Fetal alcohol spectrum disorder: development of concensus referral criteria for specialist diagnostic assessment in Australia

Background: Fetal alcohol spectrum disorder (FASD) is known to be under-recognised in Australia. The use of standard methods to identify when to refer individuals who may have FASD for specialist assessment could help improve the identification of this disorder. The purpose of this study was to develop referral criteria for use in Australia. Method: An online survey about FASD screening and diagnosis in Australia, which included 23 statements describing criteria for referral for fetal alcohol syndrome (FAS) and FASD based on published recommendations for referral in North America, was sent to 139 health professionals who had expertise or involvement in FASD screening or diagnosis. Survey findings and published criteria for referral were subsequently reviewed by a panel of 14 investigators at a consensus development workshop where criteria for referral were developed.Results: Among the 139 health professionals who were sent the survey, 103 (74%) responded, and 90 (65%) responded to the statements on criteria for referral. Over 80% of respondents agreed that referral for specialist evaluation should occur when there is evidence of significant prenatal alcohol exposure, defined as 7 or more standard drinks per week and at least 3 standard drinks on any one day, and more than 70% agreed with 13 of the16 statements that described criteria for referral other than prenatal alcohol exposure. Workshop participants recommended five independent criteria for referral: confirmed significant prenatal alcohol exposure; microcephaly and confirmed prenatal alcohol exposure; 2 or more significant central nervous system (CNS) abnormalities and confirmed prenatal alcohol exposure; 3 characteristic FAS facial anomalies; and 1 characteristic FAS facial anomaly, growth deficit and 1 or more CNS abnormalities .Conclusion: Referral criteria recommended for use in Australia are similar to those recommended in North America. There is a need to develop resources to raise awareness of these criteria among health professionals and evaluate their feasibility, acceptability and capacity to improve the identification of FASD in Australia

A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia

Background: There is little reliable information on the prevalence of fetal alcohol spectrum disorders (FASD) in Australia and no coordinated national approach to facilitate case detection. The aim of this study was to identify health professionals’ perceptions about screening for FASD in Australia. Method: A modified Delphi process was used to assess perceptions of the need for, and the process of, screening for FASD in Australia. We recruited a panel of 130 Australian health professionals with experience or expertise in FASD screening or diagnosis. A systematic review of the literature was used to develop Likert statements on screening coverage, components and assessment methods which were administered using an online survey over two survey rounds. Results: Of the panel members surveyed, 95 (73%) responded to the questions on screening in the first survey round and, of these, 81 (85%) responded to the second round. Following two rounds there was consensus agreement on the need for targeted screening at birth (76%) and in childhood (84%). Participants did not reach consensus agreement on the need for universal screening at birth (55%) or in childhood (40%). Support for targeted screening was linked to perceived constraints on service provision and the need to examine the performance, costs and benefits of screening. For targeted screening of high risk groups, we found highest agreement for siblings of known cases of FASD (96%) and children of mothers attending alcohol treatment services (93%). Participants agreed that screening for FASD primarily requires assessment of prenatal alcohol exposure at birth (86%) and in childhood (88%), and that a checklist is needed to identify the components of screening and criteria for referral at birth (84%) and in childhood (90%). Conclusions: There is an agreed need for targeted but not universal screening for FASD in Australia, and sufficient consensus among health professionals to warrant development and evaluation of standardised methods for targeted screening and referral in the Australian context. Participants emphasised the need for locally-appropriate, evidence-based approaches to facilitate case detection, and the importance of ensuring that screening and referral programs are supported by adequate diagnostic and management capacity

Challenges for adaptation in agent societies

The final publication is available at Springer via http://dx.doi.org/[insert DOIAdaptation in multiagent systems societies provides a paradigm for allowing these societies to change dynamically in order to satisfy the current requirements of the system. This support is especially required for the next generation of systems that focus on open, dynamic, and adaptive applications. In this paper, we analyze the current state of the art regarding approaches that tackle the adaptation issue in these agent societies. We survey the most relevant works up to now in order to highlight the most remarkable features according to what they support and how this support is provided. In order to compare these approaches, we also identify different characteristics of the adaptation process that are grouped in different phases. Finally, we discuss some of the most important considerations about the analyzed approaches, and we provide some interesting guidelines as open issues that should be required in future developments.This work has been partially supported by CONSOLIDER-INGENIO 2010 under grant CSD2007-00022, the European Cooperation in the field of Scientific and Technical Research IC0801 AT, and projects TIN2009-13839-C03-01 and TIN2011-27652-C03-01.Alberola Oltra, JM.; Julian Inglada, VJ.; García-Fornes, A. (2014). Challenges for adaptation in agent societies. Knowledge and Information Systems. 38(1):1-34. https://doi.org/10.1007/s10115-012-0565-yS134381Aamodt A, Plaza E (1994) Case-based reasoning; foundational issues, methodological variations, and system approaches. AI Commun 7(1):39–59Abdallah S, Lesser V (2007) Multiagent reinforcement learning and self-organization in a network of agents. In: Proceedings of the sixth international joint conference on autonomous agents and multi-agent systems, pp 172–179Abdu H, Lutfiyya H, Bauer MA (1999) A model for adaptive monitoring configurations. In: Proceedings of the VI IFIP/IEEE IM conference on network management, pp 371–384Alberola JM, Julian V, Garcia-Fornes A (2011) A cost-based transition approach for multiagent systems reorganization. In: Proceedings of the 10th international conference on aut. agents and MAS (AAMAS11), pp 1221–1222Alberola JM, Julian V, Garcia-Fornes A (2012) Multi-dimensional transition deliberation for organization adaptation in multiagent systems. In: Proceedings of the 11th international conference on aut. agents and MAS (AAMAS12) (in press)Argente E, Julian V, Botti V (2006) Multi-agent system development based on organizations. Electron Notes Theor Comput Sci 160(3):55–71Argente E, Botti V, Carrascosa C, Giret A, Julian V, Rebollo M (2011) An abstract architecture for virtual organizations: the Thomas approach. Knowl Inf Syst 29(2):379–403Ashford SJ, Taylor MS (1990) Adaptation to work transitions. An integrative approach. Res Pers Hum Resour Manag 8:1–39Ashford SJ, Blatt R, Walle DV (2003) Reflections on the looking glass: a review of research on feedback-seeking behavior in organizations. J Manag 29(6):773–799Astley WG, Van de Ven AH (1983) Central perspectives and debates in organization theory. Adm Sci Q 28(2):245–273Bond AH, Gasser L (1988) A survey of distributed artificial intelligence readings in distributed artificial intelligence. Morgan Kaufmann, Los AltosBou E, López-Sánchez M, Rodríguez-Aguilar JA (2006) Adaptation of autonomic electronic institutions through norms and institutional agents In: Engineering societies in the agents world. Number LNAI 445, Springer, Dublin, pp 300–319Bou E, López-Sánchez M, Rodríguez-Aguilar JA (2007) Towards self-configuration in autonomic electronic institutions. In: COIN 2006 workshops. Number LNAI 4386, pp 220–235Bou E, López-Sánchez M, Rodríguez-Aguilar JA (2008) Using case-based reasoning in autonomic electronic institutions. In: Proceedings of the 2007 international conference on coordination, organizations, institutions, and norms in agent systems III, pp 125–138Brett JM, Feldman DC, Weingart LR (1990) Feedback-seeking behavior of new hires and job changers. J Manag 16:737–749Bulka B, Gaston ME, desJardins M (2007) Local strategy learning in networked multi-agent team formation. Auton Agents Multi-Agent Syst 15(1):29–45Campos J, López-Sánchez M, Esteva M (2009) Assistance layer, a step forward in multi-agent systems. In: Coordination support international joint conference on autonomous agents and multiagent systems (AAMAS), pp 1301–1302Campos J, Esteva M, López-Sánchez M, Morales J, Salamó M (2011) Organisational adaptation of multi-agent systems in a peer-to-peer scenario. Computing 91(2):169–215Carley KM, and Gasser L (1999) Computational organization theory. Multiagent systems: a modern approach to distributed artificial intelligence. MIT Press, Cambridge, pp 299–330Carvalho G, Almeida H, Gatti M, Vinicius G, Paes R, Perkusich, A, Lucena C (2006) Dynamic law evolution in governance mechanisms for open multi-agent systems. In: Second workshop on software engineering for agent-oriented systemsCernuzzi L, Zambonelli F (2011) Adaptive organizational changes in agent-oriented methodologies. Knowl Eng Rev 26(2):175–190Cheng BH, Lemos R, Giese H, Inverardi P, Magee J (2009) Software engineering for self-adaptive systems: a research roadmap, pp 1–26Corkill DD, Lesser VR (1983) The use of meta-level control for coordination in a distributed problem solving networks. In: Proceedings of the eighth international joint conference on artificial intelligence. IEEE Computer Society Press, pp 748–756Corkill DD, Lander SE (1998) Diversity in agent organizations. Object Mag 8(4):41–47de Paz JF, Bajo J, González A, Rodríguez S, Corchado JM (2012) Combining case-based reasoning systems and support vector regression to evaluate the atmosphere-ocean interaction. Knowl Inf Syst 30(1):155–177DeLoach SA, Matson E (2004) An organizational model for designing adaptive multiagent systems. In: The AAAI-04 workshop on agent organizations: theory and practice (AOTP), pp 66–73DeLoach SA, Oyeman W, Matson E (2008) A capabilities-based model for adaptive organizations. Auton Agents Multi-Agent Syst 16:13–56Dignum V, Dignum F (2001) Modelling agent societies: co-ordination frameworks and institutions progress in artificial intelligence. LNAI 2258, pp 191–204Dignum V (2004) A model for organizational interaction: based on agents, founded in logic. PhD dissertation, Universiteit Utrecht. SIKS dissertation series 2004-1Dignum V, Dignum F, Sonenberg L (2004) Towards dynamic reorganization of agent societies. In: Proceedings of the workshop on coordination in emergent agent societies, pp 22–27Dignum V, Dignum F (2006) Exploring congruence between organizational structure and task performance: a simulation approach coordination, organization, institutions and norms in agent systems I. In: Proceedings of the ANIREM ’05/OOOP ’05, pp 213–230Dignum V, Dignum F (2007) A logic for agent organizations. In: Proceedings of the multi-agent logics, languages, and organisations federated workshops (MALLOW ’007), formal approaches to multi-agent systems (FAMAS ’007) workshopFox MS (1981) Formalizing virtual organizations. IEEE Transact Syst Man Cybern 11(1):70–80Gaston ME, desJardins M (2005) Agent-organized networks for dynamic team formation. In: Proceedings of the fourth international joint conference on autonomous agents and multiagent systems, pp 230–237Gaston ME, desJardins M (2008) The effect of network structure on dynamic team formation in multi-agent systems. Comput Intell 24(2):122–157Norbert G, Philippe M (1997) The reorganization of societies of autonomous agents. In: MAAMAW-97. Springer, London, pp 98–111Goldman CV, Rosenschein JS (1997) Evolving organizations of agents American association for artificial intelligence. In: Multiagent learning workshop at AAAI97Greve HR (1998) Performance, aspirations, and risky organizational change. Adm Sci Quart 43(1):58–86Guessoum Z, Ziane M, Faci N (2004) Monitoring and organizational-level adaptation of multi-agent systems. In: Proceedings of the AAMAS ’04, pp 514–521Hoogendoorn M, Treur J (2006) An adaptive multi-agent organization model based on dynamic role allocation. In: Proceedings of the IAT ’06, pp 474–481Horling B, Benyo B, Lesser V (1999) Using self-diagnosis to adapt organizational structures. In: Proceedings of the 5th international conference on autonomous agents, pp 529–536Horling B, Lesser V (2005) A survey of multi-agent organizational paradigms. Knowl Eng Rev 19(4): 281–316Hrebiniak LG, Joyce WF (1985) Organizational adaptation: strategic choice and environmental determinism. Adm Sci Quart 30(3):336–349Hübner JF, Sichman JS, Boissier O (2002) MOISE+: towards a structural, functional, and deontic model for MAS organization. In: Proceedings of the first international joint conference on autonomous agents and multiagent systems, pp 501–502Hübner JF, Sichman JS, Boissier O (2004) Using the MOISE+ for a cooperative framework of MAS reorganisation. In: Proceedings of the 17th Brazilian symposium on artificial intelligence (SBIA ’04), vol 3171, pp 506–515Hübner JF, Boissier O, Sichman JS (2005) Specifying E-alliance contract dynamics through the MOISE + reorganisation process Anais do V Encontro Nacional de Inteligde Inteligncia Artificial (ENIA 2005)Jennings NR (2001) An agent-based approach for building complex software systems. Commun ACM 44(4):35–41Kamboj S, Decker KS (2006) Organizational self-design in semi-dynamic environments In: 2007 IJCAI workshop on agent organizations: models and simulations (AOMS@IJCAI), pp 335–337Katz D, Kahn RL (1966) The social psychology of organizations. Wiley, New YorkKelly D, Amburgey TL (1991) Organizational inertia and momentum: a dynamic model of strategic change. Acad Manag J 34(3):591–612Kephart J, Chess DM (2003) The vision of autonomic computing. Computer 36(1):41–50Kim DH (1993) The link between individual and organizational learning. Sloan Manag Rev 35(1):37–50Kota R, Gibbins N, Jennings NR (2009a) Decentralised structural adaptation in agent organisations organized adaptation in multi-agent systems, pp 54–71Kota R, Gibbins N, Jennings NR (2009b) Self-organising agent organisations. In: Proceedings of the 8th international conference on autonomous agents and multiagent systems (AAMAS 2009)Kota R, Gibbins N, Jennings NR (2012) Decentralised approaches for self-adaptation in agent organisations. ACM Trans Auton Adapt Syst 7(1):1–28Kotter J, Schlesinger L (1979) Choosing strategies for change. Harv Bus Rev 106–1145Lesser VR (1998) Reflections on the nature of multi-agent coordination and its implications for an agent architecture. Auton Agents Multi-Agent Syst 89–111Levitt B, March JG (1988) Organizational learning. Annu Rev Sociol 14:319–340Luck M, McBurney P, Shehory O, Willmott S (2005) Agent technology: computing as interaction (a roadmap for agent based computing)Mathieu P, Routier JC, Secq Y (2002a) Dynamic organization of multi-agent systems. In: Proceedings of the first international joint conference on autonomous agents and multiagent systems: part 1, pp 451–452Mathieu P, Routier JC, Secq Y (2002b) Principles for dynamic multi-agent organizations. In: Proceedings of the 5th Pacific rim international workshop on multi agents: intelligent agents and multi-agent systems, pp 109–122Matson E, DeLoach S (2003) Using dynamic capability evaluation to organize a team of cooperative, autonomous robots. In: Proceedings of the 2003 international conference on artificial intelligence (IC-AI ’03), Las Vegas, pp 23–26Matson E, DeLoach S (2004) Enabling intra-robotic capabilities adaptation using an organization-based multiagent system. ICRA, pp 2135–2140Matson E, DeLoach S (2005) Formal transition in agent organizations. In: IEEE international conference on knowledge intensive multiagent systems (KIMAS ’05)Matson E, Bhatnagar R (2006) Properties of capability based agent organization transition. In: Proceedings of the IEEE/WIC/ACM international conference on intelligent agent technology IAT ’06, pp 59–65Morales J, López-Sánchez M, Esteva, M (2011) Using experience to generate new regulations. In: Proceedings of the twenty-second international joint conference on artificial Intelligence (IJCAI-11), pp 307–312Muhlestein D, Lim S (2011) Online learning with social computing based interest sharing. Knowl Inf Syst 26(1):31–58Nair R, Tambe M, Marsella S (2003) Role allocation and reallocation in multiagent teams: towards a practical analysis. In: Proceedings of the second AAMAS ’03, pp 552–559Orlikowski WJ (1996) Improvising organizational transformation over time: a situated change perspective. Inf Syst Res 7(1):63–92Panait L, Luke S (2005) Cooperative multi-agent learning: the state of the art. Auton Agents Multi-Agent Syst 11:387–434Ringold PL, Alegria J, Czaplewski RL, Mulder BS, Tolle T, Burnett K (1996) Adaptive monitoring design for ecosystem management. Ecol Appl 6(3):745–747Routier J, Mathieu P, Secq Y (2001) Dynamic skill learning: a support to agent evolution. In: Proceedings of the artificial intelligence and the simulation of behaviour symposium on adaptive agents and multi-agent systems (AISB ’01), pp 25–32Scott RW (2002) Organizations: rational, natural, and open systems, 5th edn. Prentice Hall International, New YorkSeelam A (2009) Reorganization of massive multiagent systems: MOTL/O http://books.google.es/books?id=R-s8cgAACAAJ . Southern Illinois University CarbondaleSo Y, Durfee EH (1993) An organizational self-design model for organizational change. In: AAAI93 workshop on AI and theories of groups and oranizations, pp 8–15So Y, Durfee EH (1998) Designing organizations for computational agents. Simulating organizations. MIT Press, Cambridge, pp 47–64Schwaninger M (2000) A theory for optimal organization. Technical report. Institute of Management at the University of St. Gallen, SwitzerlandTantipathananandh C, Berger-Wolf TY (2011) Finding communities in dynamic social networks. In: IEEE 11th international conference on data mining 2011, pp 1236–1241Wang Z, Liang X (2006) A graph based simulation of reorganization in multi-agent systems. In: IEEE WICACM international conference on intelligent agent technology, pp 129–132Wang D, Tse Q, Zhou Y (2011) A decentralized search engine for dynamic web communities. Knowl Inf Syst 26(1):105–125Weick KE (1979) The social psychology of organizing, 2nd edn. Addison-Wesley, ReadingWeyns D, Haesevoets R, Helleboogh A, Holvoet T, Joosen W (2010a) The MACODO middleware for context-driven dynamic agent organizations. ACM Transact Auton Adapt Syst 3:1–3:28Weyns D, Malek S, Andersson J (2010b) FORMS: a formal reference model for self-adaptation. In: Proceedings of the 7th international conference on autonomic computing, pp 205–214Weyns D, Georgeff M (2010) Self-adaptation using multiagent systems. IEEE Softw 27(1):86–91Zhong C (2006) An investigation of reorganization algorithms. Master-thesi

Structural, Metabolic, and Functional Brain Abnormalities as a Result of Prenatal Exposure to Drugs of Abuse: Evidence from Neuroimaging

Prenatal exposure to alcohol and stimulants negatively affects the developing trajectory of the central nervous system in many ways. Recent advances in neuroimaging methods have allowed researchers to study the structural, metabolic, and functional abnormalities resulting from prenatal exposure to drugs of abuse in living human subjects. Here we review the neuroimaging literature of prenatal exposure to alcohol, cocaine, and methamphetamine. Neuroimaging studies of prenatal alcohol exposure have reported differences in the structure and metabolism of many brain systems, including in frontal, parietal, and temporal regions, in the cerebellum and basal ganglia, as well as in the white matter tracts that connect these brain regions. Functional imaging studies have identified significant differences in brain activation related to various cognitive domains as a result of prenatal alcohol exposure. The published literature of prenatal exposure to cocaine and methamphetamine is much smaller, but evidence is beginning to emerge suggesting that exposure to stimulant drugs in utero may be particularly toxic to dopamine-rich basal ganglia regions. Although the interpretation of such findings is somewhat limited by the problem of polysubstance abuse and by the difficulty of obtaining precise exposure histories in retrospective studies, such investigations provide important insights into the effects of drugs of abuse on the structure, function, and metabolism of the developing human brain. These insights may ultimately help clinicians develop better diagnostic tools and devise appropriate therapeutic interventions to improve the condition of children with prenatal exposure to drugs of abuse

Systematic review of interventions for children with Fetal Alcohol Spectrum Disorders

<p>Abstract</p> <p>Background</p> <p>Children with Fetal Alcohol Spectrum Disorders (FASD) may have significant neurobehavioural problems persisting into adulthood. Early diagnosis may decrease the risk of adverse life outcomes. However, little is known about effective interventions for children with FASD. Our aim is to conduct a systematic review of the literature to identify and evaluate the evidence for pharmacological and non-pharmacological interventions for children with FASD.</p> <p>Methods</p> <p>We did an electronic search of the Cochrane Library, MEDLINE, EMBASE, PsychINFO, CINAHL and ERIC for clinical studies (Randomized controlled trials (RCT), quasi RCT, controlled trials and pre- and post-intervention studies) which evaluated pharmacological, behavioural, speech therapy, occupational therapy, physiotherapy, psychosocial and educational interventions and early intervention programs. Participants were aged under 18 years with a diagnosis of a FASD. Selection of studies for inclusion and assessment of study quality was undertaken independently by two reviewers. Meta-analysis was not possible due to diversity in the interventions and outcome measures.</p> <p>Results</p> <p>Twelve studies met the inclusion criteria. Methodological weaknesses were common, including small sample sizes; inadequate study design and short term follow up. Pharmacological interventions, evaluated in two studies (both RCT) showed some benefit from stimulant medications. Educational and learning strategies (three RCT) were evaluated in seven studies. There was some evidence to suggest that virtual reality training, cognitive control therapy, language and literacy therapy, mathematics intervention and rehearsal training for memory may be beneficial strategies. Three studies evaluating social communication and behavioural strategies (two RCT) suggested that social skills training may improve social skills and behaviour at home and Attention Process Training may improve attention.</p> <p>Conclusion</p> <p>There is limited good quality evidence for specific interventions for managing FASD, however seven randomized controlled trials that address specific functional deficits of children with FASD are underway or recently completed.</p

Imaging the Impact of Prenatal Alcohol Exposure on the Structure of the Developing Human Brain

Prenatal alcohol exposure has numerous effects on the developing brain, including damage to selective brain structure. We review structural magnetic resonance imaging (MRI) studies of brain abnormalities in subjects prenatally exposed to alcohol. The most common findings include reduced brain volume and malformations of the corpus callosum. Advanced methods have been able to detect shape, thickness and displacement changes throughout multiple brain regions. The teratogenic effects of alcohol appear to be widespread, affecting almost the entire brain. The only region that appears to be relatively spared is the occipital lobe. More recent studies have linked cognition to the underlying brain structure in alcohol-exposed subjects, and several report patterns in the severity of brain damage as it relates to facial dysmorphology or to extent of alcohol exposure. Future studies exploring relationships between brain structure, cognitive measures, dysmorphology, age, and other variables will be valuable for further comprehending the vast effects of prenatal alcohol exposure and for evaluating possible interventions

Health-related quality of life of Canadian children and youth prenatally exposed to alcohol

BACKGROUND: In Canada, the incidence of Fetal Alcohol Spectrum Disorder (FASD) has been estimated to be 1 in 100 live births. Caused by prenatal exposure to alcohol, FASD is the leading cause of neuro-developmental disabilities among Canadian children, and youth. Objective: To measure the health-related quality of life (HRQL) of Canadian children and youth diagnosed with FASD. METHODS: A prospective cross-sectional study design was used. One-hundred and twenty-six (126) children and youth diagnosed with FASD, aged 8 to 21 years, living in urban and rural communities throughout Canada participated in the study. Participants completed the Health Utilities Index Mark 3 (HUI3). HUI3 measures eight health attributes: vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain. Utilities were used to measure a single cardinal value between 0 and 1.0 (0 = all-worst health state; 1 = perfect health) to reflect the global HRQL for that child. Mean HRQL scores and range of scores of children and youth with FASD were calculated. A one-sample t-test was used to compare mean HRQL scores of children and youth with FASD to those from the Canadian population. RESULTS: Mean HRQL score of children and youth with FASD was 0.47 (95% CI: 0.42 to 0.52) as compared to a mean score of 0.93 (95% CI: 0.92 to 0.94) in those from the general Canadian population (p < 0.001). Children demonstrated moderate to severe dysfunction on the single-attributes of cognition and emotion. CONCLUSION: Children and youth with FASD have significantly lower HRQL than children and youth from the general Canadian population. This finding has significant implications for practice, policy development, and research

Darwinism, organizational evolution and survival: key challenges for future research

How do social organizations evolve? How do they adapt to environmental pressures? What resources and capabilities determine their survival within dynamic competition? Charles Darwin’s seminal work The Origin of Species (1859) has provided a significant impact on the development of the management and organization theory literatures on organizational evolution. This article introduces the JMG Special Issue focused on Darwinism, organizational evolution and survival. We discuss key themes in the organizational evolution research that have emerged in recent years. These include the increasing adoption of the co-evolutionary approach, with a particular focus on the definition of appropriate units of analysis, such as routines, and related challenges associated with exploring the relationship between co-evolution, re-use of knowledge, adaptation, and exaptation processes. We then introduce the three articles that we have finally accepted in this Special Issue after an extensive, multi-round, triple blind-review process. We briefly outline how each of these articles contributes to understanding among scholars, practitioners and policy makers of the continuous evolutionary processes within and among social organizations and systems