ABSTRACT
The capacity of public sector of co-creating with other stakeholders is challenged by the increasing presence of disruptive turbulent events, such as the COVID-19. At this regard, robustness has been identified as a suitable response to deal with this kind of events. Through a systematic literature review, we analyzed how public sector organizations have co-created with other actors during the COVID-19 and what have been the contribution of robust governance strategies. Our findings point firstly to the empirical validity of the robustness concept, providing evidence of the extensive use of robust governance strategies into the co-creation processes. Second, we identified a configurational approach to robustness, with governments co-creating by simultaneously employing several robust strategies. Thirdly, we observed a more active involvement of societal stakeholders, with emergence of proto-institutions and potential threats to the political system.
ABSTRACT
Characterising COVID-19 pandemic as a 'state of exception', we might expect great hero models of leadership to come to the fore. Instead, drawing on a thematic analysis of 246 news articles, this paper illustrates something different: communities, companies, individuals picked-up the leadership mantle but were reluctant to frame their practices under a leadership rhetoric. The paper explores spontaneous initiatives and leaderly actions that were made visible during the pandemic and proposes practice-based implications for redrawing leadership conceptualisations. These practices, coined as unleading, are characterised under four dimensions: unconditionality and social intention; purposeful action in the absence of an achievement motivation; sensing and attending to local conditions; and confident connecting and collaborating. The analysis and discussion of the four dimensions affirm that while leading and unleading are always present when organising, they are more or less visible and practiced depending on organisational, social and individual circumstances. The paper concludes by surfacing questions and reflections for the future of unleading and implications for leadership theorising and practice.
ABSTRACT
OBJECTIVE: There are limited data on the incidence of iodinated contrast-induced thyrotoxicosis, particularly in iodine-deficient regions. The aim of this study was to determine the incidence of iodinated contrast-induced thyrotoxicosis and to determine whether thyrotoxicosis was more common in patients ≥70 years compared to those <70 years of age. DESIGN: A prospective study of adult patients undergoing an outpatient CT with iodinated contrast was performed. MEASUREMENTS: Thyroid function tests (TFTs) and urine iodine measurements were performed prior to the scan. TFTs were repeated at 4- and 8-weeks postscan. Changes in TFTs from baseline were analysed. RESULTS: A total of 102 patients were included in the final analysis. Overall, TSH levels dropped (P = 0·0002), and free T3 (FT3 ) levels increased (P = 0·04) between baseline and week 4 with normalization by week 8; however, these changes were not considered clinically significant. No significant differences in free T4 (FT4 ) occurred in the overall group (P = 0·82). There were no differences in TFTs between baseline and 4 or 8 weeks for those patients aged <70 compared to ≥70 years. Two patients developed new subnormal TSH values. Of these, one had a 90-mm follicular variant papillary thyroid carcinoma diagnosed while the other had a normal thyroid assessment and TSH spontaneously normalized by 12 weeks. CONCLUSIONS: Only 2% of patients developed subclinical hyperthyroidism following a standard dose of iodinated contrast for CT investigations. Given the low incidence of iodine-induced thyrotoxicosis, there is no indication for routine pre- and post-CT thyroid function testing in our region.
