Groups, organizations, families and movements: The sociology of social systems between interaction and society

Kühl S. Groups, organizations, families and movements: The sociology of social systems between interaction and society. Systems Research and Behavioral Science. 2020;37(3):496-515.In enhancing a proposal by Luhmann, this contribution shows that it is possible to locate different types of systems between ‘face‐to‐face‐interaction’ and ‘society’: groups, organizations, families and protest movements. The common ground of these is that they use membership to attribute persons to the system or not. However, they differ fundamentally in regard to how they understand membership. In contrast to Luhmann's differentiation between interaction, organization and society, it is not only possible to imagine different types of interlocking systems but also coequal combinations of and transitions between the different types of social systems

Der diskrete Charme der Bourgeoisie - Ein Beitrag zur Soziologie des modernen Wirtschaftsbürgertums

Entgegen der These der Auflösungserscheinungen des Bürgertums stellt der Autor die Annahme auf den Prüfstand, dass wir es nach wie vor mit gesellschaftlichen Fraktionierungen bürgerlicher Lebensweisen zu tun haben. Am Beispiel autobiographischer Schriften von deutschen Topmanagern stellt der Text ein modernes Verständnis des Wirtschaftsbürgertums vor, das organisational (durch die Karrieremechanismen der Organisation) und institutionell (im Feld der Wirtschaft) verankert ist. Die moderne Sozialformation des Wirtschaftsbürgertums ist nur noch auf der Grundlage von Organisationen denkbar. Sie lässt sich, jenseits von Klasse und Stand, als Positionselite beschreiben. Anhand der Autobiographien lässt sich die Reproduktion dieser Elite auf Basis einer engen Verknüpfung zwischen familialer Herkunft, an organisationale Karrieren gebundene Leistungsbereitschaft und hoher formaler Bildung nachzeichnen. Die Abgrenzung in der Statusreproduktion zwischen Bildungs- und Wirtschaftsbürgertum weist der Autor am jeweiligen Verhältnis zur Bildung nach; zwar können beide einen hohen Bildungsgrad in Form von Bildungspatenten nachweisen, doch im Falle des Wirtschaftsbürgertums herrscht ein instrumentelles Verhältnis zur Bildung vor. Der hohe Bildungsgrad folgt hier dem Bedürfnis, den Status mittels formaler Bildung abzusichern und damit die Gefahr der eigenen Austauschbarkeit - als Personal der Organisation - zu kompensieren. Der Text macht außerdem generationale Effekte sichtbar; insbesondere indem er darlegt, inwieweit der "moderne Manager" einerseits in der Betonung seines Status seinen Vorgängern gleicht und sich doch gleichzeitig in der Art der Unternehmensführung abgrenzt - indem er bspw. die Managementkonzepte seiner Zeit aufgreift

Use of composite endpoints in early and intermediate age-related macular degeneration clinical trials - state-of-the-art and future directions

The slow progression of early AMD stages to advanced AMD requires the use of surrogate endpoints in clinical trials. The use of combined endpoints may allow for shorter and smaller trials due to increased precision. We performed a literature search for the use of composite endpoints as primary outcome measures in clinical studies of early AMD stages. PubMed was searched for composite endpoints used in early/intermediate AMD studies published during the last 10 years. A total of 673 articles of interest were identified. After reviewing abstracts and applicable full-text articles, 33 articles were eligible and thus included in the qualitative synthesis. The main composite endpoint categories were: Combined structural and functional endpoints, combined structural endpoints, combined functional endpoints and combined multi-categorical endpoints. The majority of the studies included binary composite endpoints. There was a lack of sensitivity analyses of different endpoints against accepted outcomes (i.e. progression) in the literature. Various composite outcome measures have been used but there is a lack of standardization. To date no agreement on the optimal approach to implement combined endpoints in clinical studies of early stages of AMD exists and no surrogate endpoints have been accepted for AMD progression

Comparing nuclear power trajectories in Germany and the UK: from ‘regimes' to ‘democracies’ in sociotechnical transitions and Discontinuities

This paper focuses on arguably the single most striking contrast in contemporary major energy politics in Europe (and even the developed world as a whole): the starkly differing civil nuclear policies of Germany and the UK. Germany is seeking entirely to phase out nuclear power by 2022. Yet the UK advocates a ‘nuclear renaissance’, promoting the most ambitious new nuclear construction programme in Western Europe.Here,this paper poses a simple yet quite fundamental question: what are the particular divergent conditions most strongly implicated in the contrasting developments in these two countries. With nuclear playing such an iconic role in historical discussions over technological continuity and transformation, answering this may assist in wider understandings of sociotechnical incumbency and discontinuity in the burgeoning field of‘sustainability transitions’. To this end, an ‘abductive’ approach is taken: deploying nine potentially relevant criteria for understanding the different directions pursued in Germany and the UK. Together constituted by 30 parameters spanning literatures related to socio-technical regimes in general as well as nuclear technology in particular, the criteria are divided into those that are ‘internal’ and ‘external’ to the ‘focal regime configuration’ of nuclear power and associated ‘challenger technologies’ like renewables. It is ‘internal’ criteria that are emphasised in conventional sociotechnical regime theory, with ‘external’ criteria relatively less well explored. Asking under each criterion whether attempted discontinuation of nuclear power would be more likely in Germany or the UK, a clear picture emerges. ‘Internal’ criteria suggest attempted nuclear discontinuation should be more likely in the UK than in Germany– the reverse of what is occurring. ‘External’ criteria are more aligned with observed dynamics –especially those relating to military nuclear commitments and broader ‘qualities of democracy’. Despite many differences of framing concerning exactly what constitutes ‘democracy’, a rich political science literature on this point is unanimous in characterising Germany more positively than the UK. Although based only on a single case,a potentially important question is nonetheless raised as to whether sociotechnical regime theory might usefully give greater attention to the general importance of various aspects of democracy in constituting conditions for significant technological discontinuities and transformations. If so, the policy implications are significant. A number of important areas are identified for future research, including the roles of diverse understandings and specific aspects of democracy and the particular relevance of military nuclear commitments– whose under-discussion in civil nuclear policy literatures raises its own questions of democratic accountability

Developing the concept of society: Institutional domains, regimes of inequalities and complex systems in a global era

This article develops the concept of society to meet the challenge of cross-border and global processes. Global processes have made visible the inadequacy of interpreting the concept of society as if it were a nation-state, since there is a lack of congruence of institutional domains (economy, polity, civil society, violence) and regimes of inequality (class, gender, ethnicity). The article engages with two strands of intellectual heritage in sociological analysis of society as a macro concept: the differentiation of institutions and the relations of inequality. The concepts of society and societalisation are developed by hybridising these two approaches rather than selecting only one or the other. To achieve this, the concept of system is developed by drawing on complexity science. This enables the simultaneous analysis of differentiated institutional domains (economy, polity, violence, civil society) and multiple regimes of inequality without reductionism. In turn, this facilitates the fluent theorisation of variations in the temporal and spatial reach of social systems

Challenges, facilitators and barriers to screening study participants in early disease stages-experience from the MACUSTAR study

BACKGROUND: Recruiting asymptomatic participants with early disease stages into studies is challenging and only little is known about facilitators and barriers to screening and recruitment of study participants. Thus we assessed factors associated with screening rates in the MACUSTAR study, a multi-centre, low-interventional cohort study of early stages of age-related macular degeneration (AMD). METHODS: Screening rates per clinical site and per week were compiled and applicable recruitment factors were assigned to respective time periods. A generalized linear mixed-effects model including the most relevant recruitment factors identified via in-depth interviews with study personnel was fitted to the screening data. Only participants with intermediate AMD were considered. RESULTS: A total of 766 individual screenings within 87 weeks were available for analysis. The mean screening rate was 0.6 ± 0.9 screenings per week among all sites. The participation at investigator teleconferences (relative risk increase 1.466, 95% CI [1.018-2.112]), public holidays (relative risk decrease 0.466, 95% CI [0.367-0.591]) and reaching 80% of the site's recruitment target (relative risk decrease 0.699, 95% CI [0.367-0.591]) were associated with the number of screenings at an individual site level. CONCLUSIONS: Careful planning of screening activities is necessary when recruiting early disease stages in multi-centre observational or low-interventional studies. Conducting teleconferences with local investigators can increase screening rates. When planning recruitment, seasonal and saturation effects at clinical site level need to be taken into account. TRIAL REGISTRATION: ClinicalTrials.gov NCT03349801 . Registered on 22 November 2017

Test-Retest Variability and Discriminatory Power of Measurements From Microperimetry and Dark Adaptation Assessment in People With Intermediate Age-Related Macular Degeneration - A MACUSTAR Study Report.

PURPOSE: The purpose of this study was to assess test-retest variability and discriminatory power of measures from macular integrity assessment (S-MAIA) and AdaptDx. METHODS: This is a cross-sectional study of 167 people with intermediate age-related macular degeneration (iAMD), no AMD (controls; n = 54), early AMD (n = 28), and late AMD (n = 41), recruited across 18 European ophthalmology centers. Repeat measures of mesopic and scotopic S-MAIA average (mean) threshold (MMAT decibels [dB] and SMAT [dB]) and rod intercept time (RIT [mins]) at 2 visits 14 (±7) days apart were recorded. Repeat measures were assessed by Bland-Altman analysis, intra-class correlation coefficients (ICCs) and variability ratios. Secondary analysis assessed the area under the receiver operating characteristic curves (AUC) to determine the ability to distinguish people as having no AMD, early AMD, or iAMD. RESULTS: Data were available for 128, 131, and 103 iAMD participants for the mesopic and scotopic S-MAIA and AdaptDx, respectively. MMAT and SMAT demonstrate similar test-retest variability in iAMD (95% confidence interval [CI] ICC of 0.79-0.89 and 0.78-0.89, respectively). ICCs were worse in RIT (95% CI ICC = 0.55-0.77). All tests had equivalent AUCs (approximately 70%) distinguishing between subjects with iAMD and controls, whereas early AMD was indistinguishable from iAMD on all measures (AUC = <55%). A learning effect was not seen in these assessments under the operating procedures used. CONCLUSIONS: MMAT, SMAT, and RIT have adequate test-retest variability and are all moderately good at separating people with iAMD from controls. TRANSLATIONAL RELEVANCE: Expected levels of test-retest variability and discriminatory power of the AdaptDx and MAIA devices in a clinical study setting must be considered when designing future trials for people with AMD

Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation

<p>Abstract</p> <p>Background</p> <p>There are no reports describing complications with posterior spinal fusion (PSF) with segmental spinal instrumentation (SSI) using pedicle screw fixation in patients with neuromuscular scoliosis.</p> <p>Methods</p> <p>Fifty neuromuscular patients (18 cerebral palsy, 18 Duchenne muscular dystrophy, 8 spinal muscular atrophy and 6 others) were divided in two groups according to severity of curves; group I (< 90°) and group II (> 90°). All underwent PSF and SSI with pedicle screw fixation. There were no anterior procedures. Perioperative (within three months of surgery) and postoperative (after three months of surgery) complications were retrospectively reviewed.</p> <p>Results</p> <p>There were fifty (37 perioperative, 13 postoperative) complications. Hemo/pneumothorax, pleural effusion, pulmonary edema requiring ICU care, complete spinal cord injury, deep wound infection and death were major complications; while atelectesis, pneumonia, mild pleural effusion, UTI, ileus, vomiting, gastritis, tingling sensation or radiating pain in lower limb, superficial infection and wound dehiscence were minor complications. Regarding perioperative complications, 34(68%) patients had at least one major or one minor complication. There were 16 patients with pulmonary, 14 with abdominal, 3 with wound related, 2 with neurological and 1 cardiovascular complications, respectively. There were two deaths, one due to cardiac arrest and other due to hypovolemic shock. Regarding postoperative complications 7 patients had coccygodynia, 3 had screw head prominence, 2 had bed sore and 1 had implant loosening, respectively. There was a significant relationship between age and increased intraoperative blood loss (p = 0.024). However it did not increased complications or need for ICU care. Similarly intraoperative blood loss > 3500 ml, severity of curve or need of pelvic fixation did not increase the complication rate or need for ICU. DMD patients had higher chances of coccygodynia postoperatively.</p> <p>Conclusion</p> <p>Although posterior-only approach using pedicle screw fixation had good correction rate, complications were similar to previous reports. There were few unusual complications like coccygodynia.</p