Pediatric thyroid disease: when is surgery necessary, and who should be operating on our children?

Surgical diseases of the thyroid in the pediatric population represent a diverse set of both benign and malignant conditions. Overall, incidence is rare. Benign conditions include Graves' disease, toxic adenomas, congenital hyperthyroidism, and goiter. Differentiated thyroid cancer (DTC) and medullary thyroid carcinoma (MTC), with its related familial cancer syndromes, are the most common malignancies. Near-total or total thyroidectomy is the appropriate surgery for thyroid cancer, with/out central lymph node dissection. Emerging practice guidelines from professional societies are helpful, although they generally have not addressed surgical management of the pediatric patient. Thyroidectomy in children is associated with a higher rate of complications, such as recurrent laryngeal nerve injury and hypoparathyroidism, as compared to the surgery in adults. Therefore, it is essential that pediatric thyroidectomy be performed by high-volume thyroid surgeons, regardless of specialty. Case volume to support surgical expertise usually must be borrowed from the adult experience, given the relative paucity of pediatric thyroidectomies at an institutional level. These surgeons should work as part of a multidisciplinary team that includes pediatric endocrinologists and anesthesiologists, pediatricians, nuclear medicine physicians, and pathologists to afford children the best clinical outcomes

Healing the Hurt: Trauma-Informed Approaches to the Health of Boys and Young Men of Color

From discrimination and poverty to alcoholism and assault, trauma in its varied forms plays a major part in the lives of Latino and African-American boys and young men. This paper outlines the ways in which violence prevention, family support, health care, foster care, and juvenile justice can incorporate a trauma-informed approach to improve the physical and mental health of young men and boys

Total Portfolio Activation: A Framework for Creating Social and Environmental Impact across Asset Classes

Interest in investment that pursues social and environmental impact has exploded in recent years. Although opportunities for impact investing have emerged across asset classes, most impact-investment activity has remained largely confined to a limited array of private investments, touching only a small percentage of investor portfolios. For organizations and individuals seeking greater impact and better alignment between their investment activities and their mission or values, there remains a pressing need for tools to help investors identify and seize opportunities to activate more of their assets for social and environmental benefit. To help fill this gap, this paper introduces a simple conceptual framework: Total Portfolio Activation

Fitting the Means to the Ends: One School’s Experience with Quantitative and Qualitative Methods in Curriculum Evaluation During Curriculum Change

Curriculum evaluation plays an important role in substantive curriculum change. The experience of the University of Texas Medical Branch (UTMB) with evaluation processes developed for the new Integrated Medical Curriculum (IMC) illustrates how evaluation methods may be chosen to match the goals of the curriculum evaluation process. Quantitative data such as ratings of courses or scores on external exams are useful for comparing courses or assessing whether standards have been met. Qualitative data such as students’ comments about aspects of courses are useful for eliciting explanations of observed phenomena and describing relationships between curriculum features and outcomes. The curriculum evaluation process designed for the IMC used both types of evaluation methods in a complementary fashion. Quantitative and qualitative methods have been used for formative evaluation of the new IMC courses. They are now being incorporated into processes to judge the IMC against its goals and objectives

Connecting community development loan funds to individual investors

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, June 2011."June 2011." Cataloged from PDF version of thesis.Includes bibliographical references (p. 87-90).Community development loan funds (CDLFs) play a critical role in financing affordable housing, small businesses, and non-profit organizations in low-income communities throughout the US. Since the 2008 financial crisis disrupted CDLFs' primary sources of capital-banks and foundations-many CDLFs have been pursuing new sources. During these years of economic recession, individuals' confidence in the financial system declined while the Socially Responsible Investing and Impact Investing sectors experienced significant growth. With these concurrent trends as a starting point, this thesis explores the potential for socially-minded individuals to become a more substantial source of capital for CDLFs. Using case studies of two organizations with successful individual investor programs- Boston Community Capital (BCC) and Calvert Foundation-my research examines the costs and benefits of individuals as a source of capital. Specifically, I study BCC's local capital raising for its Boston Community Loan Fund and newer Stabilizing Urban Neighborhoods Initiative and Calvert Foundation's Community Investment Note, a retail product available to individuals nationwide. My research analyzes the advantages and shortcomings of these differing approaches, assesses the viability of replicating each model, and makes recommendations for scaling up individual investing in CDLFs.by Ann DeMoss Solomon.M.C.P