Dynamic Multi-System Resilience in Human Aging/Resilience and vulnerability in a stressed system: an example from the wards
November 13, 2018
10:40 am - 11:20 am
Heather Whitson (Duke Univ.)
This talk will begin with a narrative presentation of a real-world case, taken from Dr. Whitson’s clinical practice. The case example is offered as a “springboard” to explore the value and limitations of a model whereby the hospitalized patient is conceptualized as a complex dynamical system under duress. Considering the case through the lens of complexity science, we will discuss potential approaches to predict and promote physical resilience to health stressors. How should our knowledge of complex systems inform medical decision-making and how do we translate what we know into practical clinical tools? In the second half of the talk, Dr. Whitson will present conceptual frameworks to guide clinical research on the emerging construct of physical resilience to health stressors. The talk will also introduce two test paradigms currently under study as potential predictors of physical resilience: stimulus-response tests, and complexity-based tests on physiological output data.
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Heather Whitson (Duke Univ.) Link to the source page
As a clinician, it resonated with me to hear Dr. Vural describe that in his models, sometimes "strategic repair" may be necessary in order to re-stabilize a complex system that is progressing toward critical decay (but has not yet reached the critical point). I like the notion that success or failure of the whole system could depend on the order of which nodes are repaired first. I am often faced with the clinical challenge of multi-organ failure and often an intervention that would benefit one organ system might put another at risk, so it is hard to know what sub-system to prioritize. If we could understand the human system better and it could guide "strategic repair," this could have real clinical utility.
It also resonated with me to hear Dr. Hoekstra's description of a similar stressor resulting in vastly different outcomes in his model systems. If there are feature of the system BEFORE or JUST AFTER the stressor that reliably indicate which outcome is going to occur, that would be very useful for prognostication and for making treatment decisions.
Dr. Gijzel's descriptions of data management challenges when dealing with time series human data was helpful (and also cathartic, because I deal with the same challenges). The tension about whether analytical decisions should be guided by conceptual framework and clinical judgment, as opposed to empirical decisions, was something I recognized.
I feel more strongly that the field will benefit from semantic harmonization and precise terminology.
My perspective has changed in that I will be more attentive to opportunities to study resilience changes across the lifespan. I learned about childhood metabolic changes I was not aware of. I learned a new parameter for characterizing temporal autocorrelation across varying lag times.
|Title||Author name||Source name||Year||Citation count From Scopus. Refreshed every 5 days.||Page views||Related file|
|Physical resilience in older adults: Systematic review and development of an emerging construct||Heather E. Whitson, Wei Duan-Porter, Kenneth E. Schmader, Miriam C. Morey, Harvey J. Cohen, Cathleen S. Colón-Emeric||Journals of Gerontology - Series A Biological Sciences and Medical Sciences||2016||105||6|