Quantifying plasticity: A network-based framework linking structure to dynamical regimes.

Corrigendum to 'Complexity Science in Domestic Abuse Literature: A Systematic Scoping Review'.

Mapping interrelated factors in Health in All Policies implementation in local governments: A complexity-informed review.

BackgroundAround 40% of mortality after injuries is avoidable with access to quality care. Investments in interventions which maximise the number of injured persons who access and receive quality care are paramount, especially in low-resourced settings. Selecting such interventions within complex adaptive health systems is challenging due to the multiple interactions within these systems.MethodsWe created a conceptual map, or causal loop diagram (CLD), representing the health system for injury care, focused on challenges to improving patient outcomes in low- or middle-income countries (LMICs). We used the stages of seeking, reaching, receiving and remaining in care as the care pathway framework to conceptualise the diagram. Based on expert opinion and literature searches, we elicited micro (patient and their family), meso (health service) and macro (country context) factors which affect access to quality care at each stage of the care pathway and mapped interactions between them. Factors and their interactions were adjusted during a workshop with external experts. A CLD was created using Vensim to show relationships between all factors at all stages of the care pathway. Feedback loops within the CLD which are either reinforcing (perpetuating positive or negative change) or balancing (limiting change) were elicited. Leverage points were identified as factors which are present in multiple causal loops and are potential intervention points for maximal change.ResultsWe initially identified 41 factors affecting stage 1, 13 affecting stage 2, 51 affecting stage 3 and 49 affecting stage 4. Consolidating factors of a similar theme gave 45 unique factors for the overarching model; 13 micro, 20 meso and 12 macro. We constructed two CLDs—one for the overarching health system and the other focused on healthcare services at facilities. The health service-specific map contained 22 meso factors. We identified 928 reinforcing or balancing causal loops acting within the health system for injury care affecting health outcomes. Factors acting as leverage points involved in the largest number of feedback loops relate to trust in or perceptions of the health system (748 loops and 694 loops, respectively) and willingness to seek care (636 loops). The health service-focused CLD identified funding and the provision of quality care as the main leverage points (112 loops each).DiscussionOur work, using injury care as an exemplar, moves beyond understanding the impact of factors on patient outcomes in silos. Rather, in considering comprehensive connections between all factors on outcomes, we show interactions which could lead to unintended consequences and rapidly worsen or improve health outcomes. Our identification of trust and willingness to seek care as key leverage points suggests these should be focal points for research and investment.

A complexity-science framework for studying flow: using media to probe brain-phenomenology dynamics.

This conceptual paper extends the debate about sustainability and sport management by transcending the dominant natural environmental perspective and offering a systems approach. Addresses the question, ‘Is sustainability in sport management possible?’ The nature of sustainability in sport management is discussed in the context of the tensions between the current growth model of sport, sport management research and teaching, and the sustainability imperative. Sustainability in sport management is concerned with a composite problem, and its goal is to understand and shape the interactions between complex adaptive natural systems and sport organizations as soft socio-economic entities at individual, organizational, and societal levels. A key feature that distinguishes sustainability in sport management from its current mainstream understanding and practices based on the ideology of growth ought to be its explicit prioritization of all types of sport participants as citizens, as opposed to treating them as consumers. At present, sustainability in sport management remains an impossibility.

Existing research focuses on data-driven algorithm optimization but overlooks the embodied nature of supply chains as physical and digital integrated systems, leading to a disconnect between AI and physical collaboration. This study introduces embodied intelligence into supply chain management, transcending the traditional paradigm to propose an adaptive collaboration framework through embodied perception, contextual reasoning, and physical execution. It deconstructs the core of supply chain embodied intelligence, revealing issues such as fragmented perception and delayed feedback. Based on embodied cognition and complex adaptive systems theory, a four-layer architecture with embodied perception, contextual reasoning, physical execution, and closed-loop feedback is constructed, clarifying its mechanisms. Future directions in theory, technology, and practice are outlined. This work deepens the integration of embodied intelligence with supply chains, bridges the digital and physical divide, and advances supply chain management toward an embodied adaptive paradigm for next-generation intelligent systems.

Rape trauma syndrome (RTS) is a phenomenon that refers to a recognizable pattern of psychological, physical, cognitive, and relational responses following a sexual assault. To reassess the evidence base for RTS as a valid nursing diagnosis and to offer a conceptual-theoretical-empirical (C-T-E) structure for RTS based on the Roy Adaptation Model (RAM). A scoping review of the literature, following JBI guidelines, was conducted by two reviewers in databases and gray literature. Conflicts were resolved by a third reviewer. Studies published between 1974 and 2024 involving individuals with a nursing diagnosis of "rape trauma syndrome" treated in healthcare settings were included. The analysis of the 34 articles, guided by RAM, revealed that the person who experienced rape needs to be understood as a holistic, dynamic, and complex adaptive system. RTS is a phenomenon of ineffective adaptation to rape trauma that emerges from the person's interaction and contextual environmental stimuli, such as the pressure of secrecy after rape, the circumstances of the rape, and verbal exposure of rape. Nurses can identify RTS through the adaptive modes, focusing on physical trauma, sleep pattern disturbances and nightmares, self-blame, impaired self-image, loss of interest in previous life activities, social interruption, and loneliness. There is a need for more research in different population groups and contexts, as well as for the validation of nursing interventions tailored to the specific needs of people who have experienced rape. Applying RAM broadens the understanding of the rape trauma phenomenon, offering a robust theoretical framework for autonomous assessment, clinical reasoning, and nursing care planning. The RTS nursing diagnosis, guided by RAM, offers a flexible framework for recognizing behaviors resulting from rape trauma, anticipating needs, and identifying recovery points.

The Nursing Value Index: A conceptual architecture for outcome-level attribution of nursing value.

Despite their central role, Primary Care Practitioners (PCPs) encounter numerous challenges in providing primary care for children. Complex factors spanning all levels of the health system contribute to variability in the quality of paediatric primary care. Contextually informed strategies addressing these factors can deliver positive change. These strategies recognise healthcare as a complex adaptive system and leverage the interconnectedness of the health system and communication networks of healthcare providers. Evidence describing advice-seeking practices of PCPs related to paediatric care is limited. This protocol outlines a mixed methods systematic review that aims to examine how primary care practitioners seek advice regarding paediatric care. The resulting review will synthesise the structures and characteristics of the social networks through which PCPs seek advice regarding paediatric care, how networks are measured, the benefits of these networks, and factors PCPs encounter when seeking advice. The review will be guided by the Joanna Briggs Institute Mixed Methods Systematic Review manual and the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. We will search English language publications in EMBASE, Ovid MEDLINE, and Web of Science. Relevant peer-reviewed articles published since 2013 will be included, encompassing randomised controlled trials (RCTs), non-RCTs, pre- and post-intervention studies, cross-sectional studies, qualitative studies, social network analysis, and mixed-methods studies. Data will be synthesised using a convergent integrated approach, transforming quantitative data into textual descriptions and aggregating where possible to produce integrated findings. PROSPERO Registration Number: CRD420251025798.

How does supply chain decentralization drive disruptive innovation?: An Analytical Framework Based on Complex Adaptive Systems

Research on source-grid-load-storage coordination and urban power system resilience enhancement based on complex adaptive system theory

The increasing complexity of modern medicine has intensified the need for healthcare delivery models that can integrate diverse clinical expertise while maintaining efficiency, consistency, and high-quality outcomes. Multidisciplinary healthcare centers have emerged as a response to this need, bringing together professionals from different specialties to collaborate in the diagnosis, treatment, and management of complex patient conditions. Despite their growing adoption, many of these centers face challenges related to coordination, organizational design, and performance optimization, limiting their ability to fully realize the benefits of integrated care. This study examines the organizational structures and operational dynamics of multidisciplinary healthcare centers, proposing a framework for designing and optimizing their performance in contemporary clinical environments. It argues that the effectiveness of multidisciplinary systems depends not only on the presence of diverse expertise but on the strategic alignment of workflows, communication systems, leadership structures, and data integration mechanisms. Drawing on principles from organizational theory, healthcare management, and systems thinking, the paper conceptualizes multidisciplinary centers as complex adaptive systems requiring coordinated design and continuous optimization. The proposed framework identifies key components of high-performing multidisciplinary centers, including clinical integration, structured communication, coordinated decision-making, and data-driven performance management. It further explores how technology—particularly electronic health records and advanced analytics—can support real-time coordination and enhance decision-making processes. Through scenario-based analysis, the study highlights the differences between well-integrated systems and those characterized by fragmentation and inefficiency, demonstrating the impact of organizational design on clinical and operational outcomes. In addition to its conceptual contributions, the paper addresses practical challenges such as role conflicts, communication breakdowns, and system complexity, offering strategies for mitigating these constraints. It also considers future developments in multidisciplinary care, including the role of artificial intelligence and adaptive organizational models in enhancing coordination and performance. By reframing multidisciplinary healthcare centers as strategically designed systems rather than loosely coordinated collaborations, this study contributes to a more structured and scalable approach to integrated care. It provides insights for healthcare leaders, administrators, and policymakers seeking to optimize performance in increasingly complex medical environments.

Integrating medical and social care requires professionals to navigate and connect distinct systems. In collaboration with a Massachusetts Medicaid Accountable Care Organization (ACO), registered dietitians from partner community-based organizations (CBOs) implemented a medically tailored nutrition program to address food insecurity among clinically complex patients. This study asks: How do dietitians act as boundary-spanning professionals within a cross-sector nutrition program, and how does this work enable integration of medical and social care? We conducted a qualitative case study using semi-structured interviews with nine dietitians from CBOs collaborating with a Massachusetts Medicaid ACO. Guided by Complex Adaptive Systems theory, the boundary spanning literature, and empowerment theory, we applied the Framework Method to examine how dietitians navigate cross-sector work, adapt to system challenges, and strengthen their skills through collaboration. Dietitians described the system as dynamic and interdependent, requiring ongoing adaptation. They described aspects of the ACO partnership as collaborative and supportive, enabling them to learn, adjust, and serve patients more effectively. Dietitians saw boundary spanning as exciting and mission-driven work. Cross-sector collaboration strengthened and broadened dietitians' skill set as they learned to use advanced communication and relationship-building skills to overcome challenges such as limited access to patient data and varying information systems. Working within a CBO allowed them to address patients' social needs, while connection to the health sector gave them access to patients who could benefit from nutrition supports. Dietitians met challenges with innovative patient-centered problem-solving, creativity, and flexibility, demonstrating adaptive capacity within a complex care ecosystem. Dietitians demonstrated strong boundary-spanning capacity, using cross-sector work as an opportunity to connect systems, refine their practice, and deliver more responsive nutrition care. Their success in meeting patients' needs was in part due to a flexible collaborative model that empowered actors to serve patients holistically.

IntroductionHypertensive disorders of pregnancy, such as pre-eclampsia (PE), are one of the leading causes of maternal and perinatal deaths in low- and middle-income countries (LMICs). Although clinical practice guidelines (CPGs) for PE prevention and management are available, there is limited information on their implementation in LMIC contexts. This realist synthesis therefore aims to uncover the causal explanations underpinning the implementation of CPG recommendations for PE prevention and management in Eastern, Central and Southern African contexts. By developing and refining initial programme theories (IPTs), we will generate a pragmatic evidence base explaining how contextual factors trigger mechanisms that lead to intended and unintended outcomes and why implementation varies across the different settings.Methods and analysisWe conceptualise the implementation of CPGs for PE prevention and management as complex social interventions operating within complex adaptive systems. The realist synthesis method will be employed to systematically review the literature for evidence synthesis. The review process will be conducted in five phases, each iteratively building on the previous phase to uncover generative causation and refine the IPTs. We will identify articles through iterative purposive searching in six electronic databases and search engines (Google Scholar, PubMed, Cochrane, MEDLINE, EMBASE Global Health) and through screening WHO sources. Advisory group consultations will be held to formulate, prioritise and refine IPTs. To conceptualise our realist theories through generative causation, we will analyse the data using a retroductive approach, an integration of inductive, deductive and abductive reasoning. We will inductively examine theoretical insights related to five established care moments and explore how CPGs operate during these moments, including where and how they fail to work as intended. The five care moments are: (1) Risk assessment/prevention, (2) Diagnosing disease, (3) Management of PE without severe features, (4) With severe features and (5) Decision making around birth. Deductive reasoning will support sense-making of evidence-based theories through the lens of theories that have been used to explain the adoption of guidelines in healthcare settings. Lastly, abductive reasoning, centring researcher hunches, will help to unearth mechanisms that have been insufficiently detailed in the literature. The intervention-context-actor-mechanism-outcome heuristic will be used to configure programme theories and articulate the theories using the if-then statements.Ethics and disseminationThis project is part of the larger PREvention of Severe Hypertensive Adverse events (PRESHA) project, which aims to improve the detection, prevention and management of PE in Tanzania. PRESHA has ethical clearance from the Regional Ethics Board in Norway and the National Health Research Ethics Committee in Tanzania. Findings of the review will support the contextual development of CPGs for the prevention and management of PE, which will be implemented within the context of the PRESHA trial.

Advancements in technology, complex student profiles and wide-ranging student learning needs impact feedback effectiveness. This conceptual study explored approaches to providing feedback among agents in a complex adaptive system (CAS), namely, students, staff, and learning technologies in systems analysis IT undergraduate and postgraduate courses across a 2.5-year timeframe. Pedagogical action research enabled iterative cycles of intervention and reflection. Quantitative and qualitative techniques facilitated data collection and analysis to understand feedback mechanism impacts on student outcomes. We identified a multi-faceted whole-of-course approach to facilitating feedback by categorising feedback loops across four levels: learner, instructional, staff, and system. Learner-level feedback consists of peer-to-peer and individual feedback mechanisms that support experiential learning. Instructional-level feedback involves intentional feedback provided by teaching staff to learners to guide progress. Staff-level feedback occurs via internal loops within the teaching team to improve instructional consistency, quality, and responsiveness to student learning needs. System-level feedback comprises course-based or institutional mechanisms that inform ongoing curriculum and learning design. This approach guides the understanding of the dynamic, reciprocal nature of feedback interactions in complex IT teaching environments, whilst applying graduate attributes and modelling industry practices, enabling educators to adapt to changes in teaching practices, learning needs and the IT industry.

With the rise of the platform economy, firms increasingly adopt platform-based data sharing (PDS) and signal their initiatives through public announcements. As stock prices promptly reflect investor expectations, market reactions provide a direct assessment of PDS value. However, the specific impact of PDS on stock prices and its contingent factors remain underexplored. Drawing on Complex Adaptive Systems (CAS) theory, this study collects 150 PDS announcements released by Chinese A-share firms from 2014 to 2024. Using event study methodology, the results show that PDS announcements generate positive abnormal returns, especially for firms with higher proportions of independent directors, lower supply chain concentration, and operating in more competitive industries. Moreover, physically dominated platforms and platforms with higher technological sophistication elicit stronger market responses. This study contributes to the literature by uncovering the stock market value of PDS and extending the theoretical and empirical understanding of PDS in the platform economy.

Collaboration is considered essential for addressing social and environmental crises. This article revisits Judith Innes and David Booher’s engagement with complexity science to advance a systemic strand of communicative planning theory and assess its relevance for understanding collaboration during crises. Drawing on practitioners’ experiences in five Swedish municipalities during the Syrian and Ukrainian refugee mass migrations, we show how the systemic strand helps explain how collaboration unfolds across multiple interrelated formal and informal initiatives rather than a single planning process. We also identify a key limitation of the strand: its inability to capture the inevitable exercise of exclusion and authority during crisis situations.

Emergence is a concept in complexity science that describes how many-body systems manifest novel higher-level properties, properties that can be described by replacing high-dimensional mechanisms with lower-dimensional effective variables and theories. This is captured by the idea 'More is Different'. Intelligence is a consummate emergent property manifesting increasingly efficient-cheaper and faster-uses of emergent capabilities to solve problems. This is captured by the idea 'Less is More'. In this paper, we first examine claims that Large Language Models exhibit emergent capabilities, reviewing several approaches to quantifying emergence, and secondly ask whether LLMs possess emergent intelligence. This article is part of the theme issue 'World models in natural and artificial intelligence'.

Complex Adaptive Systems and Individual Radiologist Responsibility.