Not For Profit Board of Directors and Governance

Anon-profit (NFP entity’s Board of Directors) bears ultimate responsibility for its governance. It ensures the non-profit functions in accordance with all applicable laws, regulations, and the entity’s internal guidelines and mission statement. We examine these Boards’ role in overseeing the functioning of non-profit entities and their management. We begin by reviewing the purpose of a Board of Directors and a commonly adopted structure for them including who may serve on such Boards; and how these Boards differ from those in the for-profit world. We then review the formal responsibilities that NFP Boards have for the entities they govern as well as some unspoken requirements for Board members. We examine specific activities in which these Boards typically engage and some activities which violate good governance practices. We provide examples of both well-functioning boards and some which serve as cautionary tales for entities. We discuss how a Board can deal with Board members who violate an entity’s rules and/or laws and how such members might be removed from their respective office as well as other regulatory and legal issues related to the conduct of Board members. We discuss the government entities both state and federal which regulate the function of non-profit Boards

A simple method for Bachmann's bundle pacing with indigenous modification of J-stylet

AbstractBackgroundPacing in the Bachmann's bundle (BB) area (upper atrial septum) appears superior to right atrial appendage or free wall stimulation for the prevention of paroxysmal atrial fibrillation in patients with atrial conduction delay. However, insertion of active fixation lead in the upper atrial septal position is difficult and time consuming with conventional stylet, inhibiting application of this pacing method in routine practice.MethodsThe technique of positioning the atrial lead in BB with hand-made stylet is presented with emphasis on electrocardiographic P-wave pattern and fluoroscopic landmarks.ResultsThe results demonstrate an acute implantation and short-term success of BB pacing of 14 patients out of 15 patients without major complications. Pacing parameters at implantation and 3 months postprocedure were noted which were within normal limits.ConclusionThese favorable initial results indicate that the positioning of active fixation atrial lead in BB with fluoroscopic landmarks is feasible and reproducible with a simple technique

An Examination of Issues Surrounding Nonprofit Executive Salaries: 2010-2017

This paper examines issues related to executive compensation in the nonprofit sector for the period since the last recession, 2010-2017. We explain why nonprofit executive compensation matters in terms of charitable giving in the United States. We discuss what is meant by the terms “nonprofit” and “tax-exempt”; the requirements that an entity must meet in order to achieve each respective designation; and why the two terms are not interchangeable. We examine different types of tax-exempt entities and how tax-exempt status aids organizations in raising funds from the donating public. We focus on the requirements for obtaining, and maintaining that status as a regulatory tool. We review the significant expenses for a tax-exempt non-profit and note how commercial entities face similar expenses. We illustrate how the particular expense of executive compensation is inherently different for a tax-exempt non-profit than for profit-making enterprises. We explain the factors that determine executive salaries in the former and the components of this compensation. We review the federal and state regulations governing tax-exempt nonprofit executive salaries and guidelines offered by non-governmental entities. We note that research (Balsam and Harris 2014) indicates a negative correlation between the level of disclosed executive compensation and the percentage of donations that a tax-exempt nonprofit receives. We discuss and analyze the compensation for chief executives at certain such nonprofits which have been highlighted by the mainstream media, the source of nonprofit information most easily accessible to the vast majority of donors to such entities. We conclude by highlighting why donors should have a voice in the determination of a tax exempt’s nonprofit executive compensation

Kolkata-Coventry comparative registry study of acute heart failure: an insight into the impact of public, private and universal health systems on patient outcomes in low–middle income cities (KOLCOV HF Study)

Introduction: Survival gaps in acute heart failure (AHF) continue to expand globally. Multinational heart failure (HF) registries have highlighted variations between countries. Whether discrepancies in HF practice and outcomes occur across different health systems (ie, private, public or universal healthcare) within a city or between countries remain unclear. Insight into organisational care is also scarce. With increasing public scrutiny of health inequalities, a study to address these limitations is timely. Method: KOLCOV-HF study prospectively compared patients with AHF in public (Nil Ratan Sircar Hospital (NRS)) versus private (Apollo Gleneagles Hospital (AGH)) hospitals of Kolkata, India, and one with universal health coverage in a socioeconomically comparable city of Coventry, England (University Hospitals Coventry & Warwickshire (UHCW)). Data variables were adapted from UK’s National HF Audit programme, collected over 24 months. Predictors of in-hospital mortality and length of hospitalisation were assessed for each centre. Results: Among 1652 patients, in-hospital mortality was highest in government-funded NRS (11.9%) while 3 miles north, AGH had significantly lower mortality (7.5%, p=0.034), similar to UHCW (8%). This could be attributed to distinct HF phenotypes and differences in clinical and organisational care. As expected, low blood pressure was associated with a significantly greater risk of death in patients served by public hospitals UHCW and NRS. Conclusion: Marked differences in HF characteristics, management and outcomes exist intra-regionally, and between low–middle versus high-income countries across private, public and universal healthcare systems. Physicians and policymakers should take caution when applying country-level data locally when developing strategies to address local evidence-practice gaps in HF

Prevalence, awareness, and control of hypertension in the slums of Kolkata

Background: Slum dwellers have poor socio-environmental conditions and less access to medical care, which make them susceptible to illnesses. Studies on urban slums have primarily focused on communicable diseases and less on lifestyle diseases, such as hypertension. Consequently, there is a paucity of prevalence studies of hypertension in slums in different parts of the country. The aim of the study was to provide estimates of the prevalence, awareness, and control of hypertension in an adult population sample of the slums of Kolkata. Methods: A population-based cross-sectional study was conducted in the slums of Kolkata in collaboration with Kolkata Municipality Corporation. Door-to-door survey was conducted by trained healthcare workers using a structured questionnaire. Age, sex, religion, housing conditions (house/hut), average monthly household income, education status, current use of tobacco, history of hypertension, and whether on antihypertensive treatment were recorded. Blood pressure (BP) was recorded as per standard guidelines. Hypertension was diagnosed by JNC-VII criteria. A total of 10,175 adults aged ≥20 years were enrolled in the study. Results: Overall prevalence of hypertension was 42%. Hypertension was newly detected in 19% of the population. Fifty-four percent of the hypertensive subjects were aware of their hypertension status, 38% were on antihypertensive treatment, and 12% had their BP controlled to target level. Subgroup analysis showed that the prevalence of hypertension was higher in men, above 60 years age, in the minority community, in those with a higher household income, and among the tobacco users. Conclusion: There is a high prevalence of hypertension in the slums of Kolkata. Although the awareness of the condition is high, the control of hypertension is poor

TNF α signaling beholds thalidomide saga: a review of mechanistic role of TNF-α signaling under thalidomide

Tumor necrosis factor alpha (TNF-α) is a pleiotropic inflammatory cytokine. The cytokine possesses both growth stimulating properties and growth inhibitory processes, and it appears to have self regulatory properties as well. Agents like etanercept and infliximab showed beneficial effects against rheumatoid arthritis by modulationg TNF-α proteins, however, these agents are largely unable to penetrate the blood-brain barrier, which severely limits their use in different conditions. Thalidomide, an inhibitor of TNF-α protein synthesis is readily capable of crossing the blood-brain barrier and thus thalidomide and its analogs are excellent candidates for use in determining the potential value of anti-TNF-α therapies in a variety of diseases. Thalidomide blocks TNF-α expression by different possible mechanisms. Down regulation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB), an essential transcription factor for TNF and other cytokines under thalidomide treatment leads to reduction in the TNF-α expression. Additionally, myeloid differentiation factor 88 (MyD88), an adapter protein regulates the expression of TNF under thalidomide treatment. Thalidomide treatment also leads to destruction of TNF-α mRNA thus, reducing the total expression of TNF-α protein. Thalidomide also targets reactive oxygen species (ROS) and α(1)-acid glycoprotein (AGP) to regulate TNF-α. In the present review, we discuss different possible mechanism that regulates TNF-α under thalidomide treatment. Additionally, we suggest novel strategies for the future targeting combination therapies of thalidomide and its analogs with different other anti-inflammatory drug to curb TNF-α associated diseases

Synthesis and Biological Evaluation of Dibenz[b, f][1, 5]Oxazocine Derivatives for Agonist Activity at k-opioid Receptor

A short and high yield synthetic route to dibenz[b, f][1, 5]oxazocines has been developed using Pd catalyzed intramolecular cycloamination reaction. Receptor binding assay using [125I]-dynorphin demonstrated that one of the derivative, 5b showed selective k-opioidergic property