Background: Though the functional states of other endocrine systems are not defined on the basis of levels of controlling hormones, the assessment of thyroid function is based on levels of the controlling hormone thyrotropin (TSH). We, therefore, addressed the question as to whether levels of thyroid hormones [free thyroxine (fT4), total triiodothyronine (TT3)/free triiodothyronine (fT3)], or TSH levels, within and beyond the reference ranges, provide the better guide to the range of clinical parameters associated with thyroid status. Methods: A PubMed/MEDLINE search of studies up to October 2019, examining associations of levels of thyroid hormones and TSH, taken simultaneously in the same individuals, with clinical parameters was performed. We analyzed atrial fibrillation, other cardiac parameters, osteoporosis and fracture, cancer, dementia, frailty, mortality, features of the metabolic syndrome, and pregnancy outcomes. Studies were assessed for quality by using a modified Newcastle-Ottawa score. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. A meta-analysis of the associations was performed to determine the relative likelihood of fT4, TT3/fT3, and TSH levels that are associated with the clinical parameters. Results: We identified 58 suitable articles and a total of 1880 associations. In general, clinical parameters were associated with thyroid hormone levels significantly more often than with TSH levels-the converse was not true for any of the clinical parameters. In the 1880 considered associations, fT4 levels were significantly associated with clinical parameters in 50% of analyses. The respective frequencies for TT3/fT3 and TSH levels were 53% and 23% (p < 0.0001 for both fT4 and TT3/fT3 vs. TSH). The fT4 and TT3/fT3 levels were comparably associated with clinical parameters (p = 0.71). More sophisticated statistical analyses, however, indicated that the associations with TT3/fT3 were not as robust as the associations with fT4. Conclusions: Thyroid hormones levels, and in particular fT4 levels, seem to have stronger associations with clinical parameters than do TSH levels. Associations of clinical parameters with TSH levels can be explained by the strong negative population correlation between thyroid hormones and TSH. Clinical and research components of thyroidology currently based on the measurement of the thyroid state by reference to TSH levels warrant reconsideration.

Purpose -The purpose of this paper is to examine the relationship between transformational leadership (TL) and employee desire for empowerment (EDFE). This study also aims to extend Gill and Mathur's findings regarding improving employee dedication and pro-social behavior. Design/methodology/approach -Hospitality industry employees from Canada and India were surveyed to test the relationship between TL and EDFE in countries that differ substantially in their levels of cultural power distance. Findings -Results suggest that the improvement in the degree of EDFE is positively related to the improvement in the degree of perceived TL implementation in the hospitality industry in both countries. However, substantial differences in relative impact were observed between restaurant (high in both countries) and hotel/motel workers (low in Canada, high in India). In addition to cultural power distance, levels of TL and EDFE were significantly lower in India than in Canada, and levels of TL were significantly lower among restaurant workers than among hotel/motel workers. Practical implications -Managers who exhibit TL behaviors are more likely to heighten their employees' desire to be empowered, regardless of cultural context. Originality/value -The findings help to explain failures in organizational efforts to empower workers by demonstrating the critical role of TL behaviors in heightening EDFE.

In this article, the relationship of Appreciative Inquiry (AI) with the shadow, defined as censored emotional and/or cognitive content (Shadow), is explored via three varieties of AI-Shadow relationships: (1) AI as generating Shadow through both its "light" and the censoring effect of polarizing norms, (2) AI as an intervention into the Shadow, and (3) AI itself as a Shadow process. These varieties of AI-Shadow relationships are then illustrated through two case stories. Finally, implications for our collective AI conversation are presented.

Context. Population studies of the distribution of T4/TSH set points suggest a more complex inverse relationship between T4 and TSH than that suggested by physiological studies. The reasons for the similarities and differences between the curves describing these relationships are unresolved. Methods. We subjected the curve, derived from empiric data, describing the TSH suppression response to T4, and the more mathematically derived curve describing the T4 response to TSH, to the different possible models of population variation. The implied consequences of these in terms of generating a population distribution of T4/TSH equilibrium points (a “population curve”) were generated and compared to the empiric population curve. The physiological responses to primary hypothyroidism and hyperthyroidism were incorporated into the analysis. Conclusions. Though the population curve shows a similarly inverse relationship, it is describing a different relationship than the curve describing the suppression of TSH by T4. The population curve is consistent with the physiological studies of the TSH response to T4 and implies a greater interindividual variation in the positive thyroid T4 response to TSH than in the central inhibitory TSH response to T4. The population curve in the dysthyroid states is consistent with known physiological responses to these states.