position within complex adaptive health systems

    OpenAIRE

    Kok, Maryse. C; Broerse, Jacqueline E.W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors. This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment...

  5. Performance of community health workers : situating their intermediary position within complex adaptive health systems

    NARCIS (Netherlands)

    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income

  6. Applying a complex adaptive system's understanding of health to primary care [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Johannes Bircher

    2016-09-01

    Full Text Available This paper explores the diagnostic and therapeutic potential of a new concept of health. Investigations into the nature of health have led to a new definition that explains health as a complex adaptive system (CAS and is based on five components (a-e. Humans like all biological creatures must satisfactorily respond to (a the demands of life. For this purpose they need (b a biologically given potential (BGP and (c a personally acquired potential (PAP. These properties of individuals are embedded within (d social and (e environmental determinants of health. Between these five components of health there are 10 complex interactions that justify viewing health as a CAS. In each patient, the current state of health as a CAS evolved from the past, will move forward to a new future, and has to be analyzed and treated as an autonomous whole. A diagnostic procedure is suggested as follows: together with the patient, the five components and 10 complex interactions are assessed. This may help patients to better understand their situations and to recognize possible next steps that may be useful in order to evolve toward better health by themselves. In this process mutual trust in the patient-physician interaction is critical. The described approach offers new possibilities for helping patients improve their health prospects.

  7. Performance of community health workers: situating their intermediary position within complex adaptive health systems.

    Science.gov (United States)

    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-09-02

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment combines evidence from the international literature on CHW programmes with research outcomes from the 5-year REACHOUT consortium, undertaking implementation research to improve CHW performance in six contexts (two in Asia and four in Africa). A conceptual framework on CHW performance, which explicitly conceptualizes the interface role of CHWs, is presented. Various categories of factors influencing CHW performance are distinguished in the framework: the context, the health system and intervention hardware and the health system and intervention software. Hardware elements of CHW interventions comprise the supervision systems, training, accountability and communication structures, incentives, supplies and logistics. Software elements relate to the ideas, interests, relationships, power, values and norms of the health system actors. They influence CHWs' feelings of connectedness, familiarity, self-fulfilment and serving the same goals and CHWs' perceptions of support received, respect, competence, honesty, fairness and recognition.The framework shines a spotlight on the need for programmes to pay more attention to ideas, interests, relationships, power, values and norms of CHWs, communities, health professionals and other actors in the health system, if CHW performance is to improve.

  8. Implications of complex adaptive systems theory for interpreting research about health care organizations.

    Science.gov (United States)

    Jordon, Michelle; Lanham, Holly Jordan; Anderson, Ruth A; McDaniel, Reuben R

    2010-02-01

    Data about health care organizations (HCOs) are not useful until they are interpreted. Such interpretations are influenced by the theoretical lenses used by the researcher. Our purpose was to suggest the usefulness of theories of complex adaptive systems (CASs) in guiding research interpretation. Specifically, we addressed two questions: (1) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among diverse agents? (2) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among agents that learn? We defined diversity and learning and the implications of the non-linear relationships among agents from a CAS perspective. We then identified some common analytical practices that were problematic and may lead to conceptual and methodological errors. Then we described strategies for interpreting the results of research observations. We suggest that the task of interpreting research observations of HCOs could be improved if researchers take into account that the systems they study are CASs with non-linear relationships among diverse, learning agents. Our analysis points out how interpretation of research results might be shaped by the fact that HCOs are CASs. We described how learning is, in fact, the result of interactions among diverse agents and that learning can, by itself, reduce or increase agent diversity. We encouraged researchers to be persistent in their attempts to reason about complex systems and learn to attend not only to structures, but also to processes and functions of complex systems.

  9. Health Information Exchange as a Complex and Adaptive Construct: Scoping Review

    Directory of Open Access Journals (Sweden)

    Ather Akhlaq

    2017-01-01

    The concept of HIE is an evolving and adaptive one, reflecting the ongoing quest for integrated and interoperable information to improve the efficiency and effectiveness of health systems, in a changing technological and policy environment.

  10. Selecting a change and evaluating its impact on the performance of a complex adaptive health care delivery system

    Directory of Open Access Journals (Sweden)

    Malaz A Boustani

    2010-05-01

    Full Text Available Malaz A Boustani1,2,3,4, Stephanie Munger1,2, Rajesh Gulati3,4, Mickey Vogel4, Robin A Beck3,4, Christopher M Callahan1,2,3,41Indiana University Center for Aging Research, 2Regenstrief Institute Inc., 3Indiana University School of Medicine, Department of Medicine, Division of General Internal Medicine and Geriatrics, 4Indiana University Medical Group-Primary Care; Indianapolis, IN USAAbstract: Complexity science suggests that our current health care delivery system acts as a complex adaptive system (CAS. Such systems represent a dynamic and flexible network of individuals who can coevolve with their ever changing environment. The CAS performance fluctuates and its members’ interactions continuously change over time in response to the stress generated by its surrounding environment. This paper will review the challenges of intervening and introducing a planned change into a complex adaptive health care delivery system. We explore the role of the “reflective adaptive process” in developing delivery interventions and suggest different evaluation methodologies to study the impact of such interventions on the performance of the entire system. We finally describe the implementation of a new program, the Aging Brain Care Medical Home as a case study of our proposed evaluation process.Keywords: complexity, aging brain, implementation, complex adaptive system, sustained change, care delivery

  11. Complex adaptive systems ecology

    DEFF Research Database (Denmark)

    Sommerlund, Julie

    2003-01-01

    In the following, I will analyze two articles called Complex Adaptive Systems EcologyI & II (Molin & Molin, 1997 & 2000). The CASE-articles are some of the more quirkyarticles that have come out of the Molecular Microbial Ecology Group - a groupwhere I am currently making observational studies....... They are the result of acooperation between Søren Molin, professor in the group, and his brother, JanMolin, professor at Department of Organization and Industrial Sociology atCopenhagen Business School. The cooperation arises from the recognition that bothmicrobial ecology and sociology/organization theory works...

  12. Marine complex adaptive systems

    NARCIS (Netherlands)

    Bigagli, Emanuele

    2017-01-01

    Anthropogenic and climate-related stressors challenge the health of nearly every part of the global oceans. They affect the capacity of oceans to regulate global weather and climate, as well as ocean productivity and food services, and result in the loss or degradation of marine habitats and

  13. Micro practices of coordination based on complex adaptive systems: user needs and strategies for coordinating public health in Denmark

    Directory of Open Access Journals (Sweden)

    Morten Deleuran Terkildsen

    2015-09-01

    Full Text Available Introduction: Many highly formalised approaches to coordination poorly fit public health and recent studies call for coordination based on complex adaptive systems. Our contribution is two-fold. Empirically, we focus on public health, and theoretically we build on the patient perspective and treat coordination as a process of contingent, two-level negotiations of user needs.Theory and Methods: The paper draws on the concept of user needs-based coordination and sees coordination as a process, whereby needs emerging from the life world of the user are made amenable to the health system through negotiations. The analysis is based on an explorative case study of a health promotion initiative in Denmark. It adopts an anthropological qualitative approach and uses a range of qualitative data.Results: The analysis identifies four strategies of coordination: the coordinator focusing on the individual user or on relations with other professionals; and the manager coaching the coordinator or providing structural support. Crucially, the coordination strategies by management remain weak as they do not directly relate to specific user needs.Discussion: In process of bottom-up negotiations user needs become blurred and this is especially a challenge for management. The study therefore calls for an increased focus on the level nature of negotiations to bridge the gap that currently weakens coordination strategies by management.

  14. Micro practices of coordination based on complex adaptive systems: user needs and strategies for coordinating public health in Denmark.

    Science.gov (United States)

    Terkildsen, Morten Deleuran; Wittrup, Inge; Burau, Viola

    2015-01-01

    Many highly formalised approaches to coordination poorly fit public health and recent studies call for coordination based on complex adaptive systems. Our contribution is two-fold. Empirically, we focus on public health, and theoretically we build on the patient perspective and treat coordination as a process of contingent, two-level negotiations of user needs. The paper draws on the concept of user needs-based coordination and sees coordination as a process, whereby needs emerging from the life world of the user are made amenable to the health system through negotiations. The analysis is based on an explorative case study of a health promotion initiative in Denmark. It adopts an anthropological qualitative approach and uses a range of qualitative data. The analysis identifies four strategies of coordination: the coordinator focusing on the individual user or on relations with other professionals; and the manager coaching the coordinator or providing structural support. Crucially, the coordination strategies by management remain weak as they do not directly relate to specific user needs. In process of bottom-up negotiations user needs become blurred and this is especially a challenge for management. The study therefore calls for an increased focus on the level nature of negotiations to bridge the gap that currently weakens coordination strategies by management.

  15. Adapting, piloting and evaluating complex public health interventions: lessons learned from the Nurse-Family Partnership in Canadian public health settings

    Directory of Open Access Journals (Sweden)

    S. M. Jack

    2015-01-01

    Full Text Available Introduction: The Nurse-Family Partnership (NFP is a home-visit program for young and first-time, socially and economically disadvantaged mothers. Evidence from three United States randomized controlled trials (RCTs on the effectiveness of this intervention at improving pregnancy outcomes, improving child health and development, and increasing maternal economic self-sufficiency is robust. However, the effectiveness of the NFP in Canada, with its different health and social care context, needs to be determined. The purpose of this article is to describe the complex process for moving the NFP from the research arena to full implementation in Canada. Methods: This process of evaluation in Canada includes (1 adapting the intervention; (2 piloting the intervention in small-scale feasibility and acceptability studies; and (3 conducting an RCT and process evaluation through a study called the British Columbia Healthy Connections Project (BCHCP. This large-scale evaluation also creates an opportunity to expand the NFP evidence base by conducting an additional study to examine potential biological mechanisms linking intervention and behavioural outcomes in children. Results: Adaptation of the NFP home-visit materials is a continuous process. A pilot project determined that it was feasible to enrol eligible women into the NFP. This pilot also determined that, in Canada, it was most appropriate for public health agencies to implement the NFP and for public health nurses to deliver the intervention. Finally, the pilot showed that this intensive home-visit program was acceptable to clients, their family members and health care providers. Through the BCHCP, the next steps—the RCT and process evaluation—are currently underway. The BCHCP will also set the foundation for long-term evaluation of key public health outcomes in a highly vulnerable population of families.

  16. Integration of the immune system: a complex adaptive supersystem

    Science.gov (United States)

    Crisman, Mark V.

    2001-10-01

    Immunity to pathogenic organisms is a complex process involving interacting factors within the immune system including circulating cells, tissues and soluble chemical mediators. Both the efficiency and adaptive responses of the immune system in a dynamic, often hostile, environment are essential for maintaining our health and homeostasis. This paper will present a brief review of one of nature's most elegant, complex adaptive systems.

  17. Adaptive Beamforming Based on Complex Quaternion Processes

    Directory of Open Access Journals (Sweden)

    Jian-wu Tao

    2014-01-01

    Full Text Available Motivated by the benefits of array signal processing in quaternion domain, we investigate the problem of adaptive beamforming based on complex quaternion processes in this paper. First, a complex quaternion least-mean squares (CQLMS algorithm is proposed and its performance is analyzed. The CQLMS algorithm is suitable for adaptive beamforming of vector-sensor array. The weight vector update of CQLMS algorithm is derived based on the complex gradient, leading to lower computational complexity. Because the complex quaternion can exhibit the orthogonal structure of an electromagnetic vector-sensor in a natural way, a complex quaternion model in time domain is provided for a 3-component vector-sensor array. And the normalized adaptive beamformer using CQLMS is presented. Finally, simulation results are given to validate the performance of the proposed adaptive beamformer.

  18. Complexity and network dynamics in physiological adaptation: an integrated view.

    Science.gov (United States)

    Baffy, György; Loscalzo, Joseph

    2014-05-28

    Living organisms constantly interact with their surroundings and sustain internal stability against perturbations. This dynamic process follows three fundamental strategies (restore, explore, and abandon) articulated in historical concepts of physiological adaptation such as homeostasis, allostasis, and the general adaptation syndrome. These strategies correspond to elementary forms of behavior (ordered, chaotic, and static) in complex adaptive systems and invite a network-based analysis of the operational characteristics, allowing us to propose an integrated framework of physiological adaptation from a complex network perspective. Applicability of this concept is illustrated by analyzing molecular and cellular mechanisms of adaptation in response to the pervasive challenge of obesity, a chronic condition resulting from sustained nutrient excess that prompts chaotic exploration for system stability associated with tradeoffs and a risk of adverse outcomes such as diabetes, cardiovascular disease, and cancer. Deconstruction of this complexity holds the promise of gaining novel insights into physiological adaptation in health and disease. Published by Elsevier Inc.

  19. Evaluation and mechanism for outcomes exploration of providing public health care in contract service in rural China: a multiple-case study with complex adaptive systems design.

    Science.gov (United States)

    Zhou, Huixuan; Zhang, Shengfa; Zhang, Weijun; Wang, Fugang; Zhong, You; Gu, Linni; Qu, Zhiyong; Tian, Donghua

    2015-02-27

    The Chinese government has increased the funding for public health in 2009 and experimentally applied a contract service policy (could be seen as a counterpart to family medicine) in 15 counties to promote public health services in the rural areas in 2013. The contract service aimed to convert village doctors, who had privately practiced for decades, into general practitioners under the government management, and better control the rampant chronic diseases. This study made a rare attempt to assess the effectiveness of public health services delivered under the contract service policy, explore the influencing mechanism and draw the implications for the policy extension in the future. Three pilot counties and a non-pilot one with heterogeneity in economic and health development from east to west of China were selected by a purposive sampling method. The case study methods by document collection, non-participant observation and interviews (including key informant interview and focus group interview) with 84 health providers and 20 demanders in multiple level were applied in this study. A thematic approach was used to compare diverse outcomes and analyze mechanism in the complex adaptive systems framework. Without sufficient incentives, the public health services were not conducted effectively, regardless of the implementation of the contract policy. To appropriately increase the funding for public health by local finance and properly allocate subsidy to village doctors was one of the most effective approaches to stimulate health providers and demanders' positivity and promote the policy implementation. County health bureaus acted as the most crucial agents among the complex public health systems. Their mental models influenced by the compound and various environments around them led to the diverse outcomes. If they could provide extra incentives and make the contexts of the systems ripe enough for change, the health providers and demanders would be receptive to the

  20. Adaptive learning and complex dynamics

    International Nuclear Information System (INIS)

    Gomes, Orlando

    2009-01-01

    In this paper, we explore the dynamic properties of a group of simple deterministic difference equation systems in which the conventional perfect foresight assumption gives place to a mechanism of adaptive learning. These systems have a common feature: under perfect foresight (or rational expectations) they all possess a unique fixed point steady state. This long-term outcome is obtained also under learning if the quality underlying the learning process is high. Otherwise, when the degree of inefficiency of the learning process is relatively strong, nonlinear dynamics (periodic and a-periodic cycles) arise. The specific properties of each one of the proposed systems is explored both in terms of local and global dynamics. One macroeconomic model is used to illustrate how the formation of expectations through learning may eventually lead to awkward long-term outcomes.

  1. Rethinking school-based health centers as complex adaptive systems: maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections.

    Science.gov (United States)

    Daley, Alison Moriarty

    2012-01-01

    This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts. SBHCs are one such community resource to be leveraged in these efforts. They offer adolescent-friendly primary care services and are responsive to the diverse needs of the adolescents utilizing them. However, current restrictions on contraceptive availability limit the ability of SBHCs to maximize opportunities for comprehensive reproductive care and create missed opportunities for pregnancy and STI prevention. A clinical case explores the current models of health care services related to contraceptive care provided in SBHCs and the ability to meet or miss the needs of an adolescent seeking reproductive care in a SBHC.

  2. Complex and adaptive dynamical systems a primer

    CERN Document Server

    Gros, Claudius

    2007-01-01

    We are living in an ever more complex world, an epoch where human actions can accordingly acquire far-reaching potentialities. Complex and adaptive dynamical systems are ubiquitous in the world surrounding us and require us to adapt to new realities and the way of dealing with them. This primer has been developed with the aim of conveying a wide range of "commons-sense" knowledge in the field of quantitative complex system science at an introductory level, providing an entry point to this both fascinating and vitally important subject. The approach is modular and phenomenology driven. Examples of emerging phenomena of generic importance treated in this book are: -- The small world phenomenon in social and scale-free networks. -- Phase transitions and self-organized criticality in adaptive systems. -- Life at the edge of chaos and coevolutionary avalanches resulting from the unfolding of all living. -- The concept of living dynamical systems and emotional diffusive control within cognitive system theory. Techn...

  3. Complex and Adaptive Dynamical Systems A Primer

    CERN Document Server

    Gros, Claudius

    2011-01-01

    We are living in an ever more complex world, an epoch where human actions can accordingly acquire far-reaching potentialities. Complex and adaptive dynamical systems are ubiquitous in the world surrounding us and require us to adapt to new realities and the way of dealing with them. This primer has been developed with the aim of conveying a wide range of "commons-sense" knowledge in the field of quantitative complex system science at an introductory level, providing an entry point to this both fascinating and vitally important subject. The approach is modular and phenomenology driven. Examples of emerging phenomena of generic importance treated in this book are: -- The small world phenomenon in social and scale-free networks. -- Phase transitions and self-organized criticality in adaptive systems. -- Life at the edge of chaos and coevolutionary avalanches resulting from the unfolding of all living. -- The concept of living dynamical systems and emotional diffusive control within cognitive system theory. Techn...

  4. Synchronization in complex networks with adaptive coupling

    International Nuclear Information System (INIS)

    Zhang Rong; Hu Manfeng; Xu Zhenyuan

    2007-01-01

    Generally it is very difficult to realized synchronization for some complex networks. In order to synchronize, the coupling coefficient of networks has to be very large, especially when the number of coupled nodes is larger. In this Letter, we consider the problem of synchronization in complex networks with adaptive coupling. A new concept about asymptotic stability is presented, then we proved by using the well-known LaSalle invariance principle, that the state of such a complex network can synchronize an arbitrary assigned state of an isolated node of the network as long as the feedback gain is positive. Unified system is simulated as the nodes of adaptive coupling complex networks with different topologies

  5. On complex adaptive systems and terrorism

    International Nuclear Information System (INIS)

    Ahmed, E.; Elgazzar, A.S.; Hegazi, A.S.

    2005-01-01

    Complex adaptive systems (CAS) are ubiquitous in nature. They are basic in social sciences. An overview of CAS is given with emphasize on the occurrence of bad side effects to seemingly 'wise' decisions. Hence application to terrorism is given. Some conclusions on how to deal with this phenomena are proposed

  6. The Complexities of Water Disaster Adaptation

    DEFF Research Database (Denmark)

    Buch-Hansen, Mogens; Luu Bich, Ngoc; Man Quang, Huy

    2015-01-01

    The article argues for an interdisciplinary approach to studying the complex circumstances that turn natural hazards into disasters. It takes on the ambitious task of combining a social sciences-inspired vulnerability and adaptation analysis with a natural science-based hydrological modelling...

  7. Disentangling Complexity in Bayesian Automatic Adaptive Quadrature

    Science.gov (United States)

    Adam, Gheorghe; Adam, Sanda

    2018-02-01

    The paper describes a Bayesian automatic adaptive quadrature (BAAQ) solution for numerical integration which is simultaneously robust, reliable, and efficient. Detailed discussion is provided of three main factors which contribute to the enhancement of these features: (1) refinement of the m-panel automatic adaptive scheme through the use of integration-domain-length-scale-adapted quadrature sums; (2) fast early problem complexity assessment - enables the non-transitive choice among three execution paths: (i) immediate termination (exceptional cases); (ii) pessimistic - involves time and resource consuming Bayesian inference resulting in radical reformulation of the problem to be solved; (iii) optimistic - asks exclusively for subrange subdivision by bisection; (3) use of the weaker accuracy target from the two possible ones (the input accuracy specifications and the intrinsic integrand properties respectively) - results in maximum possible solution accuracy under minimum possible computing time.

  8. Atomic switch networks as complex adaptive systems

    Science.gov (United States)

    Scharnhorst, Kelsey S.; Carbajal, Juan P.; Aguilera, Renato C.; Sandouk, Eric J.; Aono, Masakazu; Stieg, Adam Z.; Gimzewski, James K.

    2018-03-01

    Complexity is an increasingly crucial aspect of societal, environmental and biological phenomena. Using a dense unorganized network of synthetic synapses it is shown that a complex adaptive system can be physically created on a microchip built especially for complex problems. These neuro-inspired atomic switch networks (ASNs) are a dynamic system with inherent and distributed memory, recurrent pathways, and up to a billion interacting elements. We demonstrate key parameters describing self-organized behavior such as non-linearity, power law dynamics, and multistate switching regimes. Device dynamics are then investigated using a feedback loop which provides control over current and voltage power-law behavior. Wide ranging prospective applications include understanding and eventually predicting future events that display complex emergent behavior in the critical regime.

  9. Self-adapted thermocouple-diagnostic complex

    International Nuclear Information System (INIS)

    Alekseev, S.V.; Grankovskij, K.Eh.; Olejnikov, P.P.; Prijmak, S.V.; Shikalov, V.F.

    2003-01-01

    A self-adapted thermocouple-diagnostic complex (STDC) for obtaining the reliable data on the coolant temperature in the reactors of NPP is described. The STDC in based on the thermal pulse monitoring of a thermocouple in the measuring channel of a reactor. Measurement method and STDC composition are substantiated. It is shown that introduction of the developed STDC ensures realization of precise and reliable temperature monitoring in the reactors of all types [ru

  10. Managing Schools as Complex Adaptive Systems: A Strategic Perspective

    Science.gov (United States)

    Fidan, Tuncer; Balci, Ali

    2017-01-01

    This conceptual study examines the analogies between schools and complex adaptive systems and identifies strategies used to manage schools as complex adaptive systems. Complex adaptive systems approach, introduced by the complexity theory, requires school administrators to develop new skills and strategies to realize their agendas in an…

  11. Complex and adaptive dynamical systems a primer

    CERN Document Server

    Gros, Claudius

    2013-01-01

    Complex system theory is rapidly developing and gaining importance, providing tools and concepts central to our modern understanding of emergent phenomena. This primer offers an introduction to this area together with detailed coverage of the mathematics involved. All calculations are presented step by step and are straightforward to follow. This new third edition comes with new material, figures and exercises. Network theory, dynamical systems and information theory, the core of modern complex system sciences, are developed in the first three chapters, covering basic concepts and phenomena like small-world networks, bifurcation theory and information entropy. Further chapters use a modular approach to address the most important concepts in complex system sciences, with the emergence and self-organization playing a central role. Prominent examples are self-organized criticality in adaptive systems, life at the edge of chaos, hypercycles and coevolutionary avalanches, synchronization phenomena, absorbing phase...

  12. Emergent explosive synchronization in adaptive complex networks

    Science.gov (United States)

    Avalos-Gaytán, Vanesa; Almendral, Juan A.; Leyva, I.; Battiston, F.; Nicosia, V.; Latora, V.; Boccaletti, S.

    2018-04-01

    Adaptation plays a fundamental role in shaping the structure of a complex network and improving its functional fitting. Even when increasing the level of synchronization in a biological system is considered as the main driving force for adaptation, there is evidence of negative effects induced by excessive synchronization. This indicates that coherence alone cannot be enough to explain all the structural features observed in many real-world networks. In this work, we propose an adaptive network model where the dynamical evolution of the node states toward synchronization is coupled with an evolution of the link weights based on an anti-Hebbian adaptive rule, which accounts for the presence of inhibitory effects in the system. We found that the emergent networks spontaneously develop the structural conditions to sustain explosive synchronization. Our results can enlighten the shaping mechanisms at the heart of the structural and dynamical organization of some relevant biological systems, namely, brain networks, for which the emergence of explosive synchronization has been observed.

  13. Complex and adaptive dynamical systems a primer

    CERN Document Server

    Gros, Claudius

    2015-01-01

    This primer offers readers an introduction to the central concepts that form our modern understanding of complex and emergent behavior, together with detailed coverage of accompanying mathematical methods. All calculations are presented step by step and are easy to follow. This new fourth edition has been fully reorganized and includes new chapters, figures and exercises. The core aspects of modern complex system sciences are presented in the first chapters, covering network theory, dynamical systems, bifurcation and catastrophe theory, chaos and adaptive processes, together with the principle of self-organization in reaction-diffusion systems and social animals. Modern information theoretical principles are treated in further chapters, together with the concept of self-organized criticality, gene regulation networks, hypercycles and coevolutionary avalanches, synchronization phenomena, absorbing phase transitions and the cognitive system approach to the brain. Technical course prerequisites are the standard ...

  14. Adaptation and complexity in repeated games

    DEFF Research Database (Denmark)

    Maenner, Eliot Alexander

    2008-01-01

    The paper presents a learning model for two-player infinitely repeated games. In an inference step players construct minimally complex inferences of strategies based on observed play, and in an adaptation step players choose minimally complex best responses to an inference. When players randomly...... select an inference from a probability distribution with full support the set of steady states is a subset of the set of Nash equilibria in which only stage game Nash equilibria are played. When players make ‘cautious' inferences the set of steady states is the subset of self-confirming equilibria...... with Nash outcome paths. When players use different inference rules, the set of steady states can lie between the previous two cases...

  15. Modeling Power Systems as Complex Adaptive Systems

    Energy Technology Data Exchange (ETDEWEB)

    Chassin, David P.; Malard, Joel M.; Posse, Christian; Gangopadhyaya, Asim; Lu, Ning; Katipamula, Srinivas; Mallow, J V.

    2004-12-30

    Physical analogs have shown considerable promise for understanding the behavior of complex adaptive systems, including macroeconomics, biological systems, social networks, and electric power markets. Many of today's most challenging technical and policy questions can be reduced to a distributed economic control problem. Indeed, economically based control of large-scale systems is founded on the conjecture that the price-based regulation (e.g., auctions, markets) results in an optimal allocation of resources and emergent optimal system control. This report explores the state-of-the-art physical analogs for understanding the behavior of some econophysical systems and deriving stable and robust control strategies for using them. We review and discuss applications of some analytic methods based on a thermodynamic metaphor, according to which the interplay between system entropy and conservation laws gives rise to intuitive and governing global properties of complex systems that cannot be otherwise understood. We apply these methods to the question of how power markets can be expected to behave under a variety of conditions.

  16. Complex Adaptive Schools: Educational Leadership and School Change

    Science.gov (United States)

    Kershner, Brad; McQuillan, Patrick

    2016-01-01

    This paper utilizes the theoretical framework of complexity theory to compare and contrast leadership and educational change in two urban schools. Drawing on the notion of a complex adaptive system--an interdependent network of interacting elements that learns and evolves in adapting to an ever-shifting context--our case studies seek to reveal the…

  17. Application of Complex Adaptive Systems in Portfolio Management

    Science.gov (United States)

    Su, Zheyuan

    2017-01-01

    Simulation-based methods are becoming a promising research tool in financial markets. A general Complex Adaptive System can be tailored to different application scenarios. Based on the current research, we built two models that would benefit portfolio management by utilizing Complex Adaptive Systems (CAS) in Agent-based Modeling (ABM) approach.…

  18. Clinical quality needs complex adaptive systems and machine learning.

    Science.gov (United States)

    Marsland, Stephen; Buchan, Iain

    2004-01-01

    The vast increase in clinical data has the potential to bring about large improvements in clinical quality and other aspects of healthcare delivery. However, such benefits do not come without cost. The analysis of such large datasets, particularly where the data may have to be merged from several sources and may be noisy and incomplete, is a challenging task. Furthermore, the introduction of clinical changes is a cyclical task, meaning that the processes under examination operate in an environment that is not static. We suggest that traditional methods of analysis are unsuitable for the task, and identify complexity theory and machine learning as areas that have the potential to facilitate the examination of clinical quality. By its nature the field of complex adaptive systems deals with environments that change because of the interactions that have occurred in the past. We draw parallels between health informatics and bioinformatics, which has already started to successfully use machine learning methods.

  19. Leadership Behaviors of Management for Complex Adaptive Systems

    Science.gov (United States)

    2010-04-01

    Leadership Behaviors of Management for Complex Adaptive Systems Systems and Software Technology Conference April 2010 Dr. Suzette S. Johnson...2010 2. REPORT TYPE 3. DATES COVERED 00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Leadership Behaviors of Management for Complex Adaptive...as they evolve – Control is dispersed and decentralized – Simple rules and governance used to direct behavior • Complexity Leadership Theory – Built on

  20. Complexity and network dynamics in physiological adaptation: An integrated view

    OpenAIRE

    Baffy, Gyorgy; Loscalzo, Joseph

    2014-01-01

    Living organisms constantly interact with their surroundings and sustain internal stability against perturbations. This dynamic process follows three fundamental strategies (restore, explore, and abandon) articulated in historical concepts of physiological adaptation such as homeostasis, allostasis, and the general adaptation syndrome. These strategies correspond to elementary forms of behavior (ordered, chaotic, and static) in complex adaptive systems and invite a network-based analysis of t...

  1. Complex Adaptive Systems of Systems (CASOS) engineering environment.

    Energy Technology Data Exchange (ETDEWEB)

    Detry, Richard Joseph; Linebarger, John Michael; Finley, Patrick D.; Maffitt, S. Louise; Glass, Robert John, Jr.; Beyeler, Walter Eugene; Ames, Arlo Leroy

    2012-02-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex physical-socio-technical systems which we must understand to design a secure future for the nation. The Phoenix initiative implements CASoS Engineering principles combining the bottom up Complex Systems and Complex Adaptive Systems view with the top down Systems Engineering and System-of-Systems view. CASoS Engineering theory and practice must be conducted together to develop a discipline that is grounded in reality, extends our understanding of how CASoS behave and allows us to better control the outcomes. The pull of applications (real world problems) is critical to this effort, as is the articulation of a CASoS Engineering Framework that grounds an engineering approach in the theory of complex adaptive systems of systems. Successful application of the CASoS Engineering Framework requires modeling, simulation and analysis (MS and A) capabilities and the cultivation of a CASoS Engineering Community of Practice through knowledge sharing and facilitation. The CASoS Engineering Environment, itself a complex adaptive system of systems, constitutes the two platforms that provide these capabilities.

  2. Scalable Harmonization of Complex Networks With Local Adaptive Controllers

    Czech Academy of Sciences Publication Activity Database

    Kárný, Miroslav; Herzallah, R.

    2017-01-01

    Roč. 47, č. 3 (2017), s. 394-404 ISSN 2168-2216 R&D Projects: GA ČR GA13-13502S Institutional support: RVO:67985556 Keywords : Adaptive control * Adaptive estimation * Bayes methods * Complex networks * Decentralized control * Fee dback * Fee dforward systems * Recursive estimation Subject RIV: BB - Applied Statistics, Operational Research OBOR OECD: Statistics and probability Impact factor: 2.350, year: 2016 http://library.utia.cas.cz/separaty/2016/AS/karny-0457337.pdf

  3. Adaptation.

    Science.gov (United States)

    Broom, Donald M

    2006-01-01

    The term adaptation is used in biology in three different ways. It may refer to changes which occur at the cell and organ level, or at the individual level, or at the level of gene action and evolutionary processes. Adaptation by cells, especially nerve cells helps in: communication within the body, the distinguishing of stimuli, the avoidance of overload and the conservation of energy. The time course and complexity of these mechanisms varies. Adaptive characters of organisms, including adaptive behaviours, increase fitness so this adaptation is evolutionary. The major part of this paper concerns adaptation by individuals and its relationships to welfare. In complex animals, feed forward control is widely used. Individuals predict problems and adapt by acting before the environmental effect is substantial. Much of adaptation involves brain control and animals have a set of needs, located in the brain and acting largely via motivational mechanisms, to regulate life. Needs may be for resources but are also for actions and stimuli which are part of the mechanism which has evolved to obtain the resources. Hence pigs do not just need food but need to be able to carry out actions like rooting in earth or manipulating materials which are part of foraging behaviour. The welfare of an individual is its state as regards its attempts to cope with its environment. This state includes various adaptive mechanisms including feelings and those which cope with disease. The part of welfare which is concerned with coping with pathology is health. Disease, which implies some significant effect of pathology, always results in poor welfare. Welfare varies over a range from very good, when adaptation is effective and there are feelings of pleasure or contentment, to very poor. A key point concerning the concept of individual adaptation in relation to welfare is that welfare may be good or poor while adaptation is occurring. Some adaptation is very easy and energetically cheap and

  4. Understanding sustainability from an exergetic frame in complex adaptive systems

    International Nuclear Information System (INIS)

    Aguilar Hernandez, Glem Alonso

    2017-01-01

    The concept of sustainability was developed from thermodynamic properties applied to complex adaptive systems. The origins of the perception about sustainable development and limitation in its application to analyze the interaction between a system and its surroundings were described. The properties of a complex adaptive system were taken as basis to determine how a system can to be affected by the resources restriction and irreversibility of the processes. The complex adaptive system was understood using the first and second law of thermodynamics, generating a conceptual framework to define the sustainability of a system. The contributions developed by exergy were shown to analyze the sustainability of systems in an economic, social and environmental context [es

  5. Systems thinking and complexity: considerations for health promoting schools.

    Science.gov (United States)

    Rosas, Scott R

    2017-04-01

    The health promoting schools concept reflects a comprehensive and integrated philosophy to improving student and personnel health and well-being. Conceptualized as a configuration of interacting, interdependent parts connected through a web of relationships that form a whole greater than the sum of its parts, school health promotion initiatives often target several levels (e.g. individual, professional, procedural and policy) simultaneously. Health promoting initiatives, such as those operationalized under the whole school approach, include several interconnected components that are coordinated to improve health outcomes in complex settings. These complex systems interventions are embedded in intricate arrangements of physical, biological, ecological, social, political and organizational relationships. Systems thinking and characteristics of complex adaptive systems are introduced in this article to provide a perspective that emphasizes the patterns of inter-relationships associated with the nonlinear, dynamic and adaptive nature of complex hierarchical systems. Four systems thinking areas: knowledge, networks, models and organizing are explored as a means to further manage the complex nature of the development and sustainability of health promoting schools. Applying systems thinking and insights about complex adaptive systems can illuminate how to address challenges found in settings with both complicated (i.e. multi-level and multisite) and complex aspects (i.e. synergistic processes and emergent outcomes). © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Adaptive generalized combination complex synchronization of uncertain real and complex nonlinear systems

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Shi-bing, E-mail: wang-shibing@dlut.edu.cn, E-mail: wangxy@dlut.edu.cn [School of Computer and Information Engineering, Fuyang Normal University, Fuyang 236041 (China); Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian 116024 (China); Wang, Xing-yuan, E-mail: wang-shibing@dlut.edu.cn, E-mail: wangxy@dlut.edu.cn [Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian 116024 (China); Wang, Xiu-you [School of Computer and Information Engineering, Fuyang Normal University, Fuyang 236041 (China); Zhou, Yu-fei [College of Electrical Engineering and Automation, Anhui University, Hefei 230601 (China)

    2016-04-15

    With comprehensive consideration of generalized synchronization, combination synchronization and adaptive control, this paper investigates a novel adaptive generalized combination complex synchronization (AGCCS) scheme for different real and complex nonlinear systems with unknown parameters. On the basis of Lyapunov stability theory and adaptive control, an AGCCS controller and parameter update laws are derived to achieve synchronization and parameter identification of two real drive systems and a complex response system, as well as two complex drive systems and a real response system. Two simulation examples, namely, ACGCS for chaotic real Lorenz and Chen systems driving a hyperchaotic complex Lü system, and hyperchaotic complex Lorenz and Chen systems driving a real chaotic Lü system, are presented to verify the feasibility and effectiveness of the proposed scheme.

  7. Adaptive control for a class of nonlinear complex dynamical systems with uncertain complex parameters and perturbations.

    Directory of Open Access Journals (Sweden)

    Jian Liu

    Full Text Available In this paper, adaptive control is extended from real space to complex space, resulting in a new control scheme for a class of n-dimensional time-dependent strict-feedback complex-variable chaotic (hyperchaotic systems (CVCSs in the presence of uncertain complex parameters and perturbations, which has not been previously reported in the literature. In detail, we have developed a unified framework for designing the adaptive complex scalar controller to ensure this type of CVCSs asymptotically stable and for selecting complex update laws to estimate unknown complex parameters. In particular, combining Lyapunov functions dependent on complex-valued vectors and back-stepping technique, sufficient criteria on stabilization of CVCSs are derived in the sense of Wirtinger calculus in complex space. Finally, numerical simulation is presented to validate our theoretical results.

  8. Adaptive control for a class of nonlinear complex dynamical systems with uncertain complex parameters and perturbations.

    Science.gov (United States)

    Liu, Jian; Liu, Kexin; Liu, Shutang

    2017-01-01

    In this paper, adaptive control is extended from real space to complex space, resulting in a new control scheme for a class of n-dimensional time-dependent strict-feedback complex-variable chaotic (hyperchaotic) systems (CVCSs) in the presence of uncertain complex parameters and perturbations, which has not been previously reported in the literature. In detail, we have developed a unified framework for designing the adaptive complex scalar controller to ensure this type of CVCSs asymptotically stable and for selecting complex update laws to estimate unknown complex parameters. In particular, combining Lyapunov functions dependent on complex-valued vectors and back-stepping technique, sufficient criteria on stabilization of CVCSs are derived in the sense of Wirtinger calculus in complex space. Finally, numerical simulation is presented to validate our theoretical results.

  9. Adaptation to High Ethanol Reveals Complex Evolutionary Pathways.

    Directory of Open Access Journals (Sweden)

    Karin Voordeckers

    2015-11-01

    Full Text Available Tolerance to high levels of ethanol is an ecologically and industrially relevant phenotype of microbes, but the molecular mechanisms underlying this complex trait remain largely unknown. Here, we use long-term experimental evolution of isogenic yeast populations of different initial ploidy to study adaptation to increasing levels of ethanol. Whole-genome sequencing of more than 30 evolved populations and over 100 adapted clones isolated throughout this two-year evolution experiment revealed how a complex interplay of de novo single nucleotide mutations, copy number variation, ploidy changes, mutator phenotypes, and clonal interference led to a significant increase in ethanol tolerance. Although the specific mutations differ between different evolved lineages, application of a novel computational pipeline, PheNetic, revealed that many mutations target functional modules involved in stress response, cell cycle regulation, DNA repair and respiration. Measuring the fitness effects of selected mutations introduced in non-evolved ethanol-sensitive cells revealed several adaptive mutations that had previously not been implicated in ethanol tolerance, including mutations in PRT1, VPS70 and MEX67. Interestingly, variation in VPS70 was recently identified as a QTL for ethanol tolerance in an industrial bio-ethanol strain. Taken together, our results show how, in contrast to adaptation to some other stresses, adaptation to a continuous complex and severe stress involves interplay of different evolutionary mechanisms. In addition, our study reveals functional modules involved in ethanol resistance and identifies several mutations that could help to improve the ethanol tolerance of industrial yeasts.

  10. On complex adaptive systems and terrorism [rapid communication

    Science.gov (United States)

    Ahmed, E.; Elgazzar, A. S.; Hegazi, A. S.

    2005-03-01

    Complex adaptive systems (CAS) are ubiquitous in nature. They are basic in social sciences. An overview of CAS is given with emphasize on the occurrence of bad side effects to seemingly “wise” decisions. Hence application to terrorism is given. Some conclusions on how to deal with this phenomena are proposed.

  11. Complexity Thinking in PE: Game-Centred Approaches, Games as Complex Adaptive Systems, and Ecological Values

    Science.gov (United States)

    Storey, Brian; Butler, Joy

    2013-01-01

    Background: This article draws on the literature relating to game-centred approaches (GCAs), such as Teaching Games for Understanding, and dynamical systems views of motor learning to demonstrate a convergence of ideas around games as complex adaptive learning systems. This convergence is organized under the title "complexity thinking"…

  12. Complexity in practice: understanding primary care as a complex adaptive system

    Directory of Open Access Journals (Sweden)

    Beverley Ellis

    2010-06-01

    Conclusions The results are real-world exemplars of the emergent properties of complex adaptive systems. Improving clinical governance in primary care requires both complex social interactions and underpinning informatics. The socio-technical lessons learned from this research should inform future management approaches.

  13. Promoting evaluation capacity building in a complex adaptive system.

    Science.gov (United States)

    Lawrenz, Frances; Kollmann, Elizabeth Kunz; King, Jean A; Bequette, Marjorie; Pattison, Scott; Nelson, Amy Grack; Cohn, Sarah; Cardiel, Christopher L B; Iacovelli, Stephanie; Eliou, Gayra Ostgaard; Goss, Juli; Causey, Lauren; Sinkey, Anne; Beyer, Marta; Francisco, Melanie

    2018-04-10

    This study provides results from an NSF funded, four year, case study about evaluation capacity building in a complex adaptive system, the Nanoscale Informal Science Education Network (NISE Net). The results of the Complex Adaptive Systems as a Model for Network Evaluations (CASNET) project indicate that complex adaptive system concepts help to explain evaluation capacity building in a network. The NISE Network was found to be a complex learning system that was supportive of evaluation capacity building through feedback loops that provided for information sharing and interaction. Participants in the system had different levels of and sources of evaluation knowledge. To be successful at building capacity, the system needed to have a balance between both centralized and decentralized control, coherence, redundancy, and diversity. Embeddedness of individuals within the system also provided support and moved the capacity of the system forward. Finally, success depended on attention being paid to the control of resources. Implications of these findings are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Risk-return relationship in a complex adaptive system.

    Directory of Open Access Journals (Sweden)

    Kunyu Song

    Full Text Available For survival and development, autonomous agents in complex adaptive systems involving the human society must compete against or collaborate with others for sharing limited resources or wealth, by using different methods. One method is to invest, in order to obtain payoffs with risk. It is a common belief that investments with a positive risk-return relationship (namely, high risk high return and vice versa are dominant over those with a negative risk-return relationship (i.e., high risk low return and vice versa in the human society; the belief has a notable impact on daily investing activities of investors. Here we investigate the risk-return relationship in a model complex adaptive system, in order to study the effect of both market efficiency and closeness that exist in the human society and play an important role in helping to establish traditional finance/economics theories. We conduct a series of computer-aided human experiments, and also perform agent-based simulations and theoretical analysis to confirm the experimental observations and reveal the underlying mechanism. We report that investments with a negative risk-return relationship have dominance over those with a positive risk-return relationship instead in such a complex adaptive systems. We formulate the dynamical process for the system's evolution, which helps to discover the different role of identical and heterogeneous preferences. This work might be valuable not only to complexity science, but also to finance and economics, to management and social science, and to physics.

  15. Risk-return relationship in a complex adaptive system.

    Science.gov (United States)

    Song, Kunyu; An, Kenan; Yang, Guang; Huang, Jiping

    2012-01-01

    For survival and development, autonomous agents in complex adaptive systems involving the human society must compete against or collaborate with others for sharing limited resources or wealth, by using different methods. One method is to invest, in order to obtain payoffs with risk. It is a common belief that investments with a positive risk-return relationship (namely, high risk high return and vice versa) are dominant over those with a negative risk-return relationship (i.e., high risk low return and vice versa) in the human society; the belief has a notable impact on daily investing activities of investors. Here we investigate the risk-return relationship in a model complex adaptive system, in order to study the effect of both market efficiency and closeness that exist in the human society and play an important role in helping to establish traditional finance/economics theories. We conduct a series of computer-aided human experiments, and also perform agent-based simulations and theoretical analysis to confirm the experimental observations and reveal the underlying mechanism. We report that investments with a negative risk-return relationship have dominance over those with a positive risk-return relationship instead in such a complex adaptive systems. We formulate the dynamical process for the system's evolution, which helps to discover the different role of identical and heterogeneous preferences. This work might be valuable not only to complexity science, but also to finance and economics, to management and social science, and to physics.

  16. Mycobacterium tuberculosis Complex Members Adapted to Wild and Domestic Animals.

    Science.gov (United States)

    Malone, Kerri M; Gordon, Stephen V

    2017-01-01

    The Mycobacterium tuberculosis complex (MTBC) is composed of several highly genetically related species that can be broadly classified into those that are human-host adapted and those that possess the ability to propagate and transmit in a variety of wild and domesticated animals. Since the initial description of the bovine tubercle bacillus, now known as Mycobacterium bovis, by Theobald Smith in the late 1800's, isolates originating from a wide range of animal hosts have been identified and characterized as M. microti, M. pinnipedii, the Dassie bacillus, M. mungi, M. caprae, M. orygis and M. suricattae. This chapter outlines the events resulting in the identification of each of these animal-adapted species, their close genetic relationships, and how genome-based phylogenetic analyses of species-specific variation amongst MTBC members is beginning to unravel the events that resulted in the evolution of the MTBC and the observed host tropism between the human- and animal-adapted member species.

  17. Evolutionary and adaptive learning in complex markets: a brief summary

    Science.gov (United States)

    Hommes, Cars H.

    2007-06-01

    We briefly review some work on expectations and learning in complex markets, using the familiar demand-supply cobweb model. We discuss and combine two different approaches on learning. According to the adaptive learning approach, agents behave as econometricians using time series observations to form expectations, and update the parameters as more observations become available. This approach has become popular in macro. The second approach has an evolutionary flavor and is sometimes referred to as reinforcement learning. Agents employ different forecasting strategies and evaluate these strategies based upon a fitness measure, e.g. past realized profits. In this framework, boundedly rational agents switch between different, but fixed behavioral rules. This approach has become popular in finance. We combine evolutionary and adaptive learning to model complex markets and discuss whether this theory can match empirical facts and forecasting behavior in laboratory experiments with human subjects.

  18. Complex adaptative systems and computational simulation in Archaeology

    Directory of Open Access Journals (Sweden)

    Salvador Pardo-Gordó

    2017-07-01

    Full Text Available Traditionally the concept of ‘complexity’ is used as a synonym for ‘complex society’, i.e., human groups with characteristics such as urbanism, inequalities, and hierarchy. The introduction of Nonlinear Systems and Complex Adaptive Systems to the discipline of archaeology has nuanced this concept. This theoretical turn has led to the rise of modelling as a method of analysis of historical processes. This work has a twofold objective: to present the theoretical current characterized by generative thinking in archaeology and to present a concrete application of agent-based modelling to an archaeological problem: the dispersal of the first ceramic production in the western Mediterranean.

  19. Mergers and acquisitions in professional organizations: a complex adaptive systems approach.

    Science.gov (United States)

    Walls, M E; McDaniel, R R

    1999-09-01

    Nurse managers face unique challenges as they cope with mergers and acquisitions among health care organizations. These challenges can be better understood if it is recognized that health care institutions are professional organizations and that the transformations required are extremely difficult. These difficulties are caused, in part, by the institutionalized nature of professional organizations, and this nature is explicated. Professional organizations are stubborn. They are repositories of expertise and values that are societal in origin and difficult to change. When professional organizations are understood as complex adaptive systems, complexity theory offers insight that provide strategies for managing mergers and acquisitions that may not be apparent when more traditional conceptualizations of professional organizations are used. Specific managerial techniques consistent with both the institutionalized characteristics and the complex adaptive systems characteristics of professional organizations are offered to nurse managers.

  20. Complex Environmental Data Modelling Using Adaptive General Regression Neural Networks

    Science.gov (United States)

    Kanevski, Mikhail

    2015-04-01

    The research deals with an adaptation and application of Adaptive General Regression Neural Networks (GRNN) to high dimensional environmental data. GRNN [1,2,3] are efficient modelling tools both for spatial and temporal data and are based on nonparametric kernel methods closely related to classical Nadaraya-Watson estimator. Adaptive GRNN, using anisotropic kernels, can be also applied for features selection tasks when working with high dimensional data [1,3]. In the present research Adaptive GRNN are used to study geospatial data predictability and relevant feature selection using both simulated and real data case studies. The original raw data were either three dimensional monthly precipitation data or monthly wind speeds embedded into 13 dimensional space constructed by geographical coordinates and geo-features calculated from digital elevation model. GRNN were applied in two different ways: 1) adaptive GRNN with the resulting list of features ordered according to their relevancy; and 2) adaptive GRNN applied to evaluate all possible models N [in case of wind fields N=(2^13 -1)=8191] and rank them according to the cross-validation error. In both cases training were carried out applying leave-one-out procedure. An important result of the study is that the set of the most relevant features depends on the month (strong seasonal effect) and year. The predictabilities of precipitation and wind field patterns, estimated using the cross-validation and testing errors of raw and shuffled data, were studied in detail. The results of both approaches were qualitatively and quantitatively compared. In conclusion, Adaptive GRNN with their ability to select features and efficient modelling of complex high dimensional data can be widely used in automatic/on-line mapping and as an integrated part of environmental decision support systems. 1. Kanevski M., Pozdnoukhov A., Timonin V. Machine Learning for Spatial Environmental Data. Theory, applications and software. EPFL Press

  1. A Memristor-Based Hyperchaotic Complex Lü System and Its Adaptive Complex Generalized Synchronization

    Directory of Open Access Journals (Sweden)

    Shibing Wang

    2016-02-01

    Full Text Available This paper introduces a new memristor-based hyperchaotic complex Lü system (MHCLS and investigates its adaptive complex generalized synchronization (ACGS. Firstly, the complex system is constructed based on a memristor-based hyperchaotic real Lü system, and its properties are analyzed theoretically. Secondly, its dynamical behaviors, including hyperchaos, chaos, transient phenomena, as well as periodic behaviors, are explored numerically by means of bifurcation diagrams, Lyapunov exponents, phase portraits, and time history diagrams. Thirdly, an adaptive controller and a parameter estimator are proposed to realize complex generalized synchronization and parameter identification of two identical MHCLSs with unknown parameters based on Lyapunov stability theory. Finally, the numerical simulation results of ACGS and its applications to secure communication are presented to verify the feasibility and effectiveness of the proposed method.

  2. Adaptive calibration method with on-line growing complexity

    Directory of Open Access Journals (Sweden)

    Šika Z.

    2011-12-01

    Full Text Available This paper describes a modified variant of a kinematical calibration algorithm. In the beginning, a brief review of the calibration algorithm and its simple modification are described. As the described calibration modification uses some ideas used by the Lolimot algorithm, the algorithm is described and explained. Main topic of this paper is a description of a synthesis of the Lolimot-based calibration that leads to an adaptive algorithm with an on-line growing complexity. The paper contains a comparison of simple examples results and a discussion. A note about future research topics is also included.

  3. Complex adaptive systems and game theory: An unlikely union

    Science.gov (United States)

    Hadzikadic, M.; Carmichael, T.; Curtin, C.

    2010-01-01

    A Complex Adaptive System is a collection of autonomous, heterogeneous agents, whose behavior is defined with a limited number of rules. A Game Theory is a mathematical construct that assumes a small number of rational players who have a limited number of actions or strategies available to them. The CAS method has the potential to alleviate some of the shortcomings of GT. On the other hand, CAS researchers are always looking for a realistic way to define interactions among agents. GT offers an attractive option for defining the rules of such interactions in a way that is both potentially consistent with observed real-world behavior and subject to mathematical interpretation. This article reports on the results of an effort to build a CAS system that utilizes GT for determining the actions of individual agents. ?? 2009 Wiley Periodicals, Inc. Complexity, 16,24-42, 2010.

  4. A computational framework for modeling targets as complex adaptive systems

    Science.gov (United States)

    Santos, Eugene; Santos, Eunice E.; Korah, John; Murugappan, Vairavan; Subramanian, Suresh

    2017-05-01

    Modeling large military targets is a challenge as they can be complex systems encompassing myriad combinations of human, technological, and social elements that interact, leading to complex behaviors. Moreover, such targets have multiple components and structures, extending across multiple spatial and temporal scales, and are in a state of change, either in response to events in the environment or changes within the system. Complex adaptive system (CAS) theory can help in capturing the dynamism, interactions, and more importantly various emergent behaviors, displayed by the targets. However, a key stumbling block is incorporating information from various intelligence, surveillance and reconnaissance (ISR) sources, while dealing with the inherent uncertainty, incompleteness and time criticality of real world information. To overcome these challenges, we present a probabilistic reasoning network based framework called complex adaptive Bayesian Knowledge Base (caBKB). caBKB is a rigorous, overarching and axiomatic framework that models two key processes, namely information aggregation and information composition. While information aggregation deals with the union, merger and concatenation of information and takes into account issues such as source reliability and information inconsistencies, information composition focuses on combining information components where such components may have well defined operations. Since caBKBs can explicitly model the relationships between information pieces at various scales, it provides unique capabilities such as the ability to de-aggregate and de-compose information for detailed analysis. Using a scenario from the Network Centric Operations (NCO) domain, we will describe how our framework can be used for modeling targets with a focus on methodologies for quantifying NCO performance metrics.

  5. On the adaptivity and complexity embedded into differential evolution

    International Nuclear Information System (INIS)

    Senkerik, Roman; Pluhacek, Michal; Jasek, Roman; Zelinka, Ivan

    2016-01-01

    This research deals with the comparison of the two modern approaches for evolutionary algorithms, which are the adaptivity and complex chaotic dynamics. This paper aims on the investigations on the chaos-driven Differential Evolution (DE) concept. This paper is aimed at the embedding of discrete dissipative chaotic systems in the form of chaotic pseudo random number generators for the DE and comparing the influence to the performance with the state of the art adaptive representative jDE. This research is focused mainly on the possible disadvantages and advantages of both compared approaches. Repeated simulations for Lozi map driving chaotic systems were performed on the simple benchmark functions set, which are more close to the real optimization problems. Obtained results are compared with the canonical not-chaotic and not adaptive DE. Results show that with used simple test functions, the performance of ChaosDE is better in the most cases than jDE and Canonical DE, furthermore due to the unique sequencing in CPRNG given by the hidden chaotic dynamics, thus better and faster selection of unique individuals from population, ChaosDE is faster.

  6. On the adaptivity and complexity embedded into differential evolution

    Science.gov (United States)

    Senkerik, Roman; Pluhacek, Michal; Zelinka, Ivan; Jasek, Roman

    2016-06-01

    This research deals with the comparison of the two modern approaches for evolutionary algorithms, which are the adaptivity and complex chaotic dynamics. This paper aims on the investigations on the chaos-driven Differential Evolution (DE) concept. This paper is aimed at the embedding of discrete dissipative chaotic systems in the form of chaotic pseudo random number generators for the DE and comparing the influence to the performance with the state of the art adaptive representative jDE. This research is focused mainly on the possible disadvantages and advantages of both compared approaches. Repeated simulations for Lozi map driving chaotic systems were performed on the simple benchmark functions set, which are more close to the real optimization problems. Obtained results are compared with the canonical not-chaotic and not adaptive DE. Results show that with used simple test functions, the performance of ChaosDE is better in the most cases than jDE and Canonical DE, furthermore due to the unique sequencing in CPRNG given by the hidden chaotic dynamics, thus better and faster selection of unique individuals from population, ChaosDE is faster.

  7. On the adaptivity and complexity embedded into differential evolution

    Energy Technology Data Exchange (ETDEWEB)

    Senkerik, Roman; Pluhacek, Michal; Jasek, Roman [Tomas Bata University in Zlin, Faculty of Applied Informatics, Nam T.G. Masaryka 5555, 760 01 Zlin, Czech Republic, senkerik@fai.utb.cz,pluhacek@fai.utb.cz (Czech Republic); Zelinka, Ivan [Technical University of Ostrava, Faculty of Electrical Engineering and Computer Science, 17. listopadu 15,708 33 Ostrava-Poruba, Czech Republic, ivan.zelinka@vsb.cz (Czech Republic)

    2016-06-08

    This research deals with the comparison of the two modern approaches for evolutionary algorithms, which are the adaptivity and complex chaotic dynamics. This paper aims on the investigations on the chaos-driven Differential Evolution (DE) concept. This paper is aimed at the embedding of discrete dissipative chaotic systems in the form of chaotic pseudo random number generators for the DE and comparing the influence to the performance with the state of the art adaptive representative jDE. This research is focused mainly on the possible disadvantages and advantages of both compared approaches. Repeated simulations for Lozi map driving chaotic systems were performed on the simple benchmark functions set, which are more close to the real optimization problems. Obtained results are compared with the canonical not-chaotic and not adaptive DE. Results show that with used simple test functions, the performance of ChaosDE is better in the most cases than jDE and Canonical DE, furthermore due to the unique sequencing in CPRNG given by the hidden chaotic dynamics, thus better and faster selection of unique individuals from population, ChaosDE is faster.

  8. Complexity in organizations and environment - adaptive changes and adaptive decision-making

    Directory of Open Access Journals (Sweden)

    Robert Fabac

    2010-07-01

    Full Text Available The features of complexity are ever more present in modern organizations and in environments in which they operate, trying to survive and be as competitive as possible. In the processes of, the so-called emergence, the formal organizational structure, designed purposefully and with a plan, is going through a change due to complexity and the need for adaptation. As a result, there is a variety of new informal groups. At the same time, the intended structural changes and business process changes occur because of the perception that the leadership and senior organizational management have of the strategic situation. Managers in modern organizations often use business intelligence (BI systems when making important business decisions. These systems offer support to the decision-making by gathering and processing relevant data and information about the company performance, but also about the data on conditions in close and remote environment. A modern company is characterized by the complex adaptive system, but the environment in which it operates together with other business subjects (agents is also complex. Consequently, the requirements for appropriate or optimal decisions and successfully completed activities are hard to meet. Given that expected future events and circumstances often occur in nonlinear mechanisms, the decisions made by following the models of traditional predicting and planning are not satisfactory. This calls for new approaches to decision making and acting.

  9. Analyzing Katana referral hospital as a complex adaptive system: agents, interactions and adaptation to a changing environment.

    Science.gov (United States)

    Karemere, Hermès; Ribesse, Nathalie; Marchal, Bruno; Macq, Jean

    2015-01-01

    This study deals with the adaptation of Katana referral hospital in Eastern Democratic Republic of Congo in a changing environment that is affected for more than a decade by intermittent armed conflicts. His objective is to generate theoretical proposals for addressing differently the analysis of hospitals governance in the aims to assess their performance and how to improve that performance. The methodology applied approach uses a case study using mixed methods ( qualitative and quantitative) for data collection. It uses (1) hospital data to measure the output of hospitals, (2) literature review to identify among others, events and interventions recorded in the history of hospital during the study period and (3) information from individual interviews to validate the interpretation of the results of the previous two sources of data and understand the responsiveness of management team referral hospital during times of change. The study brings four theoretical propositions: (1) Interaction between key agents is a positive force driving adaptation if the actors share a same vision, (2) The strength of the interaction between agents is largely based on the nature of institutional arrangements, which in turn are shaped by the actors themselves, (3) The owner and the management team play a decisive role in the implementation of effective institutional arrangements and establishment of positive interactions between agents, (4) The analysis of recipient population's perception of health services provided allow to better tailor and adapt the health services offer to the population's needs and expectations. Research shows that it isn't enough just to provide support (financial and technical), to manage a hospital for operate and adapt to a changing environment but must still animate, considering that it is a complex adaptive system and that this animation is nothing other than the induction of a positive interaction between agents.

  10. Complexity and Health Coaching: Synergies in Nursing

    Directory of Open Access Journals (Sweden)

    Gail J. Mitchell

    2013-01-01

    Full Text Available Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons’ lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living.

  11. Adapting APSIM to model the physiology and genetics of complex adaptive traits in field crops.

    Science.gov (United States)

    Hammer, Graeme L; van Oosterom, Erik; McLean, Greg; Chapman, Scott C; Broad, Ian; Harland, Peter; Muchow, Russell C

    2010-05-01

    Progress in molecular plant breeding is limited by the ability to predict plant phenotype based on its genotype, especially for complex adaptive traits. Suitably constructed crop growth and development models have the potential to bridge this predictability gap. A generic cereal crop growth and development model is outlined here. It is designed to exhibit reliable predictive skill at the crop level while also introducing sufficient physiological rigour for complex phenotypic responses to become emergent properties of the model dynamics. The approach quantifies capture and use of radiation, water, and nitrogen within a framework that predicts the realized growth of major organs based on their potential and whether the supply of carbohydrate and nitrogen can satisfy that potential. The model builds on existing approaches within the APSIM software platform. Experiments on diverse genotypes of sorghum that underpin the development and testing of the adapted crop model are detailed. Genotypes differing in height were found to differ in biomass partitioning among organs and a tall hybrid had significantly increased radiation use efficiency: a novel finding in sorghum. Introducing these genetic effects associated with plant height into the model generated emergent simulated phenotypic differences in green leaf area retention during grain filling via effects associated with nitrogen dynamics. The relevance to plant breeding of this capability in complex trait dissection and simulation is discussed.

  12. Cross-cultural Adaptation and Validation of the Medication Regimen Complexity Index Adapted to Spanish.

    Science.gov (United States)

    Saez de la Fuente, Javier; Such Diaz, Ana; Cañamares-Orbis, Irene; Ramila, Estela; Izquierdo-Garcia, Elsa; Esteban, Concepcion; Escobar-Rodríguez, Ismael

    2016-11-01

    The most widely used validated instrument to assess the complexity of medication regimens is the Medication Regimen Complexity Index (MRCI). This study aimed to translate, adapt, and validate a reliable version of the MRCI adapted to Spanish (MRCI-E). The cross-cultural adaptation process consisted of an independent translation by 3 clinical pharmacists and a backtranslation by 2 native English speakers. A reliability analysis was conducted on 20 elderly randomly selected patients. Two clinical pharmacists calculated the MRCI-E from discharge treatments and 2 months later. For the validity analysis, the sample was augmented to 60 patients. Convergent validity was assessed by analyzing the correlation between the number of medications; discriminant validity was stratified by gender; and predictive validity was determined by analyzing the ability to predict readmission and mortality at 3 and 6 months. The MRCI-E retained the original structure of 3 sections. The reliability analysis demonstrated an excellent internal consistency (Cronbach's α=0.83), and the intraclass correlation coefficient exceeded 0.9 in all cases. The correlation coefficient with the number of medications was 0.883 ( Pdifferences were found when stratified by gender (3.6; 95%CI=-2.9 to 10.2; P=0.27). Patients who were readmitted at 3 months had a higher MRCI-E score (10.7; 95%CI=4.4 to 17.2; P=0.001). The differences remained significant in patients readmitted at 6 months, but differences in mortality were not detected. The MRCI-E retains the reliability and validity of the original index and provides a suitable tool to assess the complexity of medication regimens in Spanish.

  13. An adaptive routing strategy for packet delivery in complex networks

    International Nuclear Information System (INIS)

    Zhang, Huan; Liu, Zonghua; Tang, Ming; Hui, P.M.

    2007-01-01

    We present an efficient routing approach for delivering packets in complex networks. On delivering a message from a node to a destination, a node forwards the message to a neighbor by estimating the waiting time along the shortest path from each of its neighbors to the destination. This projected waiting time is dynamical in nature and the path through which a message is delivered would be adapted to the distribution of messages in the network. Implementing the approach on scale-free networks, we show that the present approach performs better than the shortest-path approach and another approach that takes into account of the waiting time only at the neighboring nodes. Key features in numerical results are explained by a mean field theory. The approach has the merit that messages are distributed among the nodes according to the capabilities of the nodes in handling messages

  14. The Cultural Historical Complexity of Human Personality Adaptation

    Directory of Open Access Journals (Sweden)

    Melissa E. Wynn

    2012-10-01

    Full Text Available Research on implicit intelligence has conceptualized students’ beliefs about the nature of intelligence as either fixed or malleable. This research has largely not included African American adolescents, a group for whom beliefs about intelligence have a cultural historical complexity related to both scientific racism and master narratives of race and intelligence. The purpose of this study was to investigate the nature of implicit theories of intelligence for 63 African American adolescents who are seventh and eighth graders in a public charter school. The two-way ANOVA revealed that these adolescents held a malleable view of intelligence, which did not vary by gender or grade. Exploratory correlation analysis showed some consistent relationships with achievement motivation variables found in other studies. These findings may be explained by African American cultural values and the personality characteristic adaptations that they make living within a racialized society.

  15. Public Health Adaptation to Climate Change in Canadian Jurisdictions

    Directory of Open Access Journals (Sweden)

    Stephanie E. Austin

    2015-01-01

    Full Text Available Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting autonomously.

  16. Public Health Adaptation to Climate Change in Canadian Jurisdictions

    Science.gov (United States)

    Austin, Stephanie E.; Ford, James D.; Berrang-Ford, Lea; Araos, Malcolm; Parker, Stephen; Fleury, Manon D.

    2015-01-01

    Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously. PMID:25588156

  17. Public Health Adaptation to Climate Change in OECD Countries.

    Science.gov (United States)

    Austin, Stephanie E; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D; Parker, Stephen; Fleury, Manon D

    2016-09-07

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will-or should-include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation-cross-sectoral collaboration, vertical coordination and national health adaptation planning-and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning.

  18. Temporal dark adaptation to spatially complex backgrounds : effect of an additional light source

    NARCIS (Netherlands)

    Stokkermans, M.G.M.; Heynderickx, I.E.J.

    2014-01-01

    Visual adaptation (and especially dark adaptation) has been studied extensively in the past, however, mainly addressing adaptation to fully dark backgrounds. At this stage, it is unclear whether these results are not too simple to be applied to complex situations, such as predicting adaptation of a

  19. Public Health Adaptation to Climate Change in OECD Countries

    Science.gov (United States)

    Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

    2016-01-01

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation—cross-sectoral collaboration, vertical coordination and national health adaptation planning—and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning. PMID:27618074

  20. Public Health Climate Change Adaptation Planning Using Stakeholder Feedback.

    Science.gov (United States)

    Eidson, Millicent; Clancy, Kathleen A; Birkhead, Guthrie S

    2016-01-01

    Public health climate change adaptation planning is an urgent priority requiring stakeholder feedback. The 10 Essential Public Health Services can be applied to adaptation activities. To develop a state health department climate and health adaptation plan as informed by stakeholder feedback. With Centers for Disease Control and Prevention (CDC) funding, the New York State Department of Health (NYSDOH) implemented a 2010-2013 climate and health planning process, including 7 surveys on perceptions and adaptation priorities. New York State Department of Health program managers participated in initial (n = 41, denominator unknown) and follow-up (72.2%) needs assessments. Surveillance system information was collected from 98.1% of surveillance system managers. For adaptation prioritization surveys, participants included 75.4% of NYSDOH leaders; 60.3% of local health departments (LHDs); and 53.7% of other stakeholders representing environmental, governmental, health, community, policy, academic, and business organizations. Interviews were also completed with 38.9% of other stakeholders. In 2011 surveys, 34.1% of state health program directors believed that climate change would impact their program priorities. However, 84.6% of state health surveillance system managers provided ideas for using databases for climate and health monitoring/surveillance. In 2012 surveys, 46.5% of state health leaders agreed they had sufficient information about climate and health compared to 17.1% of LHDs (P = .0046) and 40.9% of other stakeholders (nonsignificant difference). Significantly fewer (P climate and health into planning compared to state health leaders (55.8%) and other stakeholders (68.2%). Stakeholder groups agreed on the 4 highest priority adaptation categories including core public health activities such as surveillance, coordination/collaboration, education, and policy development. Feedback from diverse stakeholders was utilized by NYSDOH to develop its Climate and Health

  1. Adaptive Surface Modeling of Soil Properties in Complex Landforms

    Directory of Open Access Journals (Sweden)

    Wei Liu

    2017-06-01

    Full Text Available Abstract: Spatial discontinuity often causes poor accuracy when a single model is used for the surface modeling of soil properties in complex geomorphic areas. Here we present a method for adaptive surface modeling of combined secondary variables to improve prediction accuracy during the interpolation of soil properties (ASM-SP. Using various secondary variables and multiple base interpolation models, ASM-SP was used to interpolate soil K+ in a typical complex geomorphic area (Qinghai Lake Basin, China. Five methods, including inverse distance weighting (IDW, ordinary kriging (OK, and OK combined with different secondary variables (e.g., OK-Landuse, OK-Geology, and OK-Soil, were used to validate the proposed method. The mean error (ME, mean absolute error (MAE, root mean square error (RMSE, mean relative error (MRE, and accuracy (AC were used as evaluation indicators. Results showed that: (1 The OK interpolation result is spatially smooth and has a weak bull's-eye effect, and the IDW has a stronger ‘bull’s-eye’ effect, relatively. They both have obvious deficiencies in depicting spatial variability of soil K+. (2 The methods incorporating combinations of different secondary variables (e.g., ASM-SP, OK-Landuse, OK-Geology, and OK-Soil were associated with lower estimation bias. Compared with IDW, OK, OK-Landuse, OK-Geology, and OK-Soil, the accuracy of ASM-SP increased by 13.63%, 10.85%, 9.98%, 8.32%, and 7.66%, respectively. Furthermore, ASM-SP was more stable, with lower MEs, MAEs, RMSEs, and MREs. (3 ASM-SP presents more details than others in the abrupt boundary, which can render the result consistent with the true secondary variables. In conclusion, ASM-SP can not only consider the nonlinear relationship between secondary variables and soil properties, but can also adaptively combine the advantages of multiple models, which contributes to making the spatial interpolation of soil K+ more reasonable.

  2. Zoonoses, One Health and complexity: wicked problems and constructive conflict.

    Science.gov (United States)

    Waltner-Toews, David

    2017-07-19

    Infectious zoonoses emerge from complex interactions among social and ecological systems. Understanding this complexity requires the accommodation of multiple, often conflicting, perspectives and narratives, rooted in different value systems and temporal-spatial scales. Therefore, to be adaptive, successful and sustainable, One Health approaches necessarily entail conflicts among observers, practitioners and scholars. Nevertheless, these integrative approaches have, both implicitly and explicitly, tended to marginalize some perspectives and prioritize others, resulting in a kind of technocratic tyranny. An important function of One Health approaches should be to facilitate and manage those conflicts, rather than to impose solutions.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.

  3. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A

    2012-06-01

    Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

  4. Adaptation to climate change in the Ontario public health sector

    Science.gov (United States)

    2012-01-01

    Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs

  5. The Complex Relationship Between Diet And Health.

    Science.gov (United States)

    Bleich, Sara N; Jones-Smith, Jessica; Wolfson, Julia A; Zhu, Xiaozhou; Story, Mary

    2015-11-01

    The relationship between food and health is complex. Everyone needs food to live, but too little food, too much food, or the wrong type of food has negative consequences for health. To increase understanding of this relationship, we describe trends and patterns in food-related diseases among both adults and children. Using an ecological framework, we then describe why food intake is complex with a discussion of three broad levels--macro (including policy and social-cultural norms), local community, and individual environments--and their relationship to food consumption. Given the strong relationship between an individual's food choice and his or her surrounding environment, we end with examples of policy responses that aim to help people overcome environmental disincentives toward healthy eating. Finding ways to make eating healthfully easier and affordable for all populations is essential to shifting the average American diet toward one that promotes health. Project HOPE—The People-to-People Health Foundation, Inc.

  6. Modeling Stochastic Complexity in Complex Adaptive Systems: Non-Kolmogorov Probability and the Process Algebra Approach.

    Science.gov (United States)

    Sulis, William H

    2017-10-01

    Walter Freeman III pioneered the application of nonlinear dynamical systems theories and methodologies in his work on mesoscopic brain dynamics.Sadly, mainstream psychology and psychiatry still cling to linear correlation based data analysis techniques, which threaten to subvert the process of experimentation and theory building. In order to progress, it is necessary to develop tools capable of managing the stochastic complexity of complex biopsychosocial systems, which includes multilevel feedback relationships, nonlinear interactions, chaotic dynamics and adaptability. In addition, however, these systems exhibit intrinsic randomness, non-Gaussian probability distributions, non-stationarity, contextuality, and non-Kolmogorov probabilities, as well as the absence of mean and/or variance and conditional probabilities. These properties and their implications for statistical analysis are discussed. An alternative approach, the Process Algebra approach, is described. It is a generative model, capable of generating non-Kolmogorov probabilities. It has proven useful in addressing fundamental problems in quantum mechanics and in the modeling of developing psychosocial systems.

  7. Adaptive Asymptotical Synchronization for Stochastic Complex Networks with Time-Delay and Markovian Switching

    Directory of Open Access Journals (Sweden)

    Xueling Jiang

    2014-01-01

    Full Text Available The problem of adaptive asymptotical synchronization is discussed for the stochastic complex dynamical networks with time-delay and Markovian switching. By applying the stochastic analysis approach and the M-matrix method for stochastic complex networks, several sufficient conditions to ensure adaptive asymptotical synchronization for stochastic complex networks are derived. Through the adaptive feedback control techniques, some suitable parameters update laws are obtained. Simulation result is provided to substantiate the effectiveness and characteristics of the proposed approach.

  8. Teaching Genetic Counseling Skills: Incorporating a Genetic Counseling Adaptation Continuum Model to Address Psychosocial Complexity.

    Science.gov (United States)

    Shugar, Andrea

    2017-04-01

    Genetic counselors are trained health care professionals who effectively integrate both psychosocial counseling and information-giving into their practice. Preparing genetic counseling students for clinical practice is a challenging task, particularly when helping them develop effective and active counseling skills. Resistance to incorporating these skills may stem from decreased confidence, fear of causing harm or a lack of clarity of psycho-social goals. The author reflects on the personal challenges experienced in teaching genetic counselling students to work with psychological and social complexity, and proposes a Genetic Counseling Adaptation Continuum model and methodology to guide students in the use of advanced counseling skills.

  9. [The dimension of the paradigm of complexity in health systems].

    Science.gov (United States)

    Fajardo-Ortiz, Guillermo; Fernández-Ortega, Miguel Ángel; Ortiz-Montalvo, Armando; Olivares-Santos, Roberto Antonio

    2015-01-01

    This article presents elements to better understand health systems from the complety paradigm, innovative perspective that offers other ways in the conception of the scientific knowledge prevalent away from linear, characterized by the arise of emerging dissociative and behaviors, based on the intra and trans-disciplinarity concepts such knowledges explain and understand in a different way what happens in the health systems with a view to efficiency and effectiveness. The complexity paradigm means another way of conceptualizing the knowledge, is different from the prevalent epistemology, is still under construction does not separate, not isolated, is not reductionist, or fixed, does not solve the problems, but gives other bases to know them and study them, is a different strategy, a perspective that has basis in the systems theory, informatics and cybernetics beyond traditional knowledge, the positive logics, the newtonian physics and symmetric mathematics, in which everything is centered and balanced, joint the "soft sciences and hard sciences", it has present the Social Determinants of Health and organizational culture. Under the complexity paradigm the health systems are identified with the following concepts: entropy, neguentropy, the thermodynamic second law, attractors, chaos theory, fractals, selfmanagement and self-organization, emerging behaviors, percolation, uncertainty, networks and robusteness; such expressions open new possibilities to improve the management and better understanding of the health systems, giving rise to consider health systems as complex adaptive systems. Copyright © 2015. Published by Masson Doyma México S.A.

  10. Command Resiliency: An Adaptive Response Strategy for Complex Incidents

    National Research Council Canada - National Science Library

    Pfeifer, Joseph W

    2005-01-01

    .... Unless organizations develop a resilient response strategy that can adapt organizational and operational elements to respond to new terrorist incidents, they will find themselves with the same...

  11. Complex adaptive strategy to produce capacity-driven financial improvement.

    Science.gov (United States)

    Capuano, Terry; MacKenzie, Richard; Pintar, Kristi; Halkins, Deborah; Nester, Brian

    2009-01-01

    Managing capacity in hospitals and emergency departments (EDs) is a global problem. This article demonstrates an efficiency model applied to an acute care hospital facing a budget shortfall as a result of capacity constraints that negatively affected admissions and increased ED diversions. Operating on the hypothesis that reducing inpatient length of stay would allow patients access through all service points and would return the admissions growth rate to budget, a turnaround team was quickly assembled and charged by the chief executive officer to fix the primary cause of financial underperformance--the creeping length of stay--within 60 days. This case study is generalizable to all organizations, regardless of size. Deploying an efficiency model based on the complex adaptive systems approach of "swarmware," the hospital's rapid turnaround efforts produced the results necessary to achieve two established goals: (1) length of stay was decreased to 0.1 days below budget in the 60-day time frame, and (2) all admissions and potential admissions were accepted (saying "yes" to patients) through key points of access in the hospital. Transfer Center denials were reduced to 0 in 19 days, and monthly ED diversions decreased from 110 hours to 20 hours in 60 days. By using a swarmware approach, the hospital created additional bed capacity, allowing for community demand to be accommodated, budgeted admissions target to be exceeded, and market share to be stabilized. This article describes this project's processes and outcomes and the lessons learned and applied, which will assist healthcare leaders who are facing capacity issues in their own organization.

  12. Managing interoperability and complexity in health systems.

    Science.gov (United States)

    Bouamrane, M-M; Tao, C; Sarkar, I N

    2015-01-01

    In recent years, we have witnessed substantial progress in the use of clinical informatics systems to support clinicians during episodes of care, manage specialised domain knowledge, perform complex clinical data analysis and improve the management of health organisations' resources. However, the vision of fully integrated health information eco-systems, which provide relevant information and useful knowledge at the point-of-care, remains elusive. This journal Focus Theme reviews some of the enduring challenges of interoperability and complexity in clinical informatics systems. Furthermore, a range of approaches are proposed in order to address, harness and resolve some of the many remaining issues towards a greater integration of health information systems and extraction of useful or new knowledge from heterogeneous electronic data repositories.

  13. HEALTH TECHNOLOGIES FOR INCREASING ADAPTIVE CAPABILITIESOF PREGNANT WOMEN

    Directory of Open Access Journals (Sweden)

    T. S. Krivonogova

    2014-01-01

    trimester of pregnancy it were identified lower rates of lipid peroxidation compared with those observed during pregnancy in the usual way (control group, which corresponded to women's health indicators. At the same time in the third trimester of pregnancy it was found a significant increase in the concentration of vitamin E in the blood serum of women from the main group compared to the control group (p < 0.001.The complex of breathing exercises and aqua-gymnastics have a stimulating effect on metabolism, thereby it normalizes the level of antioxidant enzyme. During the breathing exercises process a direct correlation was revealed between the level of MDA and cortisol (r = 0.67 and between vitamin E and insulin (r = 0.61. These data allow suggesting the prospects for determining the concentration of MDA and vitamin E in the peripheral blood of pregnant women to determine the adaptive capability of the organism and the favorable course of pregnancy and childbirth.It is possible that the complex of adaptive respiratory and aqua-gymnastics performing by pregnant women promotes more intensive penetration of oxygen from the blood to tissue, which leads to better oxidation of the substrate and hence reduce the concentration of MDA in women of main group. Timely addition of breathing exercises complex during pregnancy, as well as aqua-gymnastics, promotes restoration of redox enzymatic processes in the tissues, leading to improved utilization of fetal oxygen; contributes to Verigo–Bohr strengthening effect, intensive penetration of oxygen from the blood into tissues, resulting in the release of carbon dioxide. Accumulated carbon dioxide promotes active oxygen transportation to the fetus and increases the adaptive capabilities of the organism.Thus, the experience of working with groups of pregnant women with somatic pathology and prenatal risk factors, allowed us to estimate the effectiveness of breathing exercises combined with aqua-gymnastics and develop a more

  14. Adapting to the effects of climate change on Inuit health.

    Science.gov (United States)

    Ford, James D; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-06-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks-one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context.

  15. Adapting to the Effects of Climate Change on Inuit Health

    Science.gov (United States)

    Ford, James D.; Willox, Ashlee Cunsolo; Chatwood, Susan; Furgal, Christopher; Harper, Sherilee; Mauro, Ian; Pearce, Tristan

    2014-01-01

    Climate change will have far-reaching implications for Inuit health. Focusing on adaptation offers a proactive approach for managing climate-related health risks—one that views Inuit populations as active agents in planning and responding at household, community, and regional levels. Adaptation can direct attention to the root causes of climate vulnerability and emphasize the importance of traditional knowledge regarding environmental change and adaptive strategies. An evidence base on adaptation options and processes for Inuit regions is currently lacking, however, thus constraining climate policy development. In this article, we tackled this deficit, drawing upon our understanding of the determinants of health vulnerability to climate change in Canada to propose key considerations for adaptation decision-making in an Inuit context. PMID:24754615

  16. Embedding research in health systems: lessons from complexity theory.

    Science.gov (United States)

    Caffrey, Louise; Wolfe, Charles; McKevitt, Christopher

    2016-07-22

    Internationally, there has been increasing focus on creating health research systems. This article aims to investigate the challenges of implementing apparently simple strategies to support the development of a health research system. We focus on a case study of an English National Health Service Hospital Trust that sought to implement the national recommendation that health organisations should introduce a statement about research on all patient admission letters. We apply core concepts from complexity theory to the case study and undertake a documentary analysis of the email dialogue between staff involved in implementing this initiative. The process of implementing a research statement in patient admission letters in one clinical service took 1 year and 21 days. The length of time needed was influenced firstly by adaptive self-organisation, underpinned by competing interests. Secondly, it was influenced by the relationship between systems, rather than simply being a product of issues within those systems. The relationship between the health system and the research system was weaker than might have been expected. Responsibilities were unclear, leading to confusion and delayed action. Conventional ways of thinking about organisations suggest that change happens when leaders and managers change the strategic vision, structure or procedures in an organisation and then persuade others to rationally implement the strategy. However, health research systems are complex adaptive systems characterised by high levels of unpredictability due to self-organisation and systemic interactions, which give rise to 'emergent' properties. We argue for the need to study how micro-processes of organisational dynamics may give rise to macro patterns of behaviour and strategic organisational direction and for the use of systems approaches to investigate the emergent properties of health research systems.

  17. Factors Influencing Adaptation and Performance at Physical Exercise in Complex Congenital Heart Diseases after Surgical Repair

    Directory of Open Access Journals (Sweden)

    P. P. Bassareo

    2014-01-01

    Full Text Available In the last thirty years, steady progress in the diagnostic tools and care of subjects affected by congenital heart diseases (CHD has resulted in a significant increase in their survival to adulthood, even for those affected by complex CHD. Based on these premises, a number of teenagers and adults affected by corrected (surgically or through interventional techniques CHD ask to be allowed to undertake sporting activities, both at a recreational and competitive level. The purpose of this review is to examine the mechanisms influencing the adaption at physical exercise of patients suffering from complex CHD. The conclusion is that even if there are some modest risks with exercise, they should be seen in perspective, and the life-long benefits of regular exercise on general health, mood, and well-being should be emphasized.

  18. A Bacterial-Based Algorithm to Simulate Complex Adaptative Systems

    OpenAIRE

    González Rodríguez, Diego; Hernández Carrión, José Rodolfo

    2014-01-01

    Paper presented at the 13th International Conference on Simulation of Adaptive Behavior which took place at Castellón, Spain in 2014, July 22-25. Bacteria have demonstrated an amazing capacity to overcome envi-ronmental changes by collective adaptation through genetic exchanges. Using a distributed communication system and sharing individual strategies, bacteria propagate mutations as innovations that allow them to survive in different envi-ronments. In this paper we present an agent-based...

  19. Conceptualising population health: from mechanistic thinking to complexity science

    Directory of Open Access Journals (Sweden)

    Jayasinghe Saroj

    2011-01-01

    Full Text Available Abstract The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS. The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.

  20. Conceptualising population health: from mechanistic thinking to complexity science.

    Science.gov (United States)

    Jayasinghe, Saroj

    2011-01-20

    The mechanistic interpretation of reality can be traced to the influential work by René Descartes and Sir Isaac Newton. Their theories were able to accurately predict most physical phenomena relating to motion, optics and gravity. This paradigm had at least three principles and approaches: reductionism, linearity and hierarchy. These ideas appear to have influenced social scientists and the discourse on population health. In contrast, Complexity Science takes a more holistic view of systems. It views natural systems as being 'open', with fuzzy borders, constantly adapting to cope with pressures from the environment. These are called Complex Adaptive Systems (CAS). The sub-systems within it lack stable hierarchies, and the roles of agency keep changing. The interactions with the environment and among sub-systems are non-linear interactions and lead to self-organisation and emergent properties. Theoretical frameworks such as epi+demos+cracy and the ecosocial approach to health have implicitly used some of these concepts of interacting dynamic sub-systems. Using Complexity Science we can view population health outcomes as an emergent property of CAS, which has numerous dynamic non-linear interactions among its interconnected sub-systems or agents. In order to appreciate these sub-systems and determinants, one should acquire a basic knowledge of diverse disciplines and interact with experts from different disciplines. Strategies to improve health should be multi-pronged, and take into account the diversity of actors, determinants and contexts. The dynamic nature of the system requires that the interventions are constantly monitored to provide early feedback to a flexible system that takes quick corrections.

  1. The exocyst complex in health and disease

    Directory of Open Access Journals (Sweden)

    Magdanela eMartin-Urdiroz

    2016-04-01

    Full Text Available Exocytosis involves the fusion of intracellular secretory vesicles with the PM, thereby delivering integral membrane proteins to the cell surface and releasing material into the extracellular space. Importantly, exocytosis also provides a source of lipid moieties for membrane extension. The tethering of the secretory vesicle before docking and fusion with the PM is mediated by the exocyst complex, an evolutionary conserved octameric complex of proteins. Recent findings indicate that the exocyst complex also takes part in other intra-cellular processes besides secretion. These various functions seem to converge towards defining a direction of membrane growth in a range of systems from fungi to plants and from neurons to cilia. In this review we summarise the current knowledge of exocyst function in cell polarity, signalling and cell-cell communication and discuss implications for plant and animal health and disease.

  2. Novel hybrid adaptive controller for manipulation in complex perturbation environments.

    Directory of Open Access Journals (Sweden)

    Alex M C Smith

    Full Text Available In this paper we present a hybrid control scheme, combining the advantages of task-space and joint-space control. The controller is based on a human-like adaptive design, which minimises both control effort and tracking error. Our novel hybrid adaptive controller has been tested in extensive simulations, in a scenario where a Baxter robot manipulator is affected by external disturbances in the form of interaction with the environment and tool-like end-effector perturbations. The results demonstrated improved performance in the hybrid controller over both of its component parts. In addition, we introduce a novel method for online adaptation of learning parameters, using the fuzzy control formalism to utilise expert knowledge from the experimenter. This mechanism of meta-learning induces further improvement in performance and avoids the need for tuning through trial testing.

  3. Analysing a Chinese Regional Integrated Healthcare Organisation Reform Failure using a Complex Adaptive System Approach

    Directory of Open Access Journals (Sweden)

    Wenxi Tang

    2017-06-01

    Full Text Available Introduction: China’s organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS provides a new perspective and methodology for analysing the health system and policy implementation.  Methods: We observed the typical case of Qianjiang’s Integrated Health Organization Reform (IHO for 2 years to analyse integrated care reforms using CAS theory. Via questionnaires and interviews, we observed 32 medical institutions and 344 professionals. We compared their cooperative behaviours from both organisational and inter-professional levels between 2013 and 2015, and further investigated potential reasons for why medical institutions and professionals did not form an effective IHO. We discovered how interested parties in the policy implementation process influenced reform outcome, and by theoretical induction, proposed a new semi-organised system and corresponding policy analysis flowchart that potentially suits the actual realisation of CAS.  Results: The reform did not achieve its desired effect. The Qianjiang IHO was loosely integrated rather than closely integrated, and the cooperation levels between organisations and professionals were low. This disappointing result was due to low mutual trust among IHO members, with the main contributing factors being insufficient financial incentives and the lack of a common vision.  Discussion and Conclusions: The traditional 'organised health system' is old-fashioned. Rather than being completely organised or adaptive, the health system is currently more similar to a s'emi-organised system'. Medical institutions and professionals operate in a middle ground between complete adherence

  4. The adaptation process of mothers raising a child with complex congenital heart disease.

    Science.gov (United States)

    Ahn, Jeong-Ah; Lee, Sunhee

    2018-01-01

    Mothers of children with congenital heart disease (CHD) tend to be concerned about their child's normal life. The majority of these mothers tend to experience negative psychological problems. In this study, the adaptation process of mothers raising a child with complex CHD was investigated based on the sociocultural context of Korea. The data collection was conducted by in-depth interviews and theoretical sampling was performed until the data were saturated. The collected data were analyzed using continuous theoretical comparisons. The results of the present study showed that the core category in the mothers' adaptation process was 'anxiety regarding the future', and the mothers' adaptation process consisted of the impact phase, standing against phase, and accepting phase. In the impact phase, the participants emotionally fluctuated between 'feelings of abandonment' and 'entertaining hope'. In the standing against phase, participants tended to dedicate everything to child-rearing while being affected by 'being encouraged by support' and 'being frustrated by tasks beyond their limits'. In the accepting phase, the subjects attempted to 'accept the child as is', 'resist hard feelings', and 'share hope'. Health-care providers need to develop programs that include information regarding CHD, how to care for a child with CHD, and effective child-rearing behaviors.

  5. Adaptive management for complex communal rangelands in South ...

    African Journals Online (AJOL)

    Many of the intransigent problems facing the world arise in complex systems. In this paper, I propose that communal rangelands in South Africa be recognised as complex social–ecological systems and that one of the reasons that development initiatives have had little impact on improving livelihoods and rangeland ...

  6. A Comment on Language Is a Complex Adaptive System:Position Paper

    Institute of Scientific and Technical Information of China (English)

    单妍

    2014-01-01

    Language not only functions as a communication tool, it has fundamental functions. People ’s social interaction and their past experience can affect people’s choice of language, as language is a complex, adaptive system. The paper tries to com-ment on“A comment on Language Is a Complex Adaptive System: Position Paper”from several aspects to conclude that Lan-guage Is a Complex Adaptive System:Position Paper is a comprehensive, creative and influential academic paper which is charac-teristic of high originality, well-compact organization, detailed literature review.

  7. Public health adaptation to climate change in OECD countries

    NARCIS (Netherlands)

    Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

    2016-01-01

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine

  8. Globalisation, complex humanitarian emergencies and health.

    Science.gov (United States)

    O'Dempsey, T J D; Munslow, B

    2006-01-01

    A new political economy of conflict has emerged in the aftermath of colonialism and the Cold War. Complex political emergencies have been simmering in the post-colonial world for more than three decades. Intra-country armed conflict, often combined with natural disasters, at present contributes to the displacement of over 20 million people world-wide. The international community remains profoundly uncomfortable with the complex political emergencies of the new era, torn between the respect for national sovereignty upon which the international political system of the United Nations and other agencies is built, and the growth of concern with human rights and a burgeoning International Humanitarian Law. Globalisation may have brought many benefits to some but there are also many losers. The Word Bank and the International Monetary Fund imposed structural adjustment policies to ensure debt repayment and economic restructuring that have resulted in a net reduction in expenditure on health, education and development. A downward spiral has been created of debt, disease, malnutrition, missed education, economic entrapment, poverty, powerlessness, marginalization, migration and instability. Africa's complex political emergencies are particularly virulent and tenacious. Three examples that are among the most serious humanitarian emergencies to have faced the world in recent times--those in Angola, the Democratic Republic of Congo and Sudan--are reviewed here in detail. The political evolution of these emergencies and their impact on the health of the affected populations are also explored.

  9. Cultural Adaptations: A Complex Interplay between Clinical and Cultural Issues

    OpenAIRE

    Hwang, Wei-Chin

    2011-01-01

    Psychotherapy is a Western method of treating mental illness. Culturally adapting psychotherapy to better meet the needs of ethnic minorities is an important endeavor. Hall et al. (2011) did an excellent job of reviewing the intersection and divergence between Asian culture and mindfulness and acceptance-based therapies. They also point out that some therapies can be naturally syntonic with Asian American cultural values and belief systems. This is especially important given cultural differen...

  10. The Implications of Complex Adaptive Systems Theory for C2

    National Research Council Canada - National Science Library

    Grisogono, Anne-Marie

    2006-01-01

    .... We have been researching how application of a CAS perspective to the most pressing and complex problems that defence faces can provide more effective tools and techniques to enable higher levels...

  11. Low complexity adaptive equalizers for underwater acoustic communications

    Science.gov (United States)

    Soflaei, Masoumeh; Azmi, Paeiz

    2014-08-01

    Interference signals due to scattering from surface and reflecting from bottom is one of the most important problems of reliable communications in shallow water channels. To solve this problem, one of the best suggested ways is to use adaptive equalizers. Convergence rate and misadjustment error in adaptive algorithms play important roles in adaptive equalizer performance. In this paper, affine projection algorithm (APA), selective regressor APA(SR-APA), family of selective partial update (SPU) algorithms, family of set-membership (SM) algorithms and selective partial update selective regressor APA (SPU-SR-APA) are compared with conventional algorithms such as the least mean square (LMS) in underwater acoustic communications. We apply experimental data from the Strait of Hormuz for demonstrating the efficiency of the proposed methods over shallow water channel. We observe that the values of the steady-state mean square error (MSE) of SR-APA, SPU-APA, SPU-normalized least mean square (SPU-NLMS), SPU-SR-APA, SM-APA and SM-NLMS algorithms decrease in comparison with the LMS algorithm. Also these algorithms have better convergence rates than LMS type algorithm.

  12. The African diaspora: history, adaptation and health.

    Science.gov (United States)

    Rotimi, Charles N; Tekola-Ayele, Fasil; Baker, Jennifer L; Shriner, Daniel

    2016-12-01

    The trans-Atlantic slave trade brought millions of Africans to the New World. Advances in genomics are providing novel insights into the history and health of Africans and the diasporan populations. Recent examples reviewed here include the unraveling of substantial hunter-gatherer and 'Eurasian' admixtures across sub-Saharan Africa, expanding our understanding of ancestral African genetics; the global ubiquity of mixed ancestry; the revealing of African ancestry in Latin Americans that likely derived from the slave trade; and understanding of the ancestral backgrounds of APOL1 and LPL found to influence kidney disease and lipid levels, respectively, providing specific insights into disease etiology and health disparities. Published by Elsevier Ltd.

  13. On the Origin of Complex Adaptive Traits: Progress Since the Darwin Versus Mivart Debate.

    Science.gov (United States)

    Suzuki, Takao K

    2017-06-01

    The evolutionary origin of complex adaptive traits has been a controversial topic in the history of evolutionary biology. Although Darwin argued for the gradual origins of complex adaptive traits within the theory of natural selection, Mivart insisted that natural selection could not account for the incipient stages of complex traits. The debate starting from Darwin and Mivart eventually engendered two opposite views: gradualism and saltationism. Although this has been a long-standing debate, the issue remains unresolved. However, recent studies have interrogated classic examples of complex traits, such as the asymmetrical eyes of flatfishes and leaf mimicry of butterfly wings, whose origins were debated by Darwin and Mivart. Here, I review recent findings as a starting point to provide a modern picture of the evolution of complex adaptive traits. First, I summarize the empirical evidence that unveils the evolutionary steps toward complex traits. I then argue that the evolution of complex traits could be understood within the concept of "reducible complexity." Through these discussions, I propose a conceptual framework for the formation of complex traits, named as reducible-composable multicomponent systems, that satisfy two major characteristics: reducibility into a sum of subcomponents and composability to construct traits from various additional and combinatorial arrangements of the subcomponents. This conceptual framework provides an analytical foundation for exploring evolutionary pathways to build up complex traits. This review provides certain essential avenues for deciphering the origin of complex adaptive traits. © 2017 Wiley Periodicals, Inc.

  14. Verification and Validation Challenges for Adaptive Flight Control of Complex Autonomous Systems

    Science.gov (United States)

    Nguyen, Nhan T.

    2018-01-01

    Autonomy of aerospace systems requires the ability for flight control systems to be able to adapt to complex uncertain dynamic environment. In spite of the five decades of research in adaptive control, the fact still remains that currently no adaptive control system has ever been deployed on any safety-critical or human-rated production systems such as passenger transport aircraft. The problem lies in the difficulty with the certification of adaptive control systems since existing certification methods cannot readily be used for nonlinear adaptive control systems. Research to address the notion of metrics for adaptive control began to appear in the recent years. These metrics, if accepted, could pave a path towards certification that would potentially lead to the adoption of adaptive control as a future control technology for safety-critical and human-rated production systems. Development of certifiable adaptive control systems represents a major challenge to overcome. Adaptive control systems with learning algorithms will never become part of the future unless it can be proven that they are highly safe and reliable. Rigorous methods for adaptive control software verification and validation must therefore be developed to ensure that adaptive control system software failures will not occur, to verify that the adaptive control system functions as required, to eliminate unintended functionality, and to demonstrate that certification requirements imposed by regulatory bodies such as the Federal Aviation Administration (FAA) can be satisfied. This presentation will discuss some of the technical issues with adaptive flight control and related V&V challenges.

  15. Emergence, institutionalization and renewal: Rhythms of adaptive governance in complex social-ecological systems.

    Science.gov (United States)

    Chaffin, Brian C; Gunderson, Lance H

    2016-01-01

    Adaptive governance provides the capacity for environmental managers and decision makers to confront variable degrees of uncertainty inherent to complex social-ecological systems. Current theoretical conceptualizations of adaptive governance represent a series of structures and processes best suited for either adapting or transforming existing environmental governance regimes towards forms flexible enough to confront rapid ecological change. As the number of empirical examples of adaptive governance described in the literature grows, the conceptual basis of adaptive governance remains largely under theorized. We argue that reconnecting adaptive governance with foundational concepts of ecological resilience-specifically Panarchy and the adaptive cycle of complex systems-highlights the importance of episodic disturbances and cross-scale interactions in triggering reorganizations in governance. By envisioning the processes of adaptive governance through the lens of Panarchy, scholars and practitioners alike will be better able to identify the emergence of adaptive governance, as well as take advantage of opportunities to institutionalize this type of governance in pursuit of sustainability outcomes. The synergistic analysis of adaptive governance and Panarchy can provide critical insight for analyzing the role of social dynamics during oscillating periods of stability and instability in social-ecological systems. A deeper understanding of the potential for cross-scale interactions to shape adaptive governance regimes may be useful as society faces the challenge of mitigating the impacts of global environmental change. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Immigrant Youth Mental Health, Acculturation, and Adaptation

    Science.gov (United States)

    Frabutt, James M.

    2006-01-01

    One in five youth in the United States is a child of an immigrant and children of immigrants are the most rapidly growing segment of the U.S. population under age 18. Consequently, there is a great need to better understand the psychosocial impact of immigration on children's mental health and adjustment. It is striking, however, that research on…

  17. Reframing the challenges to integrated care: a complex-adaptive systems perspective

    Directory of Open Access Journals (Sweden)

    Peter Tsasis

    2012-09-01

    Full Text Available Introduction: Despite over two decades of international experience and research on health systems integration, integrated care has not developed widely. We hypothesized that part of the problem may lie in how we conceptualize the integration process and the complex systems within which integrated care is enacted. This study aims to contribute to discourse regarding the relevance and utility of a complex-adaptive systems (CAS perspective on integrated care.Methods: In the Canadian province of Ontario, government mandated the development of fourteen Local Health Integration Networks in 2006. Against the backdrop of these efforts to integrate care, we collected focus group data from a diverse sample of healthcare professionals in the Greater Toronto Area using convenience and snowball sampling. A semi-structured interview guide was used to elicit participant views and experiences of health systems integration. We use a CAS framework to describe and analyze the data, and to assess the theoretical fit of a CAS perspective with the dominant themes in participant responses.Results: Our findings indicate that integration is challenged by system complexity, weak ties and poor alignment among professionals and organizations, a lack of funding incentives to support collaborative work, and a bureaucratic environment based on a command and control approach to management. Using a CAS framework, we identified several characteristics of CAS in our data, including diverse, interdependent and semi-autonomous actors; embedded co-evolutionary systems; emergent behaviours and non-linearity; and self-organizing capacity. Discussion and Conclusion: One possible explanation for the lack of systems change towards integration is that we have failed to treat the healthcare system as complex-adaptive. The data suggest that future integration initiatives must be anchored in a CAS perspective, and focus on building the system's capacity to self-organize. We conclude that

  18. Reframing the challenges to integrated care: a complex-adaptive systems perspective

    Directory of Open Access Journals (Sweden)

    Peter Tsasis

    2012-09-01

    Full Text Available Introduction: Despite over two decades of international experience and research on health systems integration, integrated care has not developed widely. We hypothesized that part of the problem may lie in how we conceptualize the integration process and the complex systems within which integrated care is enacted. This study aims to contribute to discourse regarding the relevance and utility of a complex-adaptive systems (CAS perspective on integrated care. Methods: In the Canadian province of Ontario, government mandated the development of fourteen Local Health Integration Networks in 2006. Against the backdrop of these efforts to integrate care, we collected focus group data from a diverse sample of healthcare professionals in the Greater Toronto Area using convenience and snowball sampling. A semi-structured interview guide was used to elicit participant views and experiences of health systems integration. We use a CAS framework to describe and analyze the data, and to assess the theoretical fit of a CAS perspective with the dominant themes in participant responses. Results: Our findings indicate that integration is challenged by system complexity, weak ties and poor alignment among professionals and organizations, a lack of funding incentives to support collaborative work, and a bureaucratic environment based on a command and control approach to management. Using a CAS framework, we identified several characteristics of CAS in our data, including diverse, interdependent and semi-autonomous actors; embedded co-evolutionary systems; emergent behaviours and non-linearity; and self-organizing capacity.  Discussion and Conclusion: One possible explanation for the lack of systems change towards integration is that we have failed to treat the healthcare system as complex-adaptive. The data suggest that future integration initiatives must be anchored in a CAS perspective, and focus on building the system's capacity to self-organize. We conclude that

  19. Leadership as an Emergent Phenomenon: A Framework for Complexity and Adaptability

    National Research Council Canada - National Science Library

    Martinez, Sandra M

    2008-01-01

    The recognition by some military leaders about the need for a different paradigm of leadership that responds to requirements for adaptability in complex environments has not necessarily translated into action...

  20. Socio-Pedagogical Complex as a Pedagogical Support Technology of Students' Social Adaptation

    Science.gov (United States)

    Sadovaya, Victoriya V.; Simonova, Galina I.

    2016-01-01

    The relevance of the problem stated in the article is determined by the need of developing technological approaches to pedagogical support of students' social adaptation. The purpose of this paper is to position the technological sequence of pedagogical support of students' social adaptation in the activities of the socio-pedagogical complex. The…

  1. Adapting the complexity level of a serious game to the proficiency of players

    NARCIS (Netherlands)

    van Oostendorp, H.; van der Spek, E.D.; Linssen, J.M.

    2014-01-01

    As games are continuously assessing the player, this assessment can be used to adapt the complexity of a game to the proficiency of the player in real time. We performed an experiment to examine the role of dynamic adaptation. In one condition, participants played a version of our serious game for

  2. Adapting the Complexity Level of a Serious Game to the Proficiency of Players

    NARCIS (Netherlands)

    van Oostendorp, Herre; van der Spek, Erik D; Linssen, Johannes Maria

    2014-01-01

    As games are continuously assessing the player, this assessment can be used to adapt the complexity of a game to the proficiency of the player in real time. We performed an experiment to examine the role of dynamic adaptation. In one condition, participants played a version of our serious game for

  3. [The approach of sciences of complexity in health services administration].

    Science.gov (United States)

    Fajardo-Ortiz, Guillermo; Ortiz-Montalvo, Armando

    2013-01-01

    Historically, health services administration has been managed under a Taylorist, Fayolist, humanist and bureaucratic focus approach. However, today dynamic and competitive behaviors that require others approaches in management are developing. Because of the social, scientific and technological changes that are occurring, it is necessary to abandon hierarchical and authoritarian schemes, "up and down" lines, prescriptive rules and order line up must be left behind. Health services administration is an adapted complex system that is not proportional, neither predictable in direction or magnitude. A new proposal is to focus on the sciences of complexity, where the social factors, materials, economics, human and ethics coincide with order and disorder, reason and unreason, and in which we must accept that the phenomenon that emerges creates different organizing different structures from the addition or subtraction of components. There is distance in the process of cause and direct effect. The mirage from the sciences of complexity are trans-disciplinary and we have accepted this in others branches of knowledge, such as quantum physics, non-linear mathematics and cybernetics, so we have to accept the influence of entropy, non-entropy, attractors, the theory of chaos and fractals.

  4. Thinking about complexity in health: A systematic review of the key systems thinking and complexity ideas in health.

    Science.gov (United States)

    Rusoja, Evan; Haynie, Deson; Sievers, Jessica; Mustafee, Navonil; Nelson, Fred; Reynolds, Martin; Sarriot, Eric; Swanson, Robert Chad; Williams, Bob

    2018-01-30

    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. This systematic review sought to identify and describe some of the key terms, concepts, and methods in recent ST/CS literature. Using the search terms "systems thinkin * AND health OR complexity theor* AND health OR complex adaptive system* AND health," we identified 516 relevant full texts out of 3982 titles across the search period (2002-2015). The peak number of articles were published in 2014 (83) with journals specifically focused on medicine/healthcare (265) and particularly the Journal of Evaluation in Clinical Practice (37) representing the largest number by volume. Dynamic/dynamical systems (n = 332), emergence (n = 294), complex adaptive system(s) (n = 270), and interdependent/interconnected (n = 263) were the most common terms with systems dynamic modelling (58) and agent-based modelling (43) as the most common methods. The review offered several important conclusions. First, while there was no core ST/CS "canon," certain terms appeared frequently across the reviewed texts. Second, even as these ideas are gaining traction in academic and practitioner communities, most are concentrated in a few journals. Finally, articles on ST/CS remain largely theoretical illustrating the need for further study and practical application. Given the challenge posed by the next phase of development, gaining a better understanding of ST/CS ideas and their use may lead to improvements in the implementation and practice of the Sustainable Development

  5. "I know, therefore I adapt?" Complexities of individual adaptation to climate-induced forest dieback in Alaska

    Directory of Open Access Journals (Sweden)

    Lauren E. Oakes

    2016-06-01

    Full Text Available Individual actions to avoid, benefit from, or cope with climate change impacts partly shape adaptation; much research on adaptation has focused at the systems level, overlooking drivers of individual responses. Theoretical frameworks and empirical studies of environmental behavior identify a complex web of cognitive, affective, and evaluative factors that motivate stewardship. We explore the relationship between knowledge of, and adaptation to, widespread, climate-induced tree mortality to understand the cognitive (i.e., knowledge and learning, affective (i.e., attitudes and place attachment, and evaluative (i.e., use values factors that influence how individuals respond to climate-change impacts. From 43 semistructured interviews with forest managers and users in a temperate forest, we identified distinct responses to local, climate-induced environmental changes that we then categorized as either behavioral or psychological adaptations. Interviewees developed a depth of knowledge about the dieback through a combination of direct, place-based experiences and indirect, mediated learning through social interactions. Knowing that the dieback was associated with climate change led to different adaptive responses among the interviewees, although knowledge alone did not explain this variation. Forest users reported psychological adaptations to process negative attitudes; these adaptations were spurred by knowledge of the causes, losses of intangible values, and impacts to a species to which they held attachment. Behavioral adaptations exclusive to a high level of knowledge included actions such as using the forests to educate others or changing transportation behaviors to reduce personal energy consumption. Managers integrated awareness of the dieback and its dynamics across spatial scales into current management objectives. Our findings suggest that adaptive management may occur from the bottom up, as individual managers implement new practices in

  6. Adaptive Analysis of Locally Complex Systems in a Globally Complex World

    Directory of Open Access Journals (Sweden)

    Timothy Lynam

    1999-12-01

    Full Text Available Zambezi Valley agro-ecosystems are environmentally, economically, and institutionally variable. This variability means that it is not possible to measure everything necessary to develop a predictive understanding of them. In particular, because people and their environments are constantly changing, what was measured yesterday may change by tomorrow. Here, I describe elements of the approach that I have developed to address this problem. Called DAAWN, for Detail as and When Needed, the approach advocates an iterative and multiscaled methodology in which we first capture as broad an understanding of the system as possible and then use awareness developed at this scale to identify where to focus subsequent, more detailed, investigations. Because we cannot hope to measure or monitor everything in these complex and adaptive agro-ecosystems, the approach requires us to make judicious use of all available knowledge about the agro-ecosystem. The DAAWN approach is rooted in systems theory, but is tempered by systems and problems where boundaries are not clearly defined, where nonlinearities are the norm, and where structural and functional change is the order of the day. I describe a few of the most important data collection tools and methods that were developed to record the knowledge of local people and to observe, monitor, and measure changes in their resources. Of particular importance is the tool that I call a "spidergram." This tool, which I used extensively with village informants, symbolizes the DAAWN approach and was a major stimulus for its development. Simulation models provide another very important tool; here, I offer some examples of spatially explicit, multi-agent models. Some key findings of the research on Zambezi Valley agro-ecosystems are also briefly presented.

  7. Adaptive Motion Gaming AI for Health Promotion

    OpenAIRE

    Paliyawan, Pujana; Kusano, Takahiro; Nakagawa, Yuto; Harada, Tomohiro; Thawonmas, Ruck

    2017-01-01

    This paper presents a design of a non-player character (AI) for promoting balancedness in use of body segments when engaging in full-body motion gaming. In our experiment, we settle a battle between the proposed AI and a player by using FightingICE, a fighting game platform for AI development. A middleware called UKI is used to allow the player to control the game by using body motion instead of the keyboard and mouse. During gameplay, the proposed AI analyze health states of the player; it d...

  8. Focus Group in Community Mental Health Research: Need for Adaption.

    Science.gov (United States)

    Zupančič, Vesna; Pahor, Majda; Kogovšek, Tina

    2018-04-27

    The article presents an analysis of the use of focus groups in researching community mental health users, starting with the reasons for using them, their implementation in mental health service users' research, and the adaptations of focus group use when researching the experiences of users. Based on personal research experience and a review of scientific publications in the Google Scholar, Web of Science, ProQuest, EBSCOhost, and Scopus databases, 20 articles published between 2010 and 2016 were selected for targeted content analysis. A checklist for reporting on the use of focus groups with community mental health service users, aiming to improve the comparability, verifiability and validity was developed. Adaptations of the implementation of focus groups in relation to participants' characteristics were suggested. Focus groups are not only useful as a scientific research technique, but also for ensuring service users' participation in decision-making in community mental health and evaluating the quality of the mental health system and services .

  9. Adapting online learning for Canada's Northern public health workforce

    Directory of Open Access Journals (Sweden)

    Marnie Bell

    2013-08-01

    Full Text Available Background . Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health education. From 2009 to 2012, the Public Health Agency of Canada (PHAC collaborated with a Northern Advisory Group to develop and implement a strategy to strengthen public health capacity in Canada's 3 northern territories. Access to relevant, effective continuing education was identified as a key issue. Challenges include diverse educational and cultural backgrounds of public health workers, geographical isolation and variable technological infrastructure across the north. Methods . PHAC's Skills Online program offers Internet-based continuing education modules for public health professionals. In partnership with the Northern Advisory Group, PHAC conducted 3 pilots between 2008 and 2012 to assess the appropriateness of the Skills Online program for Northern/Aboriginal public health workers. Module content and delivery modalities were adapted for the pilots. Adaptations included adding Inuit and Northern public health examples and using video and teleconference discussions to augment the online self-study component. Results . Findings from the pilots were informative and similar to those from previous Skills Online pilots with learners in developing countries. Online learning is effective in bridging the geographical barriers in remote locations. Incorporating content on Northern and Aboriginal health issues facilitates engagement in learning. Employer support facilitates the recruitment and retention of learners in an online program. Facilitator assets included experience as a public health professional from the north, and flexibility to use modified approaches to support and measure knowledge acquisition and application, especially for First Nations, Inuit and

  10. Adapting online learning for Canada's Northern public health workforce.

    Science.gov (United States)

    Bell, Marnie; MacDougall, Karen

    2013-01-01

    Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health education. From 2009 to 2012, the Public Health Agency of Canada (PHAC) collaborated with a Northern Advisory Group to develop and implement a strategy to strengthen public health capacity in Canada's 3 northern territories. Access to relevant, effective continuing education was identified as a key issue. Challenges include diverse educational and cultural backgrounds of public health workers, geographical isolation and variable technological infrastructure across the north. PHAC's Skills Online program offers Internet-based continuing education modules for public health professionals. In partnership with the Northern Advisory Group, PHAC conducted 3 pilots between 2008 and 2012 to assess the appropriateness of the Skills Online program for Northern/Aboriginal public health workers. Module content and delivery modalities were adapted for the pilots. Adaptations included adding Inuit and Northern public health examples and using video and teleconference discussions to augment the online self-study component. Findings from the pilots were informative and similar to those from previous Skills Online pilots with learners in developing countries. Online learning is effective in bridging the geographical barriers in remote locations. Incorporating content on Northern and Aboriginal health issues facilitates engagement in learning. Employer support facilitates the recruitment and retention of learners in an online program. Facilitator assets included experience as a public health professional from the north, and flexibility to use modified approaches to support and measure knowledge acquisition and application, especially for First Nations, Inuit and Metis learners. Results demonstrate that

  11. Adaptive practices in heart failure care teams: implications for patient-centered care in the context of complexity

    Directory of Open Access Journals (Sweden)

    Tait GR

    2015-08-01

    Full Text Available Glendon R Tait,1 Joanna Bates,2 Kori A LaDonna,3 Valerie N Schulz,4 Patricia H Strachan,5 Allan McDougall,3 Lorelei Lingard3 1Department of Psychiatry and Division of Medical Education, Dalhousie University, Halifax, NS, 2Centre for Health Education Scholarship, Vancouver General Hospital, Vancouver, BC, 3Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, 4Palliative Care, London Health Sciences Centre, University Hospital, London; 5School of Nursing, McMaster University, Hamilton, ON, Canada Background: Heart failure (HF, one of the three leading causes of death, is a chronic, progressive, incurable disease. There is growing support for integration of palliative care’s holistic approach to suffering, but insufficient understanding of how this would happen in the complex team context of HF care. This study examined how HF care teams, as defined by patients, work together to provide care to patients with advanced disease. Methods: Team members were identified by each participating patient, generating team sampling units (TSUs for each patient. Drawn from five study sites in three Canadian provinces, our dataset consists of 209 interviews from 50 TSUs. Drawing on a theoretical framing of HF teams as complex adaptive systems (CAS, interviews were analyzed using the constant comparative method associated with constructivist grounded theory. Results: This paper centers on the dominant theme of system practices, how HF care delivery is reported to work organizationally, socially, and practically, and describes two subthemes: “the way things work around here”, which were commonplace, routine ways of doing things, and “the way we make things work around here”, which were more conscious, effortful adaptations to usual practice in response to emergent needs. An adaptive practice, often a small alteration to routine, could have amplified effects beyond those intended by the innovating team

  12. Climate change adaptation: Where does global health fit in the agenda?

    Directory of Open Access Journals (Sweden)

    Bowen Kathryn J

    2012-05-01

    Full Text Available Abstract Human-induced climate change will affect the lives of most populations in the next decade and beyond. It will have greatest, and generally earliest, impact on the poorest and most disadvantaged populations on the planet. Changes in climatic conditions and increases in weather variability affect human wellbeing, safety, health and survival in many ways. Some impacts are direct-acting and immediate, such as impaired food yields and storm surges. Other health effects are less immediate and typically occur via more complex causal pathways that involve a range of underlying social conditions and sectors such as water and sanitation, agriculture and urban planning. Climate change adaptation is receiving much attention given the inevitability of climate change and its effects, particularly in developing contexts, where the effects of climate change will be experienced most strongly and the response mechanisms are weakest. Financial support towards adaptation activities from various actors including the World Bank, the European Union and the United Nations is increasing substantially. With this new global impetus and funding for adaptation action come challenges such as the importance of developing adaptation activities on a sound understanding of baseline community needs and vulnerabilities, and how these may alter with changes in climate. The global health community is paying heed to the strengthening focus on adaptation, albeit in a slow and unstructured manner. The aim of this paper is to provide an overview of adaptation and its relevance to global health, and highlight the opportunities to improve health and reduce health inequities via the new and additional funding that is available for climate change adaptation activities.

  13. Climate change adaptation: where does global health fit in the agenda?

    Science.gov (United States)

    Bowen, Kathryn J; Friel, Sharon

    2012-05-27

    Human-induced climate change will affect the lives of most populations in the next decade and beyond. It will have greatest, and generally earliest, impact on the poorest and most disadvantaged populations on the planet. Changes in climatic conditions and increases in weather variability affect human wellbeing, safety, health and survival in many ways. Some impacts are direct-acting and immediate, such as impaired food yields and storm surges. Other health effects are less immediate and typically occur via more complex causal pathways that involve a range of underlying social conditions and sectors such as water and sanitation, agriculture and urban planning. Climate change adaptation is receiving much attention given the inevitability of climate change and its effects, particularly in developing contexts, where the effects of climate change will be experienced most strongly and the response mechanisms are weakest. Financial support towards adaptation activities from various actors including the World Bank, the European Union and the United Nations is increasing substantially. With this new global impetus and funding for adaptation action come challenges such as the importance of developing adaptation activities on a sound understanding of baseline community needs and vulnerabilities, and how these may alter with changes in climate. The global health community is paying heed to the strengthening focus on adaptation, albeit in a slow and unstructured manner. The aim of this paper is to provide an overview of adaptation and its relevance to global health, and highlight the opportunities to improve health and reduce health inequities via the new and additional funding that is available for climate change adaptation activities.

  14. Information Technology in Complex Health Services

    Science.gov (United States)

    Southon, Frank Charles Gray; Sauer, Chris; Dampney, Christopher Noel Grant (Kit)

    1997-01-01

    Abstract Objective: To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services. Design: A case analysis of the failure of an implementation of a critical application in the Public Health System of the State of New South Wales, Australia, was carried out. This application had been proven in the United States environment. Measurements: Interviews involving over 60 staff at all levels of the service were undertaken by a team of three. The interviews were recorded and analyzed for key themes, and the results were shared and compared to enable a continuing critical assessment. Results: Two components of the transfer of the system were considered: the transfer from a different environment, and the diffusion throughout a large, divisionalized organization. The analyses were based on the Scott-Morton organizational fit framework. In relation to the first, it was found that there was a lack of fit in the business environments and strategies, organizational structures and strategy-structure pairing as well as the management process-roles pairing. The diffusion process experienced problems because of the lack of fit in the strategy-structure, strategy-structure-management processes, and strategy-structure-role relationships. Conclusion: The large-scale developments of integrated health services present great challenges to the efficient and reliable implementation of information technology, especially in large, divisionalized organizations. There is a need to take a more sophisticated approach to understanding the complexities of organizational factors than has traditionally been the case. PMID:9067877

  15. A Complex Adaptive Systems Approach to the Future Operational Environment

    Science.gov (United States)

    2014-05-22

    interesting to use this viewpoint to study the growing need for resilience training in the prevention of suicides and other mental health issues...sometimes seem like a runner stumbling from the starting blocks, 291Bennis, The Temporary... resiliency provides a tool to navigate complicated problems to return robustly to a level of development we have already achieved. Both strength and

  16. A case for Sandia investment in complex adaptive systems science and technology.

    Energy Technology Data Exchange (ETDEWEB)

    Colbaugh, Richard; Tsao, Jeffrey Yeenien; Johnson, Curtis Martin; Backus, George A.; Brown, Theresa Jean; Jones, Katherine A.

    2012-05-01

    This white paper makes a case for Sandia National Laboratories investments in complex adaptive systems science and technology (S&T) -- investments that could enable higher-value-added and more-robustly-engineered solutions to challenges of importance to Sandia's national security mission and to the nation. Complex adaptive systems are ubiquitous in Sandia's national security mission areas. We often ignore the adaptive complexity of these systems by narrowing our 'aperture of concern' to systems or subsystems with a limited range of function exposed to a limited range of environments over limited periods of time. But by widening our aperture of concern we could increase our impact considerably. To do so, the science and technology of complex adaptive systems must mature considerably. Despite an explosion of interest outside of Sandia, however, that science and technology is still in its youth. What has been missing is contact with real (rather than model) systems and real domain-area detail. With its center-of-gravity as an engineering laboratory, Sandia's has made considerable progress applying existing science and technology to real complex adaptive systems. It has focused much less, however, on advancing the science and technology itself. But its close contact with real systems and real domain-area detail represents a powerful strength with which to help complex adaptive systems science and technology mature. Sandia is thus both a prime beneficiary of, as well as potentially a prime contributor to, complex adaptive systems science and technology. Building a productive program in complex adaptive systems science and technology at Sandia will not be trivial, but a credible path can be envisioned: in the short run, continue to apply existing science and technology to real domain-area complex adaptive systems; in the medium run, jump-start the creation of new science and technology capability through Sandia's Laboratory Directed Research

  17. A Theory of Complex Adaptive Inquiring Organizations: Application to Continuous Assurance of Corporate Financial Information

    Science.gov (United States)

    Kuhn, John R., Jr.

    2009-01-01

    Drawing upon the theories of complexity and complex adaptive systems and the Singerian Inquiring System from C. West Churchman's seminal work "The Design of Inquiring Systems" the dissertation herein develops a systems design theory for continuous auditing systems. The dissertation consists of discussion of the two foundational theories,…

  18. The Impact of Adaptive Complex Assessment on the HOT Skill Development of Students

    Science.gov (United States)

    Raiyn, Jamal; Tilchin, Oleg

    2016-01-01

    In this paper we propose a method for the adaptive complex assessment (ACA) of the higher-order thinking (HOT) skills needed by students for problem solving, and we examine the impact of the method on the development of HOT skills in a problem-based learning (PBL) environment. Complexity in the assessment is provided by initial, formative, and…

  19. Adaptive Policies for Reducing Inequalities in the Social Determinants of Health

    Directory of Open Access Journals (Sweden)

    Gemma Carey

    2015-11-01

    Full Text Available Inequalities in the social determinants of health (SDH, which drive avoidable health disparities between different individuals or groups, is a major concern for a number of international organisations, including the World Health Organization (WHO. Despite this, the pathways to changing inequalities in the SDH remain elusive. The methodologies and concepts within system science are now viewed as important domains of knowledge, ideas and skills for tackling issues of inequality, which are increasingly understood as emergent properties of complex systems. In this paper, we introduce and expand the concept of adaptive policies to reduce inequalities in the distribution of the SDH. The concept of adaptive policy for health equity was developed through reviewing the literature on learning and adaptive policies. Using a series of illustrative examples from education and poverty alleviation, which have their basis in real world policies, we demonstrate how an adaptive policy approach is more suited to the management of the emergent properties of inequalities in the SDH than traditional policy approaches. This is because they are better placed to handle future uncertainties. Our intention is that these examples are illustrative, rather than prescriptive, and serve to create a conversation regarding appropriate adaptive policies for progressing policy action on the SDH.

  20. Adaptive and Online Health Monitoring System for Autonomous Aircraft

    OpenAIRE

    Mokhtar, Maizura; Zapatel-Bayo, Sergio Z.; Hussein, Saed; Howe, Joe M.

    2012-01-01

    Good situation awareness is one of the key attributes required to maintain safe flight, especially for an Unmanned Aerial System (UAS). Good situation awareness can be achieved by incorporating an Adaptive Health Monitoring System (AHMS) to the aircraft. The AHMS monitors the flight outcome or flight behaviours of the aircraft based on its external environmental conditions and the behaviour of its internal systems. The AHMS does this by associating a health value to the aircraft's behaviour b...

  1. Complexity control algorithm based on adaptive mode selection for interframe coding in high efficiency video coding

    Science.gov (United States)

    Chen, Gang; Yang, Bing; Zhang, Xiaoyun; Gao, Zhiyong

    2017-07-01

    The latest high efficiency video coding (HEVC) standard significantly increases the encoding complexity for improving its coding efficiency. Due to the limited computational capability of handheld devices, complexity constrained video coding has drawn great attention in recent years. A complexity control algorithm based on adaptive mode selection is proposed for interframe coding in HEVC. Considering the direct proportionality between encoding time and computational complexity, the computational complexity is measured in terms of encoding time. First, complexity is mapped to a target in terms of prediction modes. Then, an adaptive mode selection algorithm is proposed for the mode decision process. Specifically, the optimal mode combination scheme that is chosen through offline statistics is developed at low complexity. If the complexity budget has not been used up, an adaptive mode sorting method is employed to further improve coding efficiency. The experimental results show that the proposed algorithm achieves a very large complexity control range (as low as 10%) for the HEVC encoder while maintaining good rate-distortion performance. For the lowdelayP condition, compared with the direct resource allocation method and the state-of-the-art method, an average gain of 0.63 and 0.17 dB in BDPSNR is observed for 18 sequences when the target complexity is around 40%.

  2. Implementing managerial innovations in primary care: can we rank change drivers in complex adaptive organizations?

    Science.gov (United States)

    Longo, Francesco

    2007-01-01

    There has been much innovation in primary care in the past few decades. Although external and systemic constraints for health care organizations are relevant for their managerial evolution, there is also evidence that organizations operating under the same external pressures reach different levels of maturity. Which of the internal drivers available explain and foster change? Is it possible to rank change drivers by looking at their rate of efficacy in order to define a general change management path in the relationship between managers and physicians? The study is a hypothesis-generating work, designed to discuss a framework, consistent with the complex adaptive systems literature, for more effective internal change management approaches. We employed a qualitative approach to conduct a multiple case study in order to directly observe the evidence and to ask "key change players" for their perceptions. We studied different organizations all subject to the same external constraints in order to focus on the effects of internal change drivers. According to key players' opinions, the main drivers for managerial development are characteristics of the actors involved: their motivation, leadership, and commitment; the quality of relationships among the main actors; and how the resources dedicated to manage change are used. Given these criteria, any organizational strategy and goal seems to be achievable. This is consistent with the suggestions coming from the complex adaptive system literature. MANAGERIAL IMPLICATIONS: Managers have to consider the management of the relationship with professionals as the key success factor for implementing change. Managerial leadership has to be diffused in the organization both in the vertical and horizontal dimensions. Innovations need a medium or long-term perspective to become widely applied, and this requires a strong commitment which is related to managerial stability. Resources for innovation are to be considered a critical driver

  3. Going from bad to worse: Adaptation to poor health, health spending, longevity, and the value of life

    OpenAIRE

    Schünemann, Johannes; Strulik, Holger; Trimborn, Timo

    2015-01-01

    Unhealthy persons adapt to their bad state of health and persons in bad health are usually happier than estimated by healthy persons. In this paper we investigate how adaptation to a deteriorating state of health affects health spending, life expectancy, and the value of life. We set up a life cycle model in which individuals are subject to physiological aging, calibrate it with data from gerontology, and compare behavior and outcomes of adapting and non-adapting individuals. While adaptation...

  4. Structure identification and adaptive synchronization of uncertain general complex dynamical networks

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yuhua, E-mail: yuhuaxu2004@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China) and Department of Maths, Yunyang Teacher' s College, Hubei 442000 (China); Zhou Wuneng, E-mail: wnzhou@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Fang Jian' an [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Lu Hongqian [Shandong Institute of Light Industry, Shandong Jinan 250353 (China)

    2009-12-28

    This Letter proposes an approach to identify the topological structure and unknown parameters for uncertain general complex networks simultaneously. By designing effective adaptive controllers, we achieve synchronization between two complex networks. The unknown network topological structure and system parameters of uncertain general complex dynamical networks are identified simultaneously in the process of synchronization. Several useful criteria for synchronization are given. Finally, an illustrative example is presented to demonstrate the application of the theoretical results.

  5. Structure identification and adaptive synchronization of uncertain general complex dynamical networks

    International Nuclear Information System (INIS)

    Xu Yuhua; Zhou Wuneng; Fang Jian'an; Lu Hongqian

    2009-01-01

    This Letter proposes an approach to identify the topological structure and unknown parameters for uncertain general complex networks simultaneously. By designing effective adaptive controllers, we achieve synchronization between two complex networks. The unknown network topological structure and system parameters of uncertain general complex dynamical networks are identified simultaneously in the process of synchronization. Several useful criteria for synchronization are given. Finally, an illustrative example is presented to demonstrate the application of the theoretical results.

  6. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    Directory of Open Access Journals (Sweden)

    Åsa Holmner

    2012-06-01

    Full Text Available Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies.

  7. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    Science.gov (United States)

    Holmner, Åsa; Rocklöv, Joacim; Ng, Nawi; Nilsson, Maria

    2012-01-01

    Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT)’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies. PMID:22679398

  8. Health risks of climate change: An assessment of uncertainties and its implications for adaptation policies

    Science.gov (United States)

    2012-01-01

    Background Projections of health risks of climate change are surrounded with uncertainties in knowledge. Understanding of these uncertainties will help the selection of appropriate adaptation policies. Methods We made an inventory of conceivable health impacts of climate change, explored the type and level of uncertainty for each impact, and discussed its implications for adaptation policy. A questionnaire-based expert elicitation was performed using an ordinal scoring scale. Experts were asked to indicate the level of precision with which health risks can be estimated, given the present state of knowledge. We assessed the individual scores, the expertise-weighted descriptive statistics, and the argumentation given for each score. Suggestions were made for how dealing with uncertainties could be taken into account in climate change adaptation policy strategies. Results The results showed that the direction of change could be indicated for most anticipated health effects. For several potential effects, too little knowledge exists to indicate whether any impact will occur, or whether the impact will be positive or negative. For several effects, rough ‘order-of-magnitude’ estimates were considered possible. Factors limiting health impact quantification include: lack of data, multi-causality, unknown impacts considering a high-quality health system, complex cause-effect relations leading to multi-directional impacts, possible changes of present-day response-relations, and difficulties in predicting local climate impacts. Participants considered heat-related mortality and non-endemic vector-borne diseases particularly relevant for climate change adaptation. Conclusions For possible climate related health impacts characterised by ignorance, adaptation policies that focus on enhancing the health system’s and society’s capability of dealing with possible future changes, uncertainties and surprises (e.g. through resilience, flexibility, and adaptive capacity) are

  9. Phoenix : Complex Adaptive System of Systems (CASoS) engineering version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Thomas W.; Quach, Tu-Thach; Detry, Richard Joseph; Conrad, Stephen Hamilton; Kelic, Andjelka; Starks, Shirley J.; Beyeler, Walter Eugene; Brodsky, Nancy S.; Verzi, Stephen J.; Brown, Theresa Jean; Glass, Robert John, Jr.; Sunderland, Daniel J.; Mitchell, Michael David; Ames, Arlo Leroy; Maffitt, S. Louise; Finley, Patrick D.; Russell, Eric Dean; Zagonel, Aldo A.; Reedy, Geoffrey E.; Mitchell, Roger A.; Corbet, Thomas Frank, Jr.; Linebarger, John Michael

    2011-08-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to pervasive interdependencies and attendant vulnerabilities to cascades in associated systems. Phoenix was initiated to address this high-impact problem space as engineers. Our overarching goals are maximizing security, maximizing health, and minimizing risk. We design interventions, or problem solutions, that influence CASoS to achieve specific aspirations. Through application to real-world problems, Phoenix is evolving the principles and discipline of CASoS Engineering while growing a community of practice and the CASoS engineers to populate it. Both grounded in reality and working to extend our understanding and control of that reality, Phoenix is at the same time a solution within a CASoS and a CASoS itself.

  10. Fast Search and Adaptive Resolution for Complex Particle Kinetics

    Science.gov (United States)

    Larson, David J.

    2005-10-01

    A new plasma simulation algorithm, intended to bridge the gap between Eulerian fluid and kinetic regimes, is now being used for a variety of applications in ICF and weapon effects. The CPK method (Complex Particle Kinetic) concept [1] uses an ensemble of macro-particles with a Gaussian spatial profile and a Mawellian velocity distribution to represent particle distributions in phase space. Time evolution is modeled by a combination of Lagrangian motion and internal evolution within each individual macro-particle. Collisional particle-particle interactions [2] are facilitated by sorting particles into bins depending of the particle size. Different bin levels are connected by a linked list. Searching for neighboring particles is highly efficient because the search is limited to particles in neighboring bins with the possibility of interaction. The bin structure also allows the computation of various spatial moments at different resolutions. Combining the results of the moment calculations yields information on where and when increased resolution is necessary. We will present details of the particle binning process along with progress towards our goal of simulating the transition from continuum to fully kinetic physics. [1] D. W. Hewett, J. Comp. Phys. 189 (2003). [2] D. J. Larson, J. Comp. Phys. 188 (2003).

  11. Approach to evaluating health level and adaptation possibilities in schoolchildren

    Directory of Open Access Journals (Sweden)

    O.V. Andrieieva

    2014-02-01

    Full Text Available Purpose: substantiate the results of theoretical and practical investigations aimed at improving the health of students. Material: the study involved 187 children including 103 boys and 84 girls aged 7-10 years. Results: through a rapid assessment of physical health it was found that pupils of primary school age have an average level of the functional state of the organism, with a minimum resistance to risk factors (chronic non-infective diseases, etc.. For the first time, a technique for determining the level of adaptation and reserve capacity of school students proposed by Ukrainian hygienists was used in physical culture and sports practice. Conclusions: the technique reveals strain in adaptation mechanisms that corresponds to donozological condition. An idea is proposed that Nordic walking, through the positive impact on the body of aerobic mode of energy supply, is able to increase the reserve-adaptive capabilities of primary school students by improvement of their health as well as to solve the problems of health formation and health care in the physical education of youth.

  12. Cultural adaptation and validation of the Health Literacy Questionnaire (HLQ)

    DEFF Research Database (Denmark)

    Maindal, Helle Terkildsen; Kayser, Lars; Nørgaard, Ole

    2016-01-01

    Health literacy is an important construct in population health and healthcare requiring rigorous measurement. The Health Literacy Questionnaire (HLQ), with nine scales, measures a broad perception of health literacy. This study aimed to adapt the HLQ to the Danish setting, and to examine the factor......, composite scale reliability and confirmatory factor analysis (CFA). Cognitive testing revealed that only minor re-wording was required. The easiest scale to respond to positively was ‘Social support for health’, and the hardest were ‘Navigating the healthcare system’ and ‘Appraisal of health information...... with no cross-loadings or correlated residuals allowed. Given this restricted model, the fit was satisfactory. The HLQ appears robust for its intended application of assessing health literacy in a range of settings. Further work is required to demonstrate sensitivity to measure changes....

  13. How do precision medicine and system biology response to human body's complex adaptability?

    Science.gov (United States)

    Yuan, Bing

    2016-12-01

    In the field of life sciences, although system biology and "precision medicine" introduce some complex scientifific methods and techniques, it is still based on the "analysis-reconstruction" of reductionist theory as a whole. Adaptability of complex system increase system behaviour uncertainty as well as the difficulties of precise identifification and control. It also put systems biology research into trouble. To grasp the behaviour and characteristics of organism fundamentally, systems biology has to abandon the "analysis-reconstruction" concept. In accordance with the guidelines of complexity science, systems biology should build organism model from holistic level, just like the Chinese medicine did in dealing with human body and disease. When we study the living body from the holistic level, we will fifind the adaptability of complex system is not the obstacle that increases the diffificulty of problem solving. It is the "exceptional", "right-hand man" that helping us to deal with the complexity of life more effectively.

  14. Health, growth and psychosocial adaptation of immigrant children.

    Science.gov (United States)

    Gualdi-Russo, Emanuela; Toselli, Stefania; Masotti, Sabrina; Marzouk, Diaa; Sundquist, Kristina; Sundquist, Jan

    2014-08-01

    The increasing population diversity in Europe demands clarification of possible ethnic influences on the growth and health of immigrant children and their psychosocial adaptation to the host countries. This article assesses recent data on immigrant children in Europe in comparison to European natives by means of a systematic review of the literature on growth patterns and data on children's health and adaptation. There were wide variations across countries in growth patterns and development of immigrant children and natives, with different trends in Central and Northern Europe with respect to Southern Europe. In general, age at menarche was lower in immigrant girls, while male pubertal progression seemed faster in immigrants than in European natives, even when puberty began after. Owing to the significant differences in anthropometric traits (mainly stature and weight), new reference growth curves for immigrant children were constructed for the largest minority groups in Central Europe. Possible negative effects on growth, health and psychosocial adaptation were pointed out for immigrant children living in low income, disadvantaged communities with a high prevalence of poor lifestyle habits. In conclusion, this review provides a framework for the health and growth of immigrant children in Europe in comparison to native-born children: the differences among European countries in growth and development of migrants and non-migrants are closely related to the clear anthropological differences among the ethnic groups due to genetic influences. Higher morbidity and mortality was frequently associated with the minority status of these children and their low socio-economic status. The observed ethnic differences in health reveal the need for adequate health care in all groups. Therefore, we provide suggestions for the development of health care strategies in Europe. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association

  15. Methodology for Simulation and Analysis of Complex Adaptive Supply Network Structure and Dynamics Using Information Theory

    Directory of Open Access Journals (Sweden)

    Joshua Rodewald

    2016-10-01

    Full Text Available Supply networks existing today in many industries can behave as complex adaptive systems making them more difficult to analyze and assess. Being able to fully understand both the complex static and dynamic structures of a complex adaptive supply network (CASN are key to being able to make more informed management decisions and prioritize resources and production throughout the network. Previous efforts to model and analyze CASN have been impeded by the complex, dynamic nature of the systems. However, drawing from other complex adaptive systems sciences, information theory provides a model-free methodology removing many of those barriers, especially concerning complex network structure and dynamics. With minimal information about the network nodes, transfer entropy can be used to reverse engineer the network structure while local transfer entropy can be used to analyze the network structure’s dynamics. Both simulated and real-world networks were analyzed using this methodology. Applying the methodology to CASNs allows the practitioner to capitalize on observations from the highly multidisciplinary field of information theory which provides insights into CASN’s self-organization, emergence, stability/instability, and distributed computation. This not only provides managers with a more thorough understanding of a system’s structure and dynamics for management purposes, but also opens up research opportunities into eventual strategies to monitor and manage emergence and adaption within the environment.

  16. A new adaptive testing algorithm for shortening health literacy assessments

    Directory of Open Access Journals (Sweden)

    Currie Leanne M

    2011-08-01

    Full Text Available Abstract Background Low health literacy has a detrimental effect on health outcomes, as well as ability to use online health resources. Good health literacy assessment tools must be brief to be adopted in practice; test development from the perspective of item-response theory requires pretesting on large participant populations. Our objective was to develop a novel classification method for developing brief assessment instruments that does not require pretesting on large numbers of research participants, and that would be suitable for computerized adaptive testing. Methods We present a new algorithm that uses principles of measurement decision theory (MDT and Shannon's information theory. As a demonstration, we applied it to a secondary analysis of data sets from two assessment tests: a study that measured patients' familiarity with health terms (52 participants, 60 items and a study that assessed health numeracy (165 participants, 8 items. Results In the familiarity data set, the method correctly classified 88.5% of the subjects, and the average length of test was reduced by about 50%. In the numeracy data set, for a two-class classification scheme, 96.9% of the subjects were correctly classified with a more modest reduction in test length of 35.7%; a three-class scheme correctly classified 93.8% with a 17.7% reduction in test length. Conclusions MDT-based approaches are a promising alternative to approaches based on item-response theory, and are well-suited for computerized adaptive testing in the health domain.

  17. How Health Care Complexity Leads to Cooperation and Affects the Autonomy of Health Care Professionals

    NARCIS (Netherlands)

    Molleman, Eric; Broekhuis, Manda; Stoffels, Renee; Jaspers, Frans

    2008-01-01

    Health professionals increasingly face patients with complex health problems and this pressurizes them to cooperate. The authors have analyzed how the complexity of health care problems relates to two types of cooperation: consultation and multidisciplinary teamwork (MTW). Moreover, they have

  18. Selecting, adapting, and sustaining programs in health care systems

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2015-04-01

    Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

  19. Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review

    Science.gov (United States)

    Banwell, Nicola; Rutherford, Shannon; Mackey, Brendan; Chu, Cordia

    2018-01-01

    Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links. PMID:29670057

  20. Organizational Adaptative Behavior: The Complex Perspective of Individuals-Tasks Interaction

    Science.gov (United States)

    Wu, Jiang; Sun, Duoyong; Hu, Bin; Zhang, Yu

    Organizations with different organizational structures have different organizational behaviors when responding environmental changes. In this paper, we use a computational model to examine organizational adaptation on four dimensions: Agility, Robustness, Resilience, and Survivability. We analyze the dynamics of organizational adaptation by a simulation study from a complex perspective of the interaction between tasks and individuals in a sales enterprise. The simulation studies in different scenarios show that more flexible communication between employees and less hierarchy level with the suitable centralization can improve organizational adaptation.

  1. Adaptive synchronization of the complex dynamical network with non-derivative and derivative coupling

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yuhua, E-mail: yuhuaxu2004@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China) and Department of Maths, Yunyang Teachers' College, Hubei 442000 (China); Zhou Wuneng, E-mail: wnzhou@163.co [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Fang Jian' an [College of Information Science and Technology, Donghua University, Shanghai 201620 (China); Sun Wen [School of Mathematics and Information, Yangtze University, Hubei Jingzhou 434023 (China)

    2010-04-05

    This Letter investigates the synchronization of a general complex dynamical network with non-derivative and derivative coupling. Based on LaSalle's invariance principle, adaptive synchronization criteria are obtained. Analytical result shows that under the designed adaptive controllers, a general complex dynamical network with non-derivative and derivative coupling can asymptotically synchronize to a given trajectory, and several useful criteria for synchronization are given. What is more, the coupling matrix is not assumed to be symmetric or irreducible. Finally, simulations results show the method is effective.

  2. Advancing the application of systems thinking in health: managing rural China health system development in complex and dynamic contexts.

    Science.gov (United States)

    Zhang, Xiulan; Bloom, Gerald; Xu, Xiaoxin; Chen, Lin; Liang, Xiaoyun; Wolcott, Sara J

    2014-08-26

    This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. It argues that the evolution of these schemes has been the outcome of the response of a large number of agents to a rapidly changing context and of efforts by the government to influence this adaptation process and achieve public health goals. The study draws on several sources of data including a review of official policy documents and academic papers and in-depth interviews with key policy actors at national level and at a sample of localities. The study identifies three major transition points associated with changes in broad development strategy and demonstrates how the adaptation of large numbers of actors to these contextual changes had a major impact on the performance of the health system. Further, it documents how the Ministry of Health viewed its role as both an advocate for the interests of health facilities and health workers and as the agency responsible for ensuring that government health system objectives were met. It is argued that a major reason for the resilience of the health system and its ability to adapt to rapid economic and institutional change was the ability of the Ministry to provide overall strategy leadership. Additionally, it postulates that a number of interest groups have emerged, which now also seek to influence the pathway of health system development. This history illustrates the complex and political nature of the management of health system development and reform. The paper concludes that governments will need to increase their capacity to analyze the health sector as a complex system and to manage change processes.

  3. Physiological complexity and system adaptability: evidence from postural control dynamics of older adults.

    Science.gov (United States)

    Manor, Brad; Costa, Madalena D; Hu, Kun; Newton, Elizabeth; Starobinets, Olga; Kang, Hyun Gu; Peng, C K; Novak, Vera; Lipsitz, Lewis A

    2010-12-01

    The degree of multiscale complexity in human behavioral regulation, such as that required for postural control, appears to decrease with advanced aging or disease. To help delineate causes and functional consequences of complexity loss, we examined the effects of visual and somatosensory impairment on the complexity of postural sway during quiet standing and its relationship to postural adaptation to cognitive dual tasking. Participants of the MOBILIZE Boston Study were classified into mutually exclusive groups: controls [intact vision and foot somatosensation, n = 299, 76 ± 5 (SD) yr old], visual impairment only (Postural sway (i.e., center-of-pressure) dynamics were assessed during quiet standing and cognitive dual tasking, and a complexity index was quantified using multiscale entropy analysis. Postural sway speed and area, which did not correlate with complexity, were also computed. During quiet standing, the complexity index (mean ± SD) was highest in controls (9.5 ± 1.2) and successively lower in the visual (9.1 ± 1.1), somatosensory (8.6 ± 1.6), and combined (7.8 ± 1.3) impairment groups (P = 0.001). Dual tasking resulted in increased sway speed and area but reduced complexity (P postural sway speed from quiet standing to dual-tasking conditions. Sensory impairments contributed to decreased postural sway complexity, which reflected reduced adaptive capacity of the postural control system. Relatively low baseline complexity may, therefore, indicate control systems that are more vulnerable to cognitive and other stressors.

  4. Adaptive Synchronization between Two Different Complex Networks with Time-Varying Delay Coupling

    International Nuclear Information System (INIS)

    Jian-Rui, Chen; Li-Cheng, Jiao; Jian-She, Wu; Xiao-Hua, Wang

    2009-01-01

    A new general network model for two complex networks with time-varying delay coupling is presented. Then we investigate its synchronization phenomena. The two complex networks of the model differ in dynamic nodes, the number of nodes and the coupling connections. By using adaptive controllers, a synchronization criterion is derived. Numerical examples are given to demonstrate the effectiveness of the obtained synchronization criterion. This study may widen the application range of synchronization, such as in chaotic secure communication. (general)

  5. Adversity, Adaptive Calibration, and Health: The Case of Disadvantaged Families.

    Science.gov (United States)

    de Baca, Tomás Cabeza; Wahl, Richard A; Barnett, Melissa A; Figueredo, Aurelio José; Ellis, Bruce J

    2016-06-01

    Epidemiologists and medical researchers often employ an allostatic load model that focuses on environmental and lifestyle factors, together with biological vulnerabilities, to explain the deterioration of human physiological systems and chronic degenerative disease. Although this perspective has informed medicine and public health, it is agnostic toward the functional significance of pathophysiology and health deterioration. Drawing on Life History (LH) theory, the current paper reviews the literature on disadvantaged families to serve as a conceptual model of stress-health relationships in which the allocation of reproductive effort is instantiated in the LH strategies of individuals and reflects the bioenergetic and material resource tradeoffs . We propose that researchers interested in health disparities reframe chronic degenerative diseases as outcomes resulting from strategic calibration of physiological systems to best adapt, survive, and reproduce in response to demands of specific developmental contexts. These effects of adversity on later-age degenerative disease are mediated, in part, by socioemotional and cognitive mechanisms expressed in different life history strategies.

  6. Adaptive capacity of geographical clusters: Complexity science and network theory approach

    Science.gov (United States)

    Albino, Vito; Carbonara, Nunzia; Giannoccaro, Ilaria

    This paper deals with the adaptive capacity of geographical clusters (GCs), that is a relevant topic in the literature. To address this topic, GC is considered as a complex adaptive system (CAS). Three theoretical propositions concerning the GC adaptive capacity are formulated by using complexity theory. First, we identify three main properties of CAS s that affect the adaptive capacity, namely the interconnectivity, the heterogeneity, and the level of control, and define how the value of these properties influence the adaptive capacity. Then, we associate these properties with specific GC characteristics so obtaining the key conditions of GCs that give them the adaptive capacity so assuring their competitive advantage. To test these theoretical propositions, a case study on two real GCs is carried out. The considered GCs are modeled as networks where firms are nodes and inter-firms relationships are links. Heterogeneity, interconnectivity, and level of control are considered as network properties and thus measured by using the methods of the network theory.

  7. Climate change and Public health: vulnerability, impacts, and adaptation

    Science.gov (United States)

    Guzzone, F.; Setegn, S.

    2013-12-01

    Climate Change plays a significant role in public health. Changes in climate affect weather conditions that we are accustomed to. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases. According to studies by EPA, the impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's public health and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change. Transmissions of infectious disease have been associated with social, economic, ecological, health care access, and climatic factors. Some vector-borne diseases typically exhibit seasonal patterns in which the role of temperature and rainfall is well documented. Some of the infectious diseases that have been documented by previous studies, include the correlation between rainfall and drought in the occurrence of malaria, the influence of the dry season on epidemic meningococcal disease in the sub-Saharan African, and the importance of warm ocean waters in driving cholera occurrence in the Ganges River delta in Asia The rise of climate change has been a major concern in the public health sector. Climate change mainly affects vulnerable populations especially in developing countries; therefore, it's important that public health advocates are involve in the decision-making process in order to provide resources and preventative measures for the challenges that are associated with climate change. The main objective of this study is to assess the vulnerability and impact of climate change

  8. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

    Science.gov (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

    2014-07-01

    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Planning and complexity : Engaging with temporal dynamics, uncertainty and complex adaptive systems

    NARCIS (Netherlands)

    Sengupta, Ulysses; Rauws, Ward S.; de Roo, Gert

    2016-01-01

    The nature of complex systems as a transdisciplinary collection of concepts from physics and economics to sociology and ecology provides an evolving field of inquiry (Laszlo and Krippner, 1998) for urban planning and urban design. As a result, planning theory has assimilated multiple concepts from

  10. Planning and complexity : Engaging with temporal dynamics, uncertainty and complex adaptive systems

    NARCIS (Netherlands)

    Sengupta, Ulysses; Rauws, Ward S.; de Roo, Gert

    The nature of complex systems as a transdisciplinary collection of concepts from physics and economics to sociology and ecology provides an evolving field of inquiry (Laszlo and Krippner, 1998) for urban planning and urban design. As a result, planning theory has assimilated multiple concepts from

  11. Adaptive scenarios: a training model for today's public health workforce.

    Science.gov (United States)

    Uden-Holman, Tanya; Bedet, Jennifer; Walkner, Laurie; Abd-Hamid, Nor Hashidah

    2014-01-01

    With the current economic climate, money for training is scarce. In addition, time is a major barrier to participation in trainings. To meet the public health workforce's rising demand for training, while struggling with less time and fewer resources, the Upper Midwest Preparedness and Emergency Response Learning Center has developed a model of online training that provides the public health workforce with individually customized, needs-based training experiences. Adaptive scenarios are rooted in case-based reasoning, a learning approach that focuses on the specific knowledge needed to solve a problem. Proponents of case-based reasoning argue that learners benefit from being able to remember previous similar situations and reusing information and knowledge from that situation. Adaptive scenarios based on true-to-life job performance provide an opportunity to assess skills by presenting the user with choices to make in a problem-solving context. A team approach was used to develop the adaptive scenarios. Storylines were developed that incorporated situations aligning with the knowledge, skills, and attitudes outlined in the Public Health Preparedness and Response Core Competency Model. This article examines 2 adaptive scenarios: "Ready or Not? A Family Preparedness Scenario" and "Responding to a Crisis: Managing Emotions and Stress Scenario." The scenarios are available on Upper Midwest Preparedness and Emergency Response Learning Center's Learning Management System, the Training Source (http://training-source.org). Evaluation data indicate that users' experiences have been positive. Integrating the assessment and training elements of the scenarios so that the training experience is uniquely adaptive to each user is one of the most efficient ways to provide training. The opportunity to provide individualized, needs-based training without having to administer separate assessments has the potential to save time and resources. These adaptive scenarios continue to be

  12. Remediation management of complex sites using an adaptive site management approach.

    Science.gov (United States)

    Price, John; Spreng, Carl; Hawley, Elisabeth L; Deeb, Rula

    2017-12-15

    Complex sites require a disproportionate amount of resources for environmental remediation and long timeframes to achieve remediation objectives, due to their complex geologic conditions, hydrogeologic conditions, geochemical conditions, contaminant-related conditions, large scale of contamination, and/or non-technical challenges. A recent team of state and federal environmental regulators, federal agency representatives, industry experts, community stakeholders, and academia worked together as an Interstate Technology & Regulatory Council (ITRC) team to compile resources and create new guidance on the remediation management of complex sites. This article summarizes the ITRC team's recommended process for addressing complex sites through an adaptive site management approach. The team provided guidance for site managers and other stakeholders to evaluate site complexities and determine site remediation potential, i.e., whether an adaptive site management approach is warranted. Adaptive site management was described as a comprehensive, flexible approach to iteratively evaluate and adjust the remedial strategy in response to remedy performance. Key aspects of adaptive site management were described, including tools for revising and updating the conceptual site model (CSM), the importance of setting interim objectives to define short-term milestones on the journey to achieving site objectives, establishing a performance model and metrics to evaluate progress towards meeting interim objectives, and comparing actual with predicted progress during scheduled periodic evaluations, and establishing decision criteria for when and how to adapt/modify/revise the remedial strategy in response to remedy performance. Key findings will be published in an ITRC Technical and Regulatory guidance document in 2017 and free training webinars will be conducted. More information is available at www.itrc-web.org. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Development of structural model of adaptive training complex in ergatic systems for professional use

    Science.gov (United States)

    Obukhov, A. D.; Dedov, D. L.; Arkhipov, A. E.

    2018-03-01

    The article considers the structural model of the adaptive training complex (ATC), which reflects the interrelations between the hardware, software and mathematical model of ATC and describes the processes in this subject area. The description of the main components of software and hardware complex, their interaction and functioning within the common system are given. Also the article scrutinizers a brief description of mathematical models of personnel activity, a technical system and influences, the interactions of which formalize the regularities of ATC functioning. The studies of main objects of training complexes and connections between them will make it possible to realize practical implementation of ATC in ergatic systems for professional use.

  14. Dietary Supplements for Health, Adaptation, and Recovery in Athletes.

    Science.gov (United States)

    Rawson, Eric S; Miles, Mary P; Larson-Meyer, D Enette

    2018-03-01

    Some dietary supplements are recommended to athletes based on data that supports improved exercise performance. Other dietary supplements are not ergogenic per se, but may improve health, adaptation to exercise, or recovery from injury, and so could help athletes to train and/or compete more effectively. In this review, we describe several dietary supplements that may improve health, exercise adaptation, or recovery. Creatine monohydrate may improve recovery from and adaptation to intense training, recovery from periods of injury with extreme inactivity, cognitive processing, and reduce severity of or enhance recovery from mild traumatic brain injury (mTBI). Omega 3-fatty acid supplementation may also reduce severity of or enhance recovery from mTBI. Replenishment of vitamin D insufficiency or deficiency will likely improve some aspects of immune, bone, and muscle health. Probiotic supplementation can reduce the incidence, duration, and severity of upper respiratory tract infection, which may indirectly improve training or competitive performance. Preliminary data show that gelatin and/or collagen may improve connective tissue health. Some anti-inflammatory supplements, such as curcumin or tart cherry juice, may reduce inflammation and possibly delayed onset muscle soreness (DOMS). Beta-hydroxy beta-methylbutyrate (HMB) does not consistently increase strength and/or lean mass or reduce markers of muscle damage, but more research on recovery from injury that includes periods of extreme inactivity is needed. Several dietary supplements, including creatine monohydrate, omega 3-fatty acids, vitamin D, probiotics, gelatin, and curcumin/tart cherry juice could help athletes train and/or compete more effectively.

  15. Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory.

    Science.gov (United States)

    Horvat, Ana; Filipovic, Jovan

    2018-02-01

    This research focuses on Complexity Leadership Theory and the relationship between leadership-examined through the lens of Complexity Leadership Theory-and organizational maturity as an indicator of the performance of health organizations. The research adopts a perspective that conceptualizes organizations as complex adaptive systems and draws upon a survey of opinion of 189 managers working in Serbian health organizations. As the results indicate a dependency between functions of leadership and levels of the maturity of health organizations, we propose a model that connects the two. The study broadens our understanding of the implications of complexity thinking and its reflection on leadership functions and overall organizational performance. The correlations between leadership functions and maturity could have practical applications in policy processing, thus improving the quality of outcomes and the overall level of service quality. © 2017 John Wiley & Sons, Ltd.

  16. Adaptive Synchronization of Fractional Order Complex-Variable Dynamical Networks via Pinning Control

    Science.gov (United States)

    Ding, Da-Wei; Yan, Jie; Wang, Nian; Liang, Dong

    2017-09-01

    In this paper, the synchronization of fractional order complex-variable dynamical networks is studied using an adaptive pinning control strategy based on close center degree. Some effective criteria for global synchronization of fractional order complex-variable dynamical networks are derived based on the Lyapunov stability theory. From the theoretical analysis, one concludes that under appropriate conditions, the complex-variable dynamical networks can realize the global synchronization by using the proper adaptive pinning control method. Meanwhile, we succeed in solving the problem about how much coupling strength should be applied to ensure the synchronization of the fractional order complex networks. Therefore, compared with the existing results, the synchronization method in this paper is more general and convenient. This result extends the synchronization condition of the real-variable dynamical networks to the complex-valued field, which makes our research more practical. Finally, two simulation examples show that the derived theoretical results are valid and the proposed adaptive pinning method is effective. Supported by National Natural Science Foundation of China under Grant No. 61201227, National Natural Science Foundation of China Guangdong Joint Fund under Grant No. U1201255, the Natural Science Foundation of Anhui Province under Grant No. 1208085MF93, 211 Innovation Team of Anhui University under Grant Nos. KJTD007A and KJTD001B, and also supported by Chinese Scholarship Council

  17. Complexity or Meaning in Health Professional Education and Practice?

    Science.gov (United States)

    Lowe, Wendy Anne

    2014-01-01

    Objectives: Discourses of complexity have entered health professional education. This paper explores the meaning of complexity by asking how health professionals are educated and some of the consequences of that education. Design: A qualitative study was carried out drawing on reflexivity, discourse analysis and grounded methodology. Setting: Two…

  18. Preventing disasters: public health vulnerability reduction as a sustainable adaptation to climate change.

    Science.gov (United States)

    Keim, Mark E

    2011-06-01

    Global warming could increase the number and severity of extreme weather events. These events are often known to result in public health disasters, but we can lessen the effects of these disasters. By addressing the factors that cause changes in climate, we can mitigate the effects of climate change. By addressing the factors that make society vulnerable to the effects of climate, we can adapt to climate change. To adapt to climate change, a comprehensive approach to disaster risk reduction has been proposed. By reducing human vulnerability to disasters, we can lessen--and at times even prevent--their impact. Human vulnerability is a complex phenomenon that comprises social, economic, health, and cultural factors. Because public health is uniquely placed at the community level, it has the opportunity to lessen human vulnerability to climate-related disasters. At the national and international level, a supportive policy environment can enable local adaptation to disaster events. The purpose of this article is to introduce the basic concept of disaster risk reduction so that it can be applied to preventing and mitigating the negative effects of climate change and to examine the role of community-focused public health as a means for lessening human vulnerability and, as a result, the overall risk of climate-related disasters.

  19. Models, methods and software tools for building complex adaptive traffic systems

    International Nuclear Information System (INIS)

    Alyushin, S.A.

    2011-01-01

    The paper studies the modern methods and tools to simulate the behavior of complex adaptive systems (CAS), the existing systems of traffic modeling in simulators and their characteristics; proposes requirements for assessing the suitability of the system to simulate the CAS behavior in simulators. The author has developed a model of adaptive agent representation and its functioning environment to meet certain requirements set above, and has presented methods of agents' interactions and methods of conflict resolution in simulated traffic situations. A simulation system realizing computer modeling for simulating the behavior of CAS in traffic situations has been created [ru

  20. The Use of Complex Adaptive Systems as a Generative Metaphor in an Action Research Study of an Organisation

    Science.gov (United States)

    Brown, Callum

    2008-01-01

    Understanding the dynamic behaviour of organisations is challenging and this study uses a model of complex adaptive systems as a generative metaphor to address this challenge. The research question addressed is: How might a conceptual model of complex adaptive systems be used to assist in understanding the dynamic nature of organisations? Using an…

  1. Robustness of critical points in a complex adaptive system: Effects of hedge behavior

    Science.gov (United States)

    Liang, Yuan; Huang, Ji-Ping

    2013-08-01

    In our recent papers, we have identified a class of phase transitions in the market-directed resource-allocation game, and found that there exists a critical point at which the phase transitions occur. The critical point is given by a certain resource ratio. Here, by performing computer simulations and theoretical analysis, we report that the critical point is robust against various kinds of human hedge behavior where the numbers of herds and contrarians can be varied widely. This means that the critical point can be independent of the total number of participants composed of normal agents, herds and contrarians, under some conditions. This finding means that the critical points we identified in this complex adaptive system (with adaptive agents) may also be an intensive quantity, similar to those revealed in traditional physical systems (with non-adaptive units).

  2. Rolling bearing fault diagnosis using adaptive deep belief network with dual-tree complex wavelet packet.

    Science.gov (United States)

    Shao, Haidong; Jiang, Hongkai; Wang, Fuan; Wang, Yanan

    2017-07-01

    Automatic and accurate identification of rolling bearing fault categories, especially for the fault severities and compound faults, is a challenge in rotating machinery fault diagnosis. For this purpose, a novel method called adaptive deep belief network (DBN) with dual-tree complex wavelet packet (DTCWPT) is developed in this paper. DTCWPT is used to preprocess the vibration signals to refine the fault characteristics information, and an original feature set is designed from each frequency-band signal of DTCWPT. An adaptive DBN is constructed to improve the convergence rate and identification accuracy with multiple stacked adaptive restricted Boltzmann machines (RBMs). The proposed method is applied to the fault diagnosis of rolling bearings. The results confirm that the proposed method is more effective than the existing methods. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  3. Elders Health Empowerment Scale: Spanish adaptation and psychometric analysis.

    Science.gov (United States)

    Serrani Azcurra, Daniel Jorge Luis

    2014-01-01

    Empowerment refers to patient skills that allow them to become primary decision-makers in control of daily self-management of health problems. As important the concept as it is, particularly for elders with chronic diseases, few available instruments have been validated for use with Spanish speaking people. Translate and adapt the Health Empowerment Scale (HES) for a Spanish-speaking older adults sample and perform its psychometric validation. The HES was adapted based on the Diabetes Empowerment Scale-Short Form. Where "diabetes" was mentioned in the original tool, it was replaced with "health" terms to cover all kinds of conditions that could affect health empowerment. Statistical and Psychometric Analyses were conducted on 648 urban-dwelling seniors. The HES had an acceptable internal consistency with a Cronbach's α of 0.89. The convergent validity was supported by significant Pearson's Coefficient correlations between the HES total and item scores and the General Self Efficacy Scale (r= 0.77), Swedish Rheumatic Disease Empowerment Scale (r= 0.69) and Making Decisions Empowerment Scale (r= 0.70). Construct validity was evaluated using item analysis, half-split test and corrected item to total correlation coefficients; with good internal consistency (α> 0.8). The content validity was supported by Scale and Item Content Validity Index of 0.98 and 1.0, respectively. HES had acceptable face validity and reliability coefficients; which added to its ease administration and users' unbiased comprehension, could set it as a suitable tool in evaluating elder's outpatient empowerment-based medical education programs.

  4. A Complexity-Aware Video Adaptation Mechanism for Live Streaming Systems

    Directory of Open Access Journals (Sweden)

    Chen Homer H

    2007-01-01

    Full Text Available The paradigm shift of network design from performance-centric to constraint-centric has called for new signal processing techniques to deal with various aspects of resource-constrained communication and networking. In this paper, we consider the computational constraints of a multimedia communication system and propose a video adaptation mechanism for live video streaming of multiple channels. The video adaptation mechanism includes three salient features. First, it adjusts the computational resource of the streaming server block by block to provide a fine control of the encoding complexity. Second, as far as we know, it is the first mechanism to allocate the computational resource to multiple channels. Third, it utilizes a complexity-distortion model to determine the optimal coding parameter values to achieve global optimization. These techniques constitute the basic building blocks for a successful application of wireless and Internet video to digital home, surveillance, IPTV, and online games.

  5. A Complexity-Aware Video Adaptation Mechanism for Live Streaming Systems

    Science.gov (United States)

    Lu, Meng-Ting; Yao, Jason J.; Chen, Homer H.

    2007-12-01

    The paradigm shift of network design from performance-centric to constraint-centric has called for new signal processing techniques to deal with various aspects of resource-constrained communication and networking. In this paper, we consider the computational constraints of a multimedia communication system and propose a video adaptation mechanism for live video streaming of multiple channels. The video adaptation mechanism includes three salient features. First, it adjusts the computational resource of the streaming server block by block to provide a fine control of the encoding complexity. Second, as far as we know, it is the first mechanism to allocate the computational resource to multiple channels. Third, it utilizes a complexity-distortion model to determine the optimal coding parameter values to achieve global optimization. These techniques constitute the basic building blocks for a successful application of wireless and Internet video to digital home, surveillance, IPTV, and online games.

  6. Optimizing Decision Preparedness by Adapting Scenario Complexity and Automating Scenario Generation

    Science.gov (United States)

    Dunne, Rob; Schatz, Sae; Flore, Stephen M.; Nicholson, Denise

    2011-01-01

    Klein's recognition-primed decision (RPD) framework proposes that experts make decisions by recognizing similarities between current decision situations and previous decision experiences. Unfortunately, military personnel arQ often presented with situations that they have not experienced before. Scenario-based training (S8T) can help mitigate this gap. However, SBT remains a challenging and inefficient training approach. To address these limitations, the authors present an innovative formulation of scenario complexity that contributes to the larger research goal of developing an automated scenario generation system. This system will enable trainees to effectively advance through a variety of increasingly complex decision situations and experiences. By adapting scenario complexities and automating generation, trainees will be provided with a greater variety of appropriately calibrated training events, thus broadening their repositories of experience. Preliminary results from empirical testing (N=24) of the proof-of-concept formula are presented, and future avenues of scenario complexity research are also discussed.

  7. Computational Strategies for Dissecting the High-Dimensional Complexity of Adaptive Immune Repertoires

    Directory of Open Access Journals (Sweden)

    Enkelejda Miho

    2018-02-01

    Full Text Available The adaptive immune system recognizes antigens via an immense array of antigen-binding antibodies and T-cell receptors, the immune repertoire. The interrogation of immune repertoires is of high relevance for understanding the adaptive immune response in disease and infection (e.g., autoimmunity, cancer, HIV. Adaptive immune receptor repertoire sequencing (AIRR-seq has driven the quantitative and molecular-level profiling of immune repertoires, thereby revealing the high-dimensional complexity of the immune receptor sequence landscape. Several methods for the computational and statistical analysis of large-scale AIRR-seq data have been developed to resolve immune repertoire complexity and to understand the dynamics of adaptive immunity. Here, we review the current research on (i diversity, (ii clustering and network, (iii phylogenetic, and (iv machine learning methods applied to dissect, quantify, and compare the architecture, evolution, and specificity of immune repertoires. We summarize outstanding questions in computational immunology and propose future directions for systems immunology toward coupling AIRR-seq with the computational discovery of immunotherapeutics, vaccines, and immunodiagnostics.

  8. Complexity: a potential paradigm for a health promotion discipline.

    Science.gov (United States)

    Tremblay, Marie-Claude; Richard, Lucie

    2014-06-01

    Health promotion underpins a distancing from narrow, simplifying health approaches associated with the biomedical model. However, it has not yet succeeded in formally establishing its theoretical, epistemological and methodological foundations on a single paradigm. The complexity paradigm, which it has yet to broach head-on, might provide it with a disciplinary matrix in line with its implicit stances and basic values. This article seeks to establish complexity's relevance as a paradigm that can contribute to the development of a health promotion discipline. The relevance of complexity is justified primarily by its matching with several implicit epistemological and methodological/theoretical stances found in the cardinal concepts and principles of health promotion. The transcendence of ontological realism and determinism as well as receptiveness in respect of the reflexivity that complexity encompasses are congruent with the values of social justice, participation, empowerment and the concept of positive health that the field promotes. Moreover, from a methodological and theoretical standpoint, complexity assumes a holistic, contextual and transdisciplinary approach, toward which health promotion is tending through its emphasis on ecology and interdisciplinary action. In a quest to illustrate our position, developmental evaluation is presented as an example of practice stemming from a complexity paradigm that can be useful in the evaluation of health promotion initiatives. In short, we argue that it would be advantageous for health promotion to integrate this paradigm, which would provide it with a formal framework appropriate to its purposes and concerns.

  9. Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation.

    Science.gov (United States)

    Yen, Po-Yin; McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

    2017-09-07

    In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. ©Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 07.09.2017.

  10. Adaptative synchronization in multi-output fractional-order complex dynamical networks and secure communications

    Science.gov (United States)

    Mata-Machuca, Juan L.; Aguilar-López, Ricardo

    2018-01-01

    This work deals with the adaptative synchronization of complex dynamical networks with fractional-order nodes and its application in secure communications employing chaotic parameter modulation. The complex network is composed of multiple fractional-order systems with mismatch parameters and the coupling functions are given to realize the network synchronization. We introduce a fractional algebraic synchronizability condition (FASC) and a fractional algebraic identifiability condition (FAIC) which are used to know if the synchronization and parameters estimation problems can be solved. To overcome these problems, an adaptative synchronization methodology is designed; the strategy consists in proposing multiple receiver systems which tend to follow asymptotically the uncertain transmitters systems. The coupling functions and parameters of the receiver systems are adjusted continually according to a convenient sigmoid-like adaptative controller (SLAC), until the measurable output errors converge to zero, hence, synchronization between transmitter and receivers is achieved and message signals are recovered. Indeed, the stability analysis of the synchronization error is based on the fractional Lyapunov direct method. Finally, numerical results corroborate the satisfactory performance of the proposed scheme by means of the synchronization of a complex network consisting of several fractional-order unified chaotic systems.

  11. Adversity, Adaptive Calibration, and Health: The Case of Disadvantaged Families

    Science.gov (United States)

    de Baca, Tomás Cabeza; Wahl, Richard A.; Barnett, Melissa A.; Figueredo, Aurelio José; Ellis, Bruce J.

    2016-01-01

    Epidemiologists and medical researchers often employ an allostatic load model that focuses on environmental and lifestyle factors, together with biological vulnerabilities, to explain the deterioration of human physiological systems and chronic degenerative disease. Although this perspective has informed medicine and public health, it is agnostic toward the functional significance of pathophysiology and health deterioration. Drawing on Life History (LH) theory, the current paper reviews the literature on disadvantaged families to serve as a conceptual model of stress-health relationships in which the allocation of reproductive effort is instantiated in the LH strategies of individuals and reflects the bioenergetic and material resource tradeoffs. We propose that researchers interested in health disparities reframe chronic degenerative diseases as outcomes resulting from strategic calibration of physiological systems to best adapt, survive, and reproduce in response to demands of specific developmental contexts. These effects of adversity on later-age degenerative disease are mediated, in part, by socioemotional and cognitive mechanisms expressed in different life history strategies. PMID:27175327

  12. The simplicity complex: exploring simplified health messages in a complex world.

    Science.gov (United States)

    Zarcadoolas, Christina

    2011-09-01

    A challenge in individual and public health at the start of the 21st century is to effectively communicate health and science information about disease and complex emergencies. The low health literacy of millions of adults in the USA has been referred to as a 'silent killer'. A popular approach to improving health communication and health promotion to low health literate consumers has been to simplify the language of health information. The expected result has been that individuals and groups will better understand information and will then make informed decisions about their health and behaviors. This expectation has grown to include the belief that the public will be better prepared to take appropriate action in complex natural and man-made emergencies. Demonstrating the efficacy of this approach remains, in large part, uninvestigated. And it is becoming more evident that health literacy itself is complex and multifaceted. This article applies linguistic and sociolinguistic models in order to better articulate the role of simplification in health communication and health promotion. Focusing on two models from sociolinguistics-pragmatics and text theory-the article discusses their usefulness in rethinking message simplification. The discussion proposes that a richer, more theory-based understanding of text structures and functions, along with other powerful constructs, including cultural appropriateness, relevancy and context, are needed to close the gaps between health messages, health messengers and patients/the public. The article concludes by making recommendations for future study to empirically test the strengths and limitations of these models and constructs.

  13. Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective.

    Science.gov (United States)

    Nigenda, Gustavo; González-Robledo, Luz María; Juárez-Ramírez, Clara; Adam, Taghreed

    2016-05-13

    In 2003, Mexico's Seguro Popular de Salud (SPS), was launched as an innovative financial mechanism implemented to channel new funds to provide health insurance to 50 million Mexicans and to reduce systemic financial inequities. The objective of this article is to understand the complexity and dynamics that contributed to the adaptation of the policy in the implementation stage, how these changes occurred, and why, from a complex and adaptive systems perspective. A complex adaptive systems (CAS) framework was used to carry out a secondary analysis of data obtained from four SPS's implementation evaluations. We first identified key actors, their roles, incentives and power, and their responses to the policy and guidelines. We then developed a causal loop diagram to disentangle the feedback dynamics associated with the modifications of the policy implementation which we then analyzed using a CAS perspective. Implementation variations were identified in seven core design features during the first 10 years of implementation period, and in each case, the SPS's central coordination introduced modifications in response to the reactions of the different actors. We identified several CAS phenomena associated with these changes including phase transitions, network emergence, resistance to change, history dependence, and feedback loops. Our findings generate valuable lessons to policy implementation processes, especially those involving a monetary component, where the emergence of coping mechanisms and other CAS phenomena inevitably lead to modifications of policies and their interpretation by those who implement them. These include the difficulty of implementing strategies that aim to pool funds through solidarity among beneficiaries where the rich support the poor when there are no incentives for the rich to do so. Also, how resistance to change and history dependence can pose significant challenges to implementing changes, where the local actors use their significant power

  14. Genes of the major histocompatibility complex highlight interactions of the innate and adaptive immune system

    Directory of Open Access Journals (Sweden)

    Barbara Lukasch

    2017-08-01

    Full Text Available Background A well-functioning immune defence is crucial for fitness, but our knowledge about the immune system and its complex interactions is still limited. Major histocompatibility complex (MHC molecules are involved in T-cell mediated adaptive immune responses, but MHC is also highly upregulated during the initial innate immune response. The aim of our study was therefore to determine to what extent the highly polymorphic MHC is involved in interactions of the innate and adaptive immune defence and if specific functional MHC alleles (FA or heterozygosity at the MHC are more important. Methods To do this we used captive house sparrows (Passer domesticus to survey MHC diversity and immune function controlling for several environmental factors. MHC class I alleles were identified using parallel amplicon sequencing and to mirror immune function, several immunological tests that correspond to the innate and adaptive immunity were conducted. Results Our results reveal that MHC was linked to all immune tests, highlighting its importance for the immune defence. While all innate responses were associated with one single FA, adaptive responses (cell-mediated and humoral were associated with several different alleles. Discussion We found that repeated injections of an antibody in nestlings and adults were linked to different FA and hence might affect different areas of the immune system. Also, individuals with a higher number of different FA produced a smaller secondary response, indicating a disadvantage of having numerous MHC alleles. These results demonstrate the complexity of the immune system in relation to the MHC and lay the foundation for other studies to further investigate this topic.

  15. Genes of the major histocompatibility complex highlight interactions of the innate and adaptive immune system.

    Science.gov (United States)

    Lukasch, Barbara; Westerdahl, Helena; Strandh, Maria; Winkler, Hans; Moodley, Yoshan; Knauer, Felix; Hoi, Herbert

    2017-01-01

    A well-functioning immune defence is crucial for fitness, but our knowledge about the immune system and its complex interactions is still limited. Major histocompatibility complex (MHC) molecules are involved in T-cell mediated adaptive immune responses, but MHC is also highly upregulated during the initial innate immune response. The aim of our study was therefore to determine to what extent the highly polymorphic MHC is involved in interactions of the innate and adaptive immune defence and if specific functional MHC alleles (FA) or heterozygosity at the MHC are more important. To do this we used captive house sparrows ( Passer domesticus ) to survey MHC diversity and immune function controlling for several environmental factors. MHC class I alleles were identified using parallel amplicon sequencing and to mirror immune function, several immunological tests that correspond to the innate and adaptive immunity were conducted. Our results reveal that MHC was linked to all immune tests, highlighting its importance for the immune defence. While all innate responses were associated with one single FA, adaptive responses (cell-mediated and humoral) were associated with several different alleles. We found that repeated injections of an antibody in nestlings and adults were linked to different FA and hence might affect different areas of the immune system. Also, individuals with a higher number of different FA produced a smaller secondary response, indicating a disadvantage of having numerous MHC alleles. These results demonstrate the complexity of the immune system in relation to the MHC and lay the foundation for other studies to further investigate this topic.

  16. Training complexity is not decisive factor for improving adaptation to visual sensory conflict.

    Science.gov (United States)

    Yang, Yang; Pu, Fang; Li, Shuyu; Li, Yan; Li, Deyu; Fan, Yubo

    2012-01-01

    Ground-based preflight training utilizing unusual visual stimuli is useful for decreasing the susceptibility to space motion sickness (SMS). The effectiveness of the sensorimotor adaptation training is affected by the training tasks, but what kind of task is more effective remains unknown. Whether the complexity is the decisive factor to consider for designing the training and if other factors are more important need to be analyzed. The results from the analysis can help to optimize the preflight training tasks for astronauts. Twenty right-handed subjects were asked to draw the right path of 45° rotated maze before and after 30 min training. Subjects wore an up-down reversing prism spectacle in test and training sessions. Two training tasks were performed: drawing the right path of the horizontal maze (complex task but with different orientation feature) and drawing the L-shape lines (easy task with same orientation feature). The error rate and the executing time were measured during the test. Paired samples t test was used to compare the effects of the two training tasks. After each training, the error rate and the executing time were significantly decreased. However, the training effectiveness of the easy task was better as the test was finished more quickly and accurately. The complexity is not always the decisive factor for designing the adaptation training task, e.g. the orientation feature is more important in this study. In order to accelerate the adaptation and to counter SMS, the task for astronauts preflight adaptation training could be simple activities with the key features.

  17. Macroscopic description of complex adaptive networks coevolving with dynamic node states

    Science.gov (United States)

    Wiedermann, Marc; Donges, Jonathan F.; Heitzig, Jobst; Lucht, Wolfgang; Kurths, Jürgen

    2015-05-01

    In many real-world complex systems, the time evolution of the network's structure and the dynamic state of its nodes are closely entangled. Here we study opinion formation and imitation on an adaptive complex network which is dependent on the individual dynamic state of each node and vice versa to model the coevolution of renewable resources with the dynamics of harvesting agents on a social network. The adaptive voter model is coupled to a set of identical logistic growth models and we mainly find that, in such systems, the rate of interactions between nodes as well as the adaptive rewiring probability are crucial parameters for controlling the sustainability of the system's equilibrium state. We derive a macroscopic description of the system in terms of ordinary differential equations which provides a general framework to model and quantify the influence of single node dynamics on the macroscopic state of the network. The thus obtained framework is applicable to many fields of study, such as epidemic spreading, opinion formation, or socioecological modeling.

  18. Inter-plant communication through mycorrhizal networks mediates complex adaptive behaviour in plant communities.

    Science.gov (United States)

    Gorzelak, Monika A; Asay, Amanda K; Pickles, Brian J; Simard, Suzanne W

    2015-05-15

    Adaptive behaviour of plants, including rapid changes in physiology, gene regulation and defence response, can be altered when linked to neighbouring plants by a mycorrhizal network (MN). Mechanisms underlying the behavioural changes include mycorrhizal fungal colonization by the MN or interplant communication via transfer of nutrients, defence signals or allelochemicals. We focus this review on our new findings in ectomycorrhizal ecosystems, and also review recent advances in arbuscular mycorrhizal systems. We have found that the behavioural changes in ectomycorrhizal plants depend on environmental cues, the identity of the plant neighbour and the characteristics of the MN. The hierarchical integration of this phenomenon with other biological networks at broader scales in forest ecosystems, and the consequences we have observed when it is interrupted, indicate that underground 'tree talk' is a foundational process in the complex adaptive nature of forest ecosystems. Published by Oxford University Press on behalf of the Annals of Botany Company.

  19. Health and environmental effects of complex chemical mixtures: proceedings

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    The Office of Health and Environmental Research (OHER) of the Department of Energy supports a broad long-term research program on human health and environmental effects from potential exposure to energy-related complex chemical mixtures. The program seeks basic mechanistic data on the effects of complex mixtures at the cellular, molecular, and whole animal levels to aid in predicting human health effects and seeks ecological data on biological and physical transformations in the mixtures, concentrations of the mixtures in various compartments of the environment, and potential routes for human exposure to these mixtures (e.g., food chain). On June 17-18, 1985, OHER held its First Annual Technical Meeting on the Complex Chemical Mixtures Program in Chicago, IL. The primary purpose of the meeting was to enable principal investigators to report the research status and accomplishments of ongoing complex chemical mixture studies supported by OHER. To help focus future research directions round table discussions were conducted.

  20. Antecedents and Consequences of Consumer's Response to Health Information Complexity

    DEFF Research Database (Denmark)

    Hansen, Torben; Uth Thomsen, Thyra; Beckmann, Suzanne C.

    2013-01-01

    This study develops and empirically tests a model for understanding food consumers' health information seeking behaviour. Data were collected from 504 food consumers using a nationally representative consumer panel. The obtained Lisrel results suggest that consumers' product-specific health...... information seeking is positively affected by general food involvement and by usability of product-specific health information. Moreover, product-specific health information seeking and product-specific health information complexity are both positively related to post-purchase health-related dissonance....... This link between information complexity and post-purchase dissonance has implications for marketers of food products since our results suggest that consumers might avoid purchasing the same food item again if post-purchase dissonance is experienced....

  1. Genes involved in complex adaptive processes tend to have highly conserved upstream regions in mammalian genomes

    Directory of Open Access Journals (Sweden)

    Kohane Isaac

    2005-11-01

    Full Text Available Abstract Background Recent advances in genome sequencing suggest a remarkable conservation in gene content of mammalian organisms. The similarity in gene repertoire present in different organisms has increased interest in studying regulatory mechanisms of gene expression aimed at elucidating the differences in phenotypes. In particular, a proximal promoter region contains a large number of regulatory elements that control the expression of its downstream gene. Although many studies have focused on identification of these elements, a broader picture on the complexity of transcriptional regulation of different biological processes has not been addressed in mammals. The regulatory complexity may strongly correlate with gene function, as different evolutionary forces must act on the regulatory systems under different biological conditions. We investigate this hypothesis by comparing the conservation of promoters upstream of genes classified in different functional categories. Results By conducting a rank correlation analysis between functional annotation and upstream sequence alignment scores obtained by human-mouse and human-dog comparison, we found a significantly greater conservation of the upstream sequence of genes involved in development, cell communication, neural functions and signaling processes than those involved in more basic processes shared with unicellular organisms such as metabolism and ribosomal function. This observation persists after controlling for G+C content. Considering conservation as a functional signature, we hypothesize a higher density of cis-regulatory elements upstream of genes participating in complex and adaptive processes. Conclusion We identified a class of functions that are associated with either high or low promoter conservation in mammals. We detected a significant tendency that points to complex and adaptive processes were associated with higher promoter conservation, despite the fact that they have emerged

  2. A Framework of Complex Adaptive Systems: Parents As Partners in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    DʼAgata, Amy L; McGrath, Jacqueline M

    2016-01-01

    Advances in neonatal care are allowing for increased infant survival; however, neurodevelopmental complications continue. Using a complex adaptive system framework, a broad analysis of the network of agents most influential to vulnerable infants in the neonatal intensive care unit (NICU) is presented: parent, nurse, and organization. By exploring these interconnected relationships and the emergent behaviors, a model of care that increases parental caregiving in the NICU is proposed. Supportive parent caregiving early in an infant's NICU stay has the potential for more sensitive caregiving and enhanced opportunities for attachment, perhaps positively impacting neurodevelopment.

  3. Integration of FULLSWOF2D and PeanoClaw: Adaptivity and Local Time-Stepping for Complex Overland Flows

    KAUST Repository

    Unterweger, K.; Wittmann, R.; Neumann, P.; Weinzierl, T.; Bungartz, H.-J.

    2015-01-01

    © Springer International Publishing Switzerland 2015. We propose to couple our adaptive mesh refinement software PeanoClaw with existing solvers for complex overland flows that are tailored to regular Cartesian meshes. This allows us to augment them

  4. Towards a Unified Theory of Health-Disease: I. Health as a complex model-object

    Directory of Open Access Journals (Sweden)

    Naomar Almeida-Filho

    2013-06-01

    Full Text Available Theory building is one of the most crucial challenges faced by basic, clinical and population research, which form the scientific foundations of health practices in contemporary societies. The objective of the study is to propose a Unified Theory of Health-Disease as a conceptual tool for modeling health-disease-care in the light of complexity approaches. With this aim, the epistemological basis of theoretical work in the health field and concepts related to complexity theory as concerned to health problems are discussed. Secondly, the concepts of model-object, multi-planes of occurrence, modes of health and disease-illness-sickness complex are introduced and integrated into a unified theoretical framework. Finally, in the light of recent epistemological developments, the concept of Health-Disease-Care Integrals is updated as a complex reference object fit for modeling health-related processes and phenomena.

  5. Symmetry-adapted perturbation theory interaction energy decomposition for some noble gas complexes

    Science.gov (United States)

    Cukras, Janusz; Sadlej, Joanna

    2008-06-01

    This Letter contains a study of the interaction energy in HArF⋯N 2 and HArF⋯P 2 complexes. Symmetry-adapted perturbation theory (SAPT) has been applied to analyze the electrostatic, induction, dispersion and exchange contributions to the total interaction energy. The interaction energy has also been obtained by supermolecular method at the MP2, MP4, CCSD, CCSD(T) levels. The interaction energy for the studied complexes results from a partial cancelation of large attractive electrostatic, induction, dispersion terms by a strong repulsive exchange contribution. The induction and dispersion effects proved to be crucial in establishing the preference for the colinear HArF⋯N 2 and HArF⋯P 2 structures and shift direction of νHAr stretching vibrations.

  6. The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems.

    Science.gov (United States)

    Lyon, Aaron R; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J; Unützer, Jürgen; McCauley, Elizabeth

    2016-05-01

    Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the contextualized technology adaptation process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians' workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors.

  7. The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems

    Science.gov (United States)

    Lyon, Aaron R.; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J.; Unützer, Jürgen; McCauley, Elizabeth

    2015-01-01

    Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the Contextualized Technology Adaptation Process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians’ workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors. PMID:25677251

  8. Complex adaptation-based LDR image rendering for 3D image reconstruction

    Science.gov (United States)

    Lee, Sung-Hak; Kwon, Hyuk-Ju; Sohng, Kyu-Ik

    2014-07-01

    A low-dynamic tone-compression technique is developed for realistic image rendering that can make three-dimensional (3D) images similar to realistic scenes by overcoming brightness dimming in the 3D display mode. The 3D surround provides varying conditions for image quality, illuminant adaptation, contrast, gamma, color, sharpness, and so on. In general, gain/offset adjustment, gamma compensation, and histogram equalization have performed well in contrast compression; however, as a result of signal saturation and clipping effects, image details are removed and information is lost on bright and dark areas. Thus, an enhanced image mapping technique is proposed based on space-varying image compression. The performance of contrast compression is enhanced with complex adaptation in a 3D viewing surround combining global and local adaptation. Evaluating local image rendering in view of tone and color expression, noise reduction, and edge compensation confirms that the proposed 3D image-mapping model can compensate for the loss of image quality in the 3D mode.

  9. The impact of diurnal sleep on the consolidation of a complex gross motor adaptation task

    Science.gov (United States)

    Hoedlmoser, Kerstin; Birklbauer, Juergen; Schabus, Manuel; Eibenberger, Patrick; Rigler, Sandra; Mueller, Erich

    2015-01-01

    Diurnal sleep effects on consolidation of a complex, ecological valid gross motor adaptation task were examined using a bicycle with an inverse steering device. We tested 24 male subjects aged between 20 and 29 years using a between-subjects design. Participants were trained to adapt to the inverse steering bicycle during 45 min. Performance was tested before (TEST1) and after (TEST2) training, as well as after a 2 h retention interval (TEST3). During retention, participants either slept or remained awake. To assess gross motor performance, subjects had to ride the inverse steering bicycle 3 × 30 m straight-line and 3 × 30 m through a slalom. Beyond riding time, we sophisticatedly measured performance accuracy (standard deviation of steering angle) in both conditions using a rotatory potentiometer. A significant decrease of accuracy during straight-line riding after nap and wakefulness was shown. Accuracy during slalom riding remained stable after wakefulness but was reduced after sleep. We found that the duration of rapid eye movement sleep as well as sleep spindle activity are negatively related with gross motor performance changes over sleep. Together these findings suggest that the consolidation of adaptation to a new steering device does not benefit from a 2 h midday nap. We speculate that in case of strongly overlearned motor patterns such as normal cycling, diurnal sleep spindles and rapid eye movement sleep might even help to protect everyday needed skills, and to rapidly forget newly acquired, interfering and irrelevant material. PMID:25256866

  10. Child Obesity and Mental Health: A Complex Interaction.

    Science.gov (United States)

    Small, Leigh; Aplasca, Alexis

    2016-04-01

    Prevalence rates of childhood obesity have risen steeply over the last 3 decades. Given the increased national focus, the frequency of this clinical problem, and the multiple mental health factors that coexist with it, make obesity a public health concern. The complex relationships between mental health and obesity serve to potentiate the severity and interdependency of each. The purpose of this review is to create a contextual connection for the 2 conditions as outlined by the research literature and consider treatment options that affect both health problems. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Applied ELT: A Paradigm Justifying Complex Adaptive System of Language Teaching?

    Directory of Open Access Journals (Sweden)

    Masoud Mahmoodzadeh

    2013-12-01

    Full Text Available In an endeavor to reflect on the advent of Applied ELT paradigm pioneered by Pishghadam (2011 in the area of second language education, this article delves into the unexplored nature of this emerging paradigm via a contemporary complexity-driven voice. The crux of the argument addressed in this article suggests that Applied ELT is a pragmatic manifestation of complex adaptive system of language teaching. To set the grounds expressly for such enquiry, firstly it draws on both premises and axioms associated with complexity theory and its existing literature in the circle of second language research. It then tracks down the evolutionary course of the new developed paradigm of Applied ELT within the realm of second language education and also elaborates the cornerstone and manifold tenets of this paradigm sufficiently. Finally, the article attempts to critically elucidate and rationalize the recent emergence of Applied ELT paradigm through the lens of complexity theory. To broaden our thinking and understanding about the potential and multi-directional influence of ELT field, the article ends by calling for a reshaped educational direction for ELT position in second language education.

  12. MANAGING A COMPLEX ADAPTIVE ECOSYSTEM: TOWARDS A SMART MANAGEMENT OF INDUSTRIAL HERITAGE TOURISM

    Directory of Open Access Journals (Sweden)

    Maria Concetta Perfetto

    2016-09-01

    Full Text Available This paper is focused on the concept of business ecosystem, which is a relatively new field in management research. Furthermore, there is a second emerging research approach in social sciences named “complexity theory” that considers ecosystems, and business ecosystems, as complex adaptive systems. The main aim is to connect both by bringing new insights under the basis of a smart vision of tourism. In particular, we propose a theoretical discussion of the aforementioned concepts by applying them to the specific context of Industrial Heritage Management. The Industrial Heritage (i.e.: mining sites, old infrastructures, museums and historic places related to industry… is chosen because it appears well representative: it is characterized by a complex and dynamic structure which consists of an interconnected population of stakeholders and several tangible and intangible resources to recover, organize and then manage. It follows that the management of this ecosystem should take into account many factors simultaneously. Based also on the emergent initiative of Smart Tourism, a conceptual model is presented, in which each component is explained and the focal complexity aspects appearing in this business ecosystem are highlighted. We conclude with a set of propositions for recommending new paths for future studies.

  13. Obesity, Complexity, and the Role of the Health System

    OpenAIRE

    Frood, Sarah; Johnston, Lee M.; Matteson, Carrie L.; Finegood, Diane T.

    2013-01-01

    As obesity continues to increase throughout the world, there is still no well-defined solution to the issue. Reducing obesity poses a significant challenge for the health care system because it is a complex problem with numerous interconnections and elements. The complexity of obesity challenges traditional primary care practices that have been structured to address simple or less complicated conditions. Systems thinking provides a way forward for clinicians that are discouraged or overwhelme...

  14. CRISPR-Cas Adaptive Immune Systems of the Sulfolobales: Unravelling Their Complexity and Diversity

    Directory of Open Access Journals (Sweden)

    Roger A. Garrett

    2015-03-01

    Full Text Available The Sulfolobales have provided good model organisms for studying CRISPR-Cas systems of the crenarchaeal kingdom of the archaea. These organisms are infected by a wide range of exceptional archaea-specific viruses and conjugative plasmids, and their CRISPR-Cas systems generally exhibit extensive structural and functional diversity. They carry large and multiple CRISPR loci and often multiple copies of diverse Type I and Type III interference modules as well as more homogeneous adaptation modules. These acidothermophilic organisms have recently provided seminal insights into both the adaptation process, the diverse modes of interference, and their modes of regulation. The functions of the adaptation and interference modules tend to be loosely coupled and the stringency of the crRNA-DNA sequence matching during DNA interference is relatively low, in contrast to some more streamlined CRISPR-Cas systems of bacteria. Despite this, there is evidence for a complex and differential regulation of expression of the diverse functional modules in response to viral infection. Recent work also supports critical roles for non-core Cas proteins, especially during Type III-directed interference, and this is consistent with these proteins tending to coevolve with core Cas proteins. Various novel aspects of CRISPR-Cas systems of the Sulfolobales are considered including an alternative spacer acquisition mechanism, reversible spacer acquisition, the formation and significance of antisense CRISPR RNAs, and a novel mechanism for avoidance of CRISPR-Cas defense. Finally, questions regarding the basis for the complexity, diversity, and apparent redundancy, of the intracellular CRISPR-Cas systems are discussed.

  15. Genome complexity in the coelacanth is reflected in its adaptive immune system

    Science.gov (United States)

    Saha, Nil Ratan; Ota, Tatsuya; Litman, Gary W.; Hansen, John; Parra, Zuly; Hsu, Ellen; Buonocore, Francesco; Canapa, Adriana; Cheng, Jan-Fang; Amemiya, Chris T.

    2014-01-01

    We have analyzed the available genome and transcriptome resources from the coelacanth in order to characterize genes involved in adaptive immunity. Two highly distinctive IgW-encoding loci have been identified that exhibit a unique genomic organization, including a multiplicity of tandemly repeated constant region exons. The overall organization of the IgW loci precludes typical heavy chain class switching. A locus encoding IgM could not be identified either computationally or by using several different experimental strategies. Four distinct sets of genes encoding Ig light chains were identified. This includes a variant sigma-type Ig light chain previously identified only in cartilaginous fishes and which is now provisionally denoted sigma-2. Genes encoding α/β and γ/δ T-cell receptors, and CD3, CD4, and CD8 co-receptors also were characterized. Ig heavy chain variable region genes and TCR components are interspersed within the TCR α/δ locus; this organization previously was reported only in tetrapods and raises questions regarding evolution and functional cooption of genes encoding variable regions. The composition, organization and syntenic conservation of the major histocompatibility complex locus have been characterized. We also identified large numbers of genes encoding cytokines and their receptors, and other genes associated with adaptive immunity. In terms of sequence identity and organization, the adaptive immune genes of the coelacanth more closely resemble orthologous genes in tetrapods than those in teleost fishes, consistent with current phylogenomic interpretations. Overall, the work reported described herein highlights the complexity inherent in the coelacanth genome and provides a rich catalog of immune genes for future investigations.

  16. A review of human factors challenges of complex adaptive systems: discovering and understanding chaos in human performance.

    Science.gov (United States)

    Karwowski, Waldemar

    2012-12-01

    In this paper, the author explores a need for a greater understanding of the true nature of human-system interactions from the perspective of the theory of complex adaptive systems, including the essence of complexity, emergent properties of system behavior, nonlinear systems dynamics, and deterministic chaos. Human performance, more often than not, constitutes complex adaptive phenomena with emergent properties that exhibit nonlinear dynamical (chaotic) behaviors. The complexity challenges in the design and management of contemporary work systems, including service systems, are explored. Examples of selected applications of the concepts of nonlinear dynamics to the study of human physical performance are provided. Understanding and applications of the concepts of theory of complex adaptive and dynamical systems should significantly improve the effectiveness of human-centered design efforts of a large system of systems. Performance of many contemporary work systems and environments may be sensitive to the initial conditions and may exhibit dynamic nonlinear properties and chaotic system behaviors. Human-centered design of emergent human-system interactions requires application of the theories of nonlinear dynamics and complex adaptive system. The success of future human-systems integration efforts requires the fusion of paradigms, knowledge, design principles, and methodologies of human factors and ergonomics with those of the science of complex adaptive systems as well as modern systems engineering.

  17. Self-complexity and health promotion: promising but premature.

    Science.gov (United States)

    Hershberger, P J

    1990-06-01

    Self-complexity, the number of nonredundant aspects by which the self is cognitively represented, was reported in 1987 by Linville to function as a buffer against the adverse consequences of stress under conditions of high stress. An attempt was made to increase the self-complexity of 110 undergraduates through the use of psychoeducational interventions, with the goal of decreasing physical symptoms. None of four interventions produced an increase in self-complexity or a decrease in physical symptoms. Using multiple regression, the previously reported buffering interaction was evident only among those experiencing the strongest intervention, and Linville's results were not replicated when the entire data set was analyzed. The hypothesis of a relationship between self-complexity and individuals' sense of meaning and purpose in life was not corroborated by correlational analysis. It is concluded that the relationship between self-complexity and health remains intriguing but inadequately tested.

  18. Ethnographic methods for process evaluations of complex health behaviour interventions.

    Science.gov (United States)

    Morgan-Trimmer, Sarah; Wood, Fiona

    2016-05-04

    This article outlines the contribution that ethnography could make to process evaluations for trials of complex health-behaviour interventions. Process evaluations are increasingly used to examine how health-behaviour interventions operate to produce outcomes and often employ qualitative methods to do this. Ethnography shares commonalities with the qualitative methods currently used in health-behaviour evaluations but has a distinctive approach over and above these methods. It is an overlooked methodology in trials of complex health-behaviour interventions that has much to contribute to the understanding of how interventions work. These benefits are discussed here with respect to three strengths of ethnographic methodology: (1) producing valid data, (2) understanding data within social contexts, and (3) building theory productively. The limitations of ethnography within the context of process evaluations are also discussed.

  19. Adaptation

    International Development Research Centre (IDRC) Digital Library (Canada)

    building skills, knowledge or networks on adaptation, ... the African partners leading the AfricaAdapt network, together with the UK-based Institute of Development Studies; and ... UNCCD Secretariat, Regional Coordination Unit for Africa, Tunis, Tunisia .... 26 Rural–urban Cooperation on Water Management in the Context of.

  20. Literature and Cinema from "Adaptation" to Re-creation: Coping with the Complexity of Human Recollection

    Directory of Open Access Journals (Sweden)

    Carlo Testa

    2013-01-01

    Full Text Available Early 20th-century avant-gardes put a premium on the notion of "originality" and so created a cultural context in which "adaptation" -- in particular, lit-to cinema adaptation -- later came to be construed by film theory as a kind of derivative, inferior notion. This article offers the proof, based on work on the little-known original Russian sources, that none other than Èizenshtein opined differently, so much so that he preferred to argue instead for the use of the term "re-creation"; and that later semiotic theory, especially thanks to Iurii Lotman, provides us with the tools to develop the "re-creation" concept fully. In the process of re-creation, which is always a process of cultural re-contextualization, the original literary complexity lost in the transmutation must be made up in specific cinematic ways, in order to offer a final re-created artefact worthy of recollection by human society. In times of an overburdened human ability to remember historic sufferings, re-created artefacts that lose information vis-a-vis the original will be quite justly forgotten. On this basis, the article concludes with an elaboration on contemporary Italian cinema -- especially some commercially successful noirs -- drawn from literature (or rather, books of fiction and pinpoints the nature of one of that type of cinema's recurrent shortcomings. The essential defect of such films is identified in their inability to make up by cinematic means for the loss of complexity which they endure in the transition from one medium to another. This is all the more true when, as in the case of the noirs examined here, complexity is already scant in the original books in the first place.

  1. System health monitoring using multiple-model adaptive estimation techniques

    Science.gov (United States)

    Sifford, Stanley Ryan

    Monitoring system health for fault detection and diagnosis by tracking system parameters concurrently with state estimates is approached using a new multiple-model adaptive estimation (MMAE) method. This novel method is called GRid-based Adaptive Parameter Estimation (GRAPE). GRAPE expands existing MMAE methods by using new techniques to sample the parameter space. GRAPE expands on MMAE with the hypothesis that sample models can be applied and resampled without relying on a predefined set of models. GRAPE is initially implemented in a linear framework using Kalman filter models. A more generalized GRAPE formulation is presented using extended Kalman filter (EKF) models to represent nonlinear systems. GRAPE can handle both time invariant and time varying systems as it is designed to track parameter changes. Two techniques are presented to generate parameter samples for the parallel filter models. The first approach is called selected grid-based stratification (SGBS). SGBS divides the parameter space into equally spaced strata. The second approach uses Latin Hypercube Sampling (LHS) to determine the parameter locations and minimize the total number of required models. LHS is particularly useful when the parameter dimensions grow. Adding more parameters does not require the model count to increase for LHS. Each resample is independent of the prior sample set other than the location of the parameter estimate. SGBS and LHS can be used for both the initial sample and subsequent resamples. Furthermore, resamples are not required to use the same technique. Both techniques are demonstrated for both linear and nonlinear frameworks. The GRAPE framework further formalizes the parameter tracking process through a general approach for nonlinear systems. These additional methods allow GRAPE to either narrow the focus to converged values within a parameter range or expand the range in the appropriate direction to track the parameters outside the current parameter range boundary

  2. The evolution model of Uppsala in light of the complex adaptive systems approach

    Directory of Open Access Journals (Sweden)

    Rennaly Alves da Silva

    2013-11-01

    Full Text Available The behavioral approach to the internationalization of companies explains that the movements toward external markets occur in accordance with the increasing commitment of resources to mitigate the effects of uncertainty and reduce the perception of risk. Evidence indicates that the theories and practices developed in the domestic market may not be able to explain the reality of companies that operate in international markets. Thus, the Paradigm of Complexity presents itself as a comprehensive alternative to realize the relationships within organizations and markets. Accordingly, the aim of this theoretical paper is to analyze the evolution of the Uppsala Model between years 1975 and 2010 with the understanding of the companies in the process of internationalization as Complex Adaptive Systems, in accordance with the Model Kelly and Allison (1998. Four propositions are presented that show the links between the approaches. The most surprising is the perception that the conceptual evolution of the Uppsala Model seems to accompany the evolution of complexity levels, presented in Model Kelly and Allison.

  3. Complex health service needs for people who are homeless.

    Science.gov (United States)

    Moore, Gaye; Manias, Elizabeth; Gerdtz, Marie Frances

    2011-11-01

    Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing. To examine the perceptions and experiences of homeless people in relation to their health service needs as well as those of service providers involved with their care. A purposive sampling approach was undertaken with a thematic framework analysis of semi-structured interviews. Participants. Interviews were undertaken with 20 homeless people who accessed the emergency department in an acute hospital in Melbourne, Australia and 27 service providers involved in hospital and community care. Six key themes were identified from interviews: complexity of care needs, respect for homeless people and co-workers, engagement as a key strategy in continued care, lack of after-hour services, lack of appropriate accommodation and complexity of services. Findings revealed the complex and diverse nature of health concerns in homeless people. The demand on hospital services continues to increase and unless government policies take into consideration the psychosocial demands of the communities most vulnerable people efforts to divert hospital demand will continue to fail.

  4. Human health risk assessment of trichloroethylene from industrial complex a.

    Science.gov (United States)

    Sin, Saemi; Byeon, Sang-Hoon

    2012-09-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 × 10(?5) for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 × 10(?5) and 1.97 × 10(?5) for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for central tendency exposure to trichloroethylene was 1.71 for male and female residents. The hazard indexes for reasonable maximum exposure were 3.27 and 2.41 for males and females, respectively. These values were over one, which is equivalent to the threshold value. This result showed that adverse cancer and non-cancer health effects may occur and that some risk management of trichloroethylene from Industrial Complex A was needed.

  5. Methods used in adaptation of health-related guidelines: A systematic survey.

    Science.gov (United States)

    Abdul-Khalek, Rima A; Darzi, Andrea J; Godah, Mohammad W; Kilzar, Lama; Lakis, Chantal; Agarwal, Arnav; Abou-Jaoude, Elias; Meerpohl, Joerg J; Wiercioch, Wojtek; Santesso, Nancy; Brax, Hneine; Schünemann, Holger; Akl, Elie A

    2017-12-01

    Adaptation refers to the systematic approach for considering the endorsement or modification of recommendations produced in one setting for application in another as an alternative to de novo development. To describe and assess the methods used for adapting health-related guidelines published in peer-reviewed journals, and to assess the quality of the resulting adapted guidelines. We searched Medline and Embase up to June 2015. We assessed the method of adaptation, and the quality of included guidelines. Seventy-two papers were eligible. Most adapted guidelines and their source guidelines were published by professional societies (71% and 68% respectively), and in high-income countries (83% and 85% respectively). Of the 57 adapted guidelines that reported any detail about adaptation method, 34 (60%) did not use a published adaptation method. The number (and percentage) of adapted guidelines fulfilling each of the ADAPTE steps ranged between 2 (4%) and 57 (100%). The quality of adapted guidelines was highest for the "scope and purpose" domain and lowest for the "editorial independence" domain (respective mean percentages of the maximum possible scores were 93% and 43%). The mean score for "rigor of development" was 57%. Most adapted guidelines published in peer-reviewed journals do not report using a published adaptation method, and their adaptation quality was variable.

  6. Adaptation strategies for health impacts of climate change in Western Australia: Application of a Health Impact Assessment framework

    International Nuclear Information System (INIS)

    Spickett, Jeffery T.; Brown, Helen L.; Katscherian, Dianne

    2011-01-01

    Climate change is one of the greatest challenges facing the globe and there is substantial evidence that this will result in a number of health impacts, regardless of the level of greenhouse gas mitigation. It is therefore apparent that a combined approach of mitigation and adaptation will be required to protect public health. While the importance of mitigation is recognised, this project focused on the role of adaptation strategies in addressing the potential health impacts of climate change. The nature and magnitude of these health impacts will be determined by a number of parameters that are dependent upon the location. Firstly, climate change will vary between regions. Secondly, the characteristics of each region in terms of population and the ability to adapt to changes will greatly influence the extent of the health impacts that are experienced now and into the future. Effective adaptation measures therefore need to be developed with these differences in mind. A Health Impact Assessment (HIA) framework was used to consider the implications of climate change on the health of the population of Western Australia (WA) and to develop a range of adaptive responses suited to WA. A broad range of stakeholders participated in the HIA process, providing informed input into developing an understanding of the potential health impacts and potential adaptation strategies from a diverse sector perspective. Potential health impacts were identified in relation to climate change predictions in WA in the year 2030. The risk associated with each of these impacts was assessed using a qualitative process that considered the consequences and the likelihood of the health impact occurring. Adaptations were then developed which could be used to mitigate the identified health impacts and provide responses which could be used by Government for future decision making. The periodic application of a HIA framework is seen as an ideal tool to develop appropriate adaptation strategies to

  7. The Evolution of an Ecosystem Approach: the Diamond Schematic and an Adaptive Methodology for Ecosystem Sustainability and Health

    Directory of Open Access Journals (Sweden)

    David Waltner-Toews

    2005-06-01

    Full Text Available Over the past 15 yr, an international network of researchers has developed and tested a methodology for integrating complex systems theories into sustainable development projects. Drawing on our best theoretical understanding of complex systems and combining it with best practices of community engagement drawn from a wide variety of sources, we have developed a methodology that is theoretically sound and practically effective. AMESH, an Adaptive Methodology for Ecosystem Sustainability and Health, has emerged from, and been tested in, Nepal, Kenya, Canada, and Peru.

  8. Intermolecular symmetry-adapted perturbation theory study of large organic complexes

    International Nuclear Information System (INIS)

    Heßelmann, Andreas; Korona, Tatiana

    2014-01-01

    Binding energies for the complexes of the S12L database by Grimme [Chem. Eur. J. 18, 9955 (2012)] were calculated using intermolecular symmetry-adapted perturbation theory combined with a density-functional theory description of the interacting molecules. The individual interaction energy decompositions revealed no particular change in the stabilisation pattern as compared to smaller dimer systems at equilibrium structures. This demonstrates that, to some extent, the qualitative description of the interaction of small dimer systems may be extrapolated to larger systems, a method that is widely used in force-fields in which the total interaction energy is decomposed into atom-atom contributions. A comparison of the binding energies with accurate experimental reference values from Grimme, the latter including thermodynamic corrections from semiempirical calculations, has shown a fairly good agreement to within the error range of the reference binding energies

  9. Adaptation and heterogeneity of Escherichia coli MC1000 growing in complex environments

    DEFF Research Database (Denmark)

    Puentes-Téllez, Pilar; Hansen, Martin Asser; Sørensen, Søren

    2013-01-01

    In a study aiming to assess bacterial evolution in complex growth media, we evaluated the long-term adaptive response of Escherichia coli MC1000 in Luria-Bertani (LB) medium. Seven parallel populations were founded and followed over 150 days in sequential batch cultures under three different oxygen...... conditions (defined environments), and 19 evolved forms were isolated. The emergence of forms with enhanced fitness was evident in competition experiments of all evolved forms versus the ancestral strain. The evolved forms were then subjected to phenotypic and genomic analyses relative to the ancestor...... in galR, a repressor of the galactose operon. Concomitantly, the new forms revealed enhanced growth on galactose as well as galactose-containing disaccharides. This response was likely driven by the LB medium....

  10. ADAPTATION OF N-HEPTANE AUTOIGNITION TABULATION FOR COMPLEX CHEMISTRY MECHANISMS

    Directory of Open Access Journals (Sweden)

    Neven Duić

    2011-01-01

    Full Text Available The adaptation of auto-ignition tabulation for effective use of complex chemical mechanisms will be presented in this paper. Taking cool flame ignition phenomenon into account could improve numerical simulations of combustion in compression ignition engines. Current approaches of successful simulation of this phenomenon are based on the extraction of ignition delay times, heat releases and also reaction rates from tabulated data dependant on four parameters: temperature, pressure, equivalence ratio and exhaust gasses mass fraction. The methods described here were used to create lookup tables including cool flame using a comprehensive chemical mechanism without including reaction rates data (as used by other authors. The method proved to be stable for creating tables and these results will be shown, as well as initial implementation results using the tables in computational fluid dynamics software.

  11. Mental Health Literacy in Young Adults: Adaptation and Psychometric Properties of the Mental Health Literacy Questionnaire

    Directory of Open Access Journals (Sweden)

    Pedro Dias

    2018-06-01

    Full Text Available Mental health literacy (MHL is considered a prerequisite for early recognition and intervention in mental disorders, and for this reason, it has become a focus of research over the past few decades. Assessing this construct is relevant for identifying knowledge gaps and erroneous beliefs concerning mental health issues, to inform the development of interventions aimed at promoting mental health literacy as well as the evaluation of these interventions. Recently, we developed a new self-reporting measure (MHLq for assessing mental health literacy in young people (12–14 years-old, meeting the need to assess MHL from a comprehensive perspective of the construct instead of focusing on a restricted number of mental disorders or specific dimensions (e.g., knowledge concerning specific disorders; stigma. The present study aimed to adapt the MHLq for the young adult population and to examine its psychometric properties, according to the following steps: (1 item adaptation, using a think aloud procedure (n = 5; (2 data collection (n = 356, aged between 18 and 25 years old; and (3 psychometric analyses (exploratory factor analysis and internal consistency analysis. The final version of the questionnaire included 29 items (total scale α = 0.84, organized by four dimensions: (1 knowledge of mental health problems (α = 0.74; (2 erroneous beliefs/stereotypes (α = 0.72; (3 help-seeking and first aid skills (α = 0.71; and (4 self-help strategies (α = 0.60. The results suggest that the MHLq-adult form is a practical, valid, and reliable screening tool for identifying gaps in knowledge, beliefs, and behavioral intentions related to mental health and mental disorders, planning promotion programs, and evaluating intervention effectiveness.

  12. Adaptive Fault Detection for Complex Dynamic Processes Based on JIT Updated Data Set

    Directory of Open Access Journals (Sweden)

    Jinna Li

    2012-01-01

    Full Text Available A novel fault detection technique is proposed to explicitly account for the nonlinear, dynamic, and multimodal problems existed in the practical and complex dynamic processes. Just-in-time (JIT detection method and k-nearest neighbor (KNN rule-based statistical process control (SPC approach are integrated to construct a flexible and adaptive detection scheme for the control process with nonlinear, dynamic, and multimodal cases. Mahalanobis distance, representing the correlation among samples, is used to simplify and update the raw data set, which is the first merit in this paper. Based on it, the control limit is computed in terms of both KNN rule and SPC method, such that we can identify whether the current data is normal or not by online approach. Noted that the control limit obtained changes with updating database such that an adaptive fault detection technique that can effectively eliminate the impact of data drift and shift on the performance of detection process is obtained, which is the second merit in this paper. The efficiency of the developed method is demonstrated by the numerical examples and an industrial case.

  13. Genome-wide signatures of complex introgression and adaptive evolution in the big cats

    Science.gov (United States)

    Figueiró, Henrique V.; Li, Gang; Trindade, Fernanda J.; Assis, Juliana; Pais, Fabiano; Fernandes, Gabriel; Santos, Sarah H. D.; Hughes, Graham M.; Komissarov, Aleksey; Antunes, Agostinho; Trinca, Cristine S.; Rodrigues, Maíra R.; Linderoth, Tyler; Bi, Ke; Silveira, Leandro; Azevedo, Fernando C. C.; Kantek, Daniel; Ramalho, Emiliano; Brassaloti, Ricardo A.; Villela, Priscilla M. S.; Nunes, Adauto L. V.; Teixeira, Rodrigo H. F.; Morato, Ronaldo G.; Loska, Damian; Saragüeta, Patricia; Gabaldón, Toni; Teeling, Emma C.; O’Brien, Stephen J.; Nielsen, Rasmus; Coutinho, Luiz L.; Oliveira, Guilherme; Murphy, William J.; Eizirik, Eduardo

    2017-01-01

    The great cats of the genus Panthera comprise a recent radiation whose evolutionary history is poorly understood. Their rapid diversification poses challenges to resolving their phylogeny while offering opportunities to investigate the historical dynamics of adaptive divergence. We report the sequence, de novo assembly, and annotation of the jaguar (Panthera onca) genome, a novel genome sequence for the leopard (Panthera pardus), and comparative analyses encompassing all living Panthera species. Demographic reconstructions indicated that all of these species have experienced variable episodes of population decline during the Pleistocene, ultimately leading to small effective sizes in present-day genomes. We observed pervasive genealogical discordance across Panthera genomes, caused by both incomplete lineage sorting and complex patterns of historical interspecific hybridization. We identified multiple signatures of species-specific positive selection, affecting genes involved in craniofacial and limb development, protein metabolism, hypoxia, reproduction, pigmentation, and sensory perception. There was remarkable concordance in pathways enriched in genomic segments implicated in interspecies introgression and in positive selection, suggesting that these processes were connected. We tested this hypothesis by developing exome capture probes targeting ~19,000 Panthera genes and applying them to 30 wild-caught jaguars. We found at least two genes (DOCK3 and COL4A5, both related to optic nerve development) bearing significant signatures of interspecies introgression and within-species positive selection. These findings indicate that post-speciation admixture has contributed genetic material that facilitated the adaptive evolution of big cat lineages. PMID:28776029

  14. Cultural differences in complex addition: efficient Chinese versus adaptive Belgians and Canadians.

    Science.gov (United States)

    Imbo, Ineke; LeFevre, Jo-Anne

    2009-11-01

    In the present study, the authors tested the effects of working-memory load on math problem solving in 3 different cultures: Flemish-speaking Belgians, English-speaking Canadians, and Chinese-speaking Chinese currently living in Canada. Participants solved complex addition problems (e.g., 58 + 76) in no-load and working-memory load conditions, in which either the central executive or the phonological loop was loaded. The authors used the choice/no-choice method to obtain unbiased measures of strategy selection and strategy efficiency. The Chinese participants were faster than the Belgians, who were faster and more accurate than the Canadians. The Chinese also required fewer working-memory resources than did the Belgians and Canadians. However, the Chinese chose less adaptively from the available strategies than did the Belgians and Canadians. These cultural differences in math problem solving are likely the result of different instructional approaches during elementary school (practice and training in Asian countries vs. exploration and flexibility in non-Asian countries), differences in the number language, and informal cultural norms and standards. The relevance of being adaptive is discussed as well as the implications of the results in regards to the strategy choice and discovery simulation model of strategy selection (J. Shrager & R. S. Siegler, 1998).

  15. Signaling and Adaptation Modulate the Dynamics of the Photosensoric Complex of Natronomonas pharaonis.

    Directory of Open Access Journals (Sweden)

    Philipp S Orekhov

    2015-10-01

    Full Text Available Motile bacteria and archaea respond to chemical and physical stimuli seeking optimal conditions for survival. To this end transmembrane chemo- and photoreceptors organized in large arrays initiate signaling cascades and ultimately regulate the rotation of flagellar motors. To unravel the molecular mechanism of signaling in an archaeal phototaxis complex we performed coarse-grained molecular dynamics simulations of a trimer of receptor/transducer dimers, namely NpSRII/NpHtrII from Natronomonas pharaonis. Signaling is regulated by a reversible methylation mechanism called adaptation, which also influences the level of basal receptor activation. Mimicking two extreme methylation states in our simulations we found conformational changes for the transmembrane region of NpSRII/NpHtrII which resemble experimentally observed light-induced changes. Further downstream in the cytoplasmic domain of the transducer the signal propagates via distinct changes in the dynamics of HAMP1, HAMP2, the adaptation domain and the binding region for the kinase CheA, where conformational rearrangements were found to be subtle. Overall these observations suggest a signaling mechanism based on dynamic allostery resembling models previously proposed for E. coli chemoreceptors, indicating similar properties of signal transduction for archaeal photoreceptors and bacterial chemoreceptors.

  16. Exploratory behaviour in the open field test adapted for larval zebrafish: impact of environmental complexity.

    Science.gov (United States)

    Ahmad, Farooq; Richardson, Michael K

    2013-01-01

    This study aimed to develop and characterize a novel (standard) open field test adapted for larval zebrafish. We also developed and characterized a variant of the same assay consisting of a colour-enriched open field; this was used to assess the impact of environmental complexity on patterns of exploratory behaviours as well to determine natural colour preference/avoidance. We report the following main findings: (1) zebrafish larvae display characteristic patterns of exploratory behaviours in the standard open field, such as thigmotaxis/centre avoidance; (2) environmental complexity (i.e. presence of colours) differentially affects patterns of exploratory behaviours and greatly attenuates natural zone preference; (3) larvae displayed the ability to discriminate colours. As reported previously in adult zebrafish, larvae showed avoidance towards blue and black; however, in contrast to the reported adult behaviour, larvae displayed avoidance towards red. Avoidance towards yellow and preference for green and orange are shown for the first time, (4) compared to standard open field tests, exposure to the colour-enriched open field resulted in an enhanced expression of anxiety-like behaviours. To conclude, we not only developed and adapted a traditional rodent behavioural assay that serves as a gold standard in preclinical drug screening, but we also provide a version of the same test that affords the possibility to investigate the impact of environmental stress on behaviour in larval zebrafish while representing the first test for assessment of natural colour preference/avoidance in larval zebrafish. In the future, these assays will improve preclinical drug screening methodologies towards the goal to uncover novel drugs. This article is part of a Special Issue entitled: insert SI title. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. A mismatch between population health literacy and the complexity of health information

    DEFF Research Database (Denmark)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John

    2015-01-01

    skills in relation to these. DESIGN AND SETTING: An English observational study comparing health materials with national working-age population skills. METHOD: Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified......BACKGROUND: Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. AIM: To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population...... of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information....

  18. SOCIAL MEASUREMENT OF YOUTH’S HEALTH: DESIGNING OF INDICATORS OF COMPLEX SOCIOLOGICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Vitalii Valeriyevich Kulish

    2017-06-01

    Full Text Available Purpose. The article is devoted to solving the problem of social measurement of modern youth’s health. The subject of the analysis is the content of the concept, characteristics and indicators of the social health of young people, which enable using sociological research’ methods to measure a given status of the younger generation in contemporary Russian society. The purpose of this work is to define the theoretical and methodological foundations of the sociological analysis of the young people social health and to substantiate its main indicators in the tools of complex sociological research. Methodology of the study. The basis of the research is formed by the system approach, the complex approach, the logical-conceptual method and general scientific methods of research: comparative analysis, system analysis, construction of social indicators, modeling. Results. The social health of young people is defined through the category “status” and is considered as an integrated indicator of the social quality of the younger generation. It is substantiated that the social health of youth is a status of socio-demographic community in which it is able not only to adapt to the changing conditions of the social environment but is also ready to transform actively the surrounding reality, having the potential to resist destructive social phenomena and processes. The main indicators that allow measuring the social health of young people by sociological methods are determined: adaptability in the social environment, social activity in all spheres of public life, social orientation and significance of activity, behavior regulativity by social norms and universal values, creativity of thinking and behavior, readiness for social integration and self-development. A system of social indicators and indicators for conducting a sociological study of social health in historical memory, value orientations and everyday practices of young people has been developed.

  19. Exploring complex causal pathways between urban renewal, health and health inequality using a theory-driven realist approach.

    Science.gov (United States)

    Mehdipanah, Roshanak; Manzano, Ana; Borrell, Carme; Malmusi, Davide; Rodriguez-Sanz, Maica; Greenhalgh, Joanne; Muntaner, Carles; Pawson, Ray

    2015-01-01

    Urban populations are growing and to accommodate these numbers, cities are becoming more involved in urban renewal programs to improve the physical, social and economic conditions in different areas. This paper explores some of the complexities surrounding the link between urban renewal, health and health inequalities using a theory-driven approach. We focus on an urban renewal initiative implemented in Barcelona, the Neighbourhoods Law, targeting Barcelona's (Spain) most deprived neighbourhoods. We present evidence from two studies on the health evaluation of the Neighbourhoods Law, while drawing from recent urban renewal literature, to follow a four-step process to develop a program theory. We then use two specific urban renewal interventions, the construction of a large central plaza and the repair of streets and sidewalks, to further examine this link. In order for urban renewal programs to affect health and health inequality, neighbours must use and adapt to the changes produced by the intervention. However, there exist barriers that can result in negative outcomes including factors such as accessibility, safety and security. This paper provides a different perspective to the field that is largely dominated by traditional quantitative studies that are not always able to address the complexities such interventions provide. Furthermore, the framework and discussions serve as a guide for future research, policy development and evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. QUALITY ASSURANCE IN RWANDAN HIGHER LEARNING EDUCATION: IS THE SYSTEM ADAPTIVE OR COMPLEX?

    Directory of Open Access Journals (Sweden)

    Nathan Kanuma Taremwa

    2014-01-01

    Full Text Available Developing knowledge infrastructure by massive investments in education and training are taken as a benchmark in facilitating the acceleration and possible increases in skills, capacities and competences of Rwandan people has become apriority issue in the recent years. This notion is relevant to vision 2020 where human resource development and building of a knowledge based economy are fundamental pillars. In the past years, several policy reforms have taken place in education sector. However, the overarching question is if such reforms are becoming adaptive or complex and if such reforms will not compromise the quality of education in higher learning education in Rwanda? The main objective of the study was to investigate the impact of changes in Higher Learning Institutions on the quality of education in Rwanda. This research had three hypotheses, namely; there is an impact of changes in Higher Learning Institutions on quality of education in Rwanda; the current complexity in Rwandan education system is affecting the quality of education in HLIs; Tailoring education system to the regional reforms and implementation strategies is affecting the quality of education in Rwanda. This study was carried out in 10 higher learning institutions (5 public, 5 private and 2 Ministry of Education directorates (HEC and REB. Key informants were the senior management/head of institutions, experienced academic staff, and students. The parameters considered included; the learning methods, assessment styles, workloads, language of instruction, merging of public HLIs, curriculum, and the transformation of some private higher learning institutions into company forms. Main research instruments were questionnaires and interview guides. Both qualitative and quantitative research was collected. Analyses were done using SPSS and excel packages. Major findings indicate that the system is still in transition with indicative gaps. Ample time would therefore be necessary for

  1. Adapt

    Science.gov (United States)

    Bargatze, L. F.

    2015-12-01

    Active Data Archive Product Tracking (ADAPT) is a collection of software routines that permits one to generate XML metadata files to describe and register data products in support of the NASA Heliophysics Virtual Observatory VxO effort. ADAPT is also a philosophy. The ADAPT concept is to use any and all available metadata associated with scientific data to produce XML metadata descriptions in a consistent, uniform, and organized fashion to provide blanket access to the full complement of data stored on a targeted data server. In this poster, we present an application of ADAPT to describe all of the data products that are stored by using the Common Data File (CDF) format served out by the CDAWEB and SPDF data servers hosted at the NASA Goddard Space Flight Center. These data servers are the primary repositories for NASA Heliophysics data. For this purpose, the ADAPT routines have been used to generate data resource descriptions by using an XML schema named Space Physics Archive, Search, and Extract (SPASE). SPASE is the designated standard for documenting Heliophysics data products, as adopted by the Heliophysics Data and Model Consortium. The set of SPASE XML resource descriptions produced by ADAPT includes high-level descriptions of numerical data products, display data products, or catalogs and also includes low-level "Granule" descriptions. A SPASE Granule is effectively a universal access metadata resource; a Granule associates an individual data file (e.g. a CDF file) with a "parent" high-level data resource description, assigns a resource identifier to the file, and lists the corresponding assess URL(s). The CDAWEB and SPDF file systems were queried to provide the input required by the ADAPT software to create an initial set of SPASE metadata resource descriptions. Then, the CDAWEB and SPDF data repositories were queried subsequently on a nightly basis and the CDF file lists were checked for any changes such as the occurrence of new, modified, or deleted

  2. Adapting to health impacts of climate change: a study of UNFCCC Annex I parties

    International Nuclear Information System (INIS)

    Lesnikowski, A C; Ford, J D; Berrang-Ford, L; Paterson, J A; Barrera, M; Heymann, S J

    2011-01-01

    Adapting to the health effects of climate change is one of the key challenges facing public health this century. Our knowledge of progress on adaptation, however, remains in its infancy. Using the Fifth National Communications of Annex I parties to the UNFCCC, 1912 initiatives are systematically identified and analyzed. 80% of the actions identified consist of groundwork (i.e. preparatory) action, with only 20% constituting tangible adaptations. No health vulnerability was recognized by all 38 Annex I countries. Furthermore, while all initiatives affect at least one health vulnerability, only 15% had an explicit human health component. Consideration for the special needs of vulnerable groups is uneven and underdeveloped. Climate change is directly motivating 71% of groundwork actions, and 61% of adaptation initiatives are being mainstreamed into existing institutions or programs. We conclude that the adaptation responses to the health risks of climate change remain piecemeal. Policymakers in the health sector must engage with stakeholders to implement adaptation that considers how climate change will impact the health of each segment of the population, particularly within those groups already considered most vulnerable to poor health outcomes.

  3. Public Health Adaptation to Climate Change in Large Cities: A Global Baseline.

    Science.gov (United States)

    Araos, Malcolm; Austin, Stephanie E; Berrang-Ford, Lea; Ford, James D

    2016-01-01

    Climate change will have significant impacts on human health, and urban populations are expected to be highly sensitive. The health risks from climate change in cities are compounded by rapid urbanization, high population density, and climate-sensitive built environments. Local governments are positioned to protect populations from climate health risks, but it is unclear whether municipalities are producing climate-adaptive policies. In this article, we develop and apply systematic methods to assess the state of public health adaptation in 401 urban areas globally with more than 1 million people, creating the first global baseline for urban public health adaptation. We find that only 10% of the sampled urban areas report any public health adaptation initiatives. The initiatives identified most frequently address risks posed by extreme weather events and involve direct changes in management or behavior rather than capacity building, research, or long-term investments in infrastructure. Based on our characterization of the current urban health adaptation landscape, we identify several gaps: limited evidence of reporting of institutional adaptation at the municipal level in urban areas in the Global South; lack of information-based adaptation initiatives; limited focus on initiatives addressing infectious disease risks; and absence of monitoring, reporting, and evaluation. © The Author(s) 2015.

  4. Human Health Risk Assessment of Trichloroethylene from Industrial Complex A

    OpenAIRE

    Sin, Saemi; Byeon, Sang-Hoon

    2012-01-01

    This study investigated the human health risks of trichloroethylene from Industrial Complex A. The excessive carcinogenic risks for central tendency exposure were 1.40 ? 10?5 for male and female residents in the vicinity of Industrial Complex A. The excessive cancers risk for reasonable maximum exposure were 2.88 ? 10?5 and 1.97 ? 10?5 for males and females, respectively. These values indicate that there are potential cancer risks for exposure to these concentrations. The hazard index for cen...

  5. Venom Resistance as a Model for Understanding the Molecular Basis of Complex Coevolutionary Adaptations.

    Science.gov (United States)

    Holding, Matthew L; Drabeck, Danielle H; Jansa, Sharon A; Gibbs, H Lisle

    2016-11-01

    SynopsisVenom and venom resistance are molecular phenotypes widely considered to have diversified through coevolution between predators and prey. However, while evolutionary and functional studies on venom have been extensive, little is known about the molecular basis, variation, and complexity of venom resistance. We review known mechanisms of venom resistance and relate these mechanisms to their predicted impact on coevolutionary dynamics with venomous enemies. We then describe two conceptual approaches which can be used to examine venom/resistance systems. At the intraspecific level, tests of local adaptation in venom and resistance phenotypes can identify the functional mechanisms governing the outcomes of coevolution. At deeper evolutionary timescales, the combination of phylogenetically informed analyses of protein evolution coupled with studies of protein function promise to elucidate the mode and tempo of evolutionary change on potentially coevolving genes. We highlight case studies that use each approach to extend our knowledge of these systems as well as address larger questions about coevolutionary dynamics. We argue that resistance and venom are phenotypic traits which hold exceptional promise for investigating the mechanisms, dynamics, and outcomes of coevolution at the molecular level. Furthermore, extending the understanding of single gene-for-gene interactions to the whole resistance and venom phenotypes may provide a model system for examining the molecular and evolutionary dynamics of complex multi-gene interactions. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

  6. Complex Adaptive Systems of Systems (CASoS) engineering and foundations for global design.

    Energy Technology Data Exchange (ETDEWEB)

    Brodsky, Nancy S.; Finley, Patrick D.; Beyeler, Walter Eugene; Brown, Theresa Jean; Linebarger, John Michael; Moore, Thomas W.; Glass, Robert John, Jr.; Maffitt, S. Louise; Mitchell, Michael David; Ames, Arlo Leroy

    2012-01-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which must be recognized and reckoned with to design a secure future for the nation and the world. Design within CASoS requires the fostering of a new discipline, CASoS Engineering, and the building of capability to support it. Towards this primary objective, we created the Phoenix Pilot as a crucible from which systemization of the new discipline could emerge. Using a wide range of applications, Phoenix has begun building both theoretical foundations and capability for: the integration of Applications to continuously build common understanding and capability; a Framework for defining problems, designing and testing solutions, and actualizing these solutions within the CASoS of interest; and an engineering Environment required for 'the doing' of CASoS Engineering. In a secondary objective, we applied CASoS Engineering principles to begin to build a foundation for design in context of Global CASoS

  7. Complex Adaptive System of Systems (CASoS) Engineering Applications. Version 1.0.

    Energy Technology Data Exchange (ETDEWEB)

    Linebarger, John Michael; Maffitt, S. Louise (New Mexico Institute of Mining and Technology, Albuquerque, NM); Glass, Robert John, Jr.; Beyeler, Walter Eugene; Brown, Theresa Jean; Ames, Arlo Leroy

    2011-10-01

    Complex Adaptive Systems of Systems, or CASoS, are vastly complex eco-socio-economic-technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to highly-saturated interdependencies and allied vulnerabilities to cascades in associated systems. The Phoenix initiative approaches this high-impact problem space as engineers, devising interventions (problem solutions) that influence CASoS to achieve specific aspirations. CASoS embody the world's biggest problems and greatest opportunities: applications to real world problems are the driving force of our effort. We are developing engineering theory and practice together to create a discipline that is grounded in reality, extends our understanding of how CASoS behave, and allows us to better control those behaviors. Through application to real-world problems, Phoenix is evolving CASoS Engineering principles while growing a community of practice and the CASoS engineers to populate it.

  8. Shaping the midwifery profession in Nepal - Uncovering actors' connections using a Complex Adaptive Systems framework.

    Science.gov (United States)

    Bogren, Malin Upper; Berg, Marie; Edgren, Lars; van Teijlingen, Edwin; Wigert, Helena

    2016-12-01

    To explore how actors connect in a system aiming at promoting the establishment of a midwifery profession in Nepal. 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. The actors' connections can be described with a complex set of facilitators for and barriers to promoting the establishment of a midwifery profession. The identified facilitators for this establishment in Nepal are (1) a common goal and (2) a desire to collaborate, whilst the barriers are (1) different political interests and priorities, (2) competing interests of the nursing profession and societal views, (3) divergent academic opinions on a midwifery profession, and (4) insufficient communication. The results also showed that Nepalese society cannot distinguish between nursing and midwifery and that the public support for a midwifery profession was hence minimal. The move of midwifery from an occupation to a profession in Nepal is an on-going, challenging process. The study indicates the importance of understanding the motivations of, and barriers perceived by, actors that can promote or obstruct the establishment of the midwifery profession. It also points to the importance of informing the wider public about the role and responsibility of an autonomous midwifery profession. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Climate change and health in the United States of America: impacts, adaptations, and research

    International Nuclear Information System (INIS)

    Jouan, R.; Magaud, M.

    2009-11-01

    After a description of the various impacts of climate change on human health, this report describes and comments the impacts of climate change on health in the USA: impacts of heat waves, of air quality degradation, of extreme climate events, of climate change on infectious diseases and allergies, regional impacts of climate change. In a second part, it describes the strategies of adaptation to the 'climate change and health' issue in the USA: mitigation and adaptation to climate change, adaptation challenges, insufficiently prepared public health system, adaptation to heat waves, adaptation to air quality degradation, adaptation to extreme climate events, adaptation to food- and water-based diseases and to vector-based diseases, examples of proactive adaptation. The last part describes the organisation of research on 'climate change and health' in the USA: nowadays and in the future, role of federal agencies, priority research axes. The 'United States Global Change Research Program' is presented in appendix, as well as the most important research centres (mostly in universities)

  10. Critical complexity in environmental health practice: simplify and complexify

    Directory of Open Access Journals (Sweden)

    Keune Hans

    2012-06-01

    Full Text Available Abstract The magic word ‘complexity’ has been buzzing around in science, policy and society for quite some time now. There seems to be a common feel for a ‘new way’ of doing things, for overcoming the limits of tradition. From the combined perspective of critical complexity thinking and environment and health practice we want to contribute to the development of alternative routines that may help overcome the limitations of traditional environment and health science. On the one hand traditional environment and health science is too self-confident with respect to potential scientific insight in environment and health problems: complexity condemns us to limited and ambiguous knowledge and the need for simplification. A more modest attitude would be more realistic from that point of view. On the other hand from a problem solving perspective more boldness is required. Waiting for Godot (perfect undisputed knowledge will not help us with respect to the challenges posed to society by environment and health problems. A sense of urgency is legitimate: the paralysis by traditional analysis should be resolved. Nevertheless this sense of urgency should not withhold us from investing in the problem solving quality of our endeavour; quality takes time, fastness from a quality perspective often leads us to a standstill. We propose the concept of critical complexification of environment and health practice that will enable the integration of relevant actors and factors in a pragmatic manner. We will illustrate this with practical examples and especially draw attention to the practical complexities involved, confronting us not only with fundamental questions, but also with fundamental challenges.

  11. Adaptive control of structural balance for complex dynamical networks based on dynamic coupling of nodes

    Science.gov (United States)

    Gao, Zilin; Wang, Yinhe; Zhang, Lili

    2018-02-01

    In the existing research results of the complex dynamical networks controlled, the controllers are mainly used to guarantee the synchronization or stabilization of the nodes’ state, and the terms coupled with connection relationships may affect the behaviors of nodes, this obviously ignores the dynamic common behavior of the connection relationships between the nodes. In fact, from the point of view of large-scale system, a complex dynamical network can be regarded to be composed of two time-varying dynamic subsystems, which can be called the nodes subsystem and the connection relationships subsystem, respectively. Similar to the synchronization or stabilization of the nodes subsystem, some characteristic phenomena can be also emerged in the connection relationships subsystem. For example, the structural balance in the social networks and the synaptic facilitation in the biological neural networks. This paper focuses on the structural balance in dynamic complex networks. Generally speaking, the state of the connection relationships subsystem is difficult to be measured accurately in practical applications, and thus it is not easy to implant the controller directly into the connection relationships subsystem. It is noted that the nodes subsystem and the relationships subsystem are mutually coupled, which implies that the state of the connection relationships subsystem can be affected by the controllable state of nodes subsystem. Inspired by this observation, by using the structural balance theory of triad, the controller with the parameter adaptive law is proposed for the nodes subsystem in this paper, which may ensure the connection relationship matrix to approximate a given structural balance matrix in the sense of the uniformly ultimately bounded (UUB). That is, the structural balance may be obtained by employing the controlling state of the nodes subsystem. Finally, the simulations are used to show the validity of the method in this paper.

  12. The public health aspects of complex emergencies and refugee situations.

    Science.gov (United States)

    Toole, M J; Waldman, R J

    1997-01-01

    Populations affected by armed conflict have experienced severe public health consequences mediated by population displacement, food scarcity, and the collapse of basic health services, giving rise to the term complex humanitarian emergencies. These public health effects have been most severe in underdeveloped countries in Africa, Asia, and Latin America. Refugees and internally displaced persons have experienced high mortality rates during the period immediately following their migration. In Africa, crude mortality rates have been as high as 80 times baseline rates. The most common causes of death have been diarrheal diseases, measles, acute respiratory infections, and malaria. High prevalences of acute malnutrition have contributed to high case fatality rates. In conflict-affected European countries, such as the former Yugoslavia, Georgia, Azerbaijan, and Chechnya, war-related injuries have been the most common cause of death among civilian populations; however, increased incidence of communicable diseases, neonatal health problems, and nutritional deficiencies (especially among the elderly) have been documented. The most effective measures to prevent mortality and morbidity in complex emergencies include protection from violence; the provision of adequate food rations, clean water and sanitation; diarrheal disease control; measles immunization; maternal and child health care, including the case management of common endemic communicable diseases; and selective feeding programs, when indicated.

  13. A methodological survey identified eight proposed frameworks for the adaptation of health related guidelines.

    Science.gov (United States)

    Darzi, Andrea; Abou-Jaoude, Elias A; Agarwal, Arnav; Lakis, Chantal; Wiercioch, Wojtek; Santesso, Nancy; Brax, Hneine; El-Jardali, Fadi; Schünemann, Holger J; Akl, Elie A

    2017-06-01

    Our objective was to identify and describe published frameworks for adaptation of clinical, public health, and health services guidelines. We included reports describing methods of adaptation of guidelines in sufficient detail to allow its reproducibility. We searched Medline and EMBASE databases. We also searched personal files, as well manuals and handbooks of organizations and professional societies that proposed methods of adaptation and adoption of guidelines. We followed standard systematic review methodology. Our search captured 12,021 citations, out of which we identified eight proposed methods of guidelines adaptation: ADAPTE, Adapted ADAPTE, Alberta Ambassador Program adaptation phase, GRADE-ADOLOPMENT, MAGIC, RAPADAPTE, Royal College of Nursing (RCN), and Systematic Guideline Review (SGR). The ADAPTE framework consists of a 24-step process to adapt guidelines to a local context taking into consideration the needs, priorities, legislation, policies, and resources. The Alexandria Center for Evidence-Based Clinical Practice Guidelines updated one of ADAPTE's tools, modified three tools, and added three new ones. In addition, they proposed optionally using three other tools. The Alberta Ambassador Program adaptation phase consists of 11 steps and focused on adapting good-quality guidelines for nonspecific low back pain into local context. GRADE-ADOLOPMENT is an eight-step process based on the GRADE Working Group's Evidence to Decision frameworks and applied in 22 guidelines in the context of national guideline development program. The MAGIC research program developed a five-step adaptation process, informed by ADAPTE and the GRADE approach in the context of adapting thrombosis guidelines. The RAPADAPTE framework consists of 12 steps based on ADAPTE and using synthesized evidence databases, retrospectively derived from the experience of producing a high-quality guideline for the treatment of breast cancer with limited resources in Costa Rica. The RCN outlines

  14. Pinning adaptive synchronization of a class of uncertain complex dynamical networks with multi-link against network deterioration

    International Nuclear Information System (INIS)

    Li, Lixiang; Li, Weiwei; Kurths, Jürgen; Luo, Qun; Yang, Yixian; Li, Shudong

    2015-01-01

    For the reason that the uncertain complex dynamic network with multi-link is quite close to various practical networks, there is superiority in the fields of research and application. In this paper, we focus upon pinning adaptive synchronization for uncertain complex dynamic networks with multi-link against network deterioration. The pinning approach can be applied to adapt uncertain coupling factors of deteriorated networks which can compensate effects of uncertainty. Several new synchronization criterions for networks with multi-link are derived, which ensure the synchronized states to be local or global stable with uncertainty and deterioration. Results of simulation are shown to demonstrate the feasibility and usefulness of our method

  15. Key role for efflux in the preservative susceptibility and adaptive resistance of Burkholderia cepacia complex bacteria.

    Science.gov (United States)

    Rushton, Laura; Sass, Andrea; Baldwin, Adam; Dowson, Christopher G; Donoghue, Denise; Mahenthiralingam, Eshwar

    2013-07-01

    Bacteria from the Burkholderia cepacia complex (Bcc) are encountered as industrial contaminants, and little is known about the species involved or their mechanisms of preservative resistance. Multilocus sequence typing (MLST) revealed that multiple Bcc species may cause contamination, with B. lata (n = 17) and B. cenocepacia (n = 11) dominant within the collection examined. At the strain level, 11 of the 31 industrial sequence types identified had also been recovered from either natural environments or clinical infections. Minimal inhibitory (MIC) and minimum bactericidal (MBC) preservative concentrations varied across 83 selected Bcc strains, with industrial strains demonstrating increased tolerance for dimethylol dimethyl hydantoin (DMDMH). Benzisothiazolinone (BIT), DMDMH, methylisothiazolinone (MIT), a blend of 3:1 methylisothiazolinone-chloromethylisothiazolinone (M-CMIT), methyl paraben (MP), and phenoxyethanol (PH), were all effective anti-Bcc preservatives; benzethonium chloride (BC) and sodium benzoate (SB) were least effective. Since B. lata was the dominant industrial Bcc species, the type strain, 383(T) (LMG 22485(T)), was used to study preservative tolerance. Strain 383 developed stable preservative tolerance for M-CMIT, MIT, BIT, and BC, which resulted in preservative cross-resistance and altered antibiotic susceptibility, motility, and biofilm formation. Transcriptomic analysis of the B. lata 383 M-CMIT-adapted strain demonstrated that efflux played a key role in its M-CMIT tolerance and elevated fluoroquinolone resistance. The role of efflux was corroborated using the inhibitor l-Phe-Arg-β-napthylamide, which reduced the MICs of M-CMIT and ciprofloxacin. In summary, intrinsic preservative tolerance and stable adaptive changes, such as enhanced efflux, play a role in the ability of Bcc bacteria to cause industrial contamination.

  16. An Agent-Based Optimization Framework for Engineered Complex Adaptive Systems with Application to Demand Response in Electricity Markets

    Science.gov (United States)

    Haghnevis, Moeed

    The main objective of this research is to develop an integrated method to study emergent behavior and consequences of evolution and adaptation in engineered complex adaptive systems (ECASs). A multi-layer conceptual framework and modeling approach including behavioral and structural aspects is provided to describe the structure of a class of engineered complex systems and predict their future adaptive patterns. The approach allows the examination of complexity in the structure and the behavior of components as a result of their connections and in relation to their environment. This research describes and uses the major differences of natural complex adaptive systems (CASs) with artificial/engineered CASs to build a framework and platform for ECAS. While this framework focuses on the critical factors of an engineered system, it also enables one to synthetically employ engineering and mathematical models to analyze and measure complexity in such systems. In this way concepts of complex systems science are adapted to management science and system of systems engineering. In particular an integrated consumer-based optimization and agent-based modeling (ABM) platform is presented that enables managers to predict and partially control patterns of behaviors in ECASs. Demonstrated on the U.S. electricity markets, ABM is integrated with normative and subjective decision behavior recommended by the U.S. Department of Energy (DOE) and Federal Energy Regulatory Commission (FERC). The approach integrates social networks, social science, complexity theory, and diffusion theory. Furthermore, it has unique and significant contribution in exploring and representing concrete managerial insights for ECASs and offering new optimized actions and modeling paradigms in agent-based simulation.

  17. Using social network analysis to evaluate health-related adaptation decision-making in Cambodia.

    Science.gov (United States)

    Bowen, Kathryn J; Alexander, Damon; Miller, Fiona; Dany, Va

    2014-01-30

    Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or 'shadow networks') in the context of climate change adaptation policy and activities. The health governance 'map' in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes.

  18. Using Social Network Analysis to Evaluate Health-Related Adaptation Decision-Making in Cambodia

    Directory of Open Access Journals (Sweden)

    Kathryn J. Bowen

    2014-01-01

    Full Text Available Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or ‘shadow networks’ in the context of climate change adaptation policy and activities. The health governance ‘map’ in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes.

  19. Adaptation of Questionnaire Measuring Working Conditions and Health Problems Among Iranian Nursing Personnel

    Directory of Open Access Journals (Sweden)

    Narges Arsalani, RN, MSc

    2011-09-01

    Conclusion: The findings show that the adapted questionnaire has an acceptable conceptual structure and provides reliable information from the nursing profession. Consequently, the questionnaire is applicable to work situation studies among nurses and other health care workers.

  20. The burgeoning field of transdisciplinary adaptation research in Quebec (1998–: a climate change-related public health narrative

    Directory of Open Access Journals (Sweden)

    Gosselin P

    2011-09-01

    Full Text Available Pierre Gosselin1–3, Diane Bélanger1,3,4, Véronique Lapaige1,5,6, Yolaine Labbé11Quebec National Public Health Institute, Quebec, 2Laval University, Faculty of Medicine, Department of Social and Preventive Medicine, Quebec, 3National Institute of Scientific Research, Water-Earth-Environment Centre, Quebec, 4Research Centre of the Quebec University Hospital Centre, Quebec, 5University of Montreal, Faculty of Medicine, Department of Psychiatry, Montreal, 6Fernand-Seguin Research Centre, Montreal, QC, CanadaAbstract: This paper presents a public health narrative on Quebec’s new climatic conditions and human health, and describes the transdisciplinary nature of the climate change adaptation research currently being adopted in Quebec, characterized by the three phases of problem identification, problem investigation, and problem transformation. A transdisciplinary approach is essential for dealing with complex ill-defined problems concerning human–environment interactions (for example, climate change, for allowing joint research, collective leadership, complex collaborations, and significant exchanges among scientists, decision makers, and knowledge users. Such an approach is widely supported in theory but has proved to be extremely difficult to implement in practice, and those who attempt it have met with heavy resistance, succeeding when they find the occasional opportunity within institutional or social contexts. In this paper we narrate the ongoing struggle involved in tackling the negative effects of climate change in multi-actor contexts at local and regional levels, a struggle that began in a quiet way in 1998. The paper will describe how public health adaptation research is supporting transdisciplinary action and implementation while also preparing for the future, and how this interaction to tackle a life-world problem (adaptation of the Quebec public health sector to climate change in multi-actors contexts has progressively been

  1. Organizational Stress as Moderator of Relationship Between Mental Health Provider Adaptability and Organizational Commitment.

    Science.gov (United States)

    Green, Amy E; Dishop, Christopher R; Aarons, Gregory A

    2016-10-01

    Community mental health providers often operate within stressful work environments and are at high risk of emotional exhaustion, which can negatively affect job performance and client satisfaction with services. This cross-sectional study examined the relationships between organizational stress, provider adaptability, and organizational commitment. Variables were analyzed with moderated multilevel regression in a sample of 311 mental health providers from 49 community mental health programs. Stressful organizational climate, characterized by high levels of emotional exhaustion, role conflict, and role overload, was negatively related to organizational commitment. Organizational stress moderated the relationship between provider adaptability and organizational commitment, such that those who were more adaptable had greater levels of organizational commitment when organizational stress was low but were less committed than those who were less adaptable when organizational stress was high. Providers higher in adaptability may perceive their organization as a greater fit when the work environment is less stressful; however, highly adaptable providers may also exercise choice that manifests in lower commitment to staying in an overly stressful work environment. Service systems and organizational contexts are becoming increasingly demanding and stressful for direct mental health service providers. Therefore, community mental health organizations should assess and understand their organizational climate and intervene with empirically based organizational strategies when necessary to reduce stressful climates and maintain adaptable employees.

  2. Complexity and Pilot Workload Metrics for the Evaluation of Adaptive Flight Controls on a Full Scale Piloted Aircraft

    Science.gov (United States)

    Hanson, Curt; Schaefer, Jacob; Burken, John J.; Larson, David; Johnson, Marcus

    2014-01-01

    Flight research has shown the effectiveness of adaptive flight controls for improving aircraft safety and performance in the presence of uncertainties. The National Aeronautics and Space Administration's (NASA)'s Integrated Resilient Aircraft Control (IRAC) project designed and conducted a series of flight experiments to study the impact of variations in adaptive controller design complexity on performance and handling qualities. A novel complexity metric was devised to compare the degrees of simplicity achieved in three variations of a model reference adaptive controller (MRAC) for NASA's F-18 (McDonnell Douglas, now The Boeing Company, Chicago, Illinois) Full-Scale Advanced Systems Testbed (Gen-2A) aircraft. The complexity measures of these controllers are also compared to that of an earlier MRAC design for NASA's Intelligent Flight Control System (IFCS) project and flown on a highly modified F-15 aircraft (McDonnell Douglas, now The Boeing Company, Chicago, Illinois). Pilot comments during the IRAC research flights pointed to the importance of workload on handling qualities ratings for failure and damage scenarios. Modifications to existing pilot aggressiveness and duty cycle metrics are presented and applied to the IRAC controllers. Finally, while adaptive controllers may alleviate the effects of failures or damage on an aircraft's handling qualities, they also have the potential to introduce annoying changes to the flight dynamics or to the operation of aircraft systems. A nuisance rating scale is presented for the categorization of nuisance side-effects of adaptive controllers.

  3. The Sustainable Development of Industry Clusters: Emergent Knowledge Networks and Socio Complex Adaptive Systems

    Directory of Open Access Journals (Sweden)

    Susu Nousala

    2009-10-01

    Full Text Available In a highly competitive global economy the development of sustainable, innovative responses from Industry is now vital. Many industries globally need to respond rather than react to current economic climate through sustainable (economically and environmentally development. The steel industry is a critical player in the urban landscape. Like many industries, small, medium enterprises (SMEs are vital players within the steel industry supply chain. The Australian SME steel housing sector (based in rural and regional areas are still developing systemic capabilities with the aim of realizing its full potential. The question of an effective sustainable industry is much larger than any one player. This paper aims to present a proposed methodological approach for sustainable cluster development based on previous industry wide investigations. Through the lens of scalability of a socio complex adaptive system, SME development becomes arguably the most significant player with regards to industry cluster development. By starting with SME development it's possible to build an understanding of a simultaneous two layered approach, "bottom up – top down" whilst including a very diversified group.

  4. A versatile embedded boundary adaptive mesh method for compressible flow in complex geometry

    KAUST Repository

    Almarouf, Mohamad Abdulilah Alhusain Alali

    2017-02-25

    We present an embedded ghost-fluid method for numerical solutions of the compressible Navier Stokes (CNS) equations in arbitrary complex domains. A PDE multidimensional extrapolation approach is used to reconstruct the solution in the ghost-fluid regions and imposing boundary conditions on the fluid-solid interface, coupled with a multi-dimensional algebraic interpolation for freshly cleared cells. The CNS equations are numerically solved by the second order multidimensional upwind method. Block-structured adaptive mesh refinement, implemented with the Chombo framework, is utilized to reduce the computational cost while keeping high resolution mesh around the embedded boundary and regions of high gradient solutions. The versatility of the method is demonstrated via several numerical examples, in both static and moving geometry, ranging from low Mach number nearly incompressible flows to supersonic flows. Our simulation results are extensively verified against other numerical results and validated against available experimental results where applicable. The significance and advantages of our implementation, which revolve around balancing between the solution accuracy and implementation difficulties, are briefly discussed as well.

  5. A versatile embedded boundary adaptive mesh method for compressible flow in complex geometry

    KAUST Repository

    Almarouf, Mohamad Abdulilah Alhusain Alali; Samtaney, Ravi

    2017-01-01

    We present an embedded ghost-fluid method for numerical solutions of the compressible Navier Stokes (CNS) equations in arbitrary complex domains. A PDE multidimensional extrapolation approach is used to reconstruct the solution in the ghost-fluid regions and imposing boundary conditions on the fluid-solid interface, coupled with a multi-dimensional algebraic interpolation for freshly cleared cells. The CNS equations are numerically solved by the second order multidimensional upwind method. Block-structured adaptive mesh refinement, implemented with the Chombo framework, is utilized to reduce the computational cost while keeping high resolution mesh around the embedded boundary and regions of high gradient solutions. The versatility of the method is demonstrated via several numerical examples, in both static and moving geometry, ranging from low Mach number nearly incompressible flows to supersonic flows. Our simulation results are extensively verified against other numerical results and validated against available experimental results where applicable. The significance and advantages of our implementation, which revolve around balancing between the solution accuracy and implementation difficulties, are briefly discussed as well.

  6. Universal dynamics of complex adaptive systems: Gauge theory of things alive

    International Nuclear Information System (INIS)

    Mack, G.

    1994-04-01

    A universal dynamics of objects and their relations - a kind of ''universal chemistry'' - is discussed which satisfies general principles of locality and relativity. Einsteins theory of gravitation and the gauge theory of elementary particles are prototypes, but complex adaptive systems - anything that is alive in the widest sense - fall under the same paradigma. Frustration and gauge symmetry arise naturally in this context. Besides a nondissipative deterministic dynamics, which is thought to operate at a fundamental levle, a Thermo-Dynamics in sense of Prigogine is introduced by adding a diffusion process. It introduces irreversibility and entropy production. It equilibrates the chaotic local model of the time development (only) and is designed to be undetectable under continued observation with given finite measuring accuracy. Compositeness and the development of structure can be described in this framework. The existence of a critical equilibrium state may be postulated which is invariant under the dynamics. But it is usually not reached in a finite time from a given starting configuration, because local dynamics suffers from critical slowing down, especially in the presence of frustration. (orig.)

  7. Adaptive generalized matrix projective lag synchronization between two different complex networks with non-identical nodes and different dimensions

    International Nuclear Information System (INIS)

    Dai Hao; Jia Li-Xin; Zhang Yan-Bin

    2012-01-01

    The adaptive generalized matrix projective lag synchronization between two different complex networks with non-identical nodes and different dimensions is investigated in this paper. Based on Lyapunov stability theory and Barbalat's lemma, generalized matrix projective lag synchronization criteria are derived by using the adaptive control method. Furthermore, each network can be undirected or directed, connected or disconnected, and nodes in either network may have identical or different dynamics. The proposed strategy is applicable to almost all kinds of complex networks. In addition, numerical simulation results are presented to illustrate the effectiveness of this method, showing that the synchronization speed is sensitively influenced by the adaptive law strength, the network size, and the network topological structure. (general)

  8. Reservoir-based Online Adaptive Forward Models with Neural Control for Complex Locomotion in a Hexapod Robot

    DEFF Research Database (Denmark)

    Manoonpong, Poramate; Dasgupta, Sakyasingha; Goldschmidt, Dennis

    2014-01-01

    Walking animals show fascinating locomotor abilities and complex behaviors. Biological study has revealed that such complex behaviors is a result of a combination of biomechanics and neural mechanisms. While biomechanics allows for flexibility and a variety of movements, neural mechanisms generate...... locomotion, make predictions, and provide adaptation. Inspired by this finding, we present here an artificial bio-inspired walking system which combines biomechanics (in terms of its body and leg structures) and neural mechanisms. The neural mechanisms consist of 1) central pattern generator-based control...... for generating basic rhythmic patterns and coordinated movements, 2) reservoir-based adaptive forward models with efference copies for sensory prediction as well as state estimation, and 3) searching and elevation control for adapting the movement of an individual leg to deal with different environmental...

  9. Failure of large transformation projects from the viewpoint of complex adaptive systems: Management principles for dealing with project dynamics

    NARCIS (Netherlands)

    Janssen, M.; Voort, H. van der; Veenstra, A.F.E. van

    2015-01-01

    Many large transformation projects do not result in the outcomes desired or envisioned by the stakeholders. This type of project is characterised by dynamics which are both caused by and result of uncertainties and unexpected behaviour. In this paper a complex adaptive system (CAS) view was adopted

  10. Scale Development and Initial Tests of the Multidimensional Complex Adaptive Leadership Scale for School Principals: An Exploratory Mixed Method Study

    Science.gov (United States)

    Özen, Hamit; Turan, Selahattin

    2017-01-01

    This study was designed to develop the scale of the Complex Adaptive Leadership for School Principals (CAL-SP) and examine its psychometric properties. This was an exploratory mixed method research design (ES-MMD). Both qualitative and quantitative methods were used to develop and assess psychometric properties of the questionnaire. This study…

  11. Addressing Complex Problems: Using Authentic Audiences and Challenges to Develop Adaptive Leadership and Socially Responsible Agency in Leadership Learners

    Science.gov (United States)

    Andenoro, Anthony C.; Sowcik, Matthew J.; Balser, Teresa C.

    2017-01-01

    Complex and adaptive challenges threaten human well-being and sustainability. However, our leadership graduates often lack the capacity and or commitment to address these challenges in a meaningful way. This paper details a five-year study exploring the impact of an interdisciplinary undergraduate course on the development of global capacities,…

  12. The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.

    Science.gov (United States)

    Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A

    2012-02-10

    To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.

  13. A mismatch between population health literacy and the complexity of health information: an observational study.

    Science.gov (United States)

    Rowlands, Gillian; Protheroe, Joanne; Winkley, John; Richardson, Marty; Seed, Paul T; Rudd, Rima

    2015-06-01

    Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population skills in relation to these. An English observational study comparing health materials with national working-age population skills. Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified. The proportion of the population above and below these thresholds, and the sociodemographic variables associated with a greater risk of being below the thresholds, were described. Sixty-four health materials were sampled. Two competency thresholds were identified: text (literacy) only, and text + numeracy; 2515/5795 participants (43%) were below the text-only threshold, while 2905/4767 (61%) were below the text + numeracy threshold. Univariable analyses of social determinants of health showed that those groups more at risk of socioeconomic deprivation had higher odds of being below the health literacy competency threshold than those at lower risk of deprivation. Multivariable analysis resulted in some variables becoming non-significant or reduced in effect. Levels of low health literacy mirror those found in other industrialised countries, with a mismatch between the complexity of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information. © British Journal of General Practice 2015.

  14. Guidelines and Recommendations for Developing Interactive eHealth Apps for Complex Messaging in Health Promotion.

    Science.gov (United States)

    Heffernan, Kayla Joanne; Chang, Shanton; Maclean, Skye Tamara; Callegari, Emma Teresa; Garland, Suzanne Marie; Reavley, Nicola Jane; Varigos, George Andrew; Wark, John Dennis

    2016-02-09

    The now ubiquitous catchphrase, "There's an app for that," rings true owing to the growing number of mobile phone apps. In excess of 97,000 eHealth apps are available in major app stores. Yet the effectiveness of these apps varies greatly. While a minority of apps are developed grounded in theory and in conjunction with health care experts, the vast majority are not. This is concerning given the Hippocratic notion of "do no harm." There is currently no unified formal theory for developing interactive eHealth apps, and development is especially difficult when complex messaging is required, such as in health promotion and prevention. This paper aims to provide insight into the creation of interactive eHealth apps for complex messaging, by leveraging the Safe-D case study, which involved complex messaging required to guide safe but sufficient UV exposure for vitamin D synthesis in users. We aim to create recommendations for developing interactive eHealth apps for complex messages based on the lessons learned during Safe-D app development. For this case study we developed an Apple and Android app, both named Safe-D, to safely improve vitamin D status in young women through encouraging safe ultraviolet radiation exposure. The app was developed through participatory action research involving medical and human computer interaction researchers, subject matter expert clinicians, external developers, and target users. The recommendations for development were created from analysis of the development process. By working with clinicians and implementing disparate design examples from the literature, we developed the Safe-D app. From this development process, recommendations for developing interactive eHealth apps for complex messaging were created: (1) involve a multidisciplinary team in the development process, (2) manage complex messages to engage users, and (3) design for interactivity (tailor recommendations, remove barriers to use, design for simplicity). This research has

  15. Exploring the health context : a multimethod approach to climate change adaptation evaluation

    OpenAIRE

    Böckmann, Melanie

    2015-01-01

    Climate change is a major environmental Public Health issue of the 21st century. Extreme heat and cold, weather events such as flooding or storms, disease vector distribution changes, and increased pathogen loads in water might all put human health at risk. To protect health from inevitable changes, climate change adaptation strategies are implemented at local, national, and global level. Are these measures effectively reducing health risks? This dissertation explores multiple methods to eval...

  16. Managing Madness: Mental Health and Complexity in Public Policy

    Directory of Open Access Journals (Sweden)

    Ian Hickie

    2013-09-01

    Full Text Available This paper explores the concept of collaborative care, particularly in relation to a range of new models of organisation and service that are emerging in response to one of the most problematic areas of public policy – mental health. These emerging models of coordinated mental health care are testing the limits of the evidence supporting coordinated care, and require critical evaluation. Myriad concepts of collaborative or coordinated care in health, including mental health, have created multiple definitions. Once definitional issues have been surmounted, however, the evidence for coordination of health care is reasonably strong. There is considerable research about which treatments and programs are best for people with a mental illness. There are few areas seemingly as complex as mental health, given that responsibility for policy and service lies across all three tiers of Australian government and across multiple jurisdictions. It also engages public, private and non-government sectors. Co-morbidities are commonplace, particularly drug and alcohol problems among younger people. Governments in Australia have traditionally taken responsibility for policy, programs and services, either as direct service providers or through contracting outputs from others. Yet the evidence indicates that for people with a mental illness, the best solutions are often not found in government but in the community and in organisations outside of government. New organisations and new structures are attempting more holistic management approaches, combining clinical care, community support, housing, employment and other services. This paper considers some of these new models in the light of existing evidence. The key challenge facing continued reform in mental health is not uncertainty regarding programs or services, but rather how to drive coordinated care for consumers across departments, governments and providers. This review will highlight the key changes that

  17. Innoversity in knowledge-for-action and adaptation to climate change: the first steps of an 'evidence-based climatic health' transfrontier training program.

    Science.gov (United States)

    Lapaige, Véronique; Essiembre, Hélène

    2010-01-01

    It has become increasingly clear to the international scientific community that climate change is real and has important consequences for human health. To meet these new challenges, the World Health Organization recommends reinforcing the adaptive capacity of health systems. One of the possible avenues in this respect is to promote awareness and knowledge translation in climatic health, at both the local and global scales. Within such perspective, two major themes have emerged in the field of public health research: 1) the development of advanced training adapted to 'global environment' change and to the specific needs of various groups of actors (doctors, nurses, public health practitioners, health care managers, public service managers, local communities, etc) and 2) the development of strategies for implementing research results and applying various types of evidence to the management of public health issues affected by climate change. Progress on these two fronts will depend on maximum innovation in transdisciplinary and transsectoral collaborations. The general purpose of this article is to present the program of a new research and learning chair designed for this double set of developmental objectives - a chair that emphasizes 'innoversity' (the dynamic relationship between innovation and diversity) and 'transfrontier ecolearning for adaptive actions'. The Écoapprentissages, santé mentale et climat collaborative research chair (University of Montreal and Quebec National Public Health Institute) based in Montreal is a center for 'transdisciplinary research' on the transfrontier knowledge-for-action that can aid adaptation of the public health sector, the public mental health sector, and the public service sector to climate change, as well as a center for complex collaborations on evidence-based climatic health 'training'. This program-focused article comprises two main sections. The first section presents the 'general' and 'specific contexts' in which the

  18. Health Aspects of Climate Change in Cities with Mediterranean Climate, and Local Adaptation Plans.

    Science.gov (United States)

    Paz, Shlomit; Negev, Maya; Clermont, Alexandra; Green, Manfred S

    2016-04-21

    Cities with a Mediterranean-type climate (Med-cities) are particularly susceptible to health risks from climate change since they are located in biogeographical hot-spots that experience some of the strongest effects of the changing climate. The study aims to highlight health impacts of climate change in Med-cities, analyze local climate adaptation plans and make adaptation policy recommendations for the Med-city level. We identified five Med-cities with a climate change adaptation plan: Adelaide, Barcelona, Cape Town, Los Angeles and Santiago. Beyond their similar Med-climate features (although Santiago's are slightly different), the cities have different socio-economic characteristics in various aspects. We analyzed each plan according to how it addresses climate change-related drivers of health impacts among city dwellers. For each driver, we identified the types of policy adaptation tools that address it in the urban climate adaptation plans. The surveyed cities address most of the fundamental climate change-related drivers of risks to human health, including rising temperatures, flooding and drought, but the policy measures to reduce negative impacts vary across cities. We suggest recommendations for Med-cities in various aspects, depending on their local needs and vulnerability challenges: assessment of health risks, extreme events management and long-term adaptation, among others.

  19. Organizational Stress Moderates the Relationship between Mental Health Provider Adaptability and Organizational Commitment

    Science.gov (United States)

    Green, Amy E.; Dishop, Christopher; Aarons, Gregory A

    2016-01-01

    Objective Community mental health providers often operate within stressful work environments and are at high risk for emotional exhaustion, which can negatively affect job performance and client satisfaction with services. This cross-sectional study examines the relationships between organizational stress, provider adaptability, and organizational commitment. Methods Variables were analyzed using moderated multi-level regression in a sample of 311 mental health providers from 49 community mental health programs. Results Stressful organizational climate, characterized by high levels of emotional exhaustion, role conflict, and role overload, was negatively related to organizational commitment. Organizational stress moderated the relationship between provider adaptability and organizational commitment, such that those who were more adaptable had greater levels of organizational commitment when organizational stress was low, but were less committed than those who were less adaptable when organizational stress was high. Conclusions In the current study, providers higher in adaptability may perceive their organization as a greater fit when characterized by lower levels of stressfulness; however, highly adaptable providers may also exercise choice that manifests in lower commitment to staying in an overly stressful work environment. Service systems and organizational contexts are becoming increasingly demanding and stressful for direct mental health service providers. Therefore, community mental health organizations should assess and understand their organizational climate and intervene with empirically based organizational strategies when necessary to reduce stressful climates and maintain desirable employees. PMID:27301760

  20. Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care

    Directory of Open Access Journals (Sweden)

    Eva Öhman

    2016-12-01

    Full Text Available Abstract Background Clinical learning takes place in complex socio-cultural environments that are workplaces for the staff and learning places for the students. In the clinical context, the students learn by active participation and in interaction with the rest of the community at the workplace. Clinical learning occurs outside the university, therefore is it important for both the university and the student that the student is given opportunities to evaluate the clinical placements with an instrument that allows evaluation from many perspectives. The instrument Clinical Learning Environment and Supervision (CLES was originally developed for evaluation of nursing students’ clinical learning environment. The aim of this study was to adapt and validate the CLES instrument to measure medical students’ perceptions of their learning environment in primary health care. Methods In the adaptation process the face validity was tested by an expert panel of primary care physicians, who were also active clinical supervisors. The adapted CLES instrument with 25 items and six background questions was sent electronically to 1,256 medical students from one university. Answers from 394 students were eligible for inclusion. Exploratory factor analysis based on principal component methods followed by oblique rotation was used to confirm the adequate number of factors in the data. Construct validity was assessed by factor analysis. Confirmatory factor analysis was used to confirm the dimensions of CLES instrument. Results The construct validity showed a clearly indicated four-factor model. The cumulative variance explanation was 0.65, and the overall Cronbach’s alpha was 0.95. All items loaded similarly with the dimensions in the non-adapted CLES except for one item that loaded to another dimension. The CLES instrument in its adapted form had high construct validity and high reliability and internal consistency. Conclusion CLES, in its adapted form, appears

  1. Implications of health as 'the ability to adapt and self-manage' for public health policy: a qualitative study

    NARCIS (Netherlands)

    Jambroes, Marielle; Nederland, Trudi; Kaljouw, Marian; van Vliet, Katja; Essink-Bot, Marie-Louise; Ruwaard, Dirk

    2016-01-01

    To explore the implications for public health policy of a new conceptualisation of health as 'The ability to adapt and to self-manage, in the face of social, physical and emotional challenges'. Secondary qualitative data analysis of 28 focus group interviews, with 277 participants involved in public

  2. Implications of health as 'the ability to adapt and self-manage' for public health policy : A qualitative study

    NARCIS (Netherlands)

    Jambroes, Marielle; Nederland, Trudi; Kaljouw, Marian; Van Vliet, Katja; Essink-Bot, Marie Louise; Ruwaard, Dirk

    2016-01-01

    Background: To explore the implications for public health policy of a new conceptualisation of health as 'The ability to adapt and to self-manage, in the face of social, physical and emotional challenges'. Methods: Secondary qualitative data analysis of 28 focus group interviews, with 277

  3. An evidence-based public health approach to climate change adaptation.

    Science.gov (United States)

    Hess, Jeremy J; Eidson, Millicent; Tlumak, Jennifer E; Raab, Kristin K; Luber, George

    2014-11-01

    Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

  4. Outage Performance of Hybrid FSO/RF System with Low-Complexity Power Adaptation

    KAUST Repository

    Rakia, Tamer

    2016-02-26

    Hybrid free-space optical (FSO) / radio-frequency (RF) systems have emerged as a promising solution for high data- rate wireless communication systems. We consider truncated channel inversion based power adaptation strategy for coherent and non- coherent hybrid FSO/RF systems, employing an adaptive combining scheme. Specifically, we activate the RF link along with the FSO link when FSO link quality is unacceptable, and adaptively set RF transmission power to ensure constant combined signal-to-noise ratio at receiver terminal. Analytical expressions for the outage probability of the hybrid system with and without power adaptation are derived. Numerical examples show that, the hybrid FSO/RF systems with power adaptation achieve considerable outage performance improvement over conventional hybrid FSO/RF systems without power adaptation. © 2015 IEEE.

  5. Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings

    Directory of Open Access Journals (Sweden)

    Poulin P

    2013-11-01

    Full Text Available Paule Poulin,1 Lea Austen,1 Catherine M Scott,2 Michelle Poulin,1 Nadine Gall,2 Judy Seidel,3 René Lafrenière1 1Department of Surgery, 2Knowledge Management, 3Public Health Innovation and Decision Support, Alberta Health Services, Calgary, AB, Canada Purpose: Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It should involve translating and integrating scientific evidence, such as health technology assessment (HTA reports, with context-sensitive evidence to develop recommendations on whether and under what conditions a new technology will be introduced. However, the development of a program to support such decision making can require considerable time and resources. An alternative is to adapt a preexisting program to the new setting. Materials and methods: We describe a framework for adapting the Local HTA Decision Support Program, originally developed by the Department of Surgery and Surgical Services (Calgary, AB, Canada, for use by other departments. The framework consists of six steps: 1 development of a program review and adaptation manual, 2 education and readiness assessment of interested departments, 3 evaluation of the program by individual departments, 4 joint evaluation via retreats, 5 synthesis of feedback and program revision, and 6 evaluation of the adaptation process. Results: Nine departments revised the Local HTA Decision Support Program and expressed strong satisfaction with the adaptation process. Key elements for success were identified. Conclusion: Adaptation of a preexisting program may reduce duplication of effort, save resources, raise the health care providers' awareness of HTA, and foster constructive stakeholder engagement, which enhances the legitimacy of evidence

  6. Food, Health and Climate Change Adaptation in Uganda | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... food security and human health in agriculture-based livelihood systems. ... in climate variability, and their direct and indirect impact on livelihood systems. ... of its 2017 call for proposals to establish Cyber Policy Centres in the Global South.

  7. Using a social justice and health framework to assess European climate change adaptation strategies.

    Science.gov (United States)

    Boeckmann, Melanie; Zeeb, Hajo

    2014-11-28

    Climate change puts pressure on existing health vulnerabilities through higher frequency of extreme weather events, changes in disease vector distribution or exacerbated air pollution. Climate change adaptation policies may hold potential to reduce societal inequities. We assessed the role of public health and social justice in European climate change adaptation using a three-fold approach: a document analysis, a critical discourse analysis of a subgroup of strategies, and a ranking of strategies against our social justice framework. The ranking approach favored planning that includes various adaptation types, social issues and infrastructure changes. Themes on values identified in the five subgroup documents showed that risks are perceived as contradictory, technology is viewed as savior, responsibilities need to be negotiated, and social justice is advocated by only a few countries. Of 21 strategy documents assessed overall, those from Austria, England and Sweden received the highest scores in the ranking. Our qualitative assessment showed that in European adaptation planning, progress could still be made through community involvement into adaptation decisions, consistent consideration of social and demographic determinants, and a stronger link between infrastructural adaptation and the health sector. Overall, a social justice framework can serve as an evaluation guideline for adaptation policy documents.

  8. Short-term adaptations following Complex Training in team-sports: A meta-analysis.

    Science.gov (United States)

    Freitas, Tomás T; Martinez-Rodriguez, Alejandro; Calleja-González, Julio; Alcaraz, Pedro E

    2017-01-01

    The purpose of this meta-analysis was to study the short-term adaptations on sprint and vertical jump (VJ) performance following Complex Training (CT) in team-sports. CT is a resistance training method aimed at developing both strength and power, which has a direct effect on sprint and VJ. It consists on alternating heavy resistance training exercises with plyometric/power ones, set for set, on the same workout. A search of electronic databases up to July 2016 (PubMed-MEDLINE, SPORTDiscus, Web of Knowledge) was conducted. Inclusion criteria: 1) at least one CT intervention group; 2) training protocols ≥4-wks; 3) sample of team-sport players; 4) sprint or VJ as an outcome variable. Effect sizes (ES) of each intervention were calculated and subgroup analyses were performed. A total of 9 studies (13 CT groups) met the inclusion criteria. Medium effect sizes (ES) (ES = 0.73) were obtained for pre-post improvements in sprint, and small (ES = 0.41) in VJ, following CT. Experimental-groups presented better post-intervention sprint (ES = 1.01) and VJ (ES = 0.63) performance than control-groups. large ESs were exhibited in younger athletes (training programs >12 total sessions (ES = 0.74). Large ESs in programs with >12 total sessions (ES = 0.81). Medium ESs obtained for under-Division I individuals (ES = 0.56); protocols with intracomplex rest intervals ≥2 min (ES = 0.55); conditioning activities with intensities ≤85% 1RM (ES = 0.64); basketball/volleyball players (ES = 0.55). Small ESs were found for younger athletes (ES = 0.42); interventions ≥6 weeks (ES = 0.45). CT interventions have positive medium effects on sprint performance and small effects on VJ in team-sport athletes. This training method is a suitable option to include in the season planning.

  9. Distributed Recurrent Neural Forward Models with Synaptic Adaptation and CPG-based control for Complex Behaviors of Walking Robots

    Directory of Open Access Journals (Sweden)

    Sakyasingha eDasgupta

    2015-09-01

    Full Text Available Walking animals, like stick insects, cockroaches or ants, demonstrate a fascinating range of locomotive abilities and complex behaviors. The locomotive behaviors can consist of a variety of walking patterns along with adaptation that allow the animals to deal with changes in environmental conditions, like uneven terrains, gaps, obstacles etc. Biological study has revealed that such complex behaviors are a result of a combination of biomechanics and neural mechanism thus representing the true nature of embodied interactions. While the biomechanics helps maintain flexibility and sustain a variety of movements, the neural mechanisms generate movements while making appropriate predictions crucial for achieving adaptation. Such predictions or planning ahead can be achieved by way of internal models that are grounded in the overall behavior of the animal. Inspired by these findings, we present here, an artificial bio-inspired walking system which effectively combines biomechanics (in terms of the body and leg structures with the underlying neural mechanisms. The neural mechanisms consist of 1 central pattern generator based control for generating basic rhythmic patterns and coordinated movements, 2 distributed (at each leg recurrent neural network based adaptive forward models with efference copies as internal models for sensory predictions and instantaneous state estimations, and 3 searching and elevation control for adapting the movement of an individual leg to deal with different environmental conditions. Using simulations we show that this bio-inspired approach with adaptive internal models allows the walking robot to perform complex locomotive behaviors as observed in insects, including walking on undulated terrains, crossing large gaps as well as climbing over high obstacles. Furthermore we demonstrate that the newly developed recurrent network based approach to sensorimotor prediction outperforms the previous state of the art adaptive neuron

  10. Adaptation and Validation of the Social and Emotional Health Survey-Secondary into Turkish Culture

    Science.gov (United States)

    Telef, Bülent Baki; Furlong, Michael J.

    2017-01-01

    This study investigated the psychometric properties of a Turkish-language adaptation of the Social and Emotional Health Survey-Secondary (SEHS-S), a measure of core psychological assets hypothesized to be associated with adolescents' flourishing mental health. Convenience samples of students (Grades 9-12) from six Turkish high schools were used;…

  11. Health risks of climate change: An assessment of uncertainties and its implications for adaption policies

    NARCIS (Netherlands)

    Wardekker, J.A.; de Jong, A.; van Bree, L.; Turkenburg, W.C.; van der Sluijs, J.P.

    2012-01-01

    Background: Projections of health risks of climate change are surrounded with uncertainties in knowledge. Understanding of these uncertainties will help the selection of appropriate adaptation policies. Methods: We made an inventory of conceivable health impacts of climate change, explored the type

  12. Costs of Adapting to Climate Change for Human Health in Developing Countries

    OpenAIRE

    Pandey, Kiran

    2010-01-01

    This paper is one component of a global study on the Economics of Adaptation to Climate Change (EACC) in developing countries; the focus in this paper is human health. The main human health impacts of climate change are increased incidence of vector-borne disease (malaria), water-borne disease (diarrhea), cardio respiratory diseases, heat- and cold-related deaths, injuries and deaths from ...

  13. Structure identification of an uncertain network coupled with complex-variable chaotic systems via adaptive impulsive control

    International Nuclear Information System (INIS)

    Liu Dan-Feng; Wu Zhao-Yan; Ye Qing-Ling

    2014-01-01

    In this paper, structure identification of an uncertain network coupled with complex-variable chaotic systems is investigated. Both the topological structure and the system parameters can be unknown and need to be identified. Based on impulsive stability theory and the Lyapunov function method, an impulsive control scheme combined with an adaptive strategy is adopted to design effective and universal network estimators. The restriction on the impulsive interval is relaxed by adopting an adaptive strategy. Further, the proposed method can monitor the online switching topology effectively. Several numerical simulations are provided to illustrate the effectiveness of the theoretical results. (general)

  14. Complex inheritance of larval adaptation in Plutella xylostella to a novel host plant

    NARCIS (Netherlands)

    Henniges-Janssen, K.; Reineke, A.; Heckel, D.G.; Groot, A.T.

    2011-01-01

    Studying the genetics of host shifts and range expansions in phytophagous insects contributes to our understanding of the evolution of host plant adaptation. We investigated the recent host range expansion to pea, in the pea-adapted strain (P-strain) of the crucifer-specialist diamondback moth,

  15. Cognitive schemas among mental health professionals: Adaptive or maladaptive?

    Directory of Open Access Journals (Sweden)

    Sahoo Saddichha

    2012-01-01

    Full Text Available Objectives: Maladaptive cognitive schemas can lead to biases during clinical assessment or psychotherapeutic interventions. This study aimed to explore the cognitive schemas among mental health professionals. Materials and Methods: 100 mental health professionals, of both genders, equally divided between psychiatrists, psychologists, social workers, and psychiatric nurses, were approached and administered the Young Schema Questionnaire - Short Form after written informed consent. Results: Males had higher maladaptive schemas than female respondents across all schema domains, viz., disconnection/rejection, impaired autonomy, impaired limits, other-directedness, and overvigilance (P ≤ 0.05. Psychiatrists had higher maladaptive schemas than psychologists (P ≤ 0.05. Age was weakly but positively corelated with the schemas of self-sacrifice (P = 0.038 and unrelenting standards (P = 0.002 . Conclusions: Mental health professionals also may have maladaptive schemas, which needs to be addressed through schema therapy.

  16. Systematic, Multimethod Assessment of Adaptations Across Four Diverse Health Systems Interventions

    Directory of Open Access Journals (Sweden)

    Borsika A. Rabin

    2018-04-01

    Full Text Available BackgroundMany health outcomes and implementation science studies have demonstrated the importance of tailoring evidence-based care interventions to local context to improve fit. By adapting to local culture, history, resources, characteristics, and priorities, interventions are more likely to lead to improved outcomes. However, it is unclear how best to adapt evidence-based programs and promising innovations. There are few guides or examples of how to best categorize or assess health-care adaptations, and even fewer that are brief and practical for use by non-researchers.Materials and methodsThis study describes the importance and potential of assessing adaptations before, during, and after the implementation of health systems interventions. We present a promising multilevel and multimethod approach developed and being applied across four different health systems interventions. Finally, we discuss implications and opportunities for future research.ResultsThe four case studies are diverse in the conditions addressed, interventions, and implementation strategies. They include two nurse coordinator-based transition of care interventions, a data and training-driven multimodal pain management project, and a cardiovascular patient-reported outcomes project, all of which are using audit and feedback. We used the same modified adaptation framework to document changes made to the interventions and implementation strategies. To create the modified framework, we started with the adaptation and modification model developed by Stirman and colleagues and expanded it by adding concepts from the RE-AIM framework. Our assessments address the intuitive domains of Who, How, When, What, and Why to classify and organize adaptations. For each case study, we discuss how the modified framework was operationalized, the multiple methods used to collect data, results to date and approaches utilized for data analysis. These methods include a real-time tracking system and

  17. Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

    Science.gov (United States)

    Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

    2016-03-17

    in the engagement of researchers and policymakers/programme managers, in order to account for swift evolutions in health policy planning and implementation. In developing and supporting evidence-to-policy interventions, due consideration should be given to fit-for-purpose approaches, as different needs in policymaking cycles require adapted processes and knowledge. Greater consideration should be provided to approaches embedding the use of research in real-world policymaking, better suited to the complex adaptive nature of health systems.

  18. [Role adaptation process of elementary school health teachers: establishing their own positions].

    Science.gov (United States)

    Lee, Jeong Hee; Lee, Byoung Sook

    2014-06-01

    The purpose of this study was to explore and identify patterns from the phenomenon of the role adaptation process in elementary school health teachers and finally, suggest a model to describe the process. Grounded theory methodology and focus group interviews were used. Data were collected from 24 participants of four focus groups. The questions used were about their experience of role adaptation including situational contexts and interactional coping strategies. Transcribed data and field notes were analyzed with continuous comparative analysis. The core category was 'establishing their own positions', an interactional coping strategy. The phenomenon identified by participants was confusion and wandering in their role performance. Influencing contexts were unclear beliefs for their role as health teachers and non-supportive job environments. The result of the adaptation process was consolidation of their positions. Pride as health teachers and social recognition and supports intervened to produce that result. The process had three stages; entry, growth, and maturity. The role adaptation process of elementary school health teachers can be explained as establishing, strengthening and consolidating their own positions. Results of this study can be used as fundamental information for developing programs to support the role adaptation of health teachers.

  19. Settling Ulysses: An Adapted Research Agenda for Refugee Mental Health.

    Science.gov (United States)

    Namer, Yudit; Razum, Oliver

    2017-11-08

    Refugees and asylum seekers arriving in Europe during the 2015/2016 wave of migration have been exposed to war conditions in their country of origin, survived a dangerous journey, and often struggled with negative reception in transit and host countries. The mental health consequence of such forced migration experiences is named the Ulysses syndrome. Policies regarding the right to residency can play an important role in reducing mental health symptoms. We propose that facilitating a sense of belonging should be seen as one important preventive mental healthcare intervention. A refugee mental health agenda needs to take into account the interplay between refugees' and asylum seekers' mental health, feeling of belonging, and access to healthcare. We urge for policies to restore individuals' dignity, and recognize the right for homecoming to parallel the mythology of Ulysses. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  20. Innoversity in knowledge-for-action and adaptation to climate change: the first steps of an 'evidence-based climatic health' transfrontier training program

    Directory of Open Access Journals (Sweden)

    Véronique Lapaige

    2010-12-01

    adaptation of the public health sector, the public mental health sector, and the public service sector to climate change, as well as a center for complex collaborations on evidence-based climatic health 'training'. This program-focused article comprises two main sections. The first section presents the 'general' and 'specific contexts' in which the chair emerged. The 'general context' pertains to the health-related challenge of finding ways to integrate, transfer, and implement knowledge, a particularly pointed challenge in Canada. The 'specific context' refers to the emerging research field of adaptation of public health to climate change. In the second section, the characteristics of the research chair are more extensively detailed (the vision of 'innoversity' and 'transfrontier knowledge-for-action,' the approach of shared responsibility and complex collaboration, objectives, and major axes of research. We conclude with a call for complex collaboration toward knowledge-for-action in public health services/mental health services/public services' adaptation to climate change: this call is aimed at individual and institutional actors in the North and South/West and East concerned by these issues. Keywords: global changing environment, climatic health, adaptation to climate change, adaptive capacity, innoversity, diversity, complex collaboration, transdisciplinary knowledge-for-action, transfrontier training, andragogy, continuing education, ecocompetency, public health, mental health, health professional, public service manager, knowledge translation, implementation science, ecolearning, ecomanagement, eco-decision-making

  1. Climate change and health in the United States of America: impacts, adaptations, and research; Changement climatique et santeaux Etats-Unis: impacts, adaptations et recherche

    Energy Technology Data Exchange (ETDEWEB)

    Jouan, R.; Magaud, M

    2009-11-15

    After a description of the various impacts of climate change on human health, this report describes and comments the impacts of climate change on health in the USA: impacts of heat waves, of air quality degradation, of extreme climate events, of climate change on infectious diseases and allergies, regional impacts of climate change. In a second part, it describes the strategies of adaptation to the 'climate change and health' issue in the USA: mitigation and adaptation to climate change, adaptation challenges, insufficiently prepared public health system, adaptation to heat waves, adaptation to air quality degradation, adaptation to extreme climate events, adaptation to food- and water-based diseases and to vector-based diseases, examples of proactive adaptation. The last part describes the organisation of research on 'climate change and health' in the USA: nowadays and in the future, role of federal agencies, priority research axes. The 'United States Global Change Research Program' is presented in appendix, as well as the most important research centres (mostly in universities)

  2. Cultural Adaptation, Parenting and Child Mental Health Among English Speaking Asian American Immigrant Families.

    Science.gov (United States)

    Huang, Keng-Yen; Calzada, Esther; Cheng, Sabrina; Barajas-Gonzalez, R Gabriela; Brotman, Laurie Miller

    2017-08-01

    Contrary to the "model minority" myth, Asian American children, especially those from low-income immigrant families, are at risk for both behavioral and emotional problems early in life. Little is known, however, about the underlying developmental mechanisms placing Asian American children at risk, including the role of cultural adaptation and parenting. This study examined cultural adaptation, parenting practices and culture related parenting values and child mental health in a sample of 157 English speaking Asian American immigrant families of children enrolled in early childhood education programs in low-income, urban neighborhoods. Overall, cultural adaptation and parenting cultural values and behaviors were related to aspects of child mental health in meaningful ways. Parents' cultural value of independence appears to be especially salient (e.g., negatively related to behavior problems and positively related to adaptive behavior) and significantly mediates the link between cultural adaptation and adaptive behavior. Study findings have implications for supporting Asian American immigrant families to promote their young children's mental health.

  3. Study on a low complexity adaptive modulation algorithm in OFDM-ROF system with sub-carrier grouping technology

    Science.gov (United States)

    Liu, Chong-xin; Liu, Bo; Zhang, Li-jia; Xin, Xiang-jun; Tian, Qing-hua; Tian, Feng; Wang, Yong-jun; Rao, Lan; Mao, Yaya; Li, Deng-ao

    2018-01-01

    During the last decade, the orthogonal frequency division multiplexing radio-over-fiber (OFDM-ROF) system with adaptive modulation technology is of great interest due to its capability of raising the spectral efficiency dramatically, reducing the effects of fiber link or wireless channel, and improving the communication quality. In this study, according to theoretical analysis of nonlinear distortion and frequency selective fading on the transmitted signal, a low-complexity adaptive modulation algorithm is proposed in combination with sub-carrier grouping technology. This algorithm achieves the optimal performance of the system by calculating the average combined signal-to-noise ratio of each group and dynamically adjusting the origination modulation format according to the preset threshold and user's requirements. At the same time, this algorithm takes the sub-carrier group as the smallest unit in the initial bit allocation and the subsequent bit adjustment. So, the algorithm complexity is only 1 /M (M is the number of sub-carriers in each group) of Fischer algorithm, which is much smaller than many classic adaptive modulation algorithms, such as Hughes-Hartogs algorithm, Chow algorithm, and is in line with the development direction of green and high speed communication. Simulation results show that the performance of OFDM-ROF system with the improved algorithm is much better than those without adaptive modulation, and the BER of the former achieves 10e1 to 10e2 times lower than the latter when SNR values gets larger. We can obtain that this low complexity adaptive modulation algorithm is extremely useful for the OFDM-ROF system.

  4. Integrated health management and control of complex dynamical systems

    Science.gov (United States)

    Tolani, Devendra K.

    2005-11-01

    A comprehensive control and health management strategy for human-engineered complex dynamical systems is formulated for achieving high performance and reliability over a wide range of operation. Results from diverse research areas such as Probabilistic Robust Control (PRC), Damage Mitigating/Life Extending Control (DMC), Discrete Event Supervisory (DES) Control, Symbolic Time Series Analysis (STSA) and Health and Usage Monitoring System (HUMS) have been employed to achieve this goal. Continuous-domain control modules at the lower level are synthesized by PRC and DMC theories, whereas the upper-level supervision is based on DES control theory. In the PRC approach, by allowing different levels of risk under different flight conditions, the control system can achieve the desired trade off between stability robustness and nominal performance. In the DMC approach, component damage is incorporated in the control law to reduce the damage rate for enhanced structural durability. The DES controller monitors the system performance and, based on the mission requirements (e.g., performance metrics and level of damage mitigation), switches among various lower-level controllers. The core idea is to design a framework where the DES controller at the upper-level, mimics human intelligence and makes appropriate decisions to satisfy mission requirements, enhance system performance and structural durability. Recently developed tools in STSA have been used for anomaly detection and failure prognosis. The DMC deals with the usage monitoring or operational control part of health management, where as the issue of health monitoring is addressed by the anomaly detection tools. The proposed decision and control architecture has been validated on two test-beds, simulating the operations of rotorcraft dynamics and aircraft propulsion.

  5. Adaptive molecular evolution of the Major Histocompatibility Complex genes, DRA and DQA, in the genus Equus.

    Science.gov (United States)

    Kamath, Pauline L; Getz, Wayne M

    2011-05-18

    Major Histocompatibility Complex (MHC) genes are central to vertebrate immune response and are believed to be under balancing selection by pathogens. This hypothesis has been supported by observations of extremely high polymorphism, elevated nonsynonymous to synonymous base pair substitution rates and trans-species polymorphisms at these loci. In equids, the organization and variability of this gene family has been described, however the full extent of diversity and selection is unknown. As selection is not expected to act uniformly on a functional gene, maximum likelihood codon-based models of selection that allow heterogeneity in selection across codon positions can be valuable for examining MHC gene evolution and the molecular basis for species adaptations. We investigated the evolution of two class II MHC genes of the Equine Lymphocyte Antigen (ELA), DRA and DQA, in the genus Equus with the addition of novel alleles identified in plains zebra (E. quagga, formerly E. burchelli). We found that both genes exhibited a high degree of polymorphism and inter-specific sharing of allele lineages. To our knowledge, DRA allelic diversity was discovered to be higher than has ever been observed in vertebrates. Evidence was also found to support a duplication of the DQA locus. Selection analyses, evaluated in terms of relative rates of nonsynonymous to synonymous mutations (dN/dS) averaged over the gene region, indicated that the majority of codon sites were conserved and under purifying selection (dN

  6. Adaptive molecular evolution of the Major Histocompatibility Complex genes, DRA and DQA, in the genus Equus

    Directory of Open Access Journals (Sweden)

    Getz Wayne M

    2011-05-01

    Full Text Available Abstract Background Major Histocompatibility Complex (MHC genes are central to vertebrate immune response and are believed to be under balancing selection by pathogens. This hypothesis has been supported by observations of extremely high polymorphism, elevated nonsynonymous to synonymous base pair substitution rates and trans-species polymorphisms at these loci. In equids, the organization and variability of this gene family has been described, however the full extent of diversity and selection is unknown. As selection is not expected to act uniformly on a functional gene, maximum likelihood codon-based models of selection that allow heterogeneity in selection across codon positions can be valuable for examining MHC gene evolution and the molecular basis for species adaptations. Results We investigated the evolution of two class II MHC genes of the Equine Lymphocyte Antigen (ELA, DRA and DQA, in the genus Equus with the addition of novel alleles identified in plains zebra (E. quagga, formerly E. burchelli. We found that both genes exhibited a high degree of polymorphism and inter-specific sharing of allele lineages. To our knowledge, DRA allelic diversity was discovered to be higher than has ever been observed in vertebrates. Evidence was also found to support a duplication of the DQA locus. Selection analyses, evaluated in terms of relative rates of nonsynonymous to synonymous mutations (dN/dS averaged over the gene region, indicated that the majority of codon sites were conserved and under purifying selection (dN dS. However, the most likely evolutionary codon models allowed for variable rates of selection across codon sites at both loci and, at the DQA, supported the hypothesis of positive selection acting on specific sites. Conclusions Observations of elevated genetic diversity and trans-species polymorphisms supported the conclusion that balancing selection may be acting on these loci. Furthermore, at the DQA, positive selection was

  7. Integration of FULLSWOF2D and PeanoClaw: Adaptivity and Local Time-Stepping for Complex Overland Flows

    KAUST Repository

    Unterweger, K.

    2015-01-01

    © Springer International Publishing Switzerland 2015. We propose to couple our adaptive mesh refinement software PeanoClaw with existing solvers for complex overland flows that are tailored to regular Cartesian meshes. This allows us to augment them with spatial adaptivity and local time-stepping without altering the computational kernels. FullSWOF2D—Full Shallow Water Overland Flows—here is our software of choice though all paradigms hold for other solvers as well.We validate our hybrid simulation software in an artificial test scenario before we provide results for a large-scale flooding scenario of the Mecca region. The latter demonstrates that our coupling approach enables the simulation of complex “real-world” scenarios.

  8. Using Enterprise Architecture for Analysis of a Complex Adaptive Organization's Risk Inducing Characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Salguero, Laura Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Huff, Johnathon [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Matta, Anthony R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Collins, Sue S. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-08-01

    Sandia National Laboratories is an organization with a wide range of research and development activities that include nuclear, explosives, and chemical hazards. In addition, Sandia has over 2000 labs and over 40 major test facilities, such as the Thermal Test Complex, the Lightning Test Facility, and the Rocket Sled Track. In order to support safe operations, Sandia has a diverse Environment, Safety, and Health (ES&H) organization that provides expertise to support engineers and scientists in performing work safely. With such a diverse organization to support, the ES&H program continuously seeks opportunities to improve the services provided for Sandia by using various methods as part of their risk management strategy. One of the methods being investigated is using enterprise architecture analysis to mitigate risk inducing characteristics such as normalization of deviance, organizational drift, and problems in information flow. This paper is a case study for how a Department of Defense Architecture Framework (DoDAF) model of the ES&H enterprise, including information technology applications, can be analyzed to understand the level of risk associated with the risk inducing characteristics discussed above. While the analysis is not complete, we provide proposed analysis methods that will be used for future research as the project progresses.

  9. A novel sort of adaptive complex synchronizations of two indistinguishable chaotic complex nonlinear models with uncertain parameters and its applications in secure communications

    Science.gov (United States)

    Mahmoud, Emad E.; Abood, Fatimah S.

    In this paper, we will demonstrate the adaptive complex anti-lag synchronization (CALS) of two indistinguishable complex chaotic nonlinear systems with the parameters which are uncertain. The significance of CALS is not advised well in the literature yet. The CALS contains or consolidate two sorts of synchronizations (anti-lag synchronization ALS and lag synchronization LS). The state variable of the master system synchronizes with an alternate state variable of the slave system. Depending on the function of Lyapunov, a plan is orchestrated to achieve CALS of chaotic attractors of complex systems with unverifiable parameters. CALS of two indistinguishable complexes of Lü systems is viewed as, for example, an occasion for affirming the likelihood of the plan exhibited. In physics, we can see complex chaotic systems in numerous different applications, for example, applied sciences or engineering. With a specific end goal to affirm the proposed synchronization plan viability and demonstrate the hypothetical outcomes, we can compute the numerical simulation. The above outcomes will give the hypothetical establishment to the secure communication applications. CALS of complex chaotic systems in which a state variable of the master system synchronizes with an alternate state variable of the slave system is an encouraging sort of synchronization as it contributes excellent security in secure communication. Amid this secure communication, the synchronization between transmitter and collector is shut and message signals are recouped. The encryption and restoration of the signals are simulated numerically.

  10. Outage Performance of Hybrid FSO/RF System with Low-Complexity Power Adaptation

    KAUST Repository

    Rakia, Tamer; Yang, Hong-Chuan; Gebali, Fayez; Alouini, Mohamed-Slim

    2016-01-01

    Hybrid free-space optical (FSO) / radio-frequency (RF) systems have emerged as a promising solution for high data- rate wireless communication systems. We consider truncated channel inversion based power adaptation strategy for coherent and non

  11. A chimera grid scheme. [multiple overset body-conforming mesh system for finite difference adaptation to complex aircraft configurations

    Science.gov (United States)

    Steger, J. L.; Dougherty, F. C.; Benek, J. A.

    1983-01-01

    A mesh system composed of multiple overset body-conforming grids is described for adapting finite-difference procedures to complex aircraft configurations. In this so-called 'chimera mesh,' a major grid is generated about a main component of the configuration and overset minor grids are used to resolve all other features. Methods for connecting overset multiple grids and modifications of flow-simulation algorithms are discussed. Computational tests in two dimensions indicate that the use of multiple overset grids can simplify the task of grid generation without an adverse effect on flow-field algorithms and computer code complexity.

  12. Cooperation, complexity and adaptation: higher education capacity initiatives in international development assistance programmes in sub-Saharan Africa.

    OpenAIRE

    McEvoy, Peter

    2018-01-01

    At a time when global relations are characterised by great complexity, uncertainty and inequality, the role of higher education is crucial for a balanced and coherent development strategy, and achievement of the Sustainable Development Goals (SDGs). This is especially true for countries of sub-Saharan Africa, where there is a critical need to generate knowledge that can be used in the service of social and economic development, human rights and climate change adaptation. The study concern...

  13. Sports teams as complex adaptive systems: manipulating player numbers shapes behaviours during football small-sided games

    OpenAIRE

    Silva, Pedro; Vilar, Lu?s; Davids, Keith; Ara?jo, Duarte; Garganta, J?lio

    2016-01-01

    Small-sided and conditioned games (SSCGs) in sport have been modelled as complex adaptive systems. Research has shown that the relative space per player (RSP) formulated in SSCGs can impact on emergent tactical behaviours. In this study we adopted a systems orientation to analyse how different RSP values, obtained through manipulations of player numbers, influenced four measures of interpersonal coordination observed during performance in SSCGs. For this purpose we calculated positional data ...

  14. The ethics of complex relationships in primary care behavioral health.

    Science.gov (United States)

    Reiter, Jeff; Runyan, Christine

    2013-03-01

    Primary care settings are particularly prone to complex relationships that can be ethically challenging. This is due in part to three of the distinctive attributes of primary care: a whole family orientation; team-based care; and a longitudinal care delivery model. In addition, the high patient volume of primary care means that the likelihood of encountering ethically challenging relationships is probably greater than in a specialty setting. This article argues that one ethical standard of the American Psychological Association (APA, 2010, Ethical principles of psychologists and code of conduct, www.apa.org/ethics/code) (10.02, Therapy Involving Couples or Families) should be revised to better accommodate the work of psychologists in primary care. The corresponding Principles of Medical Ethics from the American Medical Association (AMA, 2012, Code of medical ethics: Current opinions with annotations, 2012-2013, Washington, DC: Author), most notably the principle regarding a physician's duty to "respect the rights of patients, colleagues, and other health professionals as well as safeguard privacy" are also noted. In addition, the article details how the three attributes of primary care often result in complex relationships, and provides suggestions for handling such relationships ethically. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  15. The adaptation of health care marketing to the digital era.

    Science.gov (United States)

    Radu, G; Solomon, M; Gheorghe, C M; Hostiuc, M; Bulescu, I A; Purcarea, V L

    2017-01-01

    The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future.

  16. The adaptation of health care marketing to the digital era

    Science.gov (United States)

    Radu, G; Solomon, M; Gheorghe, CM; Hostiuc, M; Bulescu, IA; Purcarea, VL

    2017-01-01

    The purpose of health care marketing is to learn and understand the needs and desires of prospective patients in order to be able to meet those necessities at the highest standards. A big advantage is the targeting capability of the electronic media that has led to its being used by managers of marketing in medical institutions as means of advertisement when they develop the marketing strategies. Regarding social media, it is safe to say that there are communication platforms that can promote certain behaviours thus influencing decision-making. Through social media, people stay in touch with other people and they can provide a mean for medical institutions to permanently communicate with the existing patients or with the potential ones. In addition, social media can be used in advertising and promoting strategies, by posting information about discounts, offers and advantages of accessing the products provided by a certain institution. A study was conducted on 126 patients of a dental clinic in Bucharest. 126 new patients were selected on a period of 22 months from January 2015 until October 2016. The patients never had any treatment in this clinic and were influenced by the Internet to seek for dental care services. The purpose of this study was to evaluate the digital methods of promoting medical services, bringing new patients to a clinic. The results of the study demonstrated the need for digital methods of promoting medical care services in order to expand a business. A strategic way of thinking in this case implied attracting new patients and offering them quality health care services, which ensured their satisfaction and the probability of their recommending the health facility further. This study revealed an important role of social networking sites in promoting. This high response was probably responsible due to targeted promoting services. Almost all the new patients who completed the form will remain patients of this clinic in future. PMID:28255375

  17. Adapting services to the needs of children and families with complex migration experiences: The Toulouse University Hospital's intercultural consultation.

    Science.gov (United States)

    Sturm, Gesine; Guerraoui, Zohra; Bonnet, Sylvie; Gouzvinski, Françoise; Raynaud, Jean-Philippe

    2017-08-01

    This article presents the recently created intercultural consultation at the Medical and Psychological Health Care Service (CMP) of the University Hospital la Grave at Toulouse. The approach of the intercultural consultation was elaborated in response to the increasing diversity of children and families using the service in Toulouse. It is also based on local research that indicates the difficulties service providers encounter when trying to establish a solid therapeutic alliance with families with complex migration backgrounds who accumulate different disadvantaging factors. The intercultural consultation adapts existing models of culture-sensitive consultations in child mental health care in France and Canada to the local context in Toulouse. We describe the underlying principles of the intercultural consultation work, the therapeutic and mediation techniques used, and the way the work is integrated into the global service provision of the CMP. The process is illustrated with a case study followed by a discussion of the innovations.

  18. Spacer capture and integration by a type I-F Cas1-Cas2-3 CRISPR adaptation complex.

    Science.gov (United States)

    Fagerlund, Robert D; Wilkinson, Max E; Klykov, Oleg; Barendregt, Arjan; Pearce, F Grant; Kieper, Sebastian N; Maxwell, Howard W R; Capolupo, Angela; Heck, Albert J R; Krause, Kurt L; Bostina, Mihnea; Scheltema, Richard A; Staals, Raymond H J; Fineran, Peter C

    2017-06-27

    CRISPR-Cas adaptive immune systems capture DNA fragments from invading bacteriophages and plasmids and integrate them as spacers into bacterial CRISPR arrays. In type I-E and II-A CRISPR-Cas systems, this adaptation process is driven by Cas1-Cas2 complexes. Type I-F systems, however, contain a unique fusion of Cas2, with the type I effector helicase and nuclease for invader destruction, Cas3. By using biochemical, structural, and biophysical methods, we present a structural model of the 400-kDa Cas1 4 -Cas2-3 2 complex from Pectobacterium atrosepticum with bound protospacer substrate DNA. Two Cas1 dimers assemble on a Cas2 domain dimeric core, which is flanked by two Cas3 domains forming a groove where the protospacer binds to Cas1-Cas2. We developed a sensitive in vitro assay and demonstrated that Cas1-Cas2-3 catalyzed spacer integration into CRISPR arrays. The integrase domain of Cas1 was necessary, whereas integration was independent of the helicase or nuclease activities of Cas3. Integration required at least partially duplex protospacers with free 3'-OH groups, and leader-proximal integration was stimulated by integration host factor. In a coupled capture and integration assay, Cas1-Cas2-3 processed and integrated protospacers independent of Cas3 activity. These results provide insight into the structure of protospacer-bound type I Cas1-Cas2-3 adaptation complexes and their integration mechanism.

  19. Employee stress management: An examination of adaptive and maladaptive coping strategies on employee health.

    Science.gov (United States)

    Holton, M Kim; Barry, Adam E; Chaney, J Don

    2015-01-01

    Employees commonly report feeling stressed at work. Examine how employees cope with work and personal stress, whether their coping strategies are adaptive (protective to health) or maladaptive (detrimental to health), and if the manner in which employees cope with stress influences perceived stress management. In this cross-sectional study, a random sample of 2,500 full-time university non-student employees (i.e. faculty, salaried professionals, and hourly non-professionals) were surveyed on health related behaviors including stress and coping. Approximately 1,277 completed the survey (51% ). Hierarchical logistic regression was used to assess the ability of adaptive and maladaptive coping strategies to predict self-reported stress management, while controlling for multiple demographic variables. Over half of employees surveyed reported effective stress management. Most frequently used adaptive coping strategies were communication with friend/family member and exercise, while most frequently used maladaptive coping strategies were drinking alcohol and eating more than usual. Both adaptive and maladaptive coping strategies made significant (p stress management. Only adaptive coping strategies (B = 0.265) predicted whether someone would self-identify as effectively managing stress. Use of maladaptive coping strategies decreased likelihood of self-reporting effective stress management. Actual coping strategies employed may influence employees' perceived stress management. Adaptive coping strategies may be more influential than maladaptive coping strategies on perceived stress management. Results illustrate themes for effective workplace stress management programs. Stress management programs focused on increasing use of adaptive coping may have a greater impact on employee stress management than those focused on decreasing use of maladaptive coping. Coping is not only a reaction to stressful experiences but also a consequence of coping resources. Thereby increasing the

  20. Beyond ideal speech situations: adapting to communication asymmetries in health care.

    Science.gov (United States)

    Gillespie, Alex; Reader, Tom; Cornish, Flora; Campbell, Catherine

    2014-01-01

    Inclusive, unconstrained and honest communication is widely advocated as beneficial and ethical. We critically explore this assumption by reflecting upon our research in acute care, informal care and public health. Using Habermas' ideals of dialogue to conceptualise ideal speech, we concur with observations that health care is often characterised by intractable exclusions and constraints. Rather than advocating implementing the ideals of dialogue, however, we examine how people adapt to these difficult and intransigent contexts. Non-ideal contexts, we find, sometimes call for non-ideal responses. Deception and furthering personal interests, and thus departing from the ideals of dialogue, can be adaptive responses.

  1. How to Lead the Way Through Complexity, Constraint, and Uncertainty in Academic Health Science Centers.

    Science.gov (United States)

    Lieff, Susan J; Yammarino, Francis J

    2017-05-01

    Academic medicine is in an era of unprecedented and constant change due to fluctuating economies, globalization, emerging technologies, research, and professional and educational mandates. Consequently, academic health science centers (AHSCs) are facing new levels of complexity, constraint, and uncertainty. Currently, AHSC leaders work with competing academic and health service demands and are required to work with and are accountable to a diversity of stakeholders. Given the new challenges and emerging needs, the authors believe the leadership methods and approaches AHSCs have used in the past that led to successes will be insufficient. In this Article, the authors propose that AHSCs will require a unique combination of old and new leadership approaches specifically oriented to the unique complexity of the AHSC context. They initially describe the designer (or hierarchical) and heroic (military and transformational) approaches to leadership and how they have been applied in AHSCs. While these well-researched and traditional approaches have their strengths in certain contexts, the leadership field has recognized that they can also limit leaders' abilities to enable their organizations to be engaged, adaptable, and responsive. Consequently, some new approaches have emerged that are taking hold in academic work and professional practice. The authors highlight and explore some of these new approaches-the authentic, self, shared, and network approaches to leadership-with attention to their application in and utility for the AHSC context.

  2. Public health implications of complex emergencies and natural disasters.

    Science.gov (United States)

    Culver, Amanda; Rochat, Roger; Cookson, Susan T

    2017-01-01

    During the last decade, conflict or natural disasters have displaced unprecedented numbers of persons. This leads to conditions prone to outbreaks that imperil the health of displaced persons and threaten global health security. Past literature has minimally examined the association of communicable disease outbreaks with complex emergencies (CEs) and natural disasters (NDs). To examine this association, we identified CEs and NDs using publicly available datasets from the Center for Research on the Epidemiology of Disasters and United Nations Flash and Consolidated Appeals archive for 2005-2014. We identified outbreaks from World Health Organization archives. We compared findings to identify overlap of outbreaks, including their types (whether or not of a vaccine-preventable disease), and emergency event types (CE, ND, or Both) by country and year using descriptive statistics and measure of association. There were 167 CEs, 912 NDs, 118 events linked to 'Both' types of emergencies, and 384 outbreaks. Of CEs, 43% were associated with an outbreak; 24% NDs were associated with an outbreak; and 36% of 'Both' types of emergencies were associated with an outbreak. Africa was disproportionately affected, where 67% of total CEs, 67% of 'Both' events (CE and ND), and 46% of all outbreaks occurred for the study period. The odds ratio of a vaccine-preventable outbreak occurring in a CE versus an ND was 4.14 (95% confidence limits 1.9, 9.4). CEs had greater odds of being associated with outbreaks compared with NDs. Moreover, CEs had high odds of a vaccine-preventable disease causing that outbreak. Focusing on better vaccine coverage could reduce CE-associated morbidity and mortality by preventing outbreaks from spreading.

  3. New public management in Iran's health complex: a management framework for primary health care system.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; HaghGoshayie, Elaheh; Doshmangir, Leila; Yousefi, Mahmood

    2018-05-01

    New public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex. In this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services. The NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.

  4. [The Psychosocial Adaptation Process of Psychiatric Nurses Working in Community Mental Health Centers].

    Science.gov (United States)

    Min, So Young

    2015-12-01

    The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues. Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?" The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.' The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.

  5. Leading toward value: the role of strategic human resource management in health system adaptability.

    Science.gov (United States)

    Garman, Andrew N; Polavarapu, Nandakishor; Grady, Jane C; Canar, W Jeffrey

    2013-01-01

    Personnel costs typically account for 60% or more of total operating expenses in health systems, and as such become a necessary focus in most if not all substantive health reform adaptations. This study sought to assess whether strategic alignment of the human resource (HR) and learning functions was associated with greater adaptive capacity in U.S. health systems. Data were gathered using a survey that was distributed electronically to chief human resource officers from two U.S.-based associations. The survey included questions about organizational structure, strategic human resource management, strategic learning, and organizational response to health reform. Significant correlations were found between strategic alignment of HR and HR's involvement in responses related to cost control (r = 0.46, p strategic alignment of organizational learning and HR involvement with these responses. Results suggest that HR structure may affect an organization's capacity for adaptive response. Top-management teams in health systems should consider positioning HR as part of the core leadership team, with a reporting relationship that allows HR to maximally participate in formulating and implementing organizational adaptation.

  6. An analysis of the adaptability of a professional development program in public health: results from the ALPS Study.

    Science.gov (United States)

    Richard, Lucie; Torres, Sara; Tremblay, Marie-Claude; Chiocchio, François; Litvak, Éric; Fortin-Pellerin, Laurence; Beaudet, Nicole

    2015-06-14

    Professional development is a key component of effective public health infrastructures. To be successful, professional development programs in public health and health promotion must adapt to practitioners' complex real-world practice settings while preserving the core components of those programs' models and theoretical bases. An appropriate balance must be struck between implementation fidelity, defined as respecting the core nature of the program that underlies its effects, and adaptability to context to maximize benefit in specific situations. This article presents a professional development pilot program, the Health Promotion Laboratory (HPL), and analyzes how it was adapted to three different settings while preserving its core components. An exploratory analysis was also conducted to identify team and contextual factors that might have been at play in the emergence of implementation profiles in each site. This paper describes the program, its core components and adaptive features, along with three implementation experiences in local public health teams in Quebec, Canada. For each setting, documentary sources were analyzed to trace the implementation of activities, including temporal patterns throughout the project for each program component. Information about teams and their contexts/settings was obtained through documentary analysis and semi-structured interviews with HPL participants, colleagues and managers from each organization. While each team developed a unique pattern of implementing the activities, all the program's core components were implemented. Differences of implementation were observed in terms of numbers and percentages of activities related to different components of the program as well as in the patterns of activities across time. It is plausible that organizational characteristics influencing, for example, work schedule flexibility or learning culture might have played a role in the HPL implementation process. This paper shows how a

  7. Adaptive Robust Online Constructive Fuzzy Control of a Complex Surface Vehicle System.

    Science.gov (United States)

    Wang, Ning; Er, Meng Joo; Sun, Jing-Chao; Liu, Yan-Cheng

    2016-07-01

    In this paper, a novel adaptive robust online constructive fuzzy control (AR-OCFC) scheme, employing an online constructive fuzzy approximator (OCFA), to deal with tracking surface vehicles with uncertainties and unknown disturbances is proposed. Significant contributions of this paper are as follows: 1) unlike previous self-organizing fuzzy neural networks, the OCFA employs decoupled distance measure to dynamically allocate discriminable and sparse fuzzy sets in each dimension and is able to parsimoniously self-construct high interpretable T-S fuzzy rules; 2) an OCFA-based dominant adaptive controller (DAC) is designed by employing the improved projection-based adaptive laws derived from the Lyapunov synthesis which can guarantee reasonable fuzzy partitions; 3) closed-loop system stability and robustness are ensured by stable cancelation and decoupled adaptive compensation, respectively, thereby contributing to an auxiliary robust controller (ARC); and 4) global asymptotic closed-loop system can be guaranteed by AR-OCFC consisting of DAC and ARC and all signals are bounded. Simulation studies and comprehensive comparisons with state-of-the-arts fixed- and dynamic-structure adaptive control schemes demonstrate superior performance of the AR-OCFC in terms of tracking and approximation accuracy.

  8. Complexity reduction in the H.264/AVC using highly adaptive fast mode decision based on macroblock motion activity

    Science.gov (United States)

    Abdellah, Skoudarli; Mokhtar, Nibouche; Amina, Serir

    2015-11-01

    The H.264/AVC video coding standard is used in a wide range of applications from video conferencing to high-definition television according to its high compression efficiency. This efficiency is mainly acquired from the newly allowed prediction schemes including variable block modes. However, these schemes require a high complexity to select the optimal mode. Consequently, complexity reduction in the H.264/AVC encoder has recently become a very challenging task in the video compression domain, especially when implementing the encoder in real-time applications. Fast mode decision algorithms play an important role in reducing the overall complexity of the encoder. In this paper, we propose an adaptive fast intermode algorithm based on motion activity, temporal stationarity, and spatial homogeneity. This algorithm predicts the motion activity of the current macroblock from its neighboring blocks and identifies temporal stationary regions and spatially homogeneous regions using adaptive threshold values based on content video features. Extensive experimental work has been done in high profile, and results show that the proposed source-coding algorithm effectively reduces the computational complexity by 53.18% on average compared with the reference software encoder, while maintaining the high-coding efficiency of H.264/AVC by incurring only 0.097 dB in total peak signal-to-noise ratio and 0.228% increment on the total bit rate.

  9. The South African developmental landscape: restricted potentials or expansive, complex adaptive opportunities?

    Directory of Open Access Journals (Sweden)

    C J Burman

    2013-07-01

    Full Text Available This article argues that the South African developmental landscape is currently locked into an overly technical, path dependent paradigm that is unlikely to be capable of embracing the complex challenges identified by the recent National Development Plan. The article explores the internal logic of the existing path dependent, technical condition from the perspective of complexity, in the context of the Department of Science and Technology’s Fifth Grand Challenge and “continuous change”. It is argued that drawing ideas from complexity into future developmental trajectories can add value to the National Development Plan: Vision 2030, but to do so will require dynamic mind-set shifts across multiple developmental scales and interfaces if new approaches to managing development that embraces complexity, rather than denies it, is to emerge. Keywords: development; complexity; path dependency; epistemological vigilance; sense-making; National Development Plan Disciplines: Complexity Studies; Transdisciplinary studies; Management studies; Public management; Political studies; Economics; Development Studies

  10. The health policy implications of individual adaptive behavior responses to smog pollution in urban China.

    Science.gov (United States)

    Ban, Jie; Zhou, Lian; Zhang, Yi; Brooke Anderson, G; Li, Tiantian

    2017-09-01

    Smog pollution is a serious public health issue in urban China, where it is associated with public health through a range of respiratory and cardiovascular illnesses. Despite the negative health impacts of smog pollution, individual adaptive behaviors are poorly understood. This knowledge gap hinders the development of effective public policy to support and encourage the adoption of individual adaptive and mitigating behaviors to smog pollution. A questionnaire survey of 1141 randomly sampled individuals in a typical PM 2.5 -polluted Chinese city was designed to establish smog concerns and behavior changes during smog events. The results demonstrate a variety of behavior responses associated with risk perception, experience of smog, age, and gender of respondents. An understanding of these variations is critical to the development of effective public policy and ultimately to the improvement of public health in cities affected by smog. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Adapting to the health impacts of climate change in a sustainable manner.

    Science.gov (United States)

    Hoy, Damian; Roth, Adam; Lepers, Christelle; Durham, Jo; Bell, Johann; Durand, Alexis; Lal, Padma Narsey; Souares, Yvan

    2014-12-11

    The climate is changing and this poses significant threats to human health. Climate change is one of the greatest challenges facing Pacific Island countries and territories due to their unique geophysical features, and their social, economic and cultural characteristics. The Pacific region also faces challenges with widely dispersed populations, limited resources and fragmented health systems. Over the past few years, there has been a substantial increase in international aid for health activities aimed at adapting to the threats of climate change. This funding needs to be used strategically to ensure an effective approach to reducing the health risk from climate change. Respecting the principles of development effectiveness will result in more effective and sustainable adaptation, in particular, 1) processes should be owned and driven by local communities, 2) investments should be aligned with existing national priorities and policies, and 3) existing systems must not be ignored, but rather expanded upon and reinforced.

  12. Adaptive sex allocation in birds : The complexities of linking theory and practice

    NARCIS (Netherlands)

    Komdeur, Jan; Pen, Ido

    2002-01-01

    We review some recent theoretical and empirical developments in the study of sex allocation in birds. The advent of reliable molecular sexing techniques has led to a sharp increase in the number of studies that report biased offspring sex ratios in birds. However, compelling evidence for adaptive

  13. A Structured Grid Based Solution-Adaptive Technique for Complex Separated Flows

    Science.gov (United States)

    Thornburg, Hugh; Soni, Bharat K.; Kishore, Boyalakuntla; Yu, Robert

    1996-01-01

    The objective of this work was to enhance the predictive capability of widely used computational fluid dynamic (CFD) codes through the use of solution adaptive gridding. Most problems of engineering interest involve multi-block grids and widely disparate length scales. Hence, it is desirable that the adaptive grid feature detection algorithm be developed to recognize flow structures of different type as well as differing intensity, and adequately address scaling and normalization across blocks. In order to study the accuracy and efficiency improvements due to the grid adaptation, it is necessary to quantify grid size and distribution requirements as well as computational times of non-adapted solutions. Flow fields about launch vehicles of practical interest often involve supersonic freestream conditions at angle of attack exhibiting large scale separate vortical flow, vortex-vortex and vortex-surface interactions, separated shear layers and multiple shocks of different intensity. In this work, a weight function and an associated mesh redistribution procedure is presented which detects and resolves these features without user intervention. Particular emphasis has been placed upon accurate resolution of expansion regions and boundary layers. Flow past a wedge at Mach=2.0 is used to illustrate the enhanced detection capabilities of this newly developed weight function.

  14. Adapting Evidence-Based Mental Health Treatments in Community Settings: Preliminary Results from a Partnership Approach

    Science.gov (United States)

    Southam-Gerow, Michael A.; Hourigan, Shannon E.; Allin, Robert B., Jr.

    2009-01-01

    This article describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for…

  15. Using Mental Health Consultation to Decrease Disruptive Behaviors in Preschoolers: Adapting an Empirically-Supported Intervention

    Science.gov (United States)

    Williford, Amanda P.; Shelton, Terri L.

    2008-01-01

    Background: This study examined the effectiveness of an adaptation of an empirically-supported intervention delivered using mental health consultation to preschoolers who displayed elevated disruptive behaviors. Method: Ninety-six preschoolers, their teachers, and their primary caregivers participated. Children in the intervention group received…

  16. mHealth intervention to support asthma self-management in adolescents : The ADAPT study

    NARCIS (Netherlands)

    Kosse, R.C.; Bouvy, M.L.; de Vries, T.W.; Kaptein, A.A.; Geers, H.C.J.; van Dijk, Liset; Koster, E.S.

    2017-01-01

    Purpose: Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving

  17. mHealth intervention to support asthma self-management in adolescents: the ADAPT study.

    NARCIS (Netherlands)

    Kosse, R.C.; Bouvy, M.L.; Vries, T.W. de; Kaptein, A.A.; Geers, H.C.J.; Dijk, L. van; Koster, E.S.

    2017-01-01

    Purpose: Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving

  18. Adaptation of community health worker-delivered behavioral activation for torture survivors in Kurdistan, Iraq.

    Science.gov (United States)

    Magidson, J F; Lejuez, C W; Kamal, T; Blevins, E J; Murray, L K; Bass, J K; Bolton, P; Pagoto, S

    2015-12-01

    Growing evidence supports the use of Western therapies for the treatment of depression, trauma, and stress delivered by community health workers (CHWs) in conflict-affected, resource-limited countries. A recent randomized controlled trial (Bolton et al . 2014 a ) supported the efficacy of two CHW-delivered interventions, cognitive processing therapy (CPT) and brief behavioral activation treatment for depression (BATD), for reducing depressive symptoms and functional impairment among torture survivors in the Kurdish region of Iraq. This study describes the adaptation of the CHW-delivered BATD approach delivered in this trial (Bolton et al .2014 a ), informed by the Assessment-Decision-Administration-Production-Topical experts-Integration-Training-Testing (ADAPT-ITT) framework for intervention adaptation (Wingood & DiClemente, 2008). Cultural modifications, adaptations for low-literacy, and tailored training and supervision for non-specialist CHWs are presented, along with two clinical case examples to illustrate delivery of the adapted intervention in this setting. Eleven CHWs, a study psychiatrist, and the CHW clinical supervisor were trained in BATD. The adaptation process followed the ADAPT-ITT framework and was iterative with significant input from the on-site supervisor and CHWs. Modifications were made to fit Kurdish culture, including culturally relevant analogies, use of stickers for behavior monitoring, cultural modifications to behavioral contracts, and including telephone-delivered sessions to enhance feasibility. BATD was delivered by CHWs in a resource-poor, conflict-affected area in Kurdistan, Iraq, with some important modifications, including low-literacy adaptations, increased cultural relevancy of clinical materials, and tailored training and supervision for CHWs. Barriers to implementation, lessons learned, and recommendations for future efforts to adapt behavioral therapies for resource-limited, conflict-affected areas are discussed.

  19. Addressing Complex Challenges through Adaptive Leadership: A Promising Approach to Collaborative Problem Solving

    Science.gov (United States)

    Nelson, Tenneisha; Squires, Vicki

    2017-01-01

    Organizations are faced with solving increasingly complex problems. Addressing these issues requires effective leadership that can facilitate a collaborative problem solving approach where multiple perspectives are leveraged. In this conceptual paper, we critique the effectiveness of earlier leadership models in tackling complex organizational…

  20. A Feasibility Trial of Mental Health First Aid First Nations: Acceptability, Cultural Adaptation, and Preliminary Outcomes.

    Science.gov (United States)

    Crooks, Claire V; Lapp, Andrea; Auger, Monique; van der Woerd, Kim; Snowshoe, Angela; Rogers, Billie Jo; Tsuruda, Samantha; Caron, Cassidy

    2018-03-25

    The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community-based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community-based participatory research principles, emphasizing relationship-driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews (n = 89), and surveys (n = 91) from 10 groups in four provinces. Surveys contained open-ended questions, retrospective pre-post ratings, and a scenario. We utilized data from nine facilitator interviews and 24 facilitator implementation surveys. The different lines of evidence converged to highlight strong acceptability, mixed reactions to the cultural adaptation, and gains in participants' knowledge, mental health first aid skill application, awareness, and self-efficacy, and reductions in stigma beliefs. Beyond promoting individual gains, the course served as a community-wide prevention approach by situating mental health in a colonial context and highlighting local resources and cultural strengths for promoting mental well-being. © 2018 The Authors American Journal of Community Psychology published by Wiley Periodicals, Inc. on behalf of Society for Community Research and Action.

  1. Health impacts of climate change in Vanuatu: an assessment and adaptation action plan.

    Science.gov (United States)

    Spickett, Jeffery T; Katscherian, Dianne; McIver, Lachlan

    2013-01-30

    Climate change is one of the greatest global challenges and Pacific island countries are particularly vulnerable due to, among other factors, their geography, demography and level of economic development. A Health Impact Assessment (HIA) framework was used as a basis for the consideration of the potential health impacts of changes in the climate on the population of Vanuatu, to assess the risks and propose a range of potential adaptive responses appropriate for Vanuatu. The HIA process involved the participation of a broad range of stakeholders including expert sector representatives in the areas of bio-physical, socio-economic, infrastructure, environmental diseases and food, who provided informed comment and input into the understanding of the potential health impacts and development of adaptation strategies. The risk associated with each of these impacts was assessed with the application of a qualitative process that considered both the consequences and the likelihood of each of the potential health impacts occurring. Potential adaptation strategies and actions were developed which could be used to mitigate the identified health impacts and provide responses which could be used by the various sectors in Vanuatu to contribute to future decision making processes associated with the health impacts of climate change.

  2. Dynamic optimization of the complex adaptive controlling by the structure of enterprise’s product range

    Directory of Open Access Journals (Sweden)

    Andrey Fyodorovich Shorikov

    2013-06-01

    Full Text Available This paper reviews a methodical approach to solve multi-step dynamic problem of optimal integrated adaptive management of a product portfolio structure of the enterprise. For the organization of optimal adaptive terminal control of the system the recurrent algorithm, which reduces an initial multistage problem to the realization of the final sequence of problems of optimal program terminal control is offered. In turn, the decision of each problem of optimal program terminal control is reduced to the realization of the final sequence only single-step operations in the form of the problems solving of linear and convex mathematical programming. Thus, the offered approach allows to develop management solutions at current information support, which consider feedback, and which create the optimal structure of an enterprise’s product lines, contributing to optimising of profits, as well as maintenance of the desired level of profit for a long period of time

  3. An Information Theoretic Investigation Of Complex Adaptive Supply Networks With Organizational Topologies

    Science.gov (United States)

    2016-12-22

    for the global pattern. A network view has proven useful in modeling a supply - chain for patterns of interaction. Queuing theory can be used to...phenomena. Second, operations management and supply - chain management lack metrics for evolution and dynamism in supply networks. Third, developing...robust theories in the presence of 14 adaptation is a formidable task. Supply - chain management theory can be built by identifying CAS phenomena and

  4. Food, health, and complexity: towards a conceptual understanding to guide collaborative public health action

    Directory of Open Access Journals (Sweden)

    Shannon E. Majowicz

    2016-06-01

    Full Text Available Abstract Background What we eat simultaneously impacts our exposure to pathogens, allergens, and contaminants, our nutritional status and body composition, our risks for and the progression of chronic diseases, and other outcomes. Furthermore, what we eat is influenced by a complex web of drivers, including culture, politics, economics, and our built and natural environments. To date, public health initiatives aimed at improving food-related population health outcomes have primarily been developed within ‘practice silos’, and the potential for complex interactions among such initiatives is not well understood. Therefore, our objective was to develop a conceptual model depicting how infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy can be linked via shared drivers, to illustrate potential complex interactions and support future collaboration across public health practice silos. Methods We developed the conceptual model by first conducting a systematic literature search to identify review articles containing schematics that depicted relationships between drivers and the issues of interest. Next, we synthesized drivers into a common model using a modified thematic synthesis approach that combined an inductive thematic analysis and mapping to synthesize findings. Results The literature search yielded 83 relevant references containing 101 schematics. The conceptual model contained 49 shared drivers and 227 interconnections. Each of the five issues was connected to all others. Obesity and food insecurity shared the most drivers (n = 28. Obesity shared several drivers with food allergy (n = 11, infectious foodborne illness (n = 7, and dietary contamination (n = 6. Food insecurity shared several drivers with infectious foodborne illness (n = 9 and dietary contamination (n = 9. Infectious foodborne illness shared drivers with dietary contamination (n = 8. Fewer drivers were

  5. Low-Complexity Scheduling and Power Adaptation for Coordinated Cloud-Radio Access Networks

    KAUST Repository

    Douik, Ahmed; Dahrouj, Hayssam; Al-Naffouri, Tareq Y.; Alouini, Mohamed-Slim

    2017-01-01

    In practical wireless systems, the successful implementation of resource allocation techniques strongly depends on the algorithmic complexity. Consider a cloud-radio access network (CRAN), where the central cloud is responsible for scheduling

  6. Mobilisation, politics, investment and constant adaptation: lessons from the Australian health-promotion response to HIV.

    Science.gov (United States)

    Brown, Graham; O'Donnell, Daryl; Crooks, Levinia; Lake, Rob

    2014-04-01

    The Australian response to HIV oversaw one of the most rapid and sustained changes in community behaviour in Australia's health-promotion history. The combined action of communities of gay men, sex workers, people who inject drugs, people living with HIV and clinicians working in partnership with government, public health and research has been recognised for many years as highly successful in minimising the HIV epidemic. This article will show how the Australian HIV partnership response moved from a crisis response to a constant and continuously adapting response, with challenges in sustaining the partnership. Drawing on key themes, lessons for broader health promotion are identified. The Australian HIV response has shown that a partnership that is engaged, politically active, adaptive and resourced to work across multiple social, structural, behavioural and health-service levels can reduce the transmission and impact of HIV. The experience of the response to HIV, including its successes and failures, has lessons applicable across health promotion. This includes the need to harness community mobilisation and action; sustain participation, investment and leadership across the partnership; commit to social, political and structural approaches; and build and use evidence from multiple sources to continuously adapt and evolve. So what? The Australian HIV response was one of the first health issues to have the Ottawa Charter embedded from the beginning, and has many lessons to offer broader health promotion and common challenges. As a profession and a movement, health promotion needs to engage with the interactions and synergies across the promotion of health, learn from our evidence, and resist the siloing of our responses.

  7. Adapting to Health Impacts of Climate Change in the Department of Defense.

    Science.gov (United States)

    Chrétien, Jean-Paul

    2016-01-01

    The Department of Defense (DoD) recognizes climate change as a threat to its mission and recently issued policy to implement climate change adaptation measures. However, the DoD has not conducted a comprehensive assessment of health-related climate change effects. To catalyze the needed assessment--a first step toward a comprehensive DoD climate change adaptation plan for health--this article discusses the DoD relevance of 3 selected climate change impacts: heat injuries, vector-borne diseases, and extreme weather that could lead to natural disasters. The author uses these examples to propose a comprehensive approach to planning for health-related climate change impacts in the DoD.

  8. Integrating Systems Health Management with Adaptive Controls for a Utility-Scale Wind Turbine

    Science.gov (United States)

    Frost, Susan A.; Goebel, Kai; Trinh, Khanh V.; Balas, Mark J.; Frost, Alan M.

    2011-01-01

    Increasing turbine up-time and reducing maintenance costs are key technology drivers for wind turbine operators. Components within wind turbines are subject to considerable stresses due to unpredictable environmental conditions resulting from rapidly changing local dynamics. Systems health management has the aim to assess the state-of-health of components within a wind turbine, to estimate remaining life, and to aid in autonomous decision-making to minimize damage. Advanced adaptive controls can provide the mechanism to enable optimized operations that also provide the enabling technology for Systems Health Management goals. The work reported herein explores the integration of condition monitoring of wind turbine blades with contingency management and adaptive controls. Results are demonstrated using a high fidelity simulator of a utility-scale wind turbine.

  9. Adaptations of Personal Health Record Platform for Medical Research on Chronic Diseases

    Directory of Open Access Journals (Sweden)

    A. Krukowski

    2015-05-01

    Full Text Available The article reports on experiences in e-Health platforms and services for supporting medical research into the causes and relationships among physiological parameters and health problems concerning different chronic diseases. The Personal Health Record (PHR is a way of standardizing electronic management of medical information between patients and their physicians, including medical bodies collaborating in providing integrated medical care services. We describe roles and aims behind electronic health records, follow with applicable legal and standardizations frameworks and relevant European activities, leading to the presentation of common commercial and open-source implementations of such systems, concluding with the indication of specific adaptations enabling a use of stored personal health data for scientific research into causes and evaluation of chronic illnesses. We describe ethical and privacy concerns that are relevant to using and exchanging electronic health information.

  10. Linguistic adaptation and psychometric evaluation of original oral health literacy-adult questionnaire (OHL-AQ

    Directory of Open Access Journals (Sweden)

    SHALEEN VYAS

    2016-10-01

    Full Text Available Introduction: Linguistically adapted oral health literacy tools are helpful to assess oral health literacy among local population with clarity and understandability. The original oral health literacy adult questionnaire, Oral Health Literacy Adult Questionnaire, was given in English (2013, consisting of 17 items under 4 domains. The present study rationalizes to culturally adapt and validate Oral Health Literacy Adult Questionnaire into Hindi language. Thus, we objectified to translate Oral Health Literacy Adult Questionnaire into Hindi and test its psychometric properties like reliability and validity among primary school teachers. Methods: The Oral Health Literacy Adult Questionnaire was translated into Oral Health Literacy Adult Questionnaire – Hindi Version using the World Health Organization recommended translation backtranslation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a small sample of 10 individuals. A cross-sectional study was conducted (June-July 2015 and OHL-AQ-H was administered on a convenient sample of 170 primary school teachers. Internal consistency and testretest reliability were assessed using Cronbach’s alpha and Intra-class correlation coefficient (ICC, respectively, with 2 weeks interval to ascertain adherence to the questionnaire response. Predictive validity was tested by comparing OHL-AQ-H scores with clinical indicators like oral hygiene scores and dental caries scores. The concurrent and discriminant validity was assessed through self-reported oral health and through negative association with sociodemographic variables. The data was analyzed by descriptive tests using chi-square and bivariate logistic regression in SPSS software, version 20 and p<0.05 was considered as the significance level. Results: The mean OHL-AQ-H score was 13.58±2.82. ICC and Cronbach’s alpha for Oral Health Literacy Adult Questionnaire – Hindi Version

  11. Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings.

    Science.gov (United States)

    Poulin, Paule; Austen, Lea; Scott, Catherine M; Poulin, Michelle; Gall, Nadine; Seidel, Judy; Lafrenière, René

    2013-01-01

    Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It should involve translating and integrating scientific evidence, such as health technology assessment (HTA) reports, with context-sensitive evidence to develop recommendations on whether and under what conditions a new technology will be introduced. However, the development of a program to support such decision making can require considerable time and resources. An alternative is to adapt a preexisting program to the new setting. We describe a framework for adapting the Local HTA Decision Support Program, originally developed by the Department of Surgery and Surgical Services (Calgary, AB, Canada), for use by other departments. The framework consists of six steps: 1) development of a program review and adaptation manual, 2) education and readiness assessment of interested departments, 3) evaluation of the program by individual departments, 4) joint evaluation via retreats, 5) synthesis of feedback and program revision, and 6) evaluation of the adaptation process. Nine departments revised the Local HTA Decision Support Program and expressed strong satisfaction with the adaptation process. Key elements for success were identified. Adaptation of a preexisting program may reduce duplication of effort, save resources, raise the health care providers' awareness of HTA, and foster constructive stakeholder engagement, which enhances the legitimacy of evidence-informed recommendations for introducing new health technologies. We encourage others to use this framework for program adaptation and to report their experiences.

  12. Assessing the Role of Environmental Factors on Baltic Cod Recruitment, a Complex Adaptive System Emergent Property

    Directory of Open Access Journals (Sweden)

    Dionysis Krekoukiotis

    2016-07-01

    Full Text Available For decades, fish recruitment has been a subject of intensive research with stock–recruitment models commonly used for recruitment prediction often only explaining a small fraction of the inter-annual recruitment variation. The use of environmental information to improve our ability to predict recruitment, could contribute considerably to fisheries management. However, the problem remains difficult because the mechanisms behind such complex relationships are often poorly understood; this in turn, makes it difficult to determine the forecast estimation robustness, leading to the failure of some relationships when new data become available. The utility of machine learning algorithms such as artificial neural networks (ANNs for solving complex problems has been demonstrated in aquatic studies and has led many researchers to advocate ANNs as an attractive, non-linear alternative to traditional statistical methods. The goal of this study is to design a Baltic cod recruitment model (FishANN that can account for complex ecosystem interactions. To this end, we (1 build a quantitative model representation of the conceptual understanding of the complex ecosystem interactions driving Baltic cod recruitment dynamics, and (2 apply the model to strengthen the current capability to project future changes in Baltic cod recruitment. FishANN is demonstrated to bring multiple stressors together into one model framework and estimate the relative importance of these stressors while interpreting the complex nonlinear interactions between them. Additional requirements to further improve the current study in the future are also proposed.

  13. Public Health and Climate Change Adaptation at the Federal Level: One Agency’s Response to Executive Order 13514

    Science.gov (United States)

    Schramm, Paul J.; Luber, George

    2014-01-01

    Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change. PMID:24432931

  14. Adaptation Challenges in Complex River Basins: Lessons Learned and Unlearned for the Colorado

    Science.gov (United States)

    Pulwarty, R. S.

    2008-12-01

    Climate variations affect the function and operation of existing water infrastructure - including hydropower, structural flood defenses, drainage and irrigation systems - as well as water management practices in support of efficiency and environmental needs. Selected basins around the world, including the Colorado, show agreements in model projections of increasing aridity. Adverse effects of climate change on freshwater systems aggravate the impacts of other stresses, such as population growth, changing economic activity, land-use change and urbanization and most importantly upstream-downstream winners and losers. Thus current water management practices may not be robust enough to cope with the impacts of climate change on water supply reliability. In many locations, water management does not even satisfactorily cope with current climate variability, so that large flood and drought-related environmental and economic damages occur on seasonal to decadal timescales. The recently released IPCC Technical Paper notes that adaptation procedures and risk management practices that incorporate projected hydrological changes with related uncertainties are being developed in some countries and regions.In this presentation we will review the challenges and lessons provided in drought and water resources management and optimization in the context of climate variability and projected change in the Western U.S., the European Union (including the Iberian Peninsula), the Murray-Darling Basin, and elsewhere. Since the release of the IPCC report several of the authors (including the presenter) have held meetings on comparative assessments of adaptation and its challenges in interstate and international river basins. As a first step, improved incorporation of information about current climate variability into water-related management could assist adaptation to longer-term climate change impacts. Future adaptations include technical changes that improve water use efficiency, demand

  15. Construct validity of the pediatric evaluation of disability inventory computer adaptive test (PEDI-CAT) in children with medical complexity.

    Science.gov (United States)

    Dumas, Helene M; Fragala-Pinkham, Maria A; Rosen, Elaine L; O'Brien, Jane E

    2017-11-01

    To assess construct (convergent and divergent) validity of the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) in a sample of children with complex medical conditions. Demographics, clinical information, PEDI-CAT normative score, and the Post-Acute Acuity Rating for Children (PAARC) level were collected for all post-acute hospital admissions (n = 110) from 1 April 2015 to 1 March 2016. Correlations between the PEDI-CAT Daily Activities, Mobility, and Social/Cognitive domain scores for the total sample and across three age groups (infant, preschool, and school-age) were calculated. Differences in mean PEDI-CAT scores for each domain across two groups, children with "Less Complexity," or "More Complexity" based on PAARC level were examined. All correlations for the total sample and age subgroups were statistically significant and trends across age groups were evident with the stronger associations between domains for the infant group. Significant differences were found between mean PEDI-CAT Daily Activities, Mobility, and Social/Cognitive normative scores across the two complexity groups with children in the "Less Complex" group having higher PEDI-CAT scores for all domains. This study provides evidence indicating the PEDI-CAT can be used with confidence in capturing and differentiating children's level of function in a post-acute care setting. Implications for Rehabilitation The PEDI-CAT is measure of function for children with a variety of conditions and can be used in any clinical setting. Convergent validity of the PEDI-CAT's Daily Activities, Mobility, and Social/Cognitive domains was significant and particularly strong for infants and young children with medical complexity. The PEDI-CAT was able to discriminate groups of children with differing levels of medical complexity admitted to a pediatric post-acute care hospital.

  16. Biobehavioral Insights into Adaptive Behavior in Complex and Dynamic Operational Settings: Lessons learned from the Soldier Performance and Effective, Adaptable Response Task

    Directory of Open Access Journals (Sweden)

    Amy J. Haufler

    2018-02-01

    pattern of task-related change in cortisol or sAA. We conclude that individual differences in psychophysiological reactivity and regulation in response to an ecologically valid, military-relevant task are associated with performance-related adaptive behavior in this standardized operational setting. The implications for modern day warfare, where advancing our understanding of the nature of individual differences in adaptive problem solving is critical to mission success, fitness for duty, and other occupational health-related outcomes, are discussed.

  17. Linguistic adaptation and psychometric evaluation of original Oral Health Literacy-Adult Questionnaire (OHL-AQ).

    Science.gov (United States)

    Vyas, Shaleen; Nagarajappa, Sandesh; Dasar, Pralhad L; Mishra, Prashant

    2016-10-01

    Linguistically adapted oral health literacy tools are helpful to assess oral health literacy among local population with clarity and understandability. The original oral health literacy adult questionnaire, Oral Health Literacy Adult Questionnaire, was given in English (2013), consisting of 17 items under 4 domains. The present study rationalizes to culturally adapt and validate Oral Health Literacy Adult Questionnaire into Hindi language. Thus, we objectified to translate Oral Health Literacy Adult Questionnaire into Hindi and test its psychometric properties like reliability and validity among primary school teachers. The Oral Health Literacy Adult Questionnaire was translated into Oral Health Literacy Adult Questionnaire - Hindi Version using the World Health Organization recommended translation back-translation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a small sample of 10 individuals. A cross-sectional study was conducted (June-July 2015) and OHL-AQ-H was administered on a convenient sample of 170 primary school teachers. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Intra-class correlation coefficient (ICC), respectively, with 2 weeks interval to ascertain adherence to the questionnaire response. Predictive validity was tested by comparing OHL-AQ-H scores with clinical indicators like oral hygiene scores and dental caries scores. The concurrent and discriminant validity was assessed through self-reported oral health and through negative association with sociodemographic variables. The data was analyzed by descriptive tests using chi-square and bivariate logistic regression in SPSS software, version 20 and pLiteracy Adult Questionnaire - Hindi Version were 0.94 and 0.70, respectively. Comparisons of varying levels of oral health literacy with self-reported oral health established significant concurrent validity (p=0.01). Significant

  18. Evidence-based adaptation and scale-up of a mobile phone health information service.

    Science.gov (United States)

    L'Engle, Kelly; Plourde, Kate F; Zan, Trinity

    2017-01-01

    The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs. m4RH-Mobile for Reproductive Health-is an SMS, or text message-based, health information service that began in two countries and over a period of 7 years has been adapted and scaled to new population groups and new countries. Success can be attributed to following key principles for scaling up health programs, including continuous stakeholder engagement; ongoing monitoring, evaluation, and research including extensive content and usability testing with the target audience; strategic dissemination of results; and use of marketing and sustainability principles for social initiatives. This article investigates how these factors contributed to vertical, horizontal, and global scale-up of the m4RH program. Vertical scale of m4RH is demonstrated in Tanzania, where the early engagement of stakeholders including the Ministry of Health catalyzed expansion of m4RH content and national-level program reach. Ongoing data collection has provided real-time data for decision-making, information about the user base, and peer-reviewed publications, yielding government endorsement and partner hand-off for sustainability of the m4RH platform. Horizontal scale-up and adaptation of m4RH has occurred through expansion to new populations in Rwanda, Uganda, and Tanzania, where best practices for design and implementation of mHealth programs were followed to ensure the platform meets the needs of target populations. m4RH also has been modified and packaged for global scale-up through licensing and toolkit

  19. Adaptation, interaction and urgency : a complex evolutionary economic geography approach to leisure

    NARCIS (Netherlands)

    Meekes, Jasper F.; Buda, Dorina M.; de Roo, Gert

    2017-01-01

    Local and regional governments in western European peripheral areas aim to spur leisure-led regional development. We explore planning for leisure by applying an evolutionary economic geography (EEG) approach from a complexity perspective. We identify conditions which enable and constrain leisure

  20. Development and validation of the Psychological Adaptation Scale (PAS): use in six studies of adaptation to a health condition or risk.

    Science.gov (United States)

    Biesecker, Barbara B; Erby, Lori H; Woolford, Samuel; Adcock, Jessica Young; Cohen, Julie S; Lamb, Amanda; Lewis, Katie V; Truitt, Megan; Turriff, Amy; Reeve, Bryce B

    2013-11-01

    We introduce The Psychological Adaptation Scale (PAS) for assessing adaptation to a chronic condition or risk and present validity data from six studies of genetic conditions. Informed by theory, we identified four domains of adaptation: effective coping, self-esteem, social integration, and spiritual/existential meaning. Items were selected from the PROMIS "positive illness impact" item bank and adapted from the Rosenberg self-esteem scale to create a 20-item scale. Each domain included five items, with four sub-scale scores. Data from studies of six populations: adults affected with or at risk for genetic conditions (N=3) and caregivers of children with genetic conditions (N=3) were analyzed using confirmatory factor analyses (CFA). CFA suggested that all but five posited items converge on the domains as designed. Invariance of the PAS amongst the studies further suggested it is a valid and reliable tool to facilitate comparisons of adaptation across conditions. Use of the PAS will standardize assessments of adaptation and foster understanding of the relationships among related health outcomes, such as quality of life and psychological well-being. Clinical interventions can be designed based on PAS data to enhance dimensions of psychological adaptation to a chronic health condition or risk. Published by Elsevier Ireland Ltd.

  1. A conceptual framework for addressing complexity and unfolding transition dynamics when developing sustainable adaptation strategies in urban water management.

    Science.gov (United States)

    Fratini, C F; Elle, M; Jensen, M B; Mikkelsen, P S

    2012-01-01

    To achieve a successful and sustainable adaptation to climate change we need to transform the way we think about change. Much water management research has focused on technical innovation with a range of new solutions developed to achieve a 'more sustainable and integrated urban water management cycle'. But Danish municipalities and utility companies are struggling to bring such solutions into practice. 'Green infrastructure', for example, requires the consideration of a larger range of aspects related to the urban context than the traditional urban water system optimization. There is the need for standardized methods and guidelines to organize transdisciplinary processes where different types of knowledge and perspectives are taken into account. On the basis of the macro-meso-micro pattern inspired by complexity science and transition theory, we developed a conceptual framework to organize processes addressing the complexity characterizing urban water management in the context of climate change. In this paper the framework is used to organize a research process aiming at understanding and unfolding urban dynamics for sustainable transition. The final goal is to enable local authorities and utilities to create the basis for managing and catalysing the technical and organizational innovation necessary for a sustainable transition towards climate change adaptation in urban areas.

  2. Synchronization of coupled stochastic complex-valued dynamical networks with time-varying delays via aperiodically intermittent adaptive control

    Science.gov (United States)

    Wang, Pengfei; Jin, Wei; Su, Huan

    2018-04-01

    This paper deals with the synchronization problem of a class of coupled stochastic complex-valued drive-response networks with time-varying delays via aperiodically intermittent adaptive control. Different from the previous works, the intermittent control is aperiodic and adaptive, and the restrictions on the control width and time delay are removed, which lead to a larger application scope for this control strategy. Then, based on the Lyapunov method and Kirchhoff's Matrix Tree Theorem as well as differential inequality techniques, several novel synchronization conditions are derived for the considered model. Specially, impulsive control is also considered, which can be seen as a special case of the aperiodically intermittent control when the control width tends to zero. And the corresponding synchronization criteria are given as well. As an application of the theoretical results, a class of stochastic complex-valued coupled oscillators with time-varying delays is studied, and the numerical simulations are also given to demonstrate the effectiveness of the control strategies.

  3. Sports teams as complex adaptive systems: manipulating player numbers shapes behaviours during football small-sided games.

    Science.gov (United States)

    Silva, Pedro; Vilar, Luís; Davids, Keith; Araújo, Duarte; Garganta, Júlio

    2016-01-01

    Small-sided and conditioned games (SSCGs) in sport have been modelled as complex adaptive systems. Research has shown that the relative space per player (RSP) formulated in SSCGs can impact on emergent tactical behaviours. In this study we adopted a systems orientation to analyse how different RSP values, obtained through manipulations of player numbers, influenced four measures of interpersonal coordination observed during performance in SSCGs. For this purpose we calculated positional data (GPS 15 Hz) from ten U-15 football players performing in three SSCGs varying in player numbers (3v3, 4v4 and 5v5). Key measures of SSCG system behaviours included values of (1) players' dispersion, (2) teams' separateness, (3) coupling strength and time delays between participants' emerging movements, respectively. Results showed that values of participants' dispersion increased, but the teams' separateness remained identical across treatments. Coupling strength and time delay also showed consistent values across SSCGs. These results exemplified how complex adaptive systems, like football teams, can harness inherent degeneracy to maintain similar team spatial-temporal relations with opponents through changes in inter-individual coordination modes (i.e., players' dispersion). The results imply that different team behaviours might emerge at different ratios of field dimension/player numbers. Therefore, sport pedagogists should carefully evaluate the effects of changing RSP in SSCGs as a way of promoting increased or decreased pressure on players.

  4. The Association of Benefit Finding to Psychosocial and Health Behavior Adaptation Among HIV+ Men and Women

    Science.gov (United States)

    Littlewood, Rae A.; Vanable, Peter A.; Carey, Michael P.; Blair, Donald C.

    2008-01-01

    Psychological and behavioral adaptation to HIV is integral to long-term survival. Although most research on coping with HIV has focused on factors associated with poor adaptation, recent research has expanded to include positive concomitants of adaptation, such as benefit finding. This study examined the occurrence of benefit finding among HIV+ men and women and evaluated the potential relevance of benefit finding to positive health behavior and psychosocial adaptation. HIV+ participants (N = 221) recruited during outpatient care completed self-report assessments of benefit finding, social support, depression, HAART adherence, substance use, and physical activity. In a series of multivariate analyses that controlled for demographic and health status variables, benefit finding was associated with lower depression scores, greater social support, and more physical activity, but showed no association to HAART adherence or substance use. The association of benefit finding to depression was partially mediated by differences in social support. Thus, benefit finding may improve psychological adjustment by motivating patients who experience stress-related growth to seek improved social support. PMID:18157689

  5. The Adaptive Nature of the Bone-Periodontal Ligament-Cementum Complex in a Ligature-Induced Periodontitis Rat Model

    Directory of Open Access Journals (Sweden)

    Ji-Hyun Lee

    2013-01-01

    Full Text Available The novel aspect of this study involves illustrating significant adaptation of a functionally loaded bone-PDL-cementum complex in a ligature-induced periodontitis rat model. Following 4, 8, and 15 days of ligation, proinflammatory cytokines (TNF-α and RANKL, a mineral resorption indicator (TRAP, and a cell migration and adhesion molecule for tissue regeneration (fibronectin within the complex were localized and correlated with changes in PDL-space (functional space. At 4 days of ligation, the functional space of the distal complex was widened compared to controls and was positively correlated with an increased expression of TNF-α. At 8 and 15 days, the number of RANKL(+ cells decreased near the mesial alveolar bone crest (ABC but increased at the distal ABC. TRAP(+ cells on both sides of the complex significantly increased at 8 days. A gradual change in fibronectin expression from the distal PDL-secondary cementum interfaces through precementum layers was observed when compared to increased and abrupt changes at the mesial PDL-cementum and PDL-bone interfaces in ligated and control groups. Based on our results, we hypothesize that compromised strain fields can be created in a diseased periodontium, which in response to prolonged function can significantly alter the original bone and apical cementum formations.

  6. The recovery model and complex health needs: what health psychology can learn from mental health and substance misuse service provision.

    Science.gov (United States)

    Webb, Lucy

    2012-07-01

    This article reviews key arguments around evidence-based practice and outlines the methodological demands for effective adoption of recovery model principles. The recovery model is outlined and demonstrated as compatible with current needs in substance misuse service provision. However, the concepts of evidence-based practice and the recovery model are currently incompatible unless the current value system of evidence-based practice changes to accommodate the methodologies demanded by the recovery model. It is suggested that critical health psychology has an important role to play in widening the scope of evidence-based practice to better accommodate complex social health needs.

  7. Adaptive ultrasonic imaging with the total focusing method for inspection of complex components immersed in water

    Science.gov (United States)

    Le Jeune, L.; Robert, S.; Dumas, P.; Membre, A.; Prada, C.

    2015-03-01

    In this paper, we propose an ultrasonic adaptive imaging method based on the phased-array technology and the synthetic focusing algorithm Total Focusing Method (TFM). The general principle is to image the surface by applying the TFM algorithm in a semi-infinite water medium. Then, the reconstructed surface is taken into account to make a second TFM image inside the component. In the surface reconstruction step, the TFM algorithm has been optimized to decrease computation time and to limit noise in water. In the second step, the ultrasonic paths through the reconstructed surface are calculated by the Fermat's principle and an iterative algorithm, and the classical TFM is applied to obtain an image inside the component. This paper presents several results of TFM imaging in components of different geometries, and a result obtained with a new technology of probes equipped with a flexible wedge filled with water (manufactured by Imasonic).

  8. Molecular interactions within the halophilic, thermophilic, and mesophilic prokaryotic ribosomal complexes: clues to environmental adaptation.

    Science.gov (United States)

    Mallik, Saurav; Kundu, Sudip

    2015-01-01

    Using the available crystal structures of 50S ribosomal subunits from three prokaryotic species: Escherichia coli (mesophilic), Thermus thermophilus (thermophilic), and Haloarcula marismortui (halophilic), we have analyzed different structural features of ribosomal RNAs (rRNAs), proteins, and of their interfaces. We have correlated these structural features with the environmental adaptation strategies of the corresponding species. While dense intra-rRNA packing is observed in thermophilic, loose intra-rRNA packing is observed in halophilic (both compared to mesophilic). Interestingly, protein-rRNA interfaces of both the extremophiles are densely packed compared to that of the mesophilic. The intersubunit bridge regions are almost devoid of cavities, probably ensuring the proper formation of each bridge (by not allowing any loosely packed region nearby). During rRNA binding, the ribosomal proteins experience some structural transitions. Here, we have analyzed the intrinsically disordered and ordered regions of the ribosomal proteins, which are subjected to such transitions. The intrinsically disordered and disorder-to-order transition sites of the thermophilic and mesophilic ribosomal proteins are simultaneously (i) highly conserved and (ii) slowly evolving compared to rest of the protein structure. Although high conservation is observed at such sites of halophilic ribosomal proteins, but slow rate of evolution is absent. Such differences between thermophilic, mesophilic, and halophilic can be explained from their environmental adaptation strategy. Interestingly, a universal biophysical principle evident by a linear relationship between the free energy of interface formation, interface area, and structural changes of r-proteins during assembly is always maintained, irrespective of the environmental conditions.

  9. Complex systems and health behavior change: insights from cognitive science.

    Science.gov (United States)

    Orr, Mark G; Plaut, David C

    2014-05-01

    To provide proof-of-concept that quantum health behavior can be instantiated as a computational model that is informed by cognitive science, the Theory of Reasoned Action, and quantum health behavior theory. We conducted a synthetic review of the intersection of quantum health behavior change and cognitive science. We conducted simulations, using a computational model of quantum health behavior (a constraint satisfaction artificial neural network) and tested whether the model exhibited quantum-like behavior. The model exhibited clear signs of quantum-like behavior. Quantum health behavior can be conceptualized as constraint satisfaction: a mitigation between current behavioral state and the social contexts in which it operates. We outlined implications for moving forward with computational models of both quantum health behavior and health behavior in general.

  10. Cyberspace as a Complex Adaptive System and the Policy and Operational Implications for Cyber Warfare

    Science.gov (United States)

    2014-05-22

    victims would fall prey to the attack vector. Both state and non-state actors alike, driven by a combination of intrinsic and extrinsic motivations ...different roles, motivations , and intentions. Associated complexities of safeguarding cyberspace contribute to the lack of a United States (US... psychological operations. The infosphere is also the entity that DOD doctrine refers to as the information environment in which humans and automated

  11. Analysis of Social Network Dynamics with Models from the Theory of Complex Adaptive Systems

    OpenAIRE

    Lymperopoulos , Ilias; Lekakos , George

    2013-01-01

    Part 4: Protocols, Regulation and Social Networking; International audience; The understanding and modeling of social dynamics in a complex and unpredictable world, emerges as a research target of particular importance. Success in this direction can yield valuable knowledge as to how social phenomena form and evolve in varying socioeconomic contexts comprising economic crises, societal disasters, cultural differences and security threats among others. The study of social dynamics occurring in...

  12. Low-Complexity Scheduling and Power Adaptation for Coordinated Cloud-Radio Access Networks

    KAUST Repository

    Douik, Ahmed

    2017-07-17

    In practical wireless systems, the successful implementation of resource allocation techniques strongly depends on the algorithmic complexity. Consider a cloud-radio access network (CRAN), where the central cloud is responsible for scheduling devices to the frames’ radio resources blocks (RRBs) of the single-antenna base-stations (BSs), adjusting the transmit power levels, and for synchronizing the transmit frames across the connected BSs. Previous studies show that the jointly coordinated scheduling and power control problem in the considered CRAN can be solved using an approach that scales exponentially with the number of BSs, devices, and RRBs, which makes the practical implementation infeasible for reasonably sized networks. This paper instead proposes a low-complexity solution to the problem, under the constraints that each device cannot be served by more than one BS but can be served by multiple RRBs within each BS frame, and under the practical assumption that the channel is constant during the duration of each frame. The paper utilizes graph-theoretical based techniques and shows that constructing a single power control graph is sufficient to obtain the optimal solution with a complexity that is independent of the number of RRBs. Simulation results reveal the optimality of the proposed solution for slow-varying channels, and show that the solution performs near-optimal for highly correlated channels.

  13. Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

    Science.gov (United States)

    Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

    2006-11-01

    All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance

  14. Adapting heart failure guidelines for nursing care in home health settings: challenges and solutions.

    Science.gov (United States)

    Radhakrishnan, Kavita; Topaz, Maxim; Masterson Creber, Ruth

    2014-07-01

    Nurses provide most of home health services for patients with heart failure, and yet there are no evidence-based practice guidelines developed for home health nurses. The purpose of this article was to review the challenges and solutions for adapting generally available HF clinical practice guidelines to home health nursing. Appropriate HF guidelines were identified and home health nursing-relevant guidelines were extracted by the research team. In addition, a team of nursing academic and practice experts evaluated the extracted guidelines and reached consensus through Delphi rounds. We identified 172 recommendations relevant to home health nursing from the American Heart Association and Heart Failure Society of America guidelines. The recommendations were divided into 5 groups (generic, minority populations, normal ejection fraction, reduced ejection fraction, and comorbidities) and further subgroups. Experts agreed that 87% of the recommendations selected by the research team were relevant to home health nursing and rejected 6% of the selected recommendations. Experts' opinions were split on 7% of guideline recommendations. Experts mostly disagreed on recommendations related to HF medication and laboratory prescription as well as HF patient assessment. These disagreements were due to lack of patient information available to home health nurses as well as unclear understanding of scope of practice regulations for home health nursing. After 2 Delphi rounds over 8 months, we achieved 100% agreement on the recommendations. The finalized guideline included 153 recommendations. Guideline adaptation projects should include a broad scope of nursing practice recommendations from which home health agencies can customize relevant recommendations in accordance with available information and state and agency regulations.

  15. mHealth intervention to support asthma self-management in adolescents: the ADAPT study.

    Science.gov (United States)

    Kosse, Richelle C; Bouvy, Marcel L; de Vries, Tjalling W; Kaptein, Ad A; Geers, Harm Cj; van Dijk, Liset; Koster, Ellen S

    2017-01-01

    Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. The ADAPT intervention consists of an interactive smartphone application (app) connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1) a questionnaire function to rate asthma symptoms and monitor these over time; 2) short movie clips with medication and disease information; 3) a medication reminder; 4) a chat function with peers; and 5) a chat function with the pharmacist. The pharmacist receives data from the patient's app through the desktop application, which enables the pharmacist to send information and feedback to the patient. The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient's self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. This study will provide in-depth knowledge on the effectiveness of an mHealth intervention to support asthma self-management in adolescents. These insights will also be useful for adolescents with other chronic diseases.

  16. The Immune System: Basis of so much Health and Disease: 3. Adaptive Immunity.

    Science.gov (United States)

    Scully, Crispian; Georgakopoulou, Eleni A; Hassona, Yazan

    2017-04-01

    The immune system is the body’s primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system; this article covers adaptive immunity. Clinical relevance: Dental clinicians need a basic understanding of the immune system as it underlies health and disease.

  17. Farmer Health and Adaptive Capacity in the Face of Climate Change and Variability. Part 1: Health as a Contributor to Adaptive Capacity and as an Outcome from Pressures Coping with Climate Related Adversities

    Directory of Open Access Journals (Sweden)

    Anne Parkinson

    2011-10-01

    Full Text Available This paper examines the role farmers’ health plays as an element of adaptive capacity. The study examines which of twenty aspects of adaptation may be related to overall health outcomes, controlling for demographic and on-farm-factors in health problems. The analysis is based on 3,993 farmers’ responses to a national survey of climate risk and adaptation. Hierarchical linear regression modelling was used examine the extent to which, in a multivariate analysis, the use of adaptive practices was predictively associated with self-assessed health, taking into account the farmer’s rating of whether their health was a barrier to undertaking farm work. We present two models, one excluding pre-existing health (model 1 and one including pre-existing health (model 2. The first model accounted for 21% of the variance. In this model better health was most strongly predicted by an absence of on-farm risk, greater financial viability, greater debt pressures, younger age and a desire to continue farming. Social capital (trust and reciprocity was moderately associated with health as was the intention to adopt more sustainable practices. The second model (including the farmers’ health as a barrier to undertaking farm work accounted for 43% of the variance. Better health outcomes were most strongly explained, in order of magnitude, by the absence of pre-existing health problems, greater access to social support, greater financial viability, greater debt pressures, a desire to continue farming and the condition of on-farm resources. Model 2 was a more parsimonious model (only nine predictors, compared with 15 in model 1, and explained twice as much variance in health outcomes. These results suggest that (i pre-existing health problems are a very important factor to consider when designing adaptation programs and policies and (ii these problems may mediate or modify the relationship between adaptation and health.

  18. Information-Theoretic Approaches for Evaluating Complex Adaptive Social Simulation Systems

    Energy Technology Data Exchange (ETDEWEB)

    Omitaomu, Olufemi A [ORNL; Ganguly, Auroop R [ORNL; Jiao, Yu [ORNL

    2009-01-01

    In this paper, we propose information-theoretic approaches for comparing and evaluating complex agent-based models. In information theoretic terms, entropy and mutual information are two measures of system complexity. We used entropy as a measure of the regularity of the number of agents in a social class; and mutual information as a measure of information shared by two social classes. Using our approaches, we compared two analogous agent-based (AB) models developed for regional-scale social-simulation system. The first AB model, called ABM-1, is a complex AB built with 10,000 agents on a desktop environment and used aggregate data; the second AB model, ABM-2, was built with 31 million agents on a highperformance computing framework located at Oak Ridge National Laboratory, and fine-resolution data from the LandScan Global Population Database. The initializations were slightly different, with ABM-1 using samples from a probability distribution and ABM-2 using polling data from Gallop for a deterministic initialization. The geographical and temporal domain was present-day Afghanistan, and the end result was the number of agents with one of three behavioral modes (proinsurgent, neutral, and pro-government) corresponding to the population mindshare. The theories embedded in each model were identical, and the test simulations focused on a test of three leadership theories - legitimacy, coercion, and representative, and two social mobilization theories - social influence and repression. The theories are tied together using the Cobb-Douglas utility function. Based on our results, the hypothesis that performance measures can be developed to compare and contrast AB models appears to be supported. Furthermore, we observed significant bias in the two models. Even so, further tests and investigations are required not only with a wider class of theories and AB models, but also with additional observed or simulated data and more comprehensive performance measures.

  19. A microplate adaptation of the solid-phase C1q immune complex assay

    International Nuclear Information System (INIS)

    Hunt, J.S.; Kennedy, M.P.; Barber, K.E.; McGiven, A.R.

    1980-01-01

    A method has been developed for the detection of C1q binding immune complexes in serum in which microculture plates are used as the solid-phase matrix for adsorption of C1q. This micromethod used only one-tenth of the amount of both C1q and [ 125 I]antihuman immunoglobulin per test and enabled 7 times as many samples to be tested in triplicate in comparison with the number performed in duplicate by the standard tube assay. (Auth.)

  20. Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support.

    Science.gov (United States)

    Nahum-Shani, Inbal; Smith, Shawna N; Spring, Bonnie J; Collins, Linda M; Witkiewitz, Katie; Tewari, Ambuj; Murphy, Susan A

    2018-05-18

    The just-in-time adaptive intervention (JITAI) is an intervention design aiming to provide the right type/amount of support, at the right time, by adapting to an individual's changing internal and contextual state. The availability of increasingly powerful mobile and sensing technologies underpins the use of JITAIs to support health behavior, as in such a setting an individual's state can change rapidly, unexpectedly, and in his/her natural environment. Despite the increasing use and appeal of JITAIs, a major gap exists between the growing technological capabilities for delivering JITAIs and research on the development and evaluation of these interventions. Many JITAIs have been developed with minimal use of empirical evidence, theory, or accepted treatment guidelines. Here, we take an essential first step towards bridging this gap. Building on health behavior theories and the extant literature on JITAIs, we clarify the scientific motivation for JITAIs, define their fundamental components, and highlight design principles related to these components. Examples of JITAIs from various domains of health behavior research are used for illustration. As we enter a new era of technological capacity for delivering JITAIs, it is critical that researchers develop sophisticated and nuanced health behavior theories capable of guiding the construction of such interventions. Particular attention has to be given to better understanding the implications of providing timely and ecologically sound support for intervention adherence and retention.

  1. Development of a Just-in-Time Adaptive mHealth Intervention for Insomnia: Usability Study.

    Science.gov (United States)

    Pulantara, I Wayan; Parmanto, Bambang; Germain, Anne

    2018-05-17

    Healthy sleep is a fundamental component of physical and brain health. Insomnia, however, is a prevalent sleep disorder that compromises functioning, productivity, and health. Therefore, developing efficient treatment delivery methods for insomnia can have significant societal and personal health impacts. Cognitive behavioral therapy for insomnia (CBTI) is the recommended first-line treatment of insomnia but access is currently limited for patients, since treatment must occur in specialty sleep clinics, which suffer from an insufficient number of trained clinicians. Smartphone-based interventions offer a promising means for improving the delivery of CBTI. Furthermore, novel features such as real-time monitoring and assessment, personalization, dynamic adaptations of the intervention, and context awareness can enhance treatment personalization and effectiveness, and reduce associated costs. Ultimately, this "Just in Time Adaptive Intervention" for insomnia-an intervention approach that is acceptable to patients and clinicians, and is based on mobile health (mHealth) platform and tools-can significantly improve patient access and clinician delivery of evidence-based insomnia treatments. This study aims to develop and assess the usability of a Just in Time Adaptive Intervention application platform called iREST ("interactive Resilience Enhancing Sleep Tactics") for use in behavioral insomnia interventions. iREST can be used by both patients and clinicians. The development of iREST was based on the Iterative and Incremental Development software development model. Requirement analysis was based on the case study's description, workflow and needs, clinician inputs, and a previously conducted BBTI military study/implementation of the Just in Time Adaptive Intervention architecture. To evaluate the usability of the iREST mHealth tool, a pilot usability study was conducted. Additionally, this study explores the feasibility of using an off-the-shelf wearable device to

  2. Adaptive divergence with gene flow in incipient speciation of Miscanthus floridulus / sinensis complex (Poaceae)

    KAUST Repository

    Huang, Chao-Li; Ho, Chuan-Wen; Chiang, Yu-Chung; Shigemoto, Yasumasa; Hsu, Tsai-Wen; Hwang, Chi-Chuan; Ge, Xue-Jun; Chen, Charles; Wu, Tai-Han; Chou, Chang-Hung; Huang, Hao-Jen; Gojobori, Takashi; Osada, Naoki; Chiang, Tzen-Yuh

    2014-01-01

    Young incipient species provide ideal materials for untangling the process of ecological speciation in the presence of gene flow. The Miscanthus floridulus/sinensis complex exhibits diverse phenotypic and ecological differences despite recent divergence (approximately 1.59million years ago). To elucidate the process of genetic differentiation during early stages of ecological speciation, we analyzed genomic divergence in the Miscanthus complex using 72 randomly selected genes from a newly assembled transcriptome. In this study, rampant gene flow was detected between species, estimated as M=3.36x10(-9) to 1.20x10(-6), resulting in contradicting phylogenies across loci. Nevertheless, beast analyses revealed the species identity and the effects of extrinsic cohesive forces that counteracted the non-stop introgression. As expected, early in speciation with gene flow, only 3-13 loci were highly diverged; two to five outliers (approximately 2.78-6.94% of the genome) were characterized by strong linkage disequilibrium, and asymmetrically distributed among ecotypes, indicating footprints of diversifying selection. In conclusion, ecological speciation of incipient species of Miscanthus probably followed the parapatric model, whereas allopatric speciation cannot be completely ruled out, especially between the geographically isolated northern and southern M.sinensis, for which no significant gene flow across oceanic barriers was detected. Divergence between local ecotypes in early-stage speciation began at a few genomic regions under the influence of natural selection and divergence hitchhiking that overcame gene flow.

  3. Adaptive divergence with gene flow in incipient speciation of Miscanthus floridulus / sinensis complex (Poaceae)

    KAUST Repository

    Huang, Chao-Li

    2014-11-11

    Young incipient species provide ideal materials for untangling the process of ecological speciation in the presence of gene flow. The Miscanthus floridulus/sinensis complex exhibits diverse phenotypic and ecological differences despite recent divergence (approximately 1.59million years ago). To elucidate the process of genetic differentiation during early stages of ecological speciation, we analyzed genomic divergence in the Miscanthus complex using 72 randomly selected genes from a newly assembled transcriptome. In this study, rampant gene flow was detected between species, estimated as M=3.36x10(-9) to 1.20x10(-6), resulting in contradicting phylogenies across loci. Nevertheless, beast analyses revealed the species identity and the effects of extrinsic cohesive forces that counteracted the non-stop introgression. As expected, early in speciation with gene flow, only 3-13 loci were highly diverged; two to five outliers (approximately 2.78-6.94% of the genome) were characterized by strong linkage disequilibrium, and asymmetrically distributed among ecotypes, indicating footprints of diversifying selection. In conclusion, ecological speciation of incipient species of Miscanthus probably followed the parapatric model, whereas allopatric speciation cannot be completely ruled out, especially between the geographically isolated northern and southern M.sinensis, for which no significant gene flow across oceanic barriers was detected. Divergence between local ecotypes in early-stage speciation began at a few genomic regions under the influence of natural selection and divergence hitchhiking that overcame gene flow.

  4. Agenda Setting for Health Promotion: Exploring an Adapted Model for the Social Media Era.

    Science.gov (United States)

    Albalawi, Yousef; Sixsmith, Jane

    2015-01-01

    The foundation of best practice in health promotion is a robust theoretical base that informs design, implementation, and evaluation of interventions that promote the public's health. This study provides a novel contribution to health promotion through the adaptation of the agenda-setting approach in response to the contribution of social media. This exploration and proposed adaptation is derived from a study that examined the effectiveness of Twitter in influencing agenda setting among users in relation to road traffic accidents in Saudi Arabia. The proposed adaptations to the agenda-setting model to be explored reflect two levels of engagement: agenda setting within the social media sphere and the position of social media within classic agenda setting. This exploratory research aims to assess the veracity of the proposed adaptations on the basis of the hypotheses developed to test these two levels of engagement. To validate the hypotheses, we collected and analyzed data from two primary sources: Twitter activities and Saudi national newspapers. Keyword mentions served as indicators of agenda promotion; for Twitter, interactions were used to measure the process of agenda setting within the platform. The Twitter final dataset comprised 59,046 tweets and 38,066 users who contributed by tweeting, replying, or retweeting. Variables were collected for each tweet and user. In addition, 518 keyword mentions were recorded from six popular Saudi national newspapers. The results showed significant ratification of the study hypotheses at both levels of engagement that framed the proposed adaptions. The results indicate that social media facilitates the contribution of individuals in influencing agendas (individual users accounted for 76.29%, 67.79%, and 96.16% of retweet impressions, total impressions, and amplification multipliers, respectively), a component missing from traditional constructions of agenda-setting models. The influence of organizations on agenda setting is

  5. Agenda Setting for Health Promotion: Exploring an Adapted Model for the Social Media Era

    Science.gov (United States)

    2015-01-01

    Background The foundation of best practice in health promotion is a robust theoretical base that informs design, implementation, and evaluation of interventions that promote the public’s health. This study provides a novel contribution to health promotion through the adaptation of the agenda-setting approach in response to the contribution of social media. This exploration and proposed adaptation is derived from a study that examined the effectiveness of Twitter in influencing agenda setting among users in relation to road traffic accidents in Saudi Arabia. Objective The proposed adaptations to the agenda-setting model to be explored reflect two levels of engagement: agenda setting within the social media sphere and the position of social media within classic agenda setting. This exploratory research aims to assess the veracity of the proposed adaptations on the basis of the hypotheses developed to test these two levels of engagement. Methods To validate the hypotheses, we collected and analyzed data from two primary sources: Twitter activities and Saudi national newspapers. Keyword mentions served as indicators of agenda promotion; for Twitter, interactions were used to measure the process of agenda setting within the platform. The Twitter final dataset comprised 59,046 tweets and 38,066 users who contributed by tweeting, replying, or retweeting. Variables were collected for each tweet and user. In addition, 518 keyword mentions were recorded from six popular Saudi national newspapers. Results The results showed significant ratification of the study hypotheses at both levels of engagement that framed the proposed adaptions. The results indicate that social media facilitates the contribution of individuals in influencing agendas (individual users accounted for 76.29%, 67.79%, and 96.16% of retweet impressions, total impressions, and amplification multipliers, respectively), a component missing from traditional constructions of agenda-setting models. The influence

  6. Adapting public policy theory for public health research: A framework to understand the development of national policies on global health.

    Science.gov (United States)

    Jones, Catherine M; Clavier, Carole; Potvin, Louise

    2017-03-01

    National policies on global health appear as one way that actors from health, development and foreign affairs sectors in a country coordinate state action on global health. Next to a burgeoning literature in which international relations and global governance theories are employed to understand global health policy and global health diplomacy at the international level, little is known about policy processes for global health at the national scale. We propose a framework of the policy process to understand how such policies are developed, and we identify challenges for public health researchers integrating conceptual tools from political science. We developed the framework using a two-step process: 1) reviewing literature to establish criteria for selecting a theoretical framework fit for this purpose, and 2) adapting Real-Dato's synthesis framework to integrate a cognitive approach to public policy within a constructivist perspective. Our framework identifies multiple contexts as part of the policy process, focuses on situations where actors work together to make national policy on global health, considers these interactive situations as spaces for observing external influences on policy change and proposes policy design as the output of the process. We suggest that this framework makes three contributions to the conceptualisation of national policy on global health as a research object. First, it emphasizes collective action over decisions of individual policy actors. Second, it conceptualises the policy process as organised interactive spaces for collaboration rather than as stages of a policy cycle. Third, national decision-making spaces are opportunities for transferring ideas and knowledge from different sectors and settings, and represent opportunities to identify international influences on a country's global health policy. We discuss two sets of challenges for public health researchers using interdisciplinary approaches in policy research. Copyright

  7. Implementation of a web-based national child health-care programme in a local context: A complex facilitator role.

    Science.gov (United States)

    Tell, Johanna; Olander, Ewy; Anderberg, Peter; Berglund, Johan Sanmartin

    2018-02-01

    The aim of this study was to investigate child health-care coordinators' experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives. There were eight subcategories. In the latent analysis, the theme 'Being a facilitator: a complex role' was formed to express the child health-care coordinators' experiences. Facilitating a national guideline or decision support in a local context is a complex task that requires an advocating and mediating role. For successful implementation, guidelines and decision support, such as a web-based guide and the new child health-care programme, must match professional consensus and needs and be seen as relevant by all. Participation in the development and a strong bottom-up approach was important, making the web-based guide and the programme relevant to whom it is intended to serve, and for successful implementation. The study contributes valuable knowledge when planning to implement a national web-based decision support and policy programme in a local health-care context.

  8. Strategy to fight against malnutrition in chronic patients with complex health needs

    OpenAIRE

    Burgos, Rosa; Joaquin, Clara; Blay, Carles; Ledesma, Albert; Figueiras, Guadalupe; Pérez-Portabella, Cleofe; Granados, Antonio; Gómez, Mª Dolores; González, Asunción; Sarquella, Esther; Amil, Paloma; Vaqué, Cristina

    2016-01-01

    Disease-related malnutrition (DRM) is a prevalent condition amongst older people as well as patients in all healthcare settings around the world. Chronic patients with complex health needs (CPCHN defined as those with complex chronic conditions that involve multiple health requirements, complex social support needs, or both) are especially vulnerable to malnutrition. Malnutrition is associated with increased morbidity, a higher hospital admission and readmission rate, increased needs for soci...

  9. Health and Safety Legislation in Australia: Complexity for Training Remains

    Science.gov (United States)

    Bahn, Susanne; Barratt-Pugh, Llandis

    2014-01-01

    This paper presents the findings from a study that examined the impact of the National Occupational Health and Safety Strategy 2002-2012 and the harmonisation of the Work Health and Safety Act 2011 on Australian training design, delivery and outcomes. There has been a comparative reduction in work related injuries, fatalities and disease, and…

  10. Hard wiring of T cell receptor specificity for the major histocompatibility complex is underpinned by TCR adaptability

    Energy Technology Data Exchange (ETDEWEB)

    Burrows, Scott R.; Chen, Zhenjun; Archbold, Julia K.; Tynan, Fleur E.; Beddoe, Travis; Kjer-Nielsen, Lars; Miles, John J.; Khanna, Rajiv; Moss, Denis J.; Liu, Yu Chih; Gras, Stephanie; Kostenko, Lyudmila; Brennan, Rebekah M.; Clements, Craig S.; Brooks, Andrew G.; Purcell, Anthony W.; McCluskey, James; Rossjohn, Jamie (Monash); (Queensland Inst. of Med. Rsrch.); (Melbourne)

    2010-07-07

    {alpha}{beta} T cell receptors (TCRs) are genetically restricted to corecognize peptide antigens bound to self-major histocompatibility complex (pMHC) molecules; however, the basis for this MHC specificity remains unclear. Despite the current dogma, evaluation of the TCR-pMHC-I structural database shows that the nongermline-encoded complementarity-determining region (CDR)-3 loops often contact the MHC-I, and the germline-encoded CDR1 and -2 loops frequently participate in peptide-mediated interactions. Nevertheless, different TCRs adopt a roughly conserved docking mode over the pMHC-I, in which three MHC-I residues (65, 69, and 155) are invariably contacted by the TCR in one way or another. Nonetheless, the impact of mutations at these three positions, either individually or together, was not uniformly detrimental to TCR recognition of pHLA-B*0801 or pHLA-B*3508. Moreover, when TCR-pMHC-I recognition was impaired, this could be partially restored by expression of the CD8 coreceptor. The structure of a TCR-pMHC-I complex in which these three (65, 69, and 155) MHC-I positions were all mutated resulted in shifting of the TCR footprint relative to the cognate complex and formation of compensatory interactions. Collectively, our findings reveal the inherent adaptability of the TCR in maintaining peptide recognition while accommodating changes to the central docking site on the pMHC-I.

  11. When we should worry more: using cognitive bias modification to drive adaptive health behaviour.

    Science.gov (United States)

    Notebaert, Lies; Chrystal, Jessica; Clarke, Patrick J F; Holmes, Emily A; MacLeod, Colin

    2014-01-01

    A lack of behavioural engagement in health promotion or disease prevention is a problem across many health domains. In these cases where people face a genuine danger, a reduced focus on threat and low levels of anxiety or worry are maladaptive in terms of promoting protection or prevention behaviour. Therefore, it is possible that increasing the processing of threat will increase worry and thereby enhance engagement in adaptive behaviour. Laboratory studies have shown that cognitive bias modification (CBM) can increase or decrease anxiety and worry when increased versus decreased processing of threat is encouraged. In the current study, CBM for interpretation (CBM-I) is used to target engagement in sun protection behaviour. The goal was to investigate whether inducing a negative rather than a positive interpretation bias for physical threat information can enhance worry elicited when viewing a health campaign video (warning against melanoma skin cancer), and consequently lead to more adaptive behaviour (sun protection). Participants were successfully trained to either adopt a positive or negative interpretation bias using physical threat scenarios. However, contrary to expectations results showed that participants in the positive training condition reported higher levels of worry elicited by the melanoma video than participants in the negative training condition. Video elicited worry was, however, positively correlated with a measure of engagement in sun protection behaviour, suggesting that higher levels of worry do promote adaptive behaviour. These findings imply that more research is needed to determine under which conditions increased versus decreased processing of threat can drive adaptive worry. Various potential explanations for the current findings and suggestions for future research are discussed.

  12. Envisioning engineering education and practice in the coming intelligence convergence era — a complex adaptive systems approach

    Science.gov (United States)

    Noor, Ahmed K.

    2013-12-01

    Some of the recent attempts for improving and transforming engineering education are reviewed. The attempts aim at providing the entry level engineers with the skills needed to address the challenges of future large-scale complex systems and projects. Some of the frontier sectors and future challenges for engineers are outlined. The major characteristics of the coming intelligence convergence era (the post-information age) are identified. These include the prevalence of smart devices and environments, the widespread applications of anticipatory computing and predictive / prescriptive analytics, as well as a symbiotic relationship between humans and machines. Devices and machines will be able to learn from, and with, humans in a natural collaborative way. The recent game changers in learnscapes (learning paradigms, technologies, platforms, spaces, and environments) that can significantly impact engineering education in the coming era are identified. Among these are open educational resources, knowledge-rich classrooms, immersive interactive 3D learning, augmented reality, reverse instruction / flipped classroom, gamification, robots in the classroom, and adaptive personalized learning. Significant transformative changes in, and mass customization of, learning are envisioned to emerge from the synergistic combination of the game changers and other technologies. The realization of the aforementioned vision requires the development of a new multidisciplinary framework of emergent engineering for relating innovation, complexity and cybernetics, within the future learning environments. The framework can be used to treat engineering education as a complex adaptive system, with dynamically interacting and communicating components (instructors, individual, small, and large groups of learners). The emergent behavior resulting from the interactions can produce progressively better, and continuously improving, learning environment. As a first step towards the realization of

  13. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks.

    Science.gov (United States)

    Petkova, Elisaveta P; Ebi, Kristie L; Culp, Derrin; Redlener, Irwin

    2015-08-11

    The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region's coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region's unique vulnerabilities, and outlines recommendations for improving the region's ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

  14. Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks

    Directory of Open Access Journals (Sweden)

    Elisaveta P. Petkova

    2015-08-01

    Full Text Available The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region’s coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region’s unique vulnerabilities, and outlines recommendations for improving the region’s ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

  15. Cross-cultural adaptation of the CDC Worksite Health ScoreCard questionnaire into Portuguese

    Directory of Open Access Journals (Sweden)

    Patrícia Coelho de Soárez

    2016-06-01

    Full Text Available SUMMARY Objective: Despite the progress in the implementation of health promotion programs in the workplace, there are no questionnaires in Brazil to assess the scope of health promotion interventions adopted and their scientific basis. This study aimed to translate into Brazilian Portuguese and culturally adapt the CDC Worksite Health ScoreCard (HSC questionnaire. Method: The HSC has 100 questions grouped into twelve domains. The steps are as follows: translation, reconciliation, back-translation, review by expert panel, pretesting, and final revision. The convenience sample included 27 individuals from health insurance providers and companies of various sizes, types and industries in São Paulo. Data were analyzed using descriptive statistics. Results: The average age of the sample was 38 years, most of the subjects were female (21 of 27, and were responsible for programs to promote health in these workplaces. Most questions were above the minimum value of understanding set at 90%. The participants found the questionnaire very useful to determine the extent of existing health promotion programs and to pinpoint areas that could be developed. Conclusion: The Brazilian Portuguese version of the HSC questionnaire may be a valid measure and useful to assess the degree of implementation of health promotion interventions based on evidence in local health organizations.

  16. Coordination and health sector adaptation to climate change in the Vietnamese Mekong Delta

    Directory of Open Access Journals (Sweden)

    Daniel Gilfillan

    2017-09-01

    Full Text Available This research examines the impact of three coordination dimensions on health sector adaptation to climate change in the Vietnamese Mekong Delta: cross-scale, cross-sectoral, and cross-boundary. While tasks are divided up between government ministries and departments in Vietnam, there is little collaboration on issues that span mandates. Similarly, while water flows in the Vietnamese Mekong Delta take resource management and health concerns across provincial boundaries, formal mechanisms for interprovincial collaboration are lacking. While decentralization efforts have sought to devolve authority and decision making to lower levels, there is continued state-centered top-down policy making, and this limits collaborative coordination across scales. All three of these issues inhibit health sector adaptation to climate change in the Vietnamese Mekong Delta, and though these coordination issues are recognized by the Vietnamese government, to date there has been little success in addressing them. The authors hope to stimulate further debate and discussion of coordination problems, and conclude that despite some significant challenges, the South West Steering Committee could play a facilitating role coordinating climate change responses in health and other sectors across the Vietnamese Mekong Delta. As an analysis of governance, this research is applicable to other areas and sectors in Vietnam, as well as to other parts of South East Asia.

  17. Improving the Quality of Home Health Care for Children With Medical Complexity.

    Science.gov (United States)

    Nageswaran, Savithri; Golden, Shannon L

    2017-08-01

    The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Is it health information technology? : Task complexity and work substitution

    NARCIS (Netherlands)

    Medina Palomino, Hector; Rutkowski, Anne; Verhulst, Matthijs

    2015-01-01

    New technology is making it possible to replace professions built on complex knowledge, e.g. medicine. In our exploratory research we examined how Information Technologies might be replacing some of the tasks formerly processed by physician anesthesiologists (MDAs). Data (N=1178) were collected at a

  19. Harm reduction as a complex adaptive system: A dynamic framework for analyzing Tanzanian policies concerning heroin use.

    Science.gov (United States)

    Ratliff, Eric A; Kaduri, Pamela; Masao, Frank; Mbwambo, Jessie K K; McCurdy, Sheryl A

    2016-04-01

    Contrary to popular belief, policies on drug use are not always based on scientific evidence or composed in a rational manner. Rather, decisions concerning drug policies reflect the negotiation of actors' ambitions, values, and facts as they organize in different ways around the perceived problems associated with illicit drug use. Drug policy is thus best represented as a complex adaptive system (CAS) that is dynamic, self-organizing, and coevolving. In this analysis, we use a CAS framework to examine how harm reduction emerged around heroin trafficking and use in Tanzania over the past thirty years (1985-present). This account is an organizational ethnography based on of the observant participation of the authors as actors within this system. We review the dynamic history and self-organizing nature of harm reduction, noting how interactions among system actors and components have coevolved with patterns of heroin us, policing, and treatment activities over time. Using a CAS framework, we describe harm reduction as a complex process where ambitions, values, facts, and technologies interact in the Tanzanian sociopolitical environment. We review the dynamic history and self-organizing nature of heroin policies, noting how the interactions within and between competing prohibitionist and harm reduction policies have changed with patterns of heroin use, policing, and treatment activities over time. Actors learn from their experiences to organize with other actors, align their values and facts, and implement new policies. Using a CAS approach provides researchers and policy actors a better understanding of patterns and intricacies in drug policy. This knowledge of how the system works can help improve the policy process through adaptive action to introduce new actors, different ideas, and avenues for communication into the system. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. A Hospital Is Not Just a Factory, but a Complex Adaptive System-Implications for Perioperative Care.

    Science.gov (United States)

    Mahajan, Aman; Islam, Salim D; Schwartz, Michael J; Cannesson, Maxime

    2017-07-01

    Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated. In this article, we argue that applying only factory approaches such as lean methodologies or process standardization to complex systems such as perioperative care could account for difficulties and/or failures in improving performance in care delivery. Within perioperative services, only noncomplex/low-variance surgical episodes are amenable to manufacturing-based redesign. On the other hand, complex surgery/high-variance cases and preoperative segmentation (the process of distinguishing between normal and complex cases) can be viewed as CAS-like. These systems tend to self-organize, often resist or react unpredictably to attempts at control, and therefore require application of CAS principles to modify system behavior. We describe 2 examples of perioperative redesign to illustrate the concepts outlined above. These examples present complementary and contrasting cases from 2 leading delivery systems. The Mayo Clinic example illustrates the application of manufacturing-based redesign principles to a factory-like (high-volume, low-risk, and mature practice) clinical program, while the Kaiser Permanente example illustrates the application of both manufacturing-based and self-organization-based approaches to programs and processes that are not factory-like but CAS-like. In this article, we describe how factory-like processes and CAS can coexist within a hospital and how

  1. Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

    Science.gov (United States)

    Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

    2017-01-01

    Context: Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. Objective: The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. Methods: In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. Results: A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. Conclusion: The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. PMID:28277203

  2. Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare.

    Science.gov (United States)

    Price, Alex; Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

    2017-02-01

    Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. Copyright © 2017 Longwoods Publishing.

  3. Disentangling cognition and emotion in older adults: the role of cognitive control and mental health in emotional conflict adaptation.

    Science.gov (United States)

    Hantke, Nathan C; Gyurak, Anett; Van Moorleghem, Katie; Waring, Jill D; Adamson, Maheen M; O'Hara, Ruth; Beaudreau, Sherry A

    2017-08-01

    Recent research suggests cognition has a bidirectional relationship with emotional processing in older adults, yet the relationship is still poorly understood. We aimed to examine a potential relationship between late-life cognitive function, mental health symptoms, and emotional conflict adaptation. We hypothesized that worse cognitive control abilities would be associated with poorer emotional conflict adaptation. We further hypothesized that a higher severity of mental health symptoms would be associated with poorer emotional conflict adaptation. Participants included 83 cognitively normal community-dwelling older adults who completed a targeted mental health and cognitive battery, and emotion and gender conflict-adaptation tasks. Consistent with our hypothesis, poorer performance on components of cognitive control, specifically attention and working memory, was associated with poorer emotional conflict adaptation. This association with attention and working memory was not observed in the non-affective-based gender conflict adaptation task. Mental health symptoms did not predict emotional conflict adaptation, nor did performance on other cognitive measures. Our findings suggest that emotion conflict adaptation is disrupted in older individuals who have poorer attention and working memory. Components of cognitive control may therefore be an important potential source of inter-individual differences in late-life emotion regulation and cognitive affective deficits. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. MEMS- and NEMS-based complex adaptive smart devices and systems

    Science.gov (United States)

    Varadan, Vijay K.

    2001-10-01

    The microelectronics industry has seen explosive growth during the last thirty years. Extremely large markets for logic and memory devices have driven the development of new materials, and technologies for the fabrication of even more complex devices with feature sizes now down at the sub micron and nanometer level. Recent interest has arisen in employing these materials, tools and technologies for the fabrication of miniature sensors and actuators and their integration with electronic circuits to produce smart devices and systems. This effort offers the promise of: 1) increasing the performance and manufacturability of both sensors and actuators by exploiting new batch fabrication processes developed including micro stereo lithographic and micro molding techniques; 2) developing novel classes of materials and mechanical structures not possible previously, such as diamond like carbon, silicon carbide and carbon nanotubes, micro-turbines and micro-engines; 3) development of technologies for the system level and wafer level integration of micro components at the nanometer precision, such as self-assembly techniques and robotic manipulation; 4) development of control and communication systems for MEMS devices, such as optical and RF wireless, and power delivery systems, etc. A novel composite structure can be tailored by functionalizing carbon nanotubes and chemically bonding them with the polymer matrix e.g. block or graft copolymer, or even cross-linked copolymer, to impart exceptional structural, electronic and surface properties. Bio- and mechanical-MEMS devices derived from this hybrid composite provide a new avenue for future smart systems.

  5. An atlas of the thioredoxin fold class reveals the complexity of function-enabling adaptations.

    Science.gov (United States)

    Atkinson, Holly J; Babbitt, Patricia C

    2009-10-01

    The group of proteins that contain a thioredoxin (Trx) fold is huge and diverse. Assessment of the variation in catalytic machinery of Trx fold proteins is essential in providing a foundation for understanding their functional diversity and predicting the function of the many uncharacterized members of the class. The proteins of the Trx fold class retain common features-including variations on a dithiol CxxC active site motif-that lead to delivery of function. We use protein similarity networks to guide an analysis of how structural and sequence motifs track with catalytic function and taxonomic categories for 4,082 representative sequences spanning the known superfamilies of the Trx fold. Domain structure in the fold class is varied and modular, with 2.8% of sequences containing more than one Trx fold domain. Most member proteins are bacterial. The fold class exhibits many modifications to the CxxC active site motif-only 56.8% of proteins have both cysteines, and no functional groupings have absolute conservation of the expected catalytic motif. Only a small fraction of Trx fold sequences have been functionally characterized. This work provides a global view of the complex distribution of domains and catalytic machinery throughout the fold class, showing that each superfamily contains remnants of the CxxC active site. The unifying context provided by this work can guide the comparison of members of different Trx fold superfamilies to gain insight about their structure-function relationships, illustrated here with the thioredoxins and peroxiredoxins.

  6. Trophic complexity and the adaptive value of damage-induced plant volatiles.

    Directory of Open Access Journals (Sweden)

    Ian Kaplan

    Full Text Available Indirect plant defenses are those facilitating the action of carnivores in ridding plants of their herbivorous consumers, as opposed to directly poisoning or repelling them. Of the numerous and diverse indirect defensive strategies employed by plants, inducible volatile production has garnered the most fascination among plant-insect ecologists. These volatile chemicals are emitted in response to feeding by herbivorous arthropods and serve to guide predators and parasitic wasps to their prey. Implicit in virtually all discussions of plant volatile-carnivore interactions is the premise that plants "call for help" to bodyguards that serve to boost plant fitness by limiting herbivore damage. This, by necessity, assumes a three-trophic level food chain where carnivores benefit plants, a theoretical framework that is conceptually tractable and convenient, but poorly depicts the complexity of food-web dynamics occurring in real communities. Recent work suggests that hyperparasitoids, top consumers acting from the fourth trophic level, exploit the same plant volatile cues used by third trophic level carnivores. Further, hyperparasitoids shift their foraging preferences, specifically cueing in to the odor profile of a plant being damaged by a parasitized herbivore that contains their host compared with damage from an unparasitized herbivore. If this outcome is broadly representative of plant-insect food webs at large, it suggests that damage-induced volatiles may not always be beneficial to plants with major implications for the evolution of anti-herbivore defense and manipulating plant traits to improve biological control in agricultural crops.

  7. Statistical modeling of complex health outcomes and air pollution data: Application of air quality health indexing for asthma risk assessment

    Directory of Open Access Journals (Sweden)

    Swarna Weerasinghe

    2017-03-01

    Conclusion:  This study demonstrated the importance of complex statistical model use and the consequences of lack of such modelling that accounted for data structures in public health risk assessments.

  8. On duty all the time: Health and quality of life among immigrant parents caring for a child with complex health needs

    OpenAIRE

    Kvarme, Lisbeth Gravdal; Albertini Früh, Elena; Brekke, Idunn; Gardsjord, Ragnhild; Halvorsrud, Liv; Lidén, Hilde

    2016-01-01

    Aims and objectives: To provide knowledge about how immigrant parents of children with complex health needs manage their family lives and how this affects their own health and quality of life. Background: Caregivers of children with complex health needs have additional risk for general health problems and mental health problems and immigrant parents may be more vulnerable to mental distress and failing health and quality of life. Results: Immigrant parents of children with complex health need...

  9. Health heat stress in the Porto Metropolitan Area – a matter of temperature or inadequate adaptation?

    Directory of Open Access Journals (Sweden)

    Monteiro, Ana

    2014-09-01

    Full Text Available The aim of this contribution is to understand the negative outcomes for human health during hot weather in a Mediterranean urban environment. Examining seasonal variations of thermal comfort in Porto, by Physiologically Equivalent Temperature (PET, and comparing expected and observed daily mortality (all causes and morbidity (all causes, respiratory and circulatory diseases, suggests that in southern Europe, people’s adaptation techniques for reducing heat stress and associated health risks need to be developed much further. Research already done in Porto shows that social and economic vulnerability must be included alongside with individual characteristics, like age, gender or genetics, when defining the thresholds above which negative health impacts begin to become severe. Findings from Porto show that a climate risk map is needed for every metropolitan area, with sufficient detail to give locally appropriate temperature thresholds taking into account both the local climate and the socio-economic conditions of every sector of the urban environment.

  10. Human nutrition and adaptation in Brazilian Amazon fishing areas: contributions to health policies

    Directory of Open Access Journals (Sweden)

    Gilberto Ferreira de Souza Aguiar

    2006-08-01

    Full Text Available The search for equity in access to services is presently an important principle in public policies for health in Brazil. Social inequalities in the Amazonia occur at high levels comparatively to the other regions in the country; and, within Amazonia, they particularly affect rural communities. The present study aims to appreciate associations between food and nutritional profile, adaptive strategies, and epidemiology in these communities, specially in areas of artisanal fishery, and also to suggest general lines of appropriated health policies. The construction of a context of equitable assistance and of sustainable health, without significant damage to biodiversity, depends on the capacity of public power in exploring the relationships between use and management of natural resources and the quality of life of riverine man.

  11. Building diversity in a complex academic health center.

    Science.gov (United States)

    South-Paul, Jeannette E; Roth, Loren; Davis, Paula K; Chen, Terence; Roman, Anna; Murrell, Audrey; Pettigrew, Chenits; Castleberry-Singleton, Candi; Schuman, Joel

    2013-09-01

    For 30 years, the many diversity-related health sciences programs targeting the University of Pittsburgh undergraduate campus, school of medicine, schools of the health sciences, clinical practice plan, and medical center were run independently and remained separate within the academic health center (AHC). This lack of coordination hampered their overall effectiveness in promoting diversity and inclusion. In 2007, a group of faculty and administrators from the university and the medical center recognized the need to improve institutional diversity and to better address local health disparities. In this article, the authors describe the process of linking the efforts of these institutions in a way that would be successful locally and applicable to other academic environments. First, they engaged an independent consultant to conduct a study of the AHC's diversity climate, interviewing current and former faculty and trainees to define the problem and identify areas for improvement. Next, they created the Physician Inclusion Council to address the findings of this study and to coordinate future efforts with institutional leaders. Finally, they formed four working committees to address (1) communications and outreach, (2) cultural competency, (3) recruitment, and (4) mentoring and retention. These committees oversaw the strategic development and implementation of all diversity and inclusion efforts. Together these steps led to structural changes within the AHC and the improved allocation of resources that have positioned the University of Pittsburgh to achieve not only diversity but also inclusion and to continue to address the health disparities in the Pittsburgh community.

  12. An atlas of the thioredoxin fold class reveals the complexity of function-enabling adaptations.

    Directory of Open Access Journals (Sweden)

    Holly J Atkinson

    2009-10-01

    Full Text Available The group of proteins that contain a thioredoxin (Trx fold is huge and diverse. Assessment of the variation in catalytic machinery of Trx fold proteins is essential in providing a foundation for understanding their functional diversity and predicting the function of the many uncharacterized members of the class. The proteins of the Trx fold class retain common features-including variations on a dithiol CxxC active site motif-that lead to delivery of function. We use protein similarity networks to guide an analysis of how structural and sequence motifs track with catalytic function and taxonomic categories for 4,082 representative sequences spanning the known superfamilies of the Trx fold. Domain structure in the fold class is varied and modular, with 2.8% of sequences containing more than one Trx fold domain. Most member proteins are bacterial. The fold class exhibits many modifications to the CxxC active site motif-only 56.8% of proteins have both cysteines, and no functional groupings have absolute conservation of the expected catalytic motif. Only a small fraction of Trx fold sequences have been functionally characterized. This work provides a global view of the complex distribution of domains and catalytic machinery throughout the fold class, showing that each superfamily contains remnants of the CxxC active site. The unifying context provided by this work can guide the comparison of members of different Trx fold superfamilies to gain insight about their structure-function relationships, illustrated here with the thioredoxins and peroxiredoxins.

  13. Validation of a computer-adaptive test to evaluate generic health-related quality of life

    Directory of Open Access Journals (Sweden)

    Zardaín Pilar C

    2010-12-01

    Full Text Available Abstract Background Health Related Quality of Life (HRQoL is a relevant variable in the evaluation of health outcomes. Questionnaires based on Classical Test Theory typically require a large number of items to evaluate HRQoL. Computer Adaptive Testing (CAT can be used to reduce tests length while maintaining and, in some cases, improving accuracy. This study aimed at validating a CAT based on Item Response Theory (IRT for evaluation of generic HRQoL: the CAT-Health instrument. Methods Cross-sectional study of subjects aged over 18 attending Primary Care Centres for any reason. CAT-Health was administered along with the SF-12 Health Survey. Age, gender and a checklist of chronic conditions were also collected. CAT-Health was evaluated considering: 1 feasibility: completion time and test length; 2 content range coverage, Item Exposure Rate (IER and test precision; and 3 construct validity: differences in the CAT-Health scores according to clinical variables and correlations between both questionnaires. Results 396 subjects answered CAT-Health and SF-12, 67.2% females, mean age (SD 48.6 (17.7 years. 36.9% did not report any chronic condition. Median completion time for CAT-Health was 81 seconds (IQ range = 59-118 and it increased with age (p Conclusions Although domain-specific CATs exist for various areas of HRQoL, CAT-Health is one of the first IRT-based CATs designed to evaluate generic HRQoL and it has proven feasible, valid and efficient, when administered to a broad sample of individuals attending primary care settings.

  14. Health literacy training for public health nurses in fukushima: a case-study of program adaptation, implementation and evaluation.

    Science.gov (United States)

    Goto, Aya; Rudd, Rima E; Lai, Alden Yuanhong; Yoshida-Komiya, Hiromi

    2014-05-01

    Health literacy comprises not only an individual's ability to gain access to, understand and use health information, but also health care providers' ability to make health information accessible and usable. The Fukushima nuclear accident has posed challenges related to the communication of radiation-related health information. Public health nurses are gatekeepers of community health in Japan, and have primary responsibility for communicating this complex information about science and risk to lay members of the community. A health literacy training program was designed to augment communication skills of participating nurses with two primary goals: changing communication practices and norms among public health nurses, and improving access to information for community residents. Training content incorporated an overview of health literacy skills (including numeracy), processes for assessing written materials and visual displays, as well as guidelines for text improvement. The workshop was spread across two days with two-hour sessions each day. A proximal post-training evaluation survey was conducted, followed by a more distal one-month follow-up evaluation to assess the application of learned skills in practice. Twenty-six nurses in Fukushima City attended the first trial. Post-training evaluations were highly positive, with agreement from 85-100% of participants on the appropriateness and usefulness of the workshop. During a one-month follow-up, the nurses reported applying new knowledge and skills to develop written materials. However, they faced difficulties sharing their new skills with colleagues and challenges changing work norms. Participants also encountered difficulties using graphics and explaining risks in practice. This paper highlights the importance of providing health literacy training opportunities for professionals to strengthen health system's ability to accessible information and services. This program also serves as important reference for future

  15. Health adaptation policy for climate vulnerable groups: a 'critical computational linguistics' analysis.

    Science.gov (United States)

    Seidel, Bastian M; Bell, Erica

    2014-11-28

    Many countries are developing or reviewing national adaptation policy for climate change but the extent to which these meet the health needs of vulnerable groups has not been assessed. This study examines the adequacy of such policies for nine known climate-vulnerable groups: people with mental health conditions, Aboriginal people, culturally and linguistically diverse groups, aged people, people with disabilities, rural communities, children, women, and socioeconomically disadvantaged people. The study analyses an exhaustive sample of national adaptation policy documents from Annex 1 ('developed') countries of the United Nations Framework Convention on Climate Change: 20 documents from 12 countries. A 'critical computational linguistics' method was used involving novel software-driven quantitative mapping and traditional critical discourse analysis. The study finds that references to vulnerable groups are relatively little present or non-existent, as well as poorly connected to language about practical strategies and socio-economic contexts, both also little present. The conclusions offer strategies for developing policy that is better informed by a 'social determinants of health' definition of climate vulnerability, consistent with best practice in the literature and global policy prescriptions.

  16. Adapting a Technology-Based Implementation Support Tool for Community Mental Health: Challenges and Lessons Learned.

    Science.gov (United States)

    Livet, Melanie; Fixsen, Amanda

    2018-01-01

    With mental health services shifting to community-based settings, community mental health (CMH) organizations are under increasing pressure to deliver effective services. Despite availability of evidence-based interventions, there is a gap between effective mental health practices and the care that is routinely delivered. Bridging this gap requires availability of easily tailorable implementation support tools to assist providers in implementing evidence-based intervention with quality, thereby increasing the likelihood of achieving the desired client outcomes. This study documents the process and lessons learned from exploring the feasibility of adapting such a technology-based tool, Centervention, as the example innovation, for use in CMH settings. Mixed-methods data on core features, innovation-provider fit, and organizational capacity were collected from 44 CMH providers. Lessons learned included the need to augment delivery through technology with more personal interactions, the importance of customizing and integrating the tool with existing technologies, and the need to incorporate a number of strategies to assist with adoption and use of Centervention-like tools in CMH contexts. This study adds to the current body of literature on the adaptation process for technology-based tools and provides information that can guide additional innovations for CMH settings.

  17. Dual binding mode of the nascent polypeptide-associated complex reveals a novel universal adapter site on the ribosome.

    Science.gov (United States)

    Pech, Markus; Spreter, Thomas; Beckmann, Roland; Beatrix, Birgitta

    2010-06-18

    Nascent polypeptide-associated complex (NAC) was identified in eukaryotes as the first cytosolic factor that contacts the nascent polypeptide chain emerging from the ribosome. NAC is present as a homodimer in archaea and as a highly conserved heterodimer in eukaryotes. Mutations in NAC cause severe embryonically lethal phenotypes in mice, Drosophila melanogaster, and Caenorhabditis elegans. In the yeast Saccharomyces cerevisiae NAC is quantitatively associated with ribosomes. Here we show that NAC contacts several ribosomal proteins. The N terminus of betaNAC, however, specifically contacts near the tunnel exit ribosomal protein Rpl31, which is unique to eukaryotes and archaea. Moreover, the first 23 amino acids of betaNAC are sufficient to direct an otherwise non-associated protein to the ribosome. In contrast, alphaNAC (Egd2p) contacts Rpl17, the direct neighbor of Rpl31 at the ribosomal tunnel exit site. Rpl31 was also recently identified as a contact site for the SRP receptor and the ribosome-associated complex. Furthermore, in Escherichia coli peptide deformylase (PDF) interacts with the corresponding surface area on the eubacterial ribosome. In addition to the previously identified universal adapter site represented by Rpl25/Rpl35, we therefore refer to Rpl31/Rpl17 as a novel universal docking site for ribosome-associated factors on the eukaryotic ribosome.

  18. Linguistic Adaptation and Psychometric Properties of Tamil Version of General Oral Health Assessment Index-Tml.

    Science.gov (United States)

    Appukuttan, D P; Vinayagavel, M; Balasundaram, A; Damodaran, L K; Shivaraman, P; Gunasshegaran, K

    2015-01-01

    Oral health has an impact on quality of life hence for research purpose validation of a Tamil version of General Oral Health Assessment Index would enable it to be used as a valuable tool among Tamil speaking population. In this study, we aimed to assess the psychometric properties of translated Tamil version of General Oral Health Assessment Index (GOHAI-Tml). Linguistic adaptation involved forward and backward blind translation process. Reliability was analyzed using test-retest, Cronbach alpha, and split half reliability. Inter-item and item-total correlation were evaluated using Spearman rank correlation. Convenience sampling was done, and 265 consecutive patients aged 20-70 years attending the outpatient department were recruited. Subjects were requested to fill a self-reporting questionnaire along with Tamil GOHAI version. Clinical examination was done on the same visit. Concurrent validity was measured by assessing the relationship between GOHAI scores and self-perceived oral health and general health status, satisfaction with oral health, need for dental treatment and esthetic satisfaction. Discriminant validity was evaluated by comparing the GOHAI scores with the objectively assessed clinical parameters. Exploratory factor analysis was done to examine the factor structure. Mean GOHAI-Tml was 52.7 (6.8, range 22-60, median 54). The mean number of negative impacts was 2 (2.4, range 0-11, median 1). The Spearman rank correlation for test-retest ranged from 0.8 to 0.9 (P Tamil speaking population.

  19. [Drugs in the European Union: the health-market complex].

    Science.gov (United States)

    Antoñanzas, Fernando; Rodríguez, Roberto; Sacristán, José Antonio; Illa, Rafael

    2005-01-01

    To characterize the peculiar economic nature of the pharmaceutical market in the EU, to study potential groupings of countries based on several pharmaceutical variables, to analyze some recent regulations designed to create the single market, and to present some thoughts on the decision making process in public health from the perspective of current public health budgets. We performed an economic analysis of health and pharmaceutical macrovariables, cluster analysis, review of EU pharmaceutical and industrial regulations and review of pharmaceutical budgeting legislation in the member states. The pharmaceutical market of the EU was characterized and EU countries were classified into two principal groups according to 5 selected variables. EU regulations tend to promote R + D and drug production and thus the EU industrial sector is backed up. National regulations differ in terms of pricing and drugs reimbursement. The creation of a single market for drugs in the EU should take this regulatory diversity into account and seek equilibrium between economic factors and public health. This single market may be a dangerous strategy if it becomes a general dogma and even more so if deadlines are fixed and short.

  20. The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project.

    Science.gov (United States)

    Guetterman, Timothy C; Fetters, Michael D; Mawocha, Samkeliso; Legocki, Laurie J; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

    2017-01-01

    Clinical trials are complicated, expensive, time-consuming, and frequently do not lead to discoveries that improve the health of patients with disease. Adaptive clinical trials have emerged as a methodology to provide more flexibility in design elements to better answer scientific questions regarding whether new treatments are efficacious. Limited observational data exist that describe the complex process of designing adaptive clinical trials. To address these issues, the Adaptive Designs Accelerating Promising Treatments Into Trials project developed six, tailored, flexible, adaptive, phase-III clinical trials for neurological emergencies, and investigators prospectively monitored and observed the processes. The objective of this work is to describe the adaptive design development process, the final design, and the current status of the adaptive trial designs that were developed. To observe and reflect upon the trial development process, we employed a rich, mixed methods evaluation that combined quantitative data from visual analog scale to assess attitudes about adaptive trials, along with in-depth qualitative data about the development process gathered from observations. The Adaptive Designs Accelerating Promising Treatments Into Trials team developed six adaptive clinical trial designs. Across the six designs, 53 attitude surveys were completed at baseline and after the trial planning process completed. Compared to baseline, the participants believed significantly more strongly that the adaptive designs would be accepted by National Institutes of Health review panels and non-researcher clinicians. In addition, after the trial planning process, the participants more strongly believed that the adaptive design would meet the scientific and medical goals of the studies. Introducing the adaptive design at early conceptualization proved critical to successful adoption and implementation of that trial. Involving key stakeholders from several scientific domains early

  1. Fat, Sugar, and Bone Health: A Complex Relationship

    Directory of Open Access Journals (Sweden)

    Li Tian

    2017-05-01

    Full Text Available With people aging, osteoporosis is expected to increase notably. Nutritional status is a relatively easily-modified risk factor, associated with many chronic diseases, and is involved in obesity, diabetes, and coronary heart disease (CHD, along with osteoporosis. Nutrients, such as fats, sugars, and proteins, play a primary function in bone metabolism and maintaining bone health. In Western nations, diets are generally high in saturated fats, however, currently, the nutritional patterns dominating in China continue to be high in carbohydrates from starch, cereals, and sugars. Moreover, high fat or high sugar (fructose, glucose, or sucrose impart a significant impact on bone structural integrity. Due to diet being modifiable, demonstrating the effects of nutrition on bone health can provide an approach for osteoporosis prevention. Most researchers have reported that a high-fat diet consumption is associated with bone mineral density (BMD and, as bone strength diminishes, adverse microstructure changes occur in the cancellous bone compartment, which is involved with lipid metabolism modulation disorder and the alteration of the bone marrow environment, along with an increased inflammatory environment. Some studies, however, demonstrated that a high-fat diet contributes to achieving peak bone mass, along with microstructure, at a younger age. Contrary to these results, others have shown that a high-fructose diet consumption leads to stronger bones with a superior microarchitecture than those with the intake of a high-glucose diet and, at the same time, research indicated that a high-fat diet usually deteriorates cancellous bone parameters, and that the incorporation of fructose into a high-fat diet did not aggravate bone mass loss. High-fat/high-sucrose diets have shown both beneficial and detrimental influences on bone metabolism. Combined, these studies showed that nutrition exerts different effects on bone health. Thus, a better understanding of

  2. Fat, Sugar, and Bone Health: A Complex Relationship.

    Science.gov (United States)

    Tian, Li; Yu, Xijie

    2017-05-17

    With people aging, osteoporosis is expected to increase notably. Nutritional status is a relatively easily-modified risk factor, associated with many chronic diseases, and is involved in obesity, diabetes, and coronary heart disease (CHD), along with osteoporosis. Nutrients, such as fats, sugars, and proteins, play a primary function in bone metabolism and maintaining bone health. In Western nations, diets are generally high in saturated fats, however, currently, the nutritional patterns dominating in China continue to be high in carbohydrates from starch, cereals, and sugars. Moreover, high fat or high sugar (fructose, glucose, or sucrose) impart a significant impact on bone structural integrity. Due to diet being modifiable, demonstrating the effects of nutrition on bone health can provide an approach for osteoporosis prevention. Most researchers have reported that a high-fat diet consumption is associated with bone mineral density (BMD) and, as bone strength diminishes, adverse microstructure changes occur in the cancellous bone compartment, which is involved with lipid metabolism modulation disorder and the alteration of the bone marrow environment, along with an increased inflammatory environment. Some studies, however, demonstrated that a high-fat diet contributes to achieving peak bone mass, along with microstructure, at a younger age. Contrary to these results, others have shown that a high-fructose diet consumption leads to stronger bones with a superior microarchitecture than those with the intake of a high-glucose diet and, at the same time, research indicated that a high-fat diet usually deteriorates cancellous bone parameters, and that the incorporation of fructose into a high-fat diet did not aggravate bone mass loss. High-fat/high-sucrose diets have shown both beneficial and detrimental influences on bone metabolism. Combined, these studies showed that nutrition exerts different effects on bone health. Thus, a better understanding of the regulation

  3. Bridges to Better Health and Wellness: An Adapted Health Care Manager Intervention for Hispanics with Serious Mental Illness.

    Science.gov (United States)

    Cabassa, Leopoldo J; Manrique, Yamira; Meyreles, Quisqueya; Camacho, David; Capitelli, Lucia; Younge, Richard; Dragatsi, Dianna; Alvarez, Juana; Lewis-Fernández, Roberto

    2018-01-01

    This study examined the feasibility, acceptability, and initial impact of bridges to better health and wellness (B2BHW), a culturally-adapted health care manager intervention for Hispanics with serious mental illness (SMI). Thirty-four Hispanics with SMI and at risk for cardiovascular disease were enrolled. Mixed-linear models were used to examine changes over 12-months on patient activation, self-efficacy, patient-rated quality of care, receipt of preventive primary care services, and quality of life. The majority of participants completed the intervention (85%) with high satisfaction. Significant improvements were found for patient activation, self-efficacy, patients' ratings of quality of care, and receipt of preventive primary care.

  4. Processes of Metastudy: A Study of Psychosocial Adaptation to Childhood Chronic Health Conditions

    Directory of Open Access Journals (Sweden)

    David B. Nichola

    2006-03-01

    Full Text Available Metastudy introduces a systematically aggregated interpretive portrayal of a body of literature, based on saturation and the synthesis of findings. In this metastudy, the authors examined qualitative studies addressing psychosocial adaptation to childhood chronic health conditions, published over a 30-year period (1970–2000. They describe metastudy processes, including study identification, strategies for study search and retrieval, adjudication of difference in study design and rigor, and analysis of findings. They also illustrate metastudy components through examples drawn from this project and discuss implications for practice and recommendations.

  5. Conducting health survey research in a deep rural South African community: challenges and adaptive strategies.

    Science.gov (United States)

    Casale, Marisa; Lane, Tyler; Sello, Lebo; Kuo, Caroline; Cluver, Lucie

    2013-04-24

    In many parts of the developing world, rural health requires focused policy attention, informed by reliable, representative health data. Yet there is surprisingly little published material to guide health researchers who face the unique set of hurdles associated with conducting field research in remote rural areas. In this paper we provide a detailed description of the key challenges encountered during health survey field research carried out in 2010 in a deep rural site in KwaZulu-Natal, South Africa. The aim of the field research was to collect data on the health of children aged 10 to 17 years old, and their primary adult caregivers, as part of a larger national health survey; the research was a collaboration between several South African and foreign universities, South African national government departments, and various NGO partners. In presenting each of the four fieldwork challenges encountered on this site, we describe the initial planning decisions made, the difficulties faced when implementing these in the field, and the adaptive strategies we used to respond to these challenges. We reflect on learnings of potential relevance for the research community. Our four key fieldwork challenges were scarce research capacity, staff relocation tensions, logistical constraints, and difficulties related to community buy-in. Addressing each of these obstacles required timely assessment of the situation and adaptation of field plans, in collaboration with our local NGO partner. Adaptive strategies included a greater use of local knowledge; the adoption of tribal authority boundaries as the smallest geopolitical units for sampling; a creative developmental approach to capacity building; and planned, on-going engagement with multiple community representatives. We argue that in order to maintain high scientific standards of research and manage to 'get the job done' on the ground, it is necessary to respond to fieldwork challenges that arise as a cohesive team, with timely

  6. A multi-layered governance framework for incorporating social science insights into adapting to the health impacts of climate change.

    Science.gov (United States)

    Bowen, Kathryn J; Ebi, Kristie; Friel, Sharon; McMichael, Anthony J

    2013-09-10

    Addressing climate change and its associated effects is a multi-dimensional and ongoing challenge. This includes recognizing that climate change will affect the health and wellbeing of all populations over short and longer terms, albeit in varied ways and intensities. That recognition has drawn attention to the need to take adaptive actions to lessen adverse impacts over the next few decades from unavoidable climate change, particularly in developing country settings. A range of sectors is responsible for appropriate adaptive policies and measures to address the health risks of climate change, including health services, water and sanitation, trade, agriculture, disaster management, and development. To broaden the framing of governance and decision-making processes by using innovative methods and assessments to illustrate the multi-sectoral nature of health-related adaptation to climate change. This is a shift from sector-specific to multi-level systems encompassing sectors and actors, across temporal and spatial scales. A review and synthesis of the current knowledge in the areas of health and climate change adaptation governance and decision-making processes. A novel framework is presented that incorporates social science insights into the formulation and implementation of adaptation activities and policies to lessen the health risks posed by climate change. Clarification of the roles that different sectors, organizations, and individuals occupy in relation to the development of health-related adaptation strategies will facilitate the inclusion of health and wellbeing within multi-sector adaptation policies, thereby strengthening the overall set of responses to minimize the adverse health effects of climate change.

  7. A multi-layered governance framework for incorporating social science insights into adapting to the health impacts of climate change

    Directory of Open Access Journals (Sweden)

    Kathryn J. Bowen

    2013-09-01

    Full Text Available Background: Addressing climate change and its associated effects is a multi-dimensional and ongoing challenge. This includes recognizing that climate change will affect the health and wellbeing of all populations over short and longer terms, albeit in varied ways and intensities. That recognition has drawn attention to the need to take adaptive actions to lessen adverse impacts over the next few decades from unavoidable climate change, particularly in developing country settings. A range of sectors is responsible for appropriate adaptive policies and measures to address the health risks of climate change, including health services, water and sanitation, trade, agriculture, disaster management, and development. Objectives: To broaden the framing of governance and decision-making processes by using innovative methods and assessments to illustrate the multi-sectoral nature of health-related adaptation to climate change. This is a shift from sector-specific to multi-level systems encompassing sectors and actors, across temporal and spatial scales. Design: A review and synthesis of the current knowledge in the areas of health and climate change adaptation governance and decision-making processes. Results: A novel framework is presented that incorporates social science insights into the formulation and implementation of adaptation activities and policies to lessen the health risks posed by climate change. Conclusion: Clarification of the roles that different sectors, organizations, and individuals occupy in relation to the development of health-related adaptation strategies will facilitate the inclusion of health and wellbeing within multi-sector adaptation policies, thereby strengthening the overall set of responses to minimize the adverse health effects of climate change.

  8. Complex Adaptive Systems, soil degradation and land sensitivity to desertification: A multivariate assessment of Italian agro-forest landscape.

    Science.gov (United States)

    Salvati, Luca; Mavrakis, Anastasios; Colantoni, Andrea; Mancino, Giuseppe; Ferrara, Agostino

    2015-07-15

    Degradation of soils and sensitivity of land to desertification are intensified in last decades in the Mediterranean region producing heterogeneous spatial patterns determined by the interplay of factors such as climate, land-use changes, and human pressure. The present study hypothesizes that rising levels of soil degradation and land sensitivity to desertification are reflected into increasingly complex (and non-linear) relationships between environmental and socioeconomic variables. To verify this hypothesis, the Complex Adaptive Systems (CAS) framework was used to explore the spatiotemporal dynamics of eleven indicators derived from a standard assessment of soil degradation and land sensitivity to desertification in Italy. Indicators were made available on a detailed spatial scale (773 agricultural districts) for various years (1960, 1990, 2000 and 2010) and analyzed through a multi-dimensional exploratory data analysis. Our results indicate that the number of significant pair-wise correlations observed between indicators increased with the level of soil and land degradation, although with marked differences between northern and southern Italy. 'Fast' and 'slow' factors underlying soil and land degradation, and 'rapidly-evolving' or 'locked' agricultural districts were identified according to the rapidity of change estimated for each of the indicators studied. In southern Italy, 'rapidly-evolving' districts show a high level of soil degradation and land sensitivity to desertification during the whole period of investigation. On the contrary, those districts in northern Italy are those experiencing a moderate soil degradation and land sensitivity to desertification with the highest increase in the level of sensitivity over time. The study framework contributes to the assessment of complex local systems' dynamics in affluent but divided countries. Results may inform thematic strategies for the mitigation of land and soil degradation in the framework of action

  9. Experts' Perspectives Toward a Population Health Approach for Children With Medical Complexity.

    Science.gov (United States)

    Barnert, Elizabeth S; Coller, Ryan J; Nelson, Bergen B; Thompson, Lindsey R; Chan, Vincent; Padilla, Cesar; Klitzner, Thomas S; Szilagyi, Moira; Chung, Paul J

    2017-08-01

    Because children with medical complexity (CMC) display very different health trajectories, needs, and resource utilization than other children, it is unclear how well traditional conceptions of population health apply to CMC. We sought to identify key health outcome domains for CMC as a step toward determining core health metrics for this distinct population of children. We conducted and analyzed interviews with 23 diverse national experts on CMC to better understand population health for CMC. Interviewees included child and family advocates, health and social service providers, and research, health systems, and policy leaders. We performed thematic content analyses to identify emergent themes regarding population health for CMC. Overall, interviewees conveyed that defining and measuring population health for CMC is an achievable, worthwhile goal. Qualitative themes from interviews included: 1) CMC share unifying characteristics that could serve as the basis for population health outcomes; 2) optimal health for CMC is child specific and dynamic; 3) health of CMC is intertwined with health of families; 4) social determinants of health are especially important for CMC; and 5) measuring population health for CMC faces serious conceptual and logistical challenges. Experts have taken initial steps in defining the population health of CMC. Population health for CMC involves a dynamic concept of health that is attuned to individual, health-related goals for each child. We propose a framework that can guide the identification and development of population health metrics for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  10. Natural Selection on Genes Related to Cardiovascular Health in High-Altitude Adapted Andeans.

    Science.gov (United States)

    Crawford, Jacob E; Amaru, Ricardo; Song, Jihyun; Julian, Colleen G; Racimo, Fernando; Cheng, Jade Yu; Guo, Xiuqing; Yao, Jie; Ambale-Venkatesh, Bharath; Lima, João A; Rotter, Jerome I; Stehlik, Josef; Moore, Lorna G; Prchal, Josef T; Nielsen, Rasmus

    2017-11-02

    The increase in red blood cell mass (polycythemia) due to the reduced oxygen availability (hypoxia) of residence at high altitude or other conditions is generally thought to be beneficial in terms of increasing tissue oxygen supply. However, the extreme polycythemia and accompanying increased mortality due to heart failure in chronic mountain sickness most likely reduces fitness. Tibetan highlanders have adapted to high altitude, possibly in part via the selection of genetic variants associated with reduced polycythemic response to hypoxia. In contrast, high-altitude-adapted Quechua- and Aymara-speaking inhabitants of the Andean Altiplano are not protected from high-altitude polycythemia in the same way, yet they exhibit other adaptive features for which the genetic underpinnings remain obscure. Here, we used whole-genome sequencing to scan high-altitude Andeans for signals of selection. The genes showing the strongest evidence of selection-including BRINP3, NOS2, and TBX5-are associated with cardiovascular development and function but are not in the response-to-hypoxia pathway. Using association mapping, we demonstrated that the haplotypes under selection are associated with phenotypic variations related to cardiovascular health. We hypothesize that selection in response to hypoxia in Andeans could have vascular effects and could serve to mitigate the deleterious effects of polycythemia rather than reduce polycythemia itself. Copyright © 2017. Published by Elsevier Inc.

  11. Adaptive Treatment Strategies in Youth Mental Health: A Commentary on Advantages, Challenges, and Potential Directions.

    Science.gov (United States)

    Sherrill, Joel T

    2016-01-01

    This commentary underscores the importance and potential of the research approaches and intervention strategies described in the JCCAP special issue on the Science of Adaptive Treatment Strategies in Child and Adolescent Mental Health for addressing the widely observed heterogeneity in response to even our most promising research-informed interventions. First, the commentary briefly summarizes the advantages of these approaches and highlights how these programs of research are responsive to widely agreed-upon calls for more personalized, prescriptive interventions. Next, the commentary briefly discusses key common challenges and gaps in our knowledge that might be addressed to advance the development, testing, and implementation of adaptive intervention strategies. For example, research to identify robust moderators that might serve as potential tailoring variables for initial assignment and sequencing of interventions, efforts to operationalize surrogate endpoints for early identification of individuals who are unlikely to respond to first-line interventions, and research that helps define what constitutes an adequate exposure (i.e., dose) or response threshold (e.g., response that suggests the need to intensify, switch, or augment interventions) would inform decision rules for adaptive algorithms. The commentary concludes with a discussion of potential strategies and current initiatives that might ultimately help facilitate research on more targeted, prescriptive approaches to intervening, including efforts to encourage investigators to use common data elements, to share and integrate data across trials, and to employ a more mechanism-based approach to intervention development and testing.

  12. Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

    Science.gov (United States)

    Mohamed, Somaia

    2013-03-01

    There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

  13. Operationalization of biopsychosocial case complexity in general health care : the INTERMED project

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Sollner, W; Stiefel, FC

    Objective: Lack of operationalization of the biopsychosocial model hinders its effective application to the increasingly prevalent problems of comorbidities in clinical presentations. Here, we describe the INTERMED, an instrument to assess biopsychosocial case complexity in general health care, and

  14. Psychosocial adaptation status and health-related quality of life among older Chinese adults with visual disorders.

    Science.gov (United States)

    Wang, Chong-Wen; Chan, Cecilia L W

    2009-09-01

    To examine the association of psychosocial adaptation status with vision-specific health-related quality of life (HRQOL) and the role of psychosocial adaptation in the linkage between visual impairment and vision-specific HRQOL outcomes among older adults with visual disorders. In this cross-sectional study, older urban adults with visual problems (N = 167) were interviewed using a structured questionnaire to assess their self-reported visual function, general health, psychosocial adaptation status, and vision-specific HRQOL. Performance-based measure of visual function marked by distance visual acuity was clinically conducted by ophthalmologists. It was found in the study that psychosocial adaptation status was significantly associated with vision-specific HRQOL, including the domains of mental health symptoms due to vision and dependency on others due to vision. The results also showed that psychosocial adaptation status could buffer the effect of visual impairment on vision-specific HRQOL, including the domains of social function, mental health, and dependency. Psychosocial adaptation status is significantly associated with multiple domains of vision-specific HRQOL. The findings have significant implications for health education and psychosocial intervention for older adults with age-related vision loss.

  15. mHealth intervention to support asthma self-management in adolescents: the ADAPT study

    Directory of Open Access Journals (Sweden)

    Kosse RC

    2017-03-01

    Full Text Available Richelle C Kosse,1 Marcel L Bouvy,1 Tjalling W de Vries,2 Ad A Kaptein,3 Harm CJ Geers,1 Liset van Dijk,4 Ellen S Koster1 1Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, 2Department of Paediatrics, Medical Center Leeuwarden, Leeuwarden, 3Medical Psychology, Leiden University Medical Center, Leiden, 4NIVEL, the Netherlands Institute for Health Services Research, Utrecht, the Netherlands Purpose: Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. Intervention: The ADAPT intervention consists of an interactive smartphone application (app connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1 a questionnaire function to rate asthma symptoms and monitor these over time; 2 short movie clips with medication and disease information; 3 a medication reminder; 4 a chat function with peers; and 5 a chat function with the pharmacist. The pharmacist receives data from the patient’s app through the desktop application, which enables the pharmacist to send information and feedback to the patient. Study design: The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient’s self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. Conclusion: This study will provide in

  16. Results of physiological adaptation assessmtn and health risks for labor migrants from Tajikistan

    Directory of Open Access Journals (Sweden)

    M. Khodzhiev

    2017-09-01

    Full Text Available The paper focuses on the results of physiological research performed on 9 occupational groups of migrants who came to Moscow region of Russia from southern Central Asia republics. We studied adaptation processes characteristics in labor migrants as per cardiovascular system parameters and neuromuscular apparatus parameters. We revealed peculiarities in heart rate variability (changes in stress index S1, values of AMo, VLF spectrum power, PARS parameter in migrants de-pending on neuro-emotional nature of working activity and muscular loads intensity. We detected apparent decrease in dynamometric parameters of endurance and maximum working capacity of arms muscles and backbones and legs muscles by the end of their working day. We created a procedure to determine an adaptation process stage under combined effects ex-erted by labor physical hardness and neuro-emotional intensity; unsatisfactory adaptation increases health disorders risks. We showed that long-term and intense impacts by factors determining labor process hardness caused occupational diseases of musculoskeletal system and peripheral nervous system. We revealed that as labor intensity grew working stress in a body also increased and it could transform into overstrain and occupational diseases evolvement (primary hypertension, ischemic heart diseases, and neurotic disorders. A distinctive feature is that men suffer from cardiovascular system pathologies more frequently while women tend to suffer from nervous system pathologies. In this relation, we should make separate predictions of occupational pathology probability depending on labor intensity level for males and females. Adaptation processes optimization should include organization of rational work and rest regime, healthy lifestyle for-mation, improvements in medical aid for migrants.

  17. Engaging Survivors of Human Trafficking: Complex Health Care Needs and Scarce Resources.

    Science.gov (United States)

    Judge, Abigail M; Murphy, Jennifer A; Hidalgo, Jose; Macias-Konstantopoulos, Wendy

    2018-05-01

    Human trafficking, also known as modern-day slavery, is an egregious human rights violation associated with wide-ranging medical and mental health consequences. Because of the extensive health problems related to trafficking, health care providers play a critical role in identifying survivors and engaging them in ongoing care. Although guidelines for recognizing affected patients and a framework for developing response protocols in health care settings have been described, survivors' ongoing engagement in health care services is very challenging. High rates of disengagement, lost contact, premature termination, and attrition are common outcomes. For interventions to be effective in this marginalized population, challenges in engaging survivors in long-term therapeutic primary and mental health care must be better understood and overcome. This article uses the socioecological model of public health to identify barriers to engagement; offers evidence- and practice-based recommendations for overcoming these barriers; and proposes an interdisciplinary call to action for developing more flexible, adaptable models of care.

  18. Organizational Leadership and Adaptive Reserve in Blood Pressure Control: The Heart Health NOW Study.

    Science.gov (United States)

    Henderson, Kamal H; DeWalt, Darren A; Halladay, Jacquie; Weiner, Bryan J; Kim, Jung I; Fine, Jason; Cykert, Samuel

    2018-04-01

    Our purpose was to assess whether a practice's adaptive reserve and high leadership capability in quality improvement are associated with population blood pressure control. We divided practices into quartiles of blood pressure control performance and considered the top quartile as the benchmark for comparison. Using abstracted clinical data from electronic health records, we performed a cross-sectional study to assess the association of top quartile hypertension control and (1) the baseline practice adaptive reserve (PAR) scores and (2) baseline practice leadership scores, using modified Poisson regression models adjusting for practice-level characteristics. Among 181 practices, 46 were in the top quartile, which averaged 68% or better blood pressure control. Practices with higher PAR scores compared with lower PAR scores were not more likely to reside in the top quartile of performance (prevalence ratio [PR] = 1.92 for highest quartile; 95% CI, 0.9-4.1). Similarly, high quality improvement leadership capability compared with lower capability did not predict better blood pressure control performance (PR = 0.94; 95% CI, 0.57-1.56). Practices with higher proportions of commercially insured patients were more likely than practices with lower proportions of commercially insured patients to have top quartile performance (37% vs 26%, P =.002), whereas lower proportions of the uninsured (8% vs 14%, P =.055) were associated with better performance. Our findings show that adaptive reserve and leadership capability in quality improvement implementation are not statistically associated with achieving top quartile practice-level hypertension control at baseline in the Heart Health NOW project. Our findings, however, may be limited by a lack of patient-related factors and small sample size to preclude strong conclusions. © 2018 Annals of Family Medicine, Inc.

  19. Health Belief Model Scale for Human Papilloma Virus and its Vaccination: Adaptation and Psychometric Testing.

    Science.gov (United States)

    Guvenc, Gulten; Seven, Memnun; Akyuz, Aygul

    2016-06-01

    To adapt and psychometrically test the Health Belief Model Scale for Human Papilloma Virus (HPV) and Its Vaccination (HBMS-HPVV) for use in a Turkish population and to assess the Human Papilloma Virus Knowledge score (HPV-KS) among female college students. Instrument adaptation and psychometric testing study. The sample consisted of 302 nursing students at a nursing school in Turkey between April and May 2013. Questionnaire-based data were collected from the participants. Information regarding HBMS-HPVV and HPV knowledge and descriptive characteristic of participants was collected using translated HBMS-HPVV and HPV-KS. Test-retest reliability was evaluated and Cronbach α was used to assess internal consistency reliability, and exploratory factor analysis was used to assess construct validity of the HBMS-HPVV. The scale consists of 4 subscales that measure 4 constructs of the Health Belief Model covering the perceived susceptibility and severity of HPV and the benefits and barriers. The final 14-item scale had satisfactory validity and internal consistency. Cronbach α values for the 4 subscales ranged from 0.71 to 0.78. Total HPV-KS ranged from 0 to 8 (scale range, 0-10; 3.80 ± 2.12). The HBMS-HPVV is a valid and reliable instrument for measuring young Turkish women's beliefs and attitudes about HPV and its vaccination. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  20. Effects of sex and gender on adaptation to space: behavioral health.

    Science.gov (United States)

    Goel, Namni; Bale, Tracy L; Epperson, C Neill; Kornstein, Susan G; Leon, Gloria R; Palinkas, Lawrence A; Stuster, Jack W; Dinges, David F

    2014-11-01

    This article is part of a larger body of work entitled, "The Impact of Sex and Gender on Adaptation to Space." It was developed in response to a recommendation from the 2011 National Academy of Sciences Decadal Survey, "Recapturing a Future for Space Exploration: Life and Physical Sciences for a New Era," which emphasized the need to fully understand sex and gender differences. In this article, our workgroup-consisting of expert scientists and clinicians from academia and the private sector-investigated and summarized the current body of published and unpublished human research performed to date related to sex- and gender-based differences in behavioral adaptations to human spaceflight. This review identifies sex-related differences in: (1) sleep, circadian rhythms, and neurobehavioral measures; (2) personality, group interactions, and work performance and satisfaction; and (3) stress and clinical disorders. Differences in these areas substantially impact the risks and optimal medical care required by space-faring women. To ensure the health and safety of male and female astronauts during long-duration space missions, it is imperative to understand the influences that sex and gender have on behavioral health changes occurring during spaceflight.

  1. [The economic-industrial health care complex and the social and economic dimension of development].

    Science.gov (United States)

    Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira; Maldonado, José

    2012-12-01

    The strategic role of health care in the national development agenda has been increasingly recognized and institutionalized. In addition to its importance as a structuring element of the Social Welfare State, health care plays a leading role in the generation of innovation - an essential element for competitiveness in knowledge society. However, health care's productive basis is still fragile, and this negatively affects both the universal provision of health care services and Brazil's competitive inclusion in the globalized environment. This situation suggests the need of a more systematic analysis of the complex relationships among productive, technological and social interests in the scope of health care. Consequently, it is necessary to produce further knowledge about the Economic-Industrial Health Care Complex due to its potential for contributing to a socially inclusive development model. This means reversing the hierarchy between economic and social interests in the sanitary field, thus minimizing the vulnerability of the Brazilian health care policy.

  2. Parents' perspectives of the transition to home when a child has complex technological health care needs.

    LENUS (Irish Health Repository)

    Brenner, Maria

    2015-09-01

    There is an increasing number of children with complex care needs, however, there is limited evidence of the experience of families during the process of transitioning to becoming their child\\'s primary care giver. The aim of this study was to explore parents\\' perspectives of the transition to home of a child with complex respiratory health care needs.

  3. Discovering complex interrelationships between socioeconomic status and health in Europe: A case study applying Bayesian Networks.

    Science.gov (United States)

    Alvarez-Galvez, Javier

    2016-03-01

    Studies assume that socioeconomic status determines individuals' states of health, but how does health determine socioeconomic status? And how does this association vary depending on contextual differences? To answer this question, our study uses an additive Bayesian Networks model to explain the interrelationships between health and socioeconomic determinants using complex and messy data. This model has been used to find the most probable structure in a network to describe the interdependence of these factors in five European welfare state regimes. The advantage of this study is that it offers a specific picture to describe the complex interrelationship between socioeconomic determinants and health, producing a network that is controlled by socio-demographic factors such as gender and age. The present work provides a general framework to describe and understand the complex association between socioeconomic determinants and health. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Motor adaptation in complex sports - the influence of visual context information on the adaptation of the three-point shot to altered task demands in expert basketball players.

    Science.gov (United States)

    Stöckel, Tino; Fries, Udo

    2013-01-01

    We examined the influence of visual context information on skilled motor behaviour and motor adaptation in basketball. The rules of basketball in Europe have recently changed, such that that the distance for three-point shots increased from 6.25 m to 6.75 m. As such, we tested the extent to which basketball experts can adapt to the longer distance when a) only the unfamiliar, new three-point line was provided as floor markings (NL group), or b) the familiar, old three-point line was provided in addition to the new floor markings (OL group). In the present study 20 expert basketball players performed 40 three-point shots from 6.25 m and 40 shots from 6.75 m. We assessed the percentage of hits and analysed the landing position of the ball. Results showed better adaptation of throwing performance to the longer distance when the old three-point line was provided as a visual landmark, compared to when only the new three-point line was provided. We hypothesise that the three-point line delivered relevant information needed to successfully adapt to the greater distance in the OL group, whereas it disturbed performance and ability to adapt in the NL group. The importance of visual landmarks on motor adaptation in basketball throwing is discussed relative to the influence of other information sources (i.e. angle of elevation relative to the basket) and sport practice.

  5. Bayesian demosaicing using Gaussian scale mixture priors with local adaptivity in the dual tree complex wavelet packet transform domain

    Science.gov (United States)

    Goossens, Bart; Aelterman, Jan; Luong, Hiep; Pizurica, Aleksandra; Philips, Wilfried

    2013-02-01

    In digital cameras and mobile phones, there is an ongoing trend to increase the image resolution, decrease the sensor size and to use lower exposure times. Because smaller sensors inherently lead to more noise and a worse spatial resolution, digital post-processing techniques are required to resolve many of the artifacts. Color filter arrays (CFAs), which use alternating patterns of color filters, are very popular because of price and power consumption reasons. However, color filter arrays require the use of a post-processing technique such as demosaicing to recover full resolution RGB images. Recently, there has been some interest in techniques that jointly perform the demosaicing and denoising. This has the advantage that the demosaicing and denoising can be performed optimally (e.g. in the MSE sense) for the considered noise model, while avoiding artifacts introduced when using demosaicing and denoising sequentially. In this paper, we will continue the research line of the wavelet-based demosaicing techniques. These approaches are computationally simple and very suited for combination with denoising. Therefore, we will derive Bayesian Minimum Squared Error (MMSE) joint demosaicing and denoising rules in the complex wavelet packet domain, taking local adaptivity into account. As an image model, we will use Gaussian Scale Mixtures, thereby taking advantage of the directionality of the complex wavelets. Our results show that this technique is well capable of reconstructing fine details in the image, while removing all of the noise, at a relatively low computational cost. In particular, the complete reconstruction (including color correction, white balancing etc) of a 12 megapixel RAW image takes 3.5 sec on a recent mid-range GPU.

  6. [Attaching importance to study on acute health risk assessment and adaptation of air pollution and climate change].

    Science.gov (United States)

    Shi, X M

    2017-03-10

    Air pollution and climate change have become key environmental and public health problems around the world, which poses serious threat to human health. How to assess and mitigate the health risks and increase the adaptation of the public have become an urgent topic of research in this area. The six papers in this issue will provide important and rich information on design, analysis method, indicator selection and setting about acute health risk assessment and adaptation study of air pollution and climate change in China, reflecting the advanced conceptions of multi-center and area-specific study and multi-pollutant causing acute effect study. However, the number and type of the cities included in these studies were still limited. In future, researchers should further expand detailed multi-center and multi-area study coverage, conduct area specific predicting and early warning study and strengthen adaptation study.

  7. From DTCA-PD to patient information to health information: the complex politics and semantics of EU health policy.

    Science.gov (United States)

    Brooks, Eleanor; Geyer, Robert

    2012-12-01

    Between 2001 and 2011 the pharmaceutical industry, supported by DG Enterprise, was engaged in an ongoing campaign to repeal/amend the European Union (EU) ban on direct-to-consumer advertising of prescription drugs (DTCA-PD). As it became increasingly clear that the ban would not be repealed, DTCA-PD supporters tried to shift the debate away from advertising and towards the provision of 'patient information' and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported by DG SANCO, sought to maintain the ban and oppose the industry-supported 'patient information' campaign. Instead, they promoted a concept of 'health information' that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition from DTCA-PD to patient information to health information and examine its implications for EU health policy as a complex policy space. The article examines the emergence and development of EU health policy and the evolution of the DTCA-PD debate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us about EU health policy and future EU health legislation and how it may be understood from a complexity perspective. The article concludes that the complexity framework is ideally suited for the field of public health and, in particular, the DTCA-PD debate. Having successfully shifted the policy-focus of the debate to patients' rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising. © 2012 Blackwell Publishing Ltd.

  8. Reduced-complexity adaptive multi-channel assignment for shared access points in over-loaded small-cell networks

    KAUST Repository

    Radaydeh, Redha Mahmoud

    2013-06-01

    This paper proposes a reduced-complexity downlink multi-channel assignment scheme when feedback links are capacity-limited. The system model treats the case when multiple access points are allocated to serve scheduled users in over-loaded (i.e. dense) pico/femtocell networks. It assumes that the deployed access points can be shared simultaneously and employ isotropic antenna arrays of arbitrary sizes. Moreover, they transmit their data on a common physical channel and can not coordinate their transmissions. On the other hand, each scheduled user can be served by single transmit channel from each active access point at a time, and it lacks coordination with concurrent active users. The scheme operates according to the occupancy of available transmit channels, wherein extensively occupied access points are avoided adaptively, while reducing the load of processing. The operation is linked to a target performance via controlling the observed aggregate interference from the projected set of serving points. Through the analysis, results for the scheduled user outage performance, and the average number of active access points are presented. Numerical and simulations studies clarify the gains of the proposed scheme for different operating conditions. © 2013 IEEE.

  9. Reduced-complexity adaptive multi-channel assignment for shared access points in over-loaded small-cell networks

    KAUST Repository

    Radaydeh, Redha Mahmoud; Qaraqe, Khalid A.; Alouini, Mohamed-Slim

    2013-01-01

    This paper proposes a reduced-complexity downlink multi-channel assignment scheme when feedback links are capacity-limited. The system model treats the case when multiple access points are allocated to serve scheduled users in over-loaded (i.e. dense) pico/femtocell networks. It assumes that the deployed access points can be shared simultaneously and employ isotropic antenna arrays of arbitrary sizes. Moreover, they transmit their data on a common physical channel and can not coordinate their transmissions. On the other hand, each scheduled user can be served by single transmit channel from each active access point at a time, and it lacks coordination with concurrent active users. The scheme operates according to the occupancy of available transmit channels, wherein extensively occupied access points are avoided adaptively, while reducing the load of processing. The operation is linked to a target performance via controlling the observed aggregate interference from the projected set of serving points. Through the analysis, results for the scheduled user outage performance, and the average number of active access points are presented. Numerical and simulations studies clarify the gains of the proposed scheme for different operating conditions. © 2013 IEEE.

  10. Reproductive plasticity of Hypostomus affinis (Siluriformes: Loricariidae as a mechanism to adapt to a reservoir with poor habitat complexity

    Directory of Open Access Journals (Sweden)

    Silvana Duarte

    2011-10-01

    Full Text Available In this work we describe the gonad morphology and spawning season of Hypostomus affinis (Steindachner, 1877 in a tropical reservoir based on 55 males and 125 females. Our aim was to assess eventual adaptations in reproductive tactics developed by this riverine species inhabiting an oligotrophic reservoir with low habitat complexity, few rocks and few other preferred consolidated substrata. We described the stages of cells of reproductive lineage, gonadal development and some reproductive traits which were compared with information in the available literature. Cells from the spermatogenic lineage were spermatogonia, spermatocytes, spermatids and spermatozoa, and cells from the oocytarian lineage were primary oocytes, previtelogenic oocytes, cortical vesicle oocytes and yolk globules or vitellogenic. Five stages were described for the males/females according to the distribution of oocytes and spermatogenic lineage cells: resting; initial maturation; advanced maturation; partially spent/spawned; totally spent/spawn. Females outnumbered males and reached larger size. Synchronic ovary development in two groups was found with diameter of mature oocytes ranging from 2 to 3.35 mm. Indication of early maturation, a longer reproductive period and the production of smaller eggs in small clutches seems to be features of the reservoir population not found in riverine systems. Such changes in tactics may indicate a shift to an opportunistic strategy, helping the population to withstand environmental constraints and to succeed in this oligotrophic and poorly structured reservoir.

  11. Pick a Color MARIA: Adaptive Sampling Enables the Rapid Identification of Complex Perovskite Nanocrystal Compositions with Defined Emission Characteristics.

    Science.gov (United States)

    Bezinge, Leonard; Maceiczyk, Richard M; Lignos, Ioannis; Kovalenko, Maksym V; deMello, Andrew J

    2018-06-06

    Recent advances in the development of hybrid organic-inorganic lead halide perovskite (LHP) nanocrystals (NCs) have demonstrated their versatility and potential application in photovoltaics and as light sources through compositional tuning of optical properties. That said, due to their compositional complexity, the targeted synthesis of mixed-cation and/or mixed-halide LHP NCs still represents an immense challenge for traditional batch-scale chemistry. To address this limitation, we herein report the integration of a high-throughput segmented-flow microfluidic reactor and a self-optimizing algorithm for the synthesis of NCs with defined emission properties. The algorithm, named Multiparametric Automated Regression Kriging Interpolation and Adaptive Sampling (MARIA), iteratively computes optimal sampling points at each stage of an experimental sequence to reach a target emission peak wavelength based on spectroscopic measurements. We demonstrate the efficacy of the method through the synthesis of multinary LHP NCs, (Cs/FA)Pb(I/Br) 3 (FA = formamidinium) and (Rb/Cs/FA)Pb(I/Br) 3 NCs, using MARIA to rapidly identify reagent concentrations that yield user-defined photoluminescence peak wavelengths in the green-red spectral region. The procedure returns a robust model around a target output in far fewer measurements than systematic screening of parametric space and additionally enables the prediction of other spectral properties, such as, full-width at half-maximum and intensity, for conditions yielding NCs with similar emission peak wavelength.

  12. Substance P Differentially Modulates Firing Rate of Solitary Complex (SC) Neurons from Control and Chronic Hypoxia-Adapted Adult Rats

    Science.gov (United States)

    Nichols, Nicole L.; Powell, Frank L.; Dean, Jay B.; Putnam, Robert W.

    2014-01-01

    NK1 receptors, which bind substance P, are present in the majority of brainstem regions that contain CO2/H+-sensitive neurons that play a role in central chemosensitivity. However, the effect of substance P on the chemosensitive response of neurons from these regions has not been studied. Hypoxia increases substance P release from peripheral afferents that terminate in the caudal nucleus tractus solitarius (NTS). Here we studied the effect of substance P on the chemosensitive responses of solitary complex (SC: NTS and dorsal motor nucleus) neurons from control and chronic hypoxia-adapted (CHx) adult rats. We simultaneously measured intracellular pH and electrical responses to hypercapnic acidosis in SC neurons from control and CHx adult rats using the blind whole cell patch clamp technique and fluorescence imaging microscopy. Substance P significantly increased the basal firing rate in SC neurons from control and CHx rats, although the increase was smaller in CHx rats. However, substance P did not affect the chemosensitive response of SC neurons from either group of rats. In conclusion, we found that substance P plays a role in modulating the basal firing rate of SC neurons but the magnitude of the effect is smaller for SC neurons from CHx adult rats, implying that NK1 receptors may be down regulated in CHx adult rats. Substance P does not appear to play a role in modulating the firing rate response to hypercapnic acidosis of SC neurons from either control or CHx adult rats. PMID:24516602

  13. Substance P differentially modulates firing rate of solitary complex (SC neurons from control and chronic hypoxia-adapted adult rats.

    Directory of Open Access Journals (Sweden)

    Nicole L Nichols

    Full Text Available NK1 receptors, which bind substance P, are present in the majority of brainstem regions that contain CO2/H(+-sensitive neurons that play a role in central chemosensitivity. However, the effect of substance P on the chemosensitive response of neurons from these regions has not been studied. Hypoxia increases substance P release from peripheral afferents that terminate in the caudal nucleus tractus solitarius (NTS. Here we studied the effect of substance P on the chemosensitive responses of solitary complex (SC: NTS and dorsal motor nucleus neurons from control and chronic hypoxia-adapted (CHx adult rats. We simultaneously measured intracellular pH and electrical responses to hypercapnic acidosis in SC neurons from control and CHx adult rats using the blind whole cell patch clamp technique and fluorescence imaging microscopy. Substance P significantly increased the basal firing rate in SC neurons from control and CHx rats, although the increase was smaller in CHx rats. However, substance P did not affect the chemosensitive response of SC neurons from either group of rats. In conclusion, we found that substance P plays a role in modulating the basal firing rate of SC neurons but the magnitude of the effect is smaller for SC neurons from CHx adult rats, implying that NK1 receptors may be down regulated in CHx adult rats. Substance P does not appear to play a role in modulating the firing rate response to hypercapnic acidosis of SC neurons from either control or CHx adult rats.

  14. An adaptive network-based fuzzy inference system for short-term natural gas demand estimation: Uncertain and complex environments

    International Nuclear Information System (INIS)

    Azadeh, A.; Asadzadeh, S.M.; Ghanbari, A.

    2010-01-01

    Accurate short-term natural gas (NG) demand estimation and forecasting is vital for policy and decision-making process in energy sector. Moreover, conventional methods may not provide accurate results. This paper presents an adaptive network-based fuzzy inference system (ANFIS) for estimation of NG demand. Standard input variables are used which are day of the week, demand of the same day in previous year, demand of a day before and demand of 2 days before. The proposed ANFIS approach is equipped with pre-processing and post-processing concepts. Moreover, input data are pre-processed (scaled) and finally output data are post-processed (returned to its original scale). The superiority and applicability of the ANFIS approach is shown for Iranian NG consumption from 22/12/2007 to 30/6/2008. Results show that ANFIS provides more accurate results than artificial neural network (ANN) and conventional time series approach. The results of this study provide policy makers with an appropriate tool to make more accurate predictions on future short-term NG demand. This is because the proposed approach is capable of handling non-linearity, complexity as well as uncertainty that may exist in actual data sets due to erratic responses and measurement errors.

  15. Governability Framework for the Evaluation and Implementation of Complex Public Health Functions

    Science.gov (United States)

    Varghese, Joe; Kutty, V. Raman

    2012-01-01

    Background: The dominant theoretical basis of our public health practice originates from a positivist or reductionist paradigm. It fails to take into account the complexity emerging out of public health's multiple influences originating from biological and social worlds. A deeper understanding of the interaction of elements that characterize the…

  16. Adapting Pharmacoeconomics to Shape Efficient Health Systems en Route to UHC - Lessons from Two Continents.

    Science.gov (United States)

    Miot, Jacqui; Thiede, Michael

    2017-01-01

    Background: Pharmacoeconomics is receiving increasing attention globally as a set of tools ensuring efficient use of resources in health systems, albeit with different applications depending on the contextual, cultural and development stages of each country. The factors guiding design, implementation and optimisation of pharmacoeconomics as a steering tool under the universal health coverage paradigm are explored using case studies of Germany and South Africa. Findings: German social health insurance is subject to the efficiency precept. Pharmaco-regulatory tools reflect the respective framework conditions under which they developed at particular points in time. The institutionalization and integration of pharmacoeconomics into the remit of the Institute for Quality and Efficiency in Health Care occurred only rather recently. The road has not been smooth, requiring political discourse and complex processes of negotiation. Although enshrined in the National Drug Policy, South Africa has had a more fragmented approach to medicine selection and pricing with different policies in private and public sectors. The regulatory reform for use of pharmacoeconomic tools is ongoing and will be further shaped by the introduction of National Health Insurance. Conclusion: A clear vision or framework is essential as the regulatory introduction of pharmacoeconomics is not a single event but rather a growing momentum. The path will always be subject to influences of politics, economics and market forces beyond the healthcare system so delays and modifications to pharmacoeconomic tools are to be expected. Health systems are dynamic and pharmacoeconomic reforms need to be sufficiently flexible to evolve alongside.

  17. Health diplomacy the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: Evaluating findings from Project Accept (HPTN 043

    Directory of Open Access Journals (Sweden)

    Kevany Sebastian

    2012-06-01

    Full Text Available Abstract Background Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1 respond to socio-cultural differences in risk determinants, (2 to make interventions more relevant to target population needs, and (3 in recognition of ‘global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. Methods We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1 the adaptations development and approval process and (2 the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Results Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe; religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania; economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe; epidemiological adaptations (e.g. provision of ‘youth-friendly’ services in South Africa, Zimbabwe

  18. Hazards ahead: Managing cleanup worker health and safety at the nuclear weapons complex. Background paper

    International Nuclear Information System (INIS)

    1993-02-01

    Cold War nuclear weapons production has left a legacy of environmental contamination that is unprecented in scope and complexity. The Department of Energy has begun cleaning up pollution at the Nuclear Weapons Complex (NWC)--an expensive, decades-long task that will require a workforce numbering tens of thousands of scientists, technicians, and laborers. Protecting their health and safety must be a major goal of the cleanup effort. Achieving the goal will require DOE to successfully confront significant technical and managerial challenges, but it also poses a unique opportunity to advance state-of-the-art occupational health and safety technologies and practices. The report provides an evaluation of environmental restoration and waste management at the DOE Nuclear Weapons Complex. It examines risks workers might face in cleaning up contamination at the complex and evaluates the effectiveness of DOE's occupational safety and health programs for cleanup workers

  19. Health worker posting and transfer at primary level in Tamil Nadu: Governance of a complex health system function

    Directory of Open Access Journals (Sweden)

    Surekha Garimella

    2016-01-01

    Full Text Available Background: Posting and transfer (PT of health personnel - placing the right health workers in the right place at the right time - is a core function of any large-scale health service. In the context of government health services, this may be seen as a simple process of bureaucratic governance and implementation of the rule of law. However the literature from India and comparable low and middle-income country health systems suggests that in reality PT is a contested domain, driven by varied expressions of private and public interest throughout the chain of implementation. Objective: To investigate policymaking for PT in the government health sector and implementation of policies as experienced by different health system actors and stakeholders at primary health care level. Methodology: We undertook an empirical case study of a PT reform policy at primary health care level in Tamil Nadu State, to understand how different groups of health systems actors experience PT. In-depth qualitative methods were undertaken to study processes of implementation of PT policies enacted through ′counselling′ of health workers (individualized consultations to determine postings and transfers. Results: PT emerges as a complex phenomenon, shaped partially by the laws of the state and partially as a parallel system of norms and incentives requiring consideration and coordination of the interests of different groups. Micro-practices of governance represent homegrown coping mechanisms of health administrators that reconcile public and private interests and sustain basic health system functions. Beyond a functional perspective of PT, it also reflects justice and fairness as it plays out in the health system. It signifies how well a system treats its employees, and by inference, is an index of the overall health of the system. Conclusions: For a complex governance function such as PT, the roles of private actors and private interests are not easily separable from the

  20. Health risk assessment of chemical pollutants in a petrochemical complex

    Directory of Open Access Journals (Sweden)

    F Golbabaie

    2012-12-01

    Full Text Available   Background and Aims: workers in petrochemical industries are exposed to various contaminants and are facing to serious hazards, therefore a comprehensive risk assessment program for identification of hazardous chemicals that affect human health and also determination of hazardous tasks and processes is necessary.     Methods : This descriptive cross-sectional study was conducted in three stages. First stage consisted of identifying hazardous chemicals and determination of chemicals risk ratio, the second stage included the evaluation of worker's exposure to hazardous chemicals, and the third stage was estimating the relative risk of blood cancer caused by exposure to benzene through epidemiological studies.     Results: With regard to risk assessment method, 40 chemicals were identified in this Petrochemical Company. Among them, Benzene introduced as the most hazardous chemical. The results of the second stage showed that site man workers in noon shift work and in aromatic site with mean exposure 4.29 ppm had the highest exposure to benzene. The results of estimated leukemia relative risk stage in benzene exposure, the highest relative risk in workers related to site man workers in aromatic units with cumulative benzene exposure of 4.149 ppm. Years that obtained the relative risk of 2.3. The statistical test results showed that the relationship between worker's exposure to benzene and their job was significant(p<0/001     Conclusion : This study showed that benzene with a risk ratio of 4.5 -5 have 5th rank in risk levels and this indicates that preventative actions regarding to this hazardous and carcinogenic chemical must be started as soon as possible.

  1. An Adaptive Noise Cancellation System Based on Linear and Widely Linear Complex Valued Least Mean Square Algorithms for Removing Electrooculography Artifacts from Electroencephalography Signals

    Directory of Open Access Journals (Sweden)

    Engin Cemal MENGÜÇ

    2018-03-01

    Full Text Available In this study, an adaptive noise cancellation (ANC system based on linear and widely linear (WL complex valued least mean square (LMS algorithms is designed for removing electrooculography (EOG artifacts from electroencephalography (EEG signals. The real valued EOG and EEG signals (Fp1 and Fp2 given in dataset are primarily expressed as a complex valued signal in the complex domain. Then, using the proposed ANC system, the EOG artifacts are eliminated in the complex domain from the EEG signals. Expression of these signals in the complex domain allows us to remove EOG artifacts from two EEG channels simultaneously. Moreover, in this study, it has been shown that the complex valued EEG signal exhibits noncircular behavior, and in the case, the WL-CLMS algorithm enhances the performance of the ANC system compared to real-valued LMS and CLMS algorithms. Simulation results support the proposed approach.

  2. User evaluations of design complexity: the impact of visual perceptions for effective online health communication.

    Science.gov (United States)

    Lazard, Allison; Mackert, Michael

    2014-10-01

    This paper highlights the influential role of design complexity for users' first impressions of health websites. An experimental design was utilized to investigate whether a website's level of design complexity impacts user evaluations. An online questionnaire measured the hypothesized impact of design complexity on predictors of message effectiveness. Findings reveal that increased design complexity was positively associated with higher levels of perceived design esthetics, attitude toward the website, perceived message comprehensibility, perceived ease of use, perceived usefulness, perceived message quality, perceived informativeness, and perceived visual informativeness. This research gives further evidence that design complexity should be considered an influential variable for health communicators to effectively reach their audiences, as it embodies the critical first step for message evaluation via electronic platforms. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Utilizing community-based participatory research to adapt a mental health intervention for African American emerging adults.

    Science.gov (United States)

    Mance, Gishawn A; Mendelson, Tamar; Byrd, Benjamin; Jones, Jahon; Tandon, Darius

    2010-01-01

    Adapting mental health interventions to heighten their cultural and contextual appropriateness may be critical for engaging ethnic/racial groups that have been traditionally excluded or marginalized. Community-based participatory research (CBPR) is a collaborative research approach that highlights unique strengths and expertise of those involved. Although intervention adaptations have garnered much attention there is little previous work specifically describing the adaptation process of mental health interventions using CBPR. This article summarizes the use of a CBPR approach to adapt a mental health intervention for urban adolescents and young adults disconnected from school and work, a population at elevated risk for poor mental health owing to the presence of numerous chronic stressors. We describe the process undertaken to modify the content and delivery format of an evidence-based intervention. Unique challenges of working with urban African American adolescents and young adults in a job training program are highlighted. By incorporating principles of co-learning and shared responsibility, this partnership was able to achieve positive outcomes. Our experience suggests that a CBPR approach can be used effectively to adapt a mental health intervention in collaboration with African American adolescents and emerging adults in a job training program.

  4. Local adaptations to a global health initiative: penalties for home births in Zambia.

    Science.gov (United States)

    Greeson, Dana; Sacks, Emma; Masvawure, Tsitsi B; Austin-Evelyn, Katherine; Kruk, Margaret E; Macwan'gi, Mubiana; Grépin, Karen A

    2016-11-01

    Global health initiatives (GHIs) are implemented across a variety of geographies and cultures. Those targeting maternal health often prioritise increasing facility delivery rates. Pressure on local implementers to meet GHI goals may lead to unintended programme features that could negatively impact women. This study investigates penalties for home births imposed by traditional leaders on women during the implementation of Saving Mothers, Giving Life (SMGL) in Zambia. Forty focus group discussions (FGDs) were conducted across four rural districts to assess community experiences of SMGL at the conclusion of its first year. Participants included women who recently delivered at home (3 FGDs/district), women who recently delivered in a health facility (3 FGDs/district), community health workers (2 FGDs/district) and local leaders (2 FGDs/district). Findings indicate that community leaders in some districts-independently of formal programme directive-used fines to penalise women who delivered at home rather than in a facility. Participants in nearly all focus groups reported hearing about the imposition of penalties following programme implementation. Some women reported experiencing penalties firsthand, including cash and livestock fines, or fees for child health cards that are typically free. Many women who delivered at home reported their intention to deliver in a facility in the future to avoid penalties. While communities largely supported the use of penalties to promote facility delivery, the penalties effectively introduced a new tax on poor rural women and may have deterred their utilization of postnatal and child health care services. The imposition of penalties is thus a punitive adaptation that can impose new financial burdens on vulnerable women and contribute to widening health, economic and gender inequities in communities. Health initiatives that aim to increase demand for health services should monitor local efforts to achieve programme targets in order

  5. German translation, cultural adaptation, and validation of the Health Literacy Questionnaire (HLQ).

    Science.gov (United States)

    Nolte, Sandra; Osborne, Richard H; Dwinger, Sarah; Elsworth, Gerald R; Conrad, Melanie L; Rose, Matthias; Härter, Martin; Dirmaier, Jörg; Zill, Jördis M

    2017-01-01

    The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a 'validity-driven' approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach's Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations. German Clinical Trial Registration (DRKS): DRKS00000584. Registered 23 March 2011.

  6. Farmer Health and Adaptive Capacity in the Face of Climate Change and Variability. Part 2: Contexts, Personal Attributes and Behaviors

    Directory of Open Access Journals (Sweden)

    Helen Berry

    2011-10-01

    Full Text Available This study extends the emerging body of research on farmer adaptation to climate change, by segmenting farmers on the basis of specific attributes (health, values, belief about climate change, sense of responsibility for climate change, desire to change, social, human and financial capitals and farmer demographics and considering such attributes as critical social aspects of the contextualized capacity to adapt. The segmental analysis was based on a nationally representative sample of 3,993 farmers concerned with farmer adaptation of climate risks. The resulting data were subjected to two-step cluster analysis to identify homogenous groups of farmers based on factors related to climate change adaptation. A three-cluster solution was identified wherein farmers were distinguishable on the basis of belief in climate change, desire for financial assistance and advice, social connectedness, information seeking, and adverse farm conditions. The largest group (Cluster 1: 55% was characterized by farmers who recognized being affected by drought and drying and who were actively engaged in adaptive practices, despite the fact that they had little income and poor farm resources. One third of these farmers reported that their health was a barrier to sustained activity in farming. Cluster 2 (26% was characterized by farmers not readily affected by drying, who enjoyed good incomes, good health and better farming conditions. They expressed little desire to adapt. The smallest cluster (Cluster 3: 19% was also characterized by farmers who recognized that they were affected by drying. However, despite a desire to adapt, they had very little means to do so. They reported the poorest natural resources and the poorest health, despite being younger. The findings suggest that it is the intent to adapt, starting from where people are at, which is a more important indicator of the capacity to work towards sustainable practices than assets tests alone.

  7. [Caregiver's health: adaption and validation in a Spanish population of the Experience of Caregiving Inventory (ECI)].

    Science.gov (United States)

    Crespo-Maraver, Mariacruz; Doval, Eduardo; Fernández-Castro, Jordi; Giménez-Salinas, Jordi; Prat, Gemma; Bonet, Pere

    2018-04-04

    To adapt and to validate the Experience of Caregiving Inventory (ECI) in a Spanish population, providing empirical evidence of its internal consistency, internal structure and validity. Psychometric validation of the adapted version of the ECI. One hundred and seventy-two caregivers (69.2% women), mean age 57.51 years (range: 21-89) participated. Demographic and clinical data, standardized measures (ECI, suffering scale of SCL-90-R, Zarit burden scale) were used. The two scales of negative evaluation of the ECI most related to serious mental disorders (disruptive behaviours [DB] and negative symptoms [NS]) and the two scales of positive appreciation (positive personal experiences [PPE], and good aspects of the relationship [GAR]) were analyzed. Exploratory structural equation modelling was used to analyze the internal structure. The relationship between the ECI scales and the SCL-90-R and Zarit scores was also studied. The four-factor model presented a good fit. Cronbach's alpha (DB: 0.873; NS: 0.825; PPE: 0.720; GAR: 0.578) showed a higher homogeneity in the negative scales. The SCL-90-R scores correlated with the negative ECI scales, and none of the ECI scales correlated with the Zarit scale. The Spanish version of the ECI can be considered a valid, reliable, understandable and feasible self-report measure for its administration in the health and community context. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Effective Mitigation and Adaptation Strategies for Public Health Impacts of Heatwaves for Brookline, MA

    Science.gov (United States)

    Jalalzadeh Fard, B.; Hassanzadeh, H.; Bhatia, U.; Ganguly, A. R.

    2016-12-01

    Studies on urban areas show a significant increase in frequency and intensity of heatwaves over the past decades, and predict the same trend for future. Since heatwaves have been responsible for a large number of life losses, urgent adaptation and mitigation strategies are required in the policy and decision making level for a sustainable urban planning. The Sustainability and Data Sciences Laboratory at Northeastern University, under the aegis of Thriving Earth Exchange of AGU, is working with the town of Brookline to understand the potential public health impacts of anticipated heatwaves. We consider the most important social and physical factors to obtain vulnerability and exposure parameters for each census block group of the town. Utilizing remote sensing data, we locate Urban Heat Islands (UHIs) during a recent heatwave event, as the hazard parameter. We then create priority risk map using the risk framework. Our analyses show spatial correlations between the UHIs and social factors such as poverty, and physical factors such as land cover variations. Furthermore, we investigate the future heatwave frequency and intensity increases by analyzing the climate models predictions. For future changes of UHIs, land cover changes are investigated using available predictive data. Also, socioeconomic predictions are carried out to complete the futuristic models of heatwave risks. Considering plausible scenarios for Brookline, we develop different risk maps based on the vulnerability, exposure and hazard parameters. Eventually, we suggest guidelines for Heatwave Action Plans for prioritizing effective mitigation and adaptation strategies in urban planning for the town of Brookline.

  9. French translation and cross-cultural adaptation of The Myotonic Dystrophy Health Index.

    Science.gov (United States)

    Gagnon, Cynthia; Tremblay, Marjolaine; CôTé, Isabelle; Heatwole, Chad

    2018-04-01

    Validation studies of disease-specific instruments for myotonic dystrophy type-1 (DM1) are required prior to their global use in clinical trials involving different cultures and countries. Here we translate and culturally adapt the Myotonic Dystrophy Health Index (MDHI), a disease-specific patient-reported outcome (PRO) measure, for a French DM1 population. Using the International Society for Pharmacoeconomics and Outcomes Research Task Force method for translation and adaptation of PRO questionnaires, we created a French translation of the MDHI. We subsequently tested this instrument in a cohort of French-speaking patients with DM1. The MDHI was forward and back translated and modified by consensus to create the most compatible translation. Cognitive interviews were conducted with 5 patients with DM1 to ensure the usability and understanding of the translation. The French version of the MDHI is an optimal translation of the original instrument that is acceptable to native patients and ready for clinical trial use. Muscle Nerve 57: 686-689, 2018. © 2017 Wiley Periodicals, Inc.

  10. Community-based Participatory Process – Climate Change and Health Adaptation Program for Northern First Nations and Inuit in Canada

    Directory of Open Access Journals (Sweden)

    Diane McClymont Peace

    2012-05-01

    Full Text Available Objectives: Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. Study design: The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Methods: Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Results: Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Conclusions: Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies.

  11. Community-based Participatory Process – Climate Change and Health Adaptation Program for Northern First Nations and Inuit in Canada

    Science.gov (United States)

    Peace, Diane McClymont; Myers, Erin

    2012-01-01

    Objectives Health Canada's Program for Climate Change and Health Adaptation in Northern First Nation and Inuit Communities is unique among Canadian federal programs in that it enables community-based participatory research by northern communities. Study design The program was designed to build capacity by funding communities to conduct their own research in cooperation with Aboriginal associations, academics, and governments; that way, communities could develop health-related adaptation plans and communication materials that would help in adaptation decision-making at the community, regional, national and circumpolar levels with respect to human health and a changing environment. Methods Community visits and workshops were held to familiarize northerners with the impacts of climate change on their health, as well as methods to develop research proposals and budgets to meet program requirements. Results Since the launch of the Climate Change and Health Adaptation Program in 2008, Health Canada has funded 36 community projects across Canada's North that focus on relevant health issues caused by climate change. In addition, the program supported capacity-building workshops for northerners, as well as a Pan-Arctic Results Workshop to bring communities together to showcase the results of their research. Results include: numerous films and photo-voice products that engage youth and elders and are available on the web; community-based ice monitoring, surveillance and communication networks; and information products on land, water and ice safety, drinking water, food security and safety, and traditional medicine. Conclusions Through these efforts, communities have increased their knowledge and understanding of the health effects related to climate change and have begun to develop local adaptation strategies. PMID:22584509