https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:35919 Wed 29 Jan 2020 13:18:20 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52713 Wed 28 Feb 2024 16:29:49 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47736 Wed 25 Jan 2023 15:07:51 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:55324 Wed 15 May 2024 15:39:44 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49511 Wed 13 Mar 2024 09:24:26 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:55104 Wed 10 Apr 2024 08:51:35 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30976 Wed 06 Apr 2022 14:00:21 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:50164 Wed 05 Jul 2023 16:03:32 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49761 Tue 30 May 2023 20:16:33 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:55704 Tue 18 Jun 2024 12:47:53 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:38998 Tue 05 Apr 2022 15:19:29 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52126 Thu 28 Sep 2023 15:11:11 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:25646 learning by dividing) is no longer useful, the challenge for the future is to understand the big picture (learning by connecting). Diagnostic categorization needs to embrace a meta-learning approach open to human variability.]]> Thu 21 Oct 2021 12:53:18 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30974 Thu 17 Mar 2022 14:37:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32648 needs of patients, providers and communities, and ultimately results in declining effectiveness and efficiency of the health care system as well as the health of the wider community. A needs-focused complex-adaptive health system can be represented by the 'healthcare vortex' model; how to build a needs-focused complex-adaptive health system is illustrated by Eastern Deanery AIDS Relief Program approaches in the poor neighbourhoods of Nairobi, Kenya. Findings and conclusions: A small group of nurses and community health workers focused on the care of terminally ill HIV/AIDS patients. This work identified additional problems: tuberculosis (TB) was underdiagnosed and undertreated, a local TB-technician was trained to run a local lab, a courier services helped to reach all at need, collaboration with the Ministry of Health established local TB and HIV treatment programmes and philanthropists helped to supplement treatment with nutrition support. Maternal-to-child HIV-prevention and adolescent counselling services addressed additional needs. The 'theory of the healthcare vortex' indeed matches the 'empery of the real world experiences'. Locally developed and delivered adaptive, people-centred health systems, a bottom-up community and provider initiated approach, deliver highly effective and sustainable health care despite significant resource constraints.]]> Thu 14 Apr 2022 11:04:06 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:46825 Thu 01 Dec 2022 11:01:07 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7567 Sat 24 Mar 2018 08:42:03 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7885 Sat 24 Mar 2018 08:41:36 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:8370 Sat 24 Mar 2018 08:39:46 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7468 Sat 24 Mar 2018 08:38:48 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7516 Sat 24 Mar 2018 08:38:30 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7021 Sat 24 Mar 2018 08:37:56 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7004 Sat 24 Mar 2018 08:37:50 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:8016 Sat 24 Mar 2018 08:36:50 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:13245 Sat 24 Mar 2018 08:16:00 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11094 Sat 24 Mar 2018 08:13:24 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11091 Sat 24 Mar 2018 08:12:04 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11059 Sat 24 Mar 2018 08:10:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19540 absolute risk, its reciprocal, numbers needed to treat and its inverse, index of therapeutic impotence, as well as seeking out the effect size of an intervention rather than blindly accepting P-values; three, there is an urgent need to accurately present the known in comprehensible ways through the use of visual tools; and four, there is a need to overcome the perception, that errors of commission are less troublesome than errors of omission as neither's consequences are predictable.]]> Sat 24 Mar 2018 08:02:05 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:17342 Sat 24 Mar 2018 08:01:42 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20476 Sat 24 Mar 2018 07:59:02 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19861 Sat 24 Mar 2018 07:57:04 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:18577 Sat 24 Mar 2018 07:50:18 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5153 Sat 24 Mar 2018 07:49:42 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5416 Sat 24 Mar 2018 07:48:17 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:5404 Sat 24 Mar 2018 07:43:56 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:27027 Sat 24 Mar 2018 07:30:15 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:4760 Sat 24 Mar 2018 07:21:08 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:35537 resilire, means “bouncing back”—should bouncing back be understood literally or rather metaphorically in the context of health, illness, dis‐ease, and disease? This essay examines ecological, physiological, personal, and health system perspectives inherent in the concept of resilience. It emerges that regardless of the level of aggregation, resilience is a systems property—it is as much a property of each of the subsystems of network physiology, the person, and the health care delivery system as it is a property of the health system as a whole. Given the interdependencies between people, their internal and external environments, and the health service system, strengthening resilience, ie, the ability to positively adapt to challenges and changing circumstances, will require a broad‐based public discourse: “How can we strengthen resilience and health for the benefit of people and society at large”.]]> Mon 26 Aug 2019 12:33:10 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:53901 Mon 22 Jan 2024 15:03:36 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:18699 Mon 20 Jul 2015 17:48:14 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49436 Mon 15 May 2023 13:51:13 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:55081 Mon 08 Apr 2024 14:09:44 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32647 Mon 02 Jul 2018 16:18:14 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32646 within an individual in his or her socio-cultural environment. Networks include genomic, metabolomic, proteomic, neuroendocrine, immune and mitochondrial bioenergetic elements, as well as social, environmental and health care networks. Stress systems and other physiological mechanisms create feedback loops that integrate and regulate internal networks within the individual. Minor (e.g. daily hassles) and major (e.g. trauma) stressful life experiences perturb internal and social networks resulting in physiological instability with changes ranging from improved resilience to unhealthy adaptation and 'clinical disease'. Understanding 'multimorbidity' as a complex adaptive systems response to biobehavioural and socio-environmental networks is essential. Thus, designing integrative care delivery approaches that more adequately address the underlying disease processes as the manifestation of a state of physiological dysregulation is essential. This framework can shape care delivery approaches to meet the individual's care needs in the context of his or her underlying illness experience. It recognizes 'multimorbidity' and its symptoms as the end product of complex physiological processes, namely, stress activation and mitochondrial energetics, and suggests new opportunities for treatment and prevention. The future of 'multimorbidity' management might become much more discerning by combining the balancing of physiological dysregulation with targeted personalized biotechnology interventions such as small molecule therapeutics targeting specific cellular components of the stress response, with community-embedded interventions that involve addressing psycho-socio-cultural impediments that would aim to strengthen personal/social resilience and enhance social capital.]]> Mon 02 Jul 2018 16:18:12 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:39985 Fri 22 Jul 2022 13:00:18 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:55341 Fri 17 May 2024 10:35:34 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:38935 emergence of a coronavirus (SARS-CoV-2) with novel characteristics that made it highly infectious and particularly dangerous for an older age group and people with multiple morbidities brought our complex adaptive system (CAS) “society”—the economy, health systems, and individuals—to a virtual standstill. The COVID-19 pandemic—caused by SARS-Co-2—is a typical wicked problem¹—we did not see it coming, we experience its effects, and it challenges our entrained ways of thinking and acting. In our view, it is a classic example that demonstrates how suddenly changing dynamics can destabilize a system and tip it into an unstable state. COVID-19—rather than something else—turned out to be what we colloquially call the last straw that broke the camel's back or, put in system dynamics terms, what pushed our societal systems over a tipping point. When a system suddenly tips over, the linkages between most of its agents break, and a chaotic situation ensues. Chaotic states entail a high degree of uncertainty, a state in which previously proven interventions no longer maintain the status quo. The uncertainties triggered by COVID-19 have not only shown the fragility of health and national systems but also highlighted the intrinsic and tacit dynamics underpinning them. Most notable are the markedly different responses at the policy and community level. China drastically clamped down on all societal activities and rapidly built large new hospitals to deal with those fallen ill. Iceland rapidly tested every potential case. Sweden implemented limited social distancing measures. Italy hospitalized many mild cases in an environment of limited hospital resources, and the United States, for several weeks, denied that there is a significant problem. Each of these approaches has its own dynamics affecting individuals, communities, health systems, the economy, and the nation as a whole—new patterns emerge that become understandable with increasing knowledge (Figure 1). However, the long-term outcomes and effects on the system as a whole will only become evident over the next months and years.]]> Fri 11 Mar 2022 12:03:17 AEDT ]]>