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جستجوی مقالات مرتبط با کلیدواژه

complexity theory

در نشریات گروه پزشکی
تکرار جستجوی کلیدواژه complexity theory در مقالات مجلات علمی
  • Vajihe Armanmehr, Ahmadreza Asgharpourmasouleh*
    Background

    COVID-19 has rapidly brought many changes to people’s lives. The current research aimed to explore how these changes affected the social resilience of the residents in a local neighborhood. 

    Methods

      The present case study was conducted in the spring of 2021, using in-depth interviews and field observations in the Tawheed neighborhood of Gonabad City, Iran. Purposive sampling was used to select the interviewees with maximum variation. Interviews continued until data saturation was reached, which occurred after the 17th participant was interviewed. To analyze the data, a directed qualitative content analysis and the complexity approach proposed by David Byrne and Gil Callahan were utilized. 

    Results

    The local residents’ social resilience during the pandemic was explained in light of the complexity theory. A total number of four categories and 13 sub-categories were extracted: uncertainty of the disease (uncertainty of information about the disease, no common understanding of the disease, no common norms of health behaviors, and unknown aspects of the disease), features of connectivity and network of social relationships (perceived common benefits, family cohesion, access to online social networks), initial states and availability of sources (unstable living conditions, poor health facilities, and structure of the neighborhood), interaction of micro- and macro-factors (trust in healthcare systems and leaders, and financial rules and policies). 

    Conclusion

      The social resilience of the residents in the local neighborhood during the pandemic was influenced by many factors, primarily related to their initial conditions. To improve social resilience, it seems necessary to carry out effective interventions based on local and indigenous capacities.

    Keywords: Social Resilience, Complexity Theory, COVID-19
  • Giulia Loffreda*, Stella Arakelyan, Ibrahim Bou-Orm, Hampus Holmer, Luke N. Allen, Sophie Witter, Alastair Ager, Karin Diaconu

    Background :

    Improving the adoption and implementation of policies to curb non-communicable diseases (NCDs) is a major challenge for better global health. The adoption and implementation of such policies remain deficient in various contexts, with limited insights into the facilitating and inhibiting factors. These policies have traditionally been treated as technical solutions, neglecting the critical influence of political economy dynamics. Moreover, the complex nature of these interventions is often not adequately incorporated into evidence for policy-makers. This study aims to systematically review and evaluate the factors affecting NCD policy adoption and implementation.

    Methods :

    We conducted a complex systematic review of articles discussing the adoption and implementation of World Health Organization’s (WHO’s) “best buys” NCD policies. We identified political economy factors and constructed a causal loop diagram (CLD) program theory to elucidate the interplay between factors influencing NCD policy adoption and implementation. A total of 157 papers met the inclusion criteria.

    Results :

    Our CLD highlights a central feedback loop encompassing three vital variables: (1) the ability to define, (re)shape, and pass appropriate policy into law; (2) the ability to implement the policy (linked to the enforceability of the policy and to addressing NCD local burden); and (3) ability to monitor progress, evaluate and correct the course. Insufficient context-specific data impedes the formulation and enactment of suitable policies, particularly in areas facing multiple disease burdens. Multisectoral collaboration plays a pivotal role in both policy adoption and implementation. Effective monitoring and accountability systems significantly impact policy implementation. The commercial determinants of health (CDoH) serve as a major barrier to defining, adopting, and implementing tobacco, alcohol, and diet-related policies.

    Conclusion :

    To advance global efforts, we recommend focusing on the development of robust accountability, monitoring, and evaluation systems, ensuring transparency in private sector engagement, supporting context-specific data collection, and effectively managing the CDoH. A system thinking approach can enhance the implementation of complex public health interventions.

    Keywords: Best Buys, NCD Policies, Interventions, Complexity Theory, Implementation Research
  • Lisa M. Pfadenhauer *
    In implementation science, implementation has been widely theorized and assessed. Context, on the other hand, usually played a minor role in the field and was usually conceptualized in a rather positivist way. Despite some promising efforts, there is a strong need to continue building theory on context and operationalizing the concept in implementation practice. I argue for the benefit of integrating complexity theory into our understanding of context in order to further our thinking about context and intervention as a system. This should be reflected by the way in which we build theory as well as apply this theory by employing methods that adequately account for complexity in systems.
    Keywords: Context, Implementation Science, Complexity Theory
  • Bruno Gutierrez Quiceno, Luis Alejandro Gomez Barrera
    Introduction

    The purpose of this review is to establish how the theory of complexity is understood and instituted in dentistry.

    Methods

    The stomatognathic system can be understood as a dynamic, complex, and adaptive system. Each pathological or physiological condition of this system involves physical, chemical, and biological processes in constant, open, and changing interactions with social, emotional, nutritional, political, and economic processes. Against this background, specifically, the following research questions were posed: How do researchers use complexity science in dentistry? How is complexity science described in dentistry articles?.

    Results

    A brief literature search was implemented, which identified 11 PubMed articles as well as two from the Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) database and one from the Cochrane Library for a full text review. Studies on complexity in the dental sciences are mostly presented in the form of critical opinion articles, which corresponded to 50% of the reviewed articles. In dentistry, complexity is understood as less of a theory and more as a line of thinking regarding procedures that can become complex at any given time.

    Conclusion

    This article shows that there are great difficulties in integrating complexity and understanding it in dentistry. There are many aspects from complexity science that still need to be understood in oral health.

    Keywords: Complexity, complexity science, complexity theory, complexity thinking, dentistry, oral health, public health dentistry
  • Joann E. Kirchner *, Sara J. Landes, Aaron E. Eagan
    The re-conceptualization of knowledge translation (KT) in Kitson and colleagues’ manuscript “Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation” is an advancement in how one can incorporate implementation into the KT process. Kitson notes that “the challenge is to explain how it might help in the healthcare policy, practice, and research communities.” We propose that these concepts are well presented when considering highly-partnered research that includes all sectors. In this manuscript we provide an example of highly-partnered KT effort framed within the KT Complexity Network Theory. This effort is described by identifying the activities and sectors involved.
    Keywords: Knowledge Translation, Complexity Theory, Implementation Science, Healthcare, Partnered Research
  • Tracey Bucknall *, Danielle Hitch
    A more sophisticated understanding of the unpredictable, disorderly and unstable aspects of healthcare organisations is developing in the knowledge translation (KT) literature. In an article published in this journal, Kitson et al introduced a new model for KT in healthcare based on complexity theory. The Knowledge Translation Complexity Network Model (KTCNM) provides a fresh perspective by making the complexity inherent in complex systems overt. The model encourages a whole system view and focuses on the interdependent relationships between actions, interactions and actors. Taking a systems approach assists our understanding of the connections, communication and collaboration necessary to promote knowledge mobilisation and facilitate the adoption of change. With further development, this could enable the targeting of more effective strategies across the various stakeholders and levels of service, fostering redesign and innovation.
    Keywords: Complexity Theory, Complex Adaptive Systems, Clinical Decision Making, Systems Network Analysis, Integrated Knowledge Translation
  • Jacqueline Chandler *
    This commentary addresses two points raised by Kitson and colleagues’ article. First, increasing interest in applying the Complexity Theory lens in healthcare needs further systematic work to create some commonality between concepts used. Second, our need to adopt a better understanding of how these systems organise so we can change the systems overall behaviour, creates a paradox. We seek to manipulate systems that self-organise and follow their own internal rules. Although, our actions may impact and indeed meet some of our objectives, system behaviour will always emerge with unpredictable consequences. Likewise, outcomes at the aggregated level of the system never reaches an optimal point as defined by the ‘external controller.’ Kitson and colleagues’ theoretical model may struggle to resolve the paradox of gaining control over the multiple knowledge translation (KT) systems covered by the model, because theoretically these systems retain control under the principle of self-organisation. That is not to suggest that individual agents cannot influence system dynamics just that the desired outcome cannot be guaranteed. Indeed, for systems to change they will need strong incentives.
    Keywords: Complex Adaptive Systems, Complexity Theory, Knowledge Translation
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