33 found
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  1.  13
    ‘Multimorbidity’ as the Manifestation of Network Disturbances.Joachim P. Sturmberg, Jeanette M. Bennett, Carmel M. Martin & Martin Picard - 2017 - Journal of Evaluation in Clinical Practice 23 (1):199-208.
    We argue that 'multimorbidity' is the manifestation of interconnected physiological network processes _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 and major stressful life experiences perturb internal and social networks resulting in physiological instability with changes ranging from improved resilience to (...)
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  2.  7
    Evidence‐Based Medicine—Not a Panacea for the Problems of a Complex Adaptive World.Joachim P. Sturmberg - 2019 - Journal of Evaluation in Clinical Practice 25 (5):706-716.
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  3.  40
    Knowing – in Medicine.Joachim P. Sturmberg & Carmel M. Martin - 2008 - Journal of Evaluation in Clinical Practice 14 (5):767-770.
    In this paper we argue that knowledge in health care is a multidimensional dynamic construct, in contrast to the prevailing idea of knowledge being an objective state. Polanyi demonstrated that knowledge is personal, that knowledge is discovered, and that knowledge has explicit and tacit dimensions. Complex adaptive systems science views knowledge simultaneously as a thing and a flow, constructed as well as in constant flux. The Cynefin framework is one model to help our understanding of knowledge as a personal construct (...)
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  4.  44
    The Personal Nature of Health.Joachim P. Sturmberg - 2009 - Journal of Evaluation in Clinical Practice 15 (4):766-769.
    "Every man has his particular way of being in good health" - Emanuel Kant. Emanuel Kant's description of health stands in stark contrast to accepted definitions of health. For example, the WHO defines ‘health’ as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’. However, as people get on with day-to-day living, no one can achieve the goal of ‘complete physical, mental and social well-being’. It is odd to define ‘health’ as (...)
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  5.  26
    Understanding Health System Reform–a Complex Adaptive Systems Perspective.Joachim P. Sturmberg, Di M. O'Halloran & Carmel M. Martin - 2012 - Journal of Evaluation in Clinical Practice 18 (1):202-208.
  6.  29
    Health at the Center of Health Systems Reform: How Philosophy Can Inform Policy.Joachim P. Sturmberg, Carmel M. Martin & Mark M. Moes - 2010 - Perspectives in Biology and Medicine 53 (3):341-356.
    We are never illness or disease, but, rather, always their sum in the world of day-to-day experience. Disease and illness are not closed systems, but mutually constitutive and continuously interacting worlds. In the patient’s case it is always experience as well. Pain, sickness and death help make that particular experienced identity unavoidable, and at some level ultimately inaccessible to medicine’s changing understanding of disease and tools for managing it. Health—rather than cost containment, specific conditions, or technologies—should be the central focus (...)
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  7.  11
    Diagnosis - the Limiting Focus of Taxonomy.Joachim P. Sturmberg & Carmel M. Martin - 2016 - Journal of Evaluation in Clinical Practice 22 (1):103-111.
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  8.  4
    Resilience for Health-an Emergent Property of the “Health Systems as a Whole”.Joachim P. Sturmberg - 2018 - Journal of Evaluation in Clinical Practice 24 (6):1323-1329.
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  9.  15
    Biopsychosocial Approach to Understanding Resilience: Stress Habituation and Where to Intervene.Jeanette M. Bennett, Nicolas Rohleder & Joachim P. Sturmberg - 2018 - Journal of Evaluation in Clinical Practice 24 (6):1339-1346.
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  10.  3
    Embracing Complexity in Health and Health Care-Translating a Way of Thinking Into a Way of Acting.Joachim P. Sturmberg - 2018 - Journal of Evaluation in Clinical Practice 24 (3):598-599.
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  11.  8
    COVID‐19 – How a Pandemic Reveals That Everything is Connected to Everything Else.Joachim P. Sturmberg & Carmel M. Martin - 2020 - Journal of Evaluation in Clinical Practice 26 (5):1361-1367.
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  12.  19
    Time and the Consultation – an Argument for a 'Certain Slowness'.Joachim P. Sturmberg & Paul Cilliers - 2009 - Journal of Evaluation in Clinical Practice 15 (5):881-885.
    When natural time sequences were replaced by clocks, time became a measurable commodity and the ‘speedy use of time’ a virtue. In medical practice shorter consultations allow more patients to be seen, whereas longer consultations result in a better understanding of the patient and her problems. Crossing the line of time-efficiency and time-effectiveness compromises the balance between short-term turnover and long-term outcomes. The consultation has all the hallmarks of a complex adaptive system whose characteristics are not determined by the characteristics (...)
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  13.  16
    EBM: A Narrow and Obsessive Methodology That Fails to Meet the Knowledge Needs of a Complex Adaptive Clinical World: A Commentary on Djulbegovic, B., Guyatt, G. H. & Ashcroft, R. E. (2009) Cancer Control, 16, 158–168. [REVIEW]Joachim P. Sturmberg - 2009 - Journal of Evaluation in Clinical Practice 15 (6):917-923.
  14.  27
    Perturbing Ongoing Conversations About Systems and Complexity in Health Services and Systems.Carmel M. Martin & Joachim P. Sturmberg - 2009 - Journal of Evaluation in Clinical Practice 15 (3):549-552.
  15.  5
    Complexity and Health – Yesterday's Traditions, Tomorrow's Future.Joachim P. Sturmberg & Carmel M. Martin - 2009 - Journal of Evaluation in Clinical Practice 15 (3):543-548.
  16.  4
    Approaching Complexity—Start with Awareness.Joachim P. Sturmberg - 2020 - Journal of Evaluation in Clinical Practice 26 (3):1030-1033.
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  17.  11
    Multimorbidity and Chronic Disease: An Emergent Perspective.Joachim P. Sturmberg - 2014 - Journal of Evaluation in Clinical Practice 20 (4):508-512.
  18.  16
    The Illusion of Certainty – a Deluded Perception?Joachim P. Sturmberg - 2011 - Journal of Evaluation in Clinical Practice 17 (3):507-510.
  19.  16
    Borderline Competence – From a Complexity Perspective: Conceptualization and Implementation for Certifying Examinations.Joachim P. Sturmberg & John Hinchy - 2010 - Journal of Evaluation in Clinical Practice 16 (4):867-872.
  20.  8
    Primary Health Care Organizations – Through a Conceptual and a Political Lens.Joachim P. Sturmberg - 2011 - Journal of Evaluation in Clinical Practice 17 (3):525-529.
  21.  12
    A Personalized Systems Medicine Approach to Refractory Rumination.Anup K. Kanodia, Inah Kim & Joachim P. Sturmberg - 2011 - Journal of Evaluation in Clinical Practice 17 (3):515-519.
  22.  4
    Music in the Park. An Integrating Metaphor for the Emerging Primary (Health) Care System.Joachim P. Sturmberg, Carmel M. Martin & Di O’Halloran - 2010 - Journal of Evaluation in Clinical Practice 16 (3):409-414.
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  23.  21
    Revitalizing Primary Health Care and Family Medicine/Primary Care in India – Disruptive Innovation?Rakesh Biswas, Ankur Joshi, Rajeev Joshi, Terry Kaufman, Chris Peterson, Joachim P. Sturmberg, Arjun Maitra & Carmel M. Martin - 2009 - Journal of Evaluation in Clinical Practice 15 (5):873-880.
  24.  8
    Music in the Park. An Integrating Metaphor for the Emerging Primary (Health) Care System.Joachim P. Sturmberg, Carmel M. Martin & Di O.’Halloran - 2010 - Journal of Evaluation in Clinical Practice 16 (3):409-414.
  25.  17
    Health Care Frames - From Virchow to Obama and Beyond.Joachim P. Sturmberg, Ruth di O'HalloranColagiuri, Ana Fernandez, Sue Lukersmith, Ghazal Torkfar & Luis Salvador-Carulla - 2014 - Journal of Evaluation in Clinical Practice 20 (6):1036-1044.
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  26.  5
    Identifying Patterns in Primary Care Consultations: A Cluster Analysis.Joachim P. Sturmberg, Eu-Gene Siew, Leonid Churilov & Kate Smith-Miles - 2009 - Journal of Evaluation in Clinical Practice 15 (3):558-564.
  27.  7
    Caring for People with Chronic Disease: Is 'Muddling Through' the Best Way to Handle the Multiple Complexities?Joachim P. Sturmberg - 2012 - Journal of Evaluation in Clinical Practice 18 (6):1220-1225.
  28.  7
    Variability, Continuity and Trust – Towards an Understanding of Uncertainty in Health and Health Care.Joachim P. Sturmberg - 2010 - Journal of Evaluation in Clinical Practice 16 (3):401-402.
  29.  1
    Beyond Multimorbidity: What Can We Learn From Complexity Science?Joachim P. Sturmberg, Linn O. Getz, Kurt C. Stange, Ross E. G. Upshur & Stewart W. Mercer - forthcoming - Journal of Evaluation in Clinical Practice.
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  30.  10
    Complexity Mindsets at Work.Joachim P. Sturmberg - 2016 - Journal of Evaluation in Clinical Practice 22 (1):101-102.
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  31.  4
    From P Robability to B Elievability.Joachim P. Sturmberg - 2020 - Journal of Evaluation in Clinical Practice 26 (4):1081-1086.
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  32.  20
    Leadership and Transitions: Maintaining the Science in Complexity and Complex Systems.Joachim P. Sturmberg & Carmel M. Martin - 2012 - Journal of Evaluation in Clinical Practice 18 (1):186-189.
  33. Want Improved Quality? Improve Your Systems.Joachim P. Sturmberg - 2020 - Journal of Evaluation in Clinical Practice 26 (5):1530-1533.
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