An event-system perspective on disruption: theorizing the pandemic and other discontinuities through historical and fictional accounts of the plague

Disruptions such as COVID-19 – and the subsequent flux they wreak on organizations and society – have become commonplace. In order to advance our understanding of (and adaptation to) future discontinuities and crises, we argue that we require a reconceptualization of how disruption occurs. To do so, we draw on Event Systems Theory (EST): in contrast to previous work viewing disruption as the outcome of a singular event, we focus on how disruption can occur from an event chain, i.e., a set of events that are temporally and causally connected. We abductively shape our conceptual arguments by drawing on narratives of past pandemics, reviewing two historical and two fictional texts that (re)create the experiences of those living through the Black Death and subsequent outbreaks of the bubonic plague. Rather than focusing on events themselves, we identify how certain characteristics among events in a chain lead to four micro-level experiences: stagnation, disorientation, polarization and repudiation. We then proceed to examine how these micro-level reactions culminate into macro-level transformations of economic, political and cultural norms. Our event-system perspective on disruption and crises thereby generates insight, not only into understanding the (post) pandemic world, but also into responses to future discontinuities

Intermediary roles in regulatory programs

This paper develops a role-based framework of intermediaries in regulatory programs. In examining the types of roles that organizations adopt in regulation and governance, we argue that roles have important implications for understanding organizational and program level dynamism and outcomes. We use the Regulator–Intermediary–rule-Taker framework to describe how organizational roles can be adopted through assignment, appropriation, or promotion. We then go deeper into how intermediaries adopt a variety of different roles in key regulatory programs. We examine generic intermediary roles across programs that involve four main groups of activities: creating and/or organizing, coordinating between programs, supporting implementation, and voicing an opinion. All in all, our role-based framework allows for a novel relational way to understand interorganizational and institutional dynamism in complex, interactive, and ever-changing regulatory regimes.Peer reviewe

Contribution of Systematic Serological Testing in Diagnosis of Infective Endocarditis

Despite progress with diagnostic criteria, the type and timing of laboratory tests used to diagnose infective endocarditis (IE) have not been standardized. This is especially true with serological testing. Patients with suspected IE were evaluated by a standard diagnostic protocol. This protocol mandated an evaluation of the patients according to the modified Duke criteria and used a battery of laboratory investigations, including three sets of blood cultures and systematic serological testing for Coxiella burnetii, Bartonella spp., Aspergillus spp., Legionella pneumophila, and rheumatoid factor. In addition, cardiac valvular materials obtained at surgery were subjected to a comprehensive diagnostic evaluation, including PCR aimed at documenting the presence of fastidious organisms. The study included 1,998 suspected cases of IE seen over a 9-year period from April 1994 to December 2004 in Marseilles, France. They were evaluated prospectively. A total of 427 (21.4%) patients were diagnosed as having definite endocarditis. Possible endocarditis was diagnosed in 261 (13%) cases. The etiologic diagnosis was established in 397 (93%) cases by blood cultures, serological tests, and examination of the materials obtained from cardiac valves, respectively, in 348 (81.5%), 34 (8%), and 15 (3.5%) definite cases of IE. Concomitant infection with streptococci and C. burnetii was seen in two cases. The results of serological and rheumatoid factor evaluation reclassified 38 (8.9%) possible cases of IE as definite cases. Systematic serological testing improved the performance of the modified Duke criteria and was instrumental in establishing the etiologic diagnosis in 8% (34/427) cases of IE