scholarly journals A Transdisciplinary Complex Adaptive Systems (T-CAS) Approach to Developing a National School-Based Culture of Prevention for Health Improvement: the School Health Research Network (SHRN) in Wales

2018 ◽  
Vol 22 (1) ◽  
pp. 50-61 ◽  
Author(s):  
Simon Murphy ◽  
Hannah Littlecott ◽  
Gillian Hewitt ◽  
Sarah MacDonald ◽  
Joan Roberts ◽  
...  

AbstractThe paper reflects on a transdisciplinary complex adaptive systems (T-CAS) approach to the development of a school health research network (SHRN) in Wales for a national culture of prevention for health improvement in schools. A T-CAS approach focuses on key stages and activities within a continuous network cycle to facilitate systems level change. The theory highlights the importance of establishing transdisciplinary strategic partnerships to identify and develop opportunities for system reorientation. Investment in and the linking of resources develops the capacity for key social agents to take advantage of disruption points in the re-orientated system, and engagement activities develop the network to facilitate new social interactions and opportunities for transdisciplinary activities. A focus on transdisciplinary action research to co-produce interventions, generate research evidence and inform policy and practice is shown to play an important part in developing new normative processes that act to self-regulate the emerging system. Finally, the provision of reciprocal network benefits provides critical feedback loops that stabilise the emerging adaptive system and promote the network cycle. SHRN is shown to have embedded itself in the system by securing sustainability funding from health and education, a key role in national and regional planning and recruiting every eligible school to the network. It has begun to reorient the system to one of evidence generation (56 research studies co-produced) and opportunities for data-led practice at multiple levels. Further capacity development will be required to capitalise on these. The advantages of a complex systems approach to address barriers to change and the transferability of a T-CAS network approach across settings and cultures are highlighted.

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Andrew Mckenzie ◽  
Emmanuel Sokpo ◽  
Alastair Ager

The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels of government: federal, state and local. The paper suggests that understandings informed by complexity theory and complex adaptive systems have been helpful in shaping policy and programme design across these levels. To illustrate this, three initiatives are explored: <em>Bringing PHC under one roof</em>, enhancing access to funding provided by the Global Alliance for Vaccines and Immunization, and strengthening the midwives service scheme. These initiatives have demonstrated how concepts and experience developed at subnational level can influence national policy and practice, and how work at subnational levels can add value to nationally conceived and nationally driven plans for PHC.


Author(s):  
Marta Berbés-Blázquez ◽  
Nancy B. Grimm ◽  
Elizabeth M. Cook ◽  
David M. Iwaniec ◽  
Tischa A. Muñoz-Erickson ◽  
...  

AbstractIn the absence of strong international agreements, many municipal governments are leading efforts to build resilience to climate change in general and to extreme weather events in particular. However, it is notoriously difficult to guide and activate processes of change in complex adaptive systems such as cities. Participatory scenario planning with city professionals and members of civil society provides an opportunity to coproduce positive visions of the future. Yet, not all visions are created equal. In this chapter, we introduce the Resilience, Equity, and Sustainability Qualitative (RESQ) assessment tool that we have applied to compare positive scenario visions for cities in the USA and Latin America. We use the tool to examine the visions of the two desert cities in the UrbanResilience to Extreme Events Sustainability Research Network (UREx SRN), which are Hermosillo (Mexico) and Phoenix (United States).


2021 ◽  
pp. 1-13
Author(s):  
Robert Schneider ◽  
Laurie Dupont-Leduc ◽  
Vincent Gauthray-Guyénet ◽  
Nicolas Cattaneo ◽  
LaraMelo ◽  
...  

The increase in intensity of the harvesting of eastern Quebec’s forests has resulted in profound compositional changes at the stand level. The composition and structure of presettlement stands provide key benchmarks when implementing ecosystem-based management (EBM). A core principle of EBM is the emulation of natural disturbances, and it is hypothesized that forest resilience will be maintained. Managers have thus adapted some of their silvicultural activities to better mimic the main natural disturbances in eastern Quebec. These adaptations include using variable retention harvesting systems instead of clear-cuts and converting even-aged stands. Nevertheless, other close-to-nature silvicultural practices must be developed, as gaps between managed and unmanaged stands persist. Most importantly, there is a need to consider global change within EBM, which could be accomplished by prioritizing forest functions rather than composition or structure when establishing silvicultural objectives. Elements of the complex adaptive systems approach to increasing forest resilience can be incorporated into the larger-scale EBM approach. This could be done by considering the functional complementarity of species, forest function, and stand structure in forest management planning. These efforts must not be constrained, however, to allowable annual cut calculations, as these are not sufficiently sensitive to compare different management scenarios.


Author(s):  
Sarah Munro ◽  
Jude Kornelsen ◽  
Elizabeth Wilcox ◽  
Sarah Kaufman ◽  
Nick Bansback ◽  
...  

Background:Despite the suggested benefits of shared decision-making (SDM), its implementation in policy and practice has been slow and inconsistent. Use of complex adaptive systems (CAS) theory may provide understanding of how healthcare system factors influence implementation of SDM. Methods:Using the example of choice of mode of birth after a previous caesarean section, in-depth, semi-structured interviews were conducted with patients, providers, and decision makers in British Columbia, Canada, to explore the system characteristics and processes that influence implementation of SDM. Implementation and knowledge translation principles guided study design, and constructionist grounded theory informed iterative data collection and analysis. Findings:Analysis of interviews (n=58) revealed that patients formed early preferences for mode of delivery (after the primary caesarean) through careful deliberation of social risks and benefits. Physicians acted as information providers of clinical risks and benefits, while decision makers revealed concerns related to liability and patient safety. These concerns stemmed from perceptions of limited access to surgical resources, which had resulted from budget constraints. Discussion and conclusions:To facilitate the effective implementation of SDM in policy and practice it may be critical to initiate SDM once patients become aware of their healthcare options, assist patients to address the social risks that influence their preferences, manage perceptions of risk related to patient safety and litigation among physicians, and enhance access to healthcare resources.


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