Leadership development for managers in turbulent times

This document is the Accepted Manuscript version of a published work that appeared in final form in Journal of Management Development. To access the final edited and published work see http://www.emeraldinsight.com/loi/jmd.Purpose In a turbulent economic climate, characterised by pressures to improve productivity and reduce costs, leadership and performance management have a more central role in helping to ensure competitive advantage. This paper explores current demands on leaders; and endeavours to explore linkages between management education and agile leadership Design/methodology/approach Taking a grounded theory approach, this paper uses the concepts of volatility, uncertainty, complexity and ambiguity (VUCA) to investigate the impact on desired attributes of leaders and the extent to which this is underpinned by current management education programmes. It draws on the VUCA model of agile management to examine current practices and experiences and considers future trends. Empirical research includes case studies and analysis of management syllabuses. Findings Syllabuses do not reflect the attributes that organizations expect leaders to possess and are content driven rather than process focussed. VUCA is not yet mainstream in academic thinking. Practical implications There is a disparity between the output of Business Schools and the expectations of organizations. This may affect productivity. It is suggested that the use of live consultancies may provide a more beneficial management development experience. Originality/value This research opens an international debate that seeks to assess the relevance of current management education to the needs of organizations for agile, high performing leader

Update on the diagnosis of GH deficiency in adults

GH deficiency (GHD) in adults is associated with considerable morbidity and mortality. The diagnosis of GHD is generally straightforward in children as growth retardation is present; however, in adults, diagnosis of GHD is often challenging. Other markers are therefore needed to identify adults who have GHD and could potentially benefit from GH replacement therapy. Consensus guidelines for the diag-nosis and treatment of adult GHD recommend provocative testing of GH secretion for patients who have evidence of hypothalamic –pituitary disease, patients with childhood-onset GHD, and patients who have undergone cranial irradiation or have a history of head trauma. Suspicion of GHD is also heightened in the presence of other pituitary hormone deficits. Tests for GHD include measurement of the hormone in urine or serum or measurement of stimu-lated GH levels after administration of various provocative agents. The results of several studies indi-cate that non-stimulated serum or urine measurements of GH levels cannot reliably predict deficiency in adults. Although glucagon and arginine tests produce a pronounced GH response with few false positives, the insulin tolerance test (ITT) is currently considered to be the gold standard of the GH stimulation tests available. Unfortunately, the ITT has some disadvantages and questionable reproducibility, which have prompted the development of several new tests for GHD that are based on pharmacological stimuli. Of these, GH-releasing hormone (GHRH) plus arginine and GHRH plus GH-releasing peptide (GHRP) appear to be reliable and practical. Thus, in cases where ITT is contraindicated or inconclusive, the combination of arginine and GHRH is an effective alternative. As experience with this test as well as with GHRH/GHRP-6 accumulates, they may supplant ITT as the diagnostic test of choice. European Journal of Endocrinology 148 S3–S

Autonomously functioning thyroid nodule in a patient with a thyrotropin-secreting pituitary adenoma: possible cause-effect relationship

peer reviewedA 51-year-old female patient with long-standing hyperthyroidism due to a thyrotropin-secreting pituitary adenoma is reported, who became thyrotoxic again shortly after successful pituitary surgery. Functional testing and scintigraphy suggested the diagnosis of autonomous functioning thyroid nodules, which was confirmed by pathological examination of the resected thyroid tissue. This is the first report revealing the transition from a pituitary-dependent to a thyroid-dependent hyperthyroidism. Autonomous functioning thyroid nodules are, however, considered an intrinsic thyroid defect. In similarity with other disorders, in which trophic hormones may induce an autonomous secretion by the target gland, this report opens the possibility that a humoral factor may play a role in the development of autonomous functioning thyroid nodules