They're all complex adaptive systems that might be studied and researched in the academic field known as complexity science. This highly interdisciplinary field seeks answers to fundamental questions about living, adaptable, changeable systems.
Dr. Brian Castellani, associate professor at Kent State University at Ashtabula, has created the Center for Complexity in Health (CCH), an international institute for the study of two very specific complex adaptive systems: health and health care.
CCH researchers are currently consulting on two research projects with the Office of Naval Research and U.S. Army Medical Research and Material Command to explore allostatic load: the physiological consequences of chronic exposure to fluctuating or heightened neural or neuroendocrine response that results from repeated or chronic stress. It is used to explain how frequent activation of the body's stress response, essential for managing acute threats, can in fact damage the body in the long run. It is generally measured through a composite index of indicators of cumulative strain on several organs and tissues, but especially on the cardiovascular system.
According to Castellani, the new science of complexity and its computational methods, which use high-powered computer algorithms to simulate the dynamics of complex systems, really took off in the late 1990s.
"We wanted to create an environment which applies these new techniques to the study of health and health care through a cross-disciplinary program of teaching, training and research," Castellani said.
The center is one of only a handful in the world.
"Prior to the past several years, nothing like it existed," Castellani said. "The Center for Complexity in Health is now one of very few centers devoted to complexity in health in the United States and Europe.
Castellani and his team, which includes Research Coordinator for Computational Modeling and IT Resources, Michael Ball, and Graduate Assistant, Kenneth Carvalho, started the center in 2010 with internal funding and complete support from Kent State Ashtabula Dean and Chief Administrative Officer Dr. Susan Stocker.
Currently, CCH is a virtual center consisting of two websites. On the CCH web site researchers can find information about and links to current research, complexity resources and team member publications, such as Dr. Frederic Hafferty's latest presentations on complexity and medical education. Hafferty, of the Mayo Clinic, is among the growing network of CCH research collaborators. The website also includes an interactive computer simulation developed by Ball, which models the spread of an infectious disease through a randomly moving population.
The Sociology and Complexity Science site is an educational research resource with links to academic publications and Castellani's sociology and complexity blog. In January, the CCH self-published the proceedings of the Center for Complexity in Health (PCCH) on its web site. It is a peer-reviewed annual publication designed both to showcase and provide a publication outlet for some of the main avenues of research being conducted in the CCH.
These areas include medical professionalism, community health, allostatic load, school systems, medical learning environments and case-based modeling â€“ all explored from a complexity science perspective.
Only two years in, the CCH already has had success in achieving several of its objectives, especially in the area of international collaboration.
"One of my goals is for the center to be an intellectual clearinghouse where a network of researchers within the academic, scientific and health care communities can collaborate and address problems with an advanced set of methodological tools," Castellani said.
This network has grown extensively, spanning from the Ashtabula campus to as far away as the Netherlands. Castellani and CCH team member (and brother) Dr. John Castellani, associate professor at Johns Hopkins University, recently presented a paper on education as a complex system at the International Sociological Association World Congress of Sociology in Gothenburg, Sweden. Relationships have been developed in England, Germany, Italy and Spain.
The CCH team also includes James Price, deputy head of the Institute of Postgraduate Medicine at Brighton and Sussex Medical School in the UK. Other team members include Dr. J.G. Buckwalter, director of research at Headington Institute and a research scientist at the Institute for Creative Technologies at the University of Southern California, and Dr. Rajeev Rajaram, Kent State Ashtabula assistant professor of Mathematics. Castellani has also established connections with Summa Health System's Department of Psychiatry in Akron.
"This is precisely the kind of multidisciplinary initiative that is propelling Kent State into the ranks of national research universities," Dr. W. Grant McGimpsey, vice president for research at Kent State, said. "The CCH is linking our faculty to other exceptional scholars and collaborators throughout the nation and with international partners abroad. We are assuming a leadership role on three fronts: as conveners, bringing the multiple parties together; as investigators, leading the discoveries; and as facilitators, making it all happen. The human health research space is one of the university's top priorities.
In addition to fostering interdisciplinary research with internal and external health care entities, the center is committed to undergraduate education in science, technology and mathematics in application to health and health care, particularly public health.
"As part of our research methods courses, we started a mathematical modeling clinic, which helps bring undergrads into the research experience by teaching them how to use the latest developments in computational modeling," Castellani said.
Plans are to locate a physical center in the new state-of-the-art Robert S. Morrison Health and Science Building on the Ashtabula campus. Castellani and his team are actively pursuing external funding for the center and specific research endeavors.