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Complexity Sciences

  • Joachim P. Sturmberg
Chapter

Abstract

Complexity sciences, in plain English, are the sciences of interconnectedness.

The aim of complexity sciences is to understand the many different facets of phenomena. Complexity sciences employs a variety of different methodological approaches to describe and to analyse multifaceted phenomena like health, the economy, or environmental systems.
  • Basically, a system consists of a number of parts that are connected to each other. Systems differ depending on the nature of their connectedness. Simple systems have one-to-one relationships and their behaviour is precisely predictable. Complicated systems have one-to-many relationships with mostly predictable behaviours.

  • This book deals with complex adaptive systems with many-to-many relationships. Their many-to-many relationships make their behaviour emergent, hence their outcomes are unpredictable. Complex adaptive systems have a special characteristic, the members of the system can learn from feedback and experiences. The relationships in complex adaptive systems change constantly allowing the system to evolve over time in light of changing demands. However, a system’s overall behaviour, despite its adaptation to changing circumstances, remains relatively stable within boundaries, but occasionally, its behaviour may change abruptly and dramatically for no apparent reason.

One can compare the behaviour of complex adaptive systems to that of a family; most of the time a family stays together despite ups and downs, but occasionally a family can abruptly break apart to the surprise of its members and its surroundings.
  • Another important characteristic of complex adaptive systems is its nonlinear behaviour to change, i.e. the magnitude of change in one member of the system shows a disproportional change in that of others. As experience shows, small changes in the behaviour of a system member often show dramatic changes in the behaviour of the whole system, whereas a major change in the behaviour of that member typically results in little or no change.

Studying complex adaptive systems aims to understand the relationships and the dynamics between the members of the systems. This understanding allows for better responses when the system as a whole is challenged by constraints and/or unfamiliar challenges.

A special characteristic of social systems is their “goal-delivering” nature. In organisational terms these are codified by their purpose, goals, and values statements.

References

  1. 1.
    Evens H (1972) Mathematical circles squared. Prindle, Weber and Schmidt, BostonGoogle Scholar
  2. 2.
    Cilliers P (2001) Boundaries, hierarchies and networks in complex systems. Int J Innov Manag 5(02):135–147CrossRefGoogle Scholar
  3. 3.
    Box GEP, Draper NR (1987) Empirical model building and response surfaces. Wiley, New YorkGoogle Scholar
  4. 4.
    Mikulecky DC If the whole world is complex - why bother? http://www.people.vcu.edu/~mikuleck/alskuniv.htm
  5. 5.
    Stirzaker R, Biggs H, Roux D, Cilliers P (2010) Requisite simplicities to help negotiate complex problems. Ambio 39(8):600–607CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Kurtz CF, Snowden DJ (2003) The new dynamics of strategy: sense-making in a complex and complicated world. IBM Syst J 42(3):462–483CrossRefGoogle Scholar
  7. 7.
    Cilliers P (1998) Complexity and postmodernism. Understanding complex systems. Routledge, LondonGoogle Scholar
  8. 8.
    The Action to Control Cardiovascular Risk in Diabetes Study Group (2008) Effects of intensive glucose lowering in Type 2 diabetes. N Engl J Med 358(24):2545–2559CrossRefPubMedCentralGoogle Scholar
  9. 9.
    Leyvraz S, Pampallona S, Martinelli G, Ploner F, Perey L, Aversa S et al (2008) A threefold dose intensity treatment with ifosfamide, carboplatin, and etoposide for patients with small cell lung cancer: a randomized trial. J Natl Cancer Inst 100(8):533–541CrossRefPubMedGoogle Scholar
  10. 10.
    Mittra I (2007) The disconnection between tumor response and survival. Nat Clin Pract Oncol 4(4):203CrossRefPubMedGoogle Scholar
  11. 11.
    Blas E, Gilson L, Kelly MP, Labonté R, Lapitan J, Muntaner C et al (2008) Addressing social determinants of health inequities: what can the state and civil society do? Lancet 372(9650):1684–1689CrossRefPubMedGoogle Scholar
  12. 12.
    Hider P (2002) Electronic prescribing: a critical appraisal of the literature. Department of Public Health and General Practice, Christchurch. Christchurch School of Medicine, Contract No.: 2Google Scholar
  13. 13.
    Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U (2008) The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc 15(5):585–600CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Zurn P, Dolea C, Stilwell B (2005) Nurse retention and recruitment: developing a motivated workforce. GenevaGoogle Scholar
  15. 15.
    Ali S (2008) Infectious disease, global cities and complexity. Paper presented at the annual meeting of the American Sociological Association Annual Meeting, Sheraton Boston and the Boston Marriott Copley Place, Boston, MA, Jul 31, 2008 http://www.allacademic.com/meta/p_mla_apa_research_citation/2/3/7/3/0/p237304_index.html Google Scholar
  16. 16.
    Kuhn M, Siciliani L (2008) Upcoding and optimal auditing in health care (or The Economics of DRG Creep): SSRN, CEPR Discussion Paper No. DP6689Google Scholar
  17. 17.
    Grumbach K, Bodenheimer T (2004) Can health care teams improve primary care practice? JAMA291(10):1246–1251Google Scholar
  18. 18.
    Smith RD (2006) Responding to global infectious disease outbreaks: lessons from SARS on the role of risk perception, communication and management. Soc Sci Med 63(12):3113–3123CrossRefPubMedGoogle Scholar
  19. 19.
    Frohlich KL, Potvin L (2008) Transcending the known in public health practice: the inequality paradox: the population approach and vulnerable populations. Am J Public Health 98(2):216–221CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B (2005) Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev (2):CD001271Google Scholar
  21. 21.
    Goldberger A (1996) Non-linear dynamics for clinicians: chaos theory, fractals, and complexity at the bedside. Lancet 347:(9011) 1312–1314CrossRefPubMedGoogle Scholar
  22. 22.
    Stella P, Ellis D, Maser RE, Orchard TJ (2000) Cardiovascular autonomic neuropathy (expiration and inspiration ratio) in type 1 diabetes. Incidence and predictors. J Diabet Complicat 14(1):1–6CrossRefGoogle Scholar
  23. 23.
    Wood LD, Parsons DW, Jones S, Lin J, Sjoblom T, Leary RJ et al (2007) The genomic landscapes of human breast and colorectal cancers. Science 318(5853):1108–1113CrossRefPubMedGoogle Scholar
  24. 24.
    Heng HHQ (2007) Cancer genome sequencing: the challenges ahead. Bioessays 29(8):783–794CrossRefPubMedGoogle Scholar
  25. 25.
    Sutherns R (2004) Adding women’s voices to the call for sustainable rural maternity care. Can J Rural Med 9(4):239–244PubMedGoogle Scholar
  26. 26.
    Treating tobacco use and dependence - a systems approach (2000) A guide for health care administrators, insurers, managed care organizations, and purchasers In: 2000 UPHS, editor. Washington, DC http://www.surgeongeneral.gov/tobacco/systems.htm.
  27. 27.
    Nishida C, Uauy R, Kumanyika S, Shetty P (2004) The joint WHO/FAO expert consultation on diet, nutrition and the prevention of chronic diseases: process, product and policy implications. Public Health Nutr (1A):245–250Google Scholar
  28. 28.
    Heng HHQ (2008) The conflict between complex systems and reductionism. JAMA 300(13):1580–1581CrossRefPubMedGoogle Scholar
  29. 29.
    House of Representatives Standing Committee on Health and Ageing (2006) The blame game. Report on the inquiry into health funding. Commonwealth of Australia, Canberra, Nov 2006Google Scholar
  30. 30.
    Plamping D (1998) Looking forward: change and resistance to change in the NHS. Br Med J 317(7150):69–71CrossRefGoogle Scholar
  31. 31.
    Snyderman R, Weil AT (2002) Integrative medicine: bringing medicine back to its roots. Arch Intern Med 162(4):395–397CrossRefPubMedGoogle Scholar
  32. 32.
    Suchman AL (2006) A new theoretical foundation for relationship-centered care. Complex l. J Gen Intern Med 21(Suppl 1):S40–S4CrossRefGoogle Scholar
  33. 33.
    Biswas R, Martin CM, Sturmberg JS, Mukherji KJ, Lee EWH, Umakanth S et al (2009) Social cognitive ontology and user driven health care. In: Hatzipanagos S, Warburton S (eds) Handbook of research on social software and developing community ontologies. IGI Global, London, pp 67–85CrossRefGoogle Scholar
  34. 34.
    Martin CM, Peterson C, Robinson R, Sturmberg JP (2009) Care for chronic illness in Australian general practice - focus groups of chronic disease self-help groups over 10 years. Implications for chronic care systems reforms. Asia Pac Fam Med 8(1):1Google Scholar
  35. 35.
    Eysenbach G (2008) Medicine 2.0: social networking, collaboration, participation, apomediation, and openness. J Med Internet Res 10(3):e22. Available at: http://www.jmir.org/2008/3/e22/
  36. 36.
    Chen DT, Werhane PH, Mills AE (2007) Role of organization ethics in critical care medicine. Critical care medicine organizational and management ethics in the intensive care unit. Crit Care Med 35(2):S11–S17CrossRefPubMedGoogle Scholar
  37. 37.
    Atun RA, Kyratsis I, Jelic G, Rados-Malicbegovic D, Gurol-Urganci I (2007) Diffusion of complex health innovations-implementation of primary health care reforms in Bosnia and Herzegovina. Health Policy Plan 22(1):28–39CrossRefPubMedGoogle Scholar
  38. 38.
    Sturmberg JP, O’Halloran DM, Martin CM (2010) People at the centre of complex adaptive health systems reform. Med J Aust 193(8):474–478PubMedGoogle Scholar
  39. 39.
    Sturmberg JP, Martin CM (2010) The dynamics of health care reform - learning from a complex adaptive systems theoretical perspective. Nonlinear Dyn Psych Life Sci 14(4):525–540Google Scholar
  40. 40.
    Martin CM, Felix Bortolotti M, Strasser S (2010) W(h)ither complexity? The emperor’s new toolkit? or Elucidating the evolution of health systems knowledge? J Eval Clin Pract 16(3):415–420CrossRefPubMedGoogle Scholar
  41. 41.
    Paina L, Peters DH (2012) Understanding pathways for scaling up health services through the lens of complex adaptive systems. Health Policy Plan 27(5):365–373CrossRefPubMedGoogle Scholar
  42. 42.
    Sturmberg JP, O’Halloran DM, Martin CM (2012) Understanding health system reform - a complex adaptive systems perspective. J Eval Clin Pract 8(1):202–208CrossRefGoogle Scholar
  43. 43.
    Kottke TE. Simple Rules That Reduce Hospital Readmission. The Permanente Journal. 2013; 17(3):91–93CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Marchal B, Van Belle S, De Brouwere V, Witter S (2013) Studying complex interventions: reflections from the FEMHealth project on evaluating fee exemption policies in West Africa and Morocco. BMC Health Serv Res 13(1):469CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Swanson R, Atun R, Best A, Betigeri A, de Campos F, Chunharas S et al (2015) Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions. Glob Health 11(1):5CrossRefGoogle Scholar
  46. 46.
    Shigayeva A, Coker RJ (2015) Communicable disease control programmes and health systems: an analytical approach to sustainability. Health Policy Plan 30(3):368–385CrossRefPubMedGoogle Scholar
  47. 47.
    Plsek P (2001) Appendix B: redesigning health care with insights from the science of complex adaptive systems. In: Committee on quality of health care in America - Institute of Medicine, editor. Crossing the quality chasm: a new health system for the 21st century. National Academy Press, Washington DC, pp 309–322Google Scholar
  48. 48.
    Glouberman S, Zimmerman B (2002) Complicated and complex systems: what would successful reform of medicare look like? Ottawa: Discussion Paper No 8. Commission on the Future of Health Care in Canada, July 2002Google Scholar
  49. 49.
    Begun JW, Zimmerman B, Dooley K (2003) Health care organizations as complex adaptive systems. In: Mick SM, Wyttenbach M, (eds) Advances in health care organization theory. Jossey-Bass, San Francisco, pp 253–288Google Scholar
  50. 50.
    Gottlieb K (2013) The Nuka system of Care: improving health through ownership and relationships. Int J Circumpolar Health 72:doi:10.3402/ijch.v72i0.21118Google Scholar
  51. 51.
    Collins B (2015) Intentional whole health system redesign. Southcentral Foundation’s ‘Nuka’ system of care. King’s Fund, LondonGoogle Scholar
  52. 52.
    Kaplan RS, Porter ME (2011) How to solve the cost crisis in health care. Harv Bus Rev 89(9):47–64Google Scholar
  53. 53.
    Freedman LP, Schaaf M (2013) Act global, but think local: accountability at the frontlines. Reprod Health Matters 21(42):103–112CrossRefPubMedGoogle Scholar
  54. 54.
    Bloom G, Wolcott S (2013) Building institutions for health and health systems in contexts of rapid change. Soc Sci Med 96:216–222CrossRefPubMedGoogle Scholar
  55. 55.
    Gilson L, Elloker S, Olckers P, Lehmann U (2014) Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care. Health Res Policy Syst 12(1):30CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Seelos C, Mair J (2012) Innovation is not the holy grail. Stanf Soc Innov Rev 10(4):44–49Google Scholar
  57. 57.
    Cilliers P (2013) Understanding complex systems. In: Sturmberg JP, Martin CM (eds) Handbook of systems and complexity in health. Springer, New York, pp 27–38CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Joachim P. Sturmberg
    • 1
  1. 1.University of NewcastleWamberalAustralia

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