Complexity Theory and Al-Qaeda: Examining Complex Leadership

Recent events in the world are forcing us to restructure our understanding of leadership and organization. The al- Qaeda organization and its pervasive presence in the world demonstrated first-hand the power of a flexible, moderately coupled network of individuals brought together by a common need and aligned behind an informal and emergent leader. Its structure, which resulted from bottom-up coordination of individuals who voluntarily came together based on common need rather than from top-down hierarchical control, clearly demonstrates the power of a networked system based on relationships and shared vision and mission. To understand this and other types of network organizations, traditional models of leadership and organizational theory may no longer be sufficient, and may perhaps even limit our ability to realize the capabilities and resilience of such organizational forms. To address such limitations, leadership theorists are exhibiting interest in new perspectives on organizing such as complexity theory (Boal et al., in press; Hunt & Ropo, in press; Marion & Uhl-Bien, 2001; McKelvey, in press; Streatfield, 2001). Complexity theory proposes that organizations are complex systems composed of a diversity of agents who interact with and mutually affect one another, leading to spontaneous “bottom-up” emergence of novel behavior (Marion & Uhl-Bien, 2001; Regine & Lewin, 2000). Because of this, leadership in complex systems requires a shift in thinking from traditional “command-and-control” models that focus on control and stifle emergence (McKelvey, in press) to “complex leadership” models (Marion & Uhl-Bien, 2001) that enable interconnectivity and foster dynamic systems behavior and innovation. In this way, complexity theory helps explain organizational behavior relative to the “dynamic swirl” of social and organizational events that influence complex systems and their agents. The purpose of this article is to derive propositions regarding complexity and complex leadership (Marion & Uhl-Bien, 2001) and to illustrate them using the case of al-Qaeda. We will argue that the conditions that led to the emergence of al-Qaeda were conducive to complex leadership, and that complex leadership helps explain the success of this terrorist movement. Although detailed data of the sort needed for rigorous qualitative analysis are obviously unavailable, we believe that the al- Qaeda example is such a powerful illustration of complexity concepts that it merits a nontraditional format for presentation

Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography

A prospective study using sonography and computed tomography (CT) was performed on 102 patients consecutively identified as having acute pancreatitis to see which method provided the most information. Each examination was graded for visualization of the pancreas, extent of disease, and the detection of complications. CT was found to be of significantly greater value than sonography due to the high percentage (38%) of nondiagnostic studies with the latter method. Of the 102 patients, 70% had abnormal CT studies, including 18% with extrapancreatic phlegmons, 10% with pseudocysts, 5% with acute hemorrhage, and 3% with pancreatic abscesses

The clinical significance of acute pancreatic hemorrhage

Computed tomography (CT) has the ability to demonstrate acute hemorrhage both within the pancreatic parenchyma and the adjacent retroperitoneal spaces. It was found that during the acute phase of pancreatic hemorrhage (about 1-7 days) the CT number of hemorrhage is significantly greater than that of the gland. At the present time the true incidence of pancreatic hemorrhage and the relation of the CT demonstration of hemorrhage to the clinical entity of hemorrhagic pancreatitis is unclear. The CT, laboratory, and clinical findings in eight patients with acute pancreatitis were analyzed to help answer these questions. This limited experience suggests pancreatic hemorrhage is more frequent than hemorrhagic pancreatitis as currently defined clinically

Acute pancreatitis: clinical vs. CT findings

In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptoms. This was especially true of phlegmonous pancreatitis, where the CT findings could persist for months

Significance of a dilated pancreatic duct on CT examination

The infrequency of reports demonstrating dilatation of the pancreatic ducts in patients with chronic pancreatitis by CT, despite its frequent demonstration on endoscopic retrograde cholangiopancreatography (ERCP), prompted a review of 500 cases performed at the University of Miami School of Medicine/Jackson Memorial Hospital for suspected pancreatic disease. Pancreatic duct dilatation was demonstrated in 10 patients. An equal occurrence was documented in patients with chronic pancreatitis and with carcinoma. Therefore, the presence of dilated pancreatic duct only confirms the presence of pancreatic disease. No etiology should be favored by the isolated finding of a dilated duct on CT scanning

The role of percutaneous aspiration in the diagnosis of pancreatic abscess

Percutaneous aspiration should be performed on pancreatic/peripancreatic fluid collections when an abscess is suspected. Thirty-one percutaneous aspirations were performed on 21 such patients and seven (33%) proved to have an abscess. A Gram stain after the aspiration is important, as it can make an immediate diagnosis of an abscess. By helping make an early diagnosis, percutaneous aspiration might reduce the high mortality rate associated with a pancreatic abscess while avoiding surgery in those who have sterile fluid collections. Two complications (6%) occurred: superinfection of a pseudocyst and a hemoperitoneum