• Health is a system state unique to each and every individual arising from the network dynamics of his internal physiological function, external physical and social environments and the ways of making sense of one’s experiences. These characteristics have also been observed by West who showed that organisms exhibit remarkably simple and systemic scaling laws that describe their complex structures and physiological functions across multiple physical and temporal scales. This limits the rate with which resources can be provided to sustain cellular and organ function . George Ellis emphasized that “he basis of complexity consist of modular hierarchical structures, leading to emergent levels of structure and function based on lower level network .” In other words, top-down actions provide contextual constraints that limit the possible bottom-up actions.
In addition, the socioeconomic context has epigenetic effects that have an impact on the health of the next generations and is most detrimental for the most vulnerable portion of the population (113–116). • First, the health system design, in educational, organizational as well as cultural terms, persists as an assembly of dependent units focused in a reductionist way on delivering care for acute problems or single diseases, unable to deal with complexities arising from the chronic sequelae of multiple co-occurring conditions. Recent evidence indicates that common and complex disease is rarely caused by specific gene mutations but rather by genome instability that manifest at the level of DNA methylation and changes in gene expression . The external environmental as well as internal physiological perturbations produced by stochastic or random genomic changes , rather than punctuated common genetic DNA mutations, are responsible for most diseases and their intra-person genome heterogeneity . Moreover, different cells may contain unique acquired genetic features in DNA sequence, DNA methylation, and protein expression .
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Discovering incongruences between perceptions (i.e., mental models) and the physical reality necessitates the search for mental models that better reflect the realities of the real world (8–14). In this paper we explore health, and by implication disease, as an emergent state. Health, as an emergent state, is the result of the interplay amongst environmental, socio-cultural and economic-political contexts and internal biological potentials, each of which is organized in complex adaptive networks. This understanding of health has implications for health care delivery and health system redesigns.
- In addition, there is cross-talk between the immune system and the brain; peripheral cytokines can stimulate the HPA axis , and induce illness behavior via indirect [e.g., the vagus nerve ] or direct (e.g., crossing leaky portions of the blood brain barrier) pathways .
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- Thus, during recovery, a well-regulated body critically restores the balance between the neuroendocrine and immune systems.
A disease is a disorder that affects health by affecting an organism’s body, organs, tissues or cells. • HRV monitors are becoming readily available and may provide a simple objective measure to quantify the overall physiological state of a person’s system function, however, its validity in non-critical clinical practice will require further study. • The etiology of both disease states and illness experiences can be best explained and visualized with the component cause model as developed by Rothman . • Health and disease causality can be understood best in an adaptive system dynamics framework and in terms of the life of the human organism and the type of life a human organism is living .
If an individual perceives greater coping ability (e.g., more resources or skills) than the situation demands, the body will likely mount an appropriate physiological response, meaning activation with quick recovery. However, if an individual decides their ability to cope whether conscious or subconscious is smaller than the demands of the situation, the interpretation leads to a loss of control—the importance of which has been highlighted by Antonovsky —or threat to self. This perceived threat may cause excessive activation of the stress systems and exaggerated parasympathetic withdrawal. Mounting evidence indicates the prevailing linear reductive notion that diseases are caused by a single identifiable cause is no longer sustainable .
Consequences for Health Care1 Delivery and Health Care Service Design
Readers interested in the historical developments of systems and complexity sciences should refer to the historical texts of Ashby, von Bertalanffy, Bak, Capra, Gell-Mann, Hollands, Jansh, Kauffman and Prigogine and Stengers. Networks/Network Sciences–study of complex networks of any kind, agents/actors are represented as nodes, their links as edges, network sciences produce predictive models of the behavior of complex networks. See our editorial guidelines for everything you need to know about Frontiers’ peer review process. Peer review Our efficient and rigorous peer review means you’ll get a decision on your manuscript in just 77 days. Publishing fees Article processing charges apply to articles that are accepted for publication by our external editors, following rigorous peer review.
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When it comes to the written reflective element, proper communication with the supervisors as the project progresses is of great benefit. The programme is also available for intermittent learners, this differs from the part-time structure as students have up to 6 years to complete their MSc. Further, there is no assumption of sequential study, students inform the programme teams of the courses they wish to study, and enrolment is made following this instruction.
The programme draws upon the parallels that exist between these diseases, learning from the challenges that exist and aiming to connect individuals to lay the foundations for a global community of practice. Our aim is to provide advanced qualifications for biomedical, medical, public health, and veterinary personnel. The course is designed to instruct students in the practice of formulating and implementing strategies and programmes aimed at renewing and strengthening scientific knowledge xpmutations.org development and building human capital. In conclusion, this paper attempted a synthesis of facts and theories about health and disease that result in the four observable health states. It led to the insight that the effective care of patients’ illnesses requires a strategy that combines person-centeredness with the scientific approach of managing the molecular network physiology, which together underlie the emergence of subjective health experiences and objective disease formation.