Yes / Purpose The objective of this study was to advance our knowledge of pharmaceutical supply chain resilience using Complex Adaptive System theory (CAS). Design/methodology/approach An exploratory research design which adopted a qualitative approach was used to achieve the study’s research objective. Qualitative data were gathered through 23 semi-structured interviews with key supply chain actors across the PSC in the United Kingdom (UK). Findings The findings demonstrate that CAS, as a theory, provides a systemic approach to understanding PSC resilience by taking into consideration the various elements (environment, PSC characteristics, vulnerabilities and resilience strategies) that make up the entire system. It also provides explanations for key findings, like the impact of power, conflict and complexity in the PSC, which are influenced by the interactions between supply chain actors and as such increase its susceptibility to the negative impact of disruption. Furthermore, the antecedents for building resilience strategies were the outcome of the decision-making process referred to as co-evolution from a CAS perspective. Originality/value Based on the data collected, the study was able to reflect on the relationships, interactions and interfaces between actors in the PSC using the CAS theory, which supports the proposition that resilience strategies can be adopted by supply chain actors to enhance this service supply chain. This is a novel empirical study of resilience across multiple levels of the PSC and as such adds valuable new knowledge about the phenomenon and the use of CAS theory as a vehicle for exploration and knowledge construction in other supply chains.

BACKGROUND:This paper proposes a novel model for homeopathic remedy action on living systems. Research indicates that homeopathic remedies (a) contain measurable source and silica nanoparticles heterogeneously dispersed in colloidal solution / (b) act by modulating biological function of the allostatic stress response network (c) evoke biphasic actions on living systems via organism-dependent adaptive and endogenously amplified effects / (d) improve systemic resilience.DISCUSSION:The proposed active components of homeopathic remedies are nanoparticles of source substance in water-based colloidal solution, not bulk-form drugs. Nanoparticles have unique biological and physico-chemical properties, including increased catalytic reactivity, protein and DNA adsorption, bioavailability, dose-sparing, electromagnetic, and quantum effects different from bulk-form materials. Trituration and/or liquid succussions during classical remedy preparation create "top-down" nanostructures. Plants can biosynthesize remedy-templated silica nanostructures. Nanoparticles stimulate hormesis, a beneficial low-dose adaptive response. Homeopathic remedies prescribed in low doses spaced intermittently over time act as biological signals that stimulate the organism's allostatic biological stress response network, evoking nonlinear modulatory, self-organizing change. Potential mechanisms include time-dependent sensitization (TDS), a type of adaptive plasticity/metaplasticity involving progressive amplification of host responses, which reverse direction and oscillate at physiological limits. To mobilize hormesis and TDS, the remedy must be appraised as a salient, but low level, novel threat, stressor, or homeostatic disruption for the whole organism. Silica nanoparticles adsorb remedy source and amplify effects. Properly-timed remedy dosing elicits disease-primed compensatory reversal in direction of maladaptive dynamics of the allostatic network, thus promoting resilience and recovery from disease.SUMMARY:Homeopathic remedies are proposed as source nanoparticles that mobilize hormesis and time-dependent sensitization via non-pharmacological effects on specific biological adaptive and amplification mechanisms. The nanoparticle nature of remedies would distinguish them from conventional bulk drugs in structure, morphology, and functional properties. Outcomes would depend upon the ability of the organism to respond to the remedy as a novel stressor or heterotypic biological threat, initiating reversals of cumulative, cross-adapted biological maladaptations underlying disease in the allostatic stress response network. Systemic resilience would improve. This model provides a foundation for theory-driven research on the role of nanomaterials in living systems, mechanisms of homeopathic remedy actions and translational uses in nanomedicine.

This dissertation consists of a development of the notion of equilibrium in non-cooperative games (introduced by John Nash in his doctoral dissertation submitted in May 1950) from the point of view of games played by complex adaptive systems (such as States) who adapt to an asymmetric distribution of bargaining power. The main ingredient of this dissertation is the notion of the contextually normalized solution, that implies that players routinely repeat strategies that work, and that an asymmetric complex game will be in a stable state so long as the set of normal strategies consists of the stronger players’ most preferred and the weaker players’ least disliked strategies. There is no other generality in rational behaviour; all else is relative to the frame of reference.

Although Code of Maryland policy mandates multidisciplinary, integrated teams for residential service provider organizations (RPOs) for an intellectual/developmental disabilities (IDD) population, alignment criteria to identify and evaluate the functional characteristics of such teams do not exist. This ambiguity has resulted in potential conflict in the goals of service delivery, as well as misaligned quality assessment and policy development criteria. The intent of this general qualitative study was to use complex adaptive systems theory and Vitkiene's work on corporate ethos to determine whether the services provided by a single RPO were consistent and aligned with the regulatory mandate set by the state. Data were acquired from the Maryland Office of Health Care Quality, for the years 2010-2015 that consisted of compliance inspections, reports, citations, as well as responses and corrective actions made by the IDD-RPO. Data were deductively coded according to Vitkiene's 3 ethos principles: economy (profit), procedure (task completion), and beneficence (customer service) and then subjected to a content analysis procedure. The study affirmed the lack of alignment criteria within the RPO by demonstrating ambiguity in how services were measured. Findings identified beneficence as most likely to be associated with a multidisciplinary team. Positive social change implications stem from recommendations to repurpose public health compliance data to address issues of misalignment in institutional service delivery; these findings may also be used by policy makers to focus on ethos as a means to focus on realigning policy objectives, the regulatory environment, and the work done at the RPO level to encourage better quality of life for individuals diagnosed with IDD.

Komplexitetsteori ger ett nytt synsätt på hälso- och sjukvårdens organisation, vilken beskrivs som ett komplext adaptivt system, vars ingående delar står i en inbördes relation till varandra och interagerar i dynamiska, icke linjära mönster. Detta synsätt kontrasterar mot det mer traditionella som ser sjukvården som en hierarkisk och linjär organisationsstruktur. Denna litteraturstudie har som syfte att beskriva hur omvårdnad kan påverkas av en organisationsstuktur präglad av teorin om komplexa adaptiva system. Elva artiklar granskades och analyserades, varvid fyra teman framträdde: ledarskap och medinflytande, samverkan, intellektuell mångfald och informationsflöde. Resultatet visar att omvårdnadsproblem uppmärksammades och åtgärdades snabbare på enheter som organiserats med fokus på medarbetarnas delaktighet och där ledarskapet främjat en hög grad av samverkan inom och mellan vårdens olika professioner samt verkat för ett klimat där alla medarbetare fritt kunde framföra och delge sina åsikter. Komplexitetsteoretiska resonemang ger således nya insikter om hur hälso- och sjukvården kan organiseras för att optimera patienternas välbefinnande och hälsa. / Complexity theory provides a new view on the organization of healthcare, which is described as a complex adaptive system. The integrated parts of this system are interconnected in dynamic, non linear patterns. This contrasts to the traditional way of viewing an organization as hierarchal and linear. The aim of this literature study was to describe how an organizational structure based on complex adaptive systems theory can impact nursing. Eleven articles were examined, revealing four themes: leadership and participation, collaboration, cognitive diversity and information flow. The result showed improved nursing quality and patient outcomes in units organized with a focus on staff participation, a leadership promoting interdisciplinary collaboration and a climate where all employees were free to express and share their opinions. Complexity theory provides new insights how the organization of health care can optimize patients' health and wellbeing.

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Approved for public release, distribution is unlimited / Organizational structure has profound effects on a joint force commander's ability to perform military actions. Organizations and their environment exhibit an interdependent relationship, requiring a commander to evolve his organization to rapidly achieve mission accomplishment. The CNO Strategic Studies Group XIX report of September 2000 has identified the FORCEnet as being the basis for the U.S. Navy's future network-centric organization, and outlines a military environment that includes multitudes of manned and unmanned vehicles, platforms, sensors, weapons and warfighters. These naval elements will operate jointly, leveraging organizational structure to rapidly sense, assess, and respond to the defense of the nation's security interests as directed by the President. The focus of this research is to examine this envisioned future military environment, the military actions required to achieve success in that environment and the organizational structure(s) that will best fit those action requirements. / Lieutenant Commander, United States Navy

A presente dissertação tem por objetivo discutir a importância de uma postura resiliente para a busca do urbanismo sustentável. O termo \"sustentável\" e suas variantes passaram por um desgaste nas últimas décadas, formando uma barreira prejudicial à sua aplicação efetiva. A \"resiliência\", surge, então, como uma forma de revisitar a questão, através de um conceito oriundo da física, que possibilita conceber uma transposição teórica para a arquitetura e o urbanismo, disciplinas nas quais o tema pode colaborar na formulação de novas ferramentas e conceitos aplicáveis ao planejamento e projeto. Almeja-se, através da sua conceituação teórica, contribuir para a elaboração de uma postura resiliente e promover o termo \"resiliência urbana\" em direção ao enfrentamento da crise urbana, ocasionada pelo crescimento vertiginoso da urbanização mundial e da consequente aglomeração populacional nas cidades. Nos países em desenvolvimento, essa abordagem pode ser de grande utilidade, dado que a crise urbana é fortalecida pelo avanço da informalidade e pela formação de novos tecidos urbanos às margens do planejamento. O conceito de resiliência, neste caso, possibilita uma discussão voltada às questões de espontaneidade, improvisos, constantes mudanças e transformações, inerentes à condição urbana, se discutido dentro de uma abordagem de Sistemas Adaptativos Complexos. Para tanto, elaborou-se uma análise reflexiva, a fim de aferir a transferência da teoria para prática, a partir de três projetos urbanos já implantados: as intervenções em torno da Línea K, em Medellín, Colômbia, o sistema teleférico do Complexo do Alemão e o Parque Sitiê, ambos na cidade do Rio de Janeiro. A partir daí, pôde-se constatar que a visão sistêmica adaptativa e complexa da resiliência traz a possibilidade de promover a inter-relação entre sociedade, economia e ambiente na construção do meio urbano e, assim, encorajar uma nova postura frente a difusão de um Urbanismo Sustentável. / The present dissertation aims to discuss the importance of a resilient posture in the search for a sustainable urbanism. The term \"sustainable\" and its variants have gone through a wear and tear through the last few decades, forming a barrier which prejudices its effective application. The \"resilience\" term then appears as a way of revisiting this matter, through a concept derived from physics, that allows a theoretical transposition to architecture and urbanism disciplines in which the subject can cooperate in the formulation of new tools and concepts that can be applied into planning and project design process. Over the theoretical conception, it is intended the contribution on the elaboration of a resilient attitude and therefore promotes the term \"urban resilience\" towards the current urban crisis, caused by the dramatical growth of the world urbanization and the consequent population cluster within cities. In developing countries, the approach can be very useful, given that the urban crisis is strengthened by the rise of informality and the formation of new urban networks at the edge of planning actions. The concept of resilience, in this case, enables a discussion focused on spontaneity issues, improvisations, changes and transformations, inherent to the urban condition, discussed within a Complex Adaptive Systems approach. However to elaborate a reflexive analysis it is necessary to verify the transformation of theory into practice from three urban projects already implemented: Line K\'s urban interventions in Medellín, Colombia, cable car system at Alemão Complex and Sitiê Park, both in Rio de Janeiro, Brazil. In conclusion, an adaptive and complex systemic view of resilience has the potential to promote an interrelationship between society, economy and environment during the construction of an urban environment and therefore encourage a new attitude towards the diffusion of Sustainable Urbanism.

A presente dissertação tem por objetivo discutir a importância de uma postura resiliente para a busca do urbanismo sustentável. O termo \"sustentável\" e suas variantes passaram por um desgaste nas últimas décadas, formando uma barreira prejudicial à sua aplicação efetiva. A \"resiliência\", surge, então, como uma forma de revisitar a questão, através de um conceito oriundo da física, que possibilita conceber uma transposição teórica para a arquitetura e o urbanismo, disciplinas nas quais o tema pode colaborar na formulação de novas ferramentas e conceitos aplicáveis ao planejamento e projeto. Almeja-se, através da sua conceituação teórica, contribuir para a elaboração de uma postura resiliente e promover o termo \"resiliência urbana\" em direção ao enfrentamento da crise urbana, ocasionada pelo crescimento vertiginoso da urbanização mundial e da consequente aglomeração populacional nas cidades. Nos países em desenvolvimento, essa abordagem pode ser de grande utilidade, dado que a crise urbana é fortalecida pelo avanço da informalidade e pela formação de novos tecidos urbanos às margens do planejamento. O conceito de resiliência, neste caso, possibilita uma discussão voltada às questões de espontaneidade, improvisos, constantes mudanças e transformações, inerentes à condição urbana, se discutido dentro de uma abordagem de Sistemas Adaptativos Complexos. Para tanto, elaborou-se uma análise reflexiva, a fim de aferir a transferência da teoria para prática, a partir de três projetos urbanos já implantados: as intervenções em torno da Línea K, em Medellín, Colômbia, o sistema teleférico do Complexo do Alemão e o Parque Sitiê, ambos na cidade do Rio de Janeiro. A partir daí, pôde-se constatar que a visão sistêmica adaptativa e complexa da resiliência traz a possibilidade de promover a inter-relação entre sociedade, economia e ambiente na construção do meio urbano e, assim, encorajar uma nova postura frente a difusão de um Urbanismo Sustentável. / The present dissertation aims to discuss the importance of a resilient posture in the search for a sustainable urbanism. The term \"sustainable\" and its variants have gone through a wear and tear through the last few decades, forming a barrier which prejudices its effective application. The \"resilience\" term then appears as a way of revisiting this matter, through a concept derived from physics, that allows a theoretical transposition to architecture and urbanism disciplines in which the subject can cooperate in the formulation of new tools and concepts that can be applied into planning and project design process. Over the theoretical conception, it is intended the contribution on the elaboration of a resilient attitude and therefore promotes the term \"urban resilience\" towards the current urban crisis, caused by the dramatical growth of the world urbanization and the consequent population cluster within cities. In developing countries, the approach can be very useful, given that the urban crisis is strengthened by the rise of informality and the formation of new urban networks at the edge of planning actions. The concept of resilience, in this case, enables a discussion focused on spontaneity issues, improvisations, changes and transformations, inherent to the urban condition, discussed within a Complex Adaptive Systems approach. However to elaborate a reflexive analysis it is necessary to verify the transformation of theory into practice from three urban projects already implemented: Line K\'s urban interventions in Medellín, Colombia, cable car system at Alemão Complex and Sitiê Park, both in Rio de Janeiro, Brazil. In conclusion, an adaptive and complex systemic view of resilience has the potential to promote an interrelationship between society, economy and environment during the construction of an urban environment and therefore encourage a new attitude towards the diffusion of Sustainable Urbanism.

The merging of business and information technology (IT) strategies, effectively becoming a Digital Business Strategy (DBS), is changing the way that organisations have to leverage resources to create differential value. Due to the DBS being such a novice idea, there is no clear understanding of what the DBS is, what its characteristics and boundaries are, how it impacts alignment between business and IT, and how it impacts organisational performance. Without this understanding, organisations leveraging a DBS run the risk of launching technological initiatives or making organisational changes that are disjointed from their strategic direction. These misaligned efforts may result in unrealised strategy and unsatisfactory organisational performance. The purpose of this study was to define the boundaries and characteristics of the DBS, provide a definition of a DBS and to establish if the DBS has a positive effect on organisational performance. To examine the DBS, it was observed in its natural habitat, through a single case study approach, focusing on an organisation that has been leveraging a DBS as part of their digital journey. The organisation is a South African based financial services provider and is a subsidiary of a larger financial services provider. In this study, the DBS was observed from an intellectual, operational, social and cultural alignment perspective, using a combination of the Strategic Alignment Model (SAM) and the Complex Adaptive System (CAS) frameworks. This study subscribed to a mixed-method approach which included both qualitative and quantitative research techniques. Staff providing input into this study included senior, middle, junior and non-management employees. The study was conducted over a period of thirteen months. The findings from both the qualitative and quantitative data suggest that to leverage a DBS the organisation must be concerned with more than just leveraging digital resources. For instance, organisations must focus on customer and staff empowerment, use customer and industry-related information to create opportunistic and competitive decision-making opportunities, and create a change-ready culture where bold experimentation and failing forward is embraced. Researchers and practitioners alike can use the findings of this case study as lessons on how to leverage organisational resources in the context of the DBS.