A Framework for Organizational Effectiveness in the Non-Profit Organization

None profit organizations are entrusted with societys most important functions educating minds, uplifting souls and protecting health and safety. Most research on management performance systems has focused on for profit organizations with less emphasis or research conducted in the none profit sector. Lately, however, the publics faith in these institutions has been seriously undermined by revelations of wrongdoing and mismanagement. Recent scandals in organizations such as United Way of America, the United Nations, Empire Blue Cross and the National Association for the Advancement of Colored People bring to light that the performance of none profits is shrouded behind a veil of secrecy lifted only when disasters occur. (Herzlinger, 1999) According to Herzlinger, four common problems manifest themselves in none profit organizations, which are being aggressively tackled in profit organizations. First is the problem of ineffective organizations, ones that do not accomplish their social missions. A second problem is inefficiency such as spending too much on fund raising and administration and devoting less than a majority of funds to a service. A third difficulty is that of private inurement, where individuals who control tax exempt organizations attain excessive benefits for themselves. A fourth problem is excessive risk and lack of accountability. These problems are readily associated with none profit organizations as they lack the self interest that comes with ownership ensuring managers do not receive excessive compensation, that the business accomplishes it goals efficiently, and that risks are appropriately evaluated. Second they often lack the competition that would force efficiency and finally they lack the ultimate barometer of business success, the profit measure. (1999

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mechanism of sensing antimicrobial peptides by bacteria : towards a structural understanding ; LPS-bound structures of designed peptides : effects of incorporation of β-turn nucleating amino acids (D-Pro and Asn).

The Aps system, consisting of a transmembrane sensor protein ApsS and two cytosolic ApsX and ApsR, is responsible for antimicrobial peptides (AMPs) resistance mechanism in Gram-positive bacteria. The ApsS acts as a sensor to have direct interactions with AMPs through its extra-cellular loop connected to two transmembrane (TM) segments. To determine the three-dimensional structures of ApsS and to elucidate the interactions of AMPs with the TM domains of ApsS, the TM regions of Staphylococcus epidermidis ApsS (ApsS-TM) were constructed, expressed and purified for NMR structural studies. Uniformly 15N-labeled of ApsS-TM were overexpressed as a fusion protein with ketosteroid isomerase protein (KSI) in Escherichia coli, and the fusion protein was purified by nickel affinity chromatography under denaturing conditions. Cyanogen bromide (CNBr) cleavage was used to release the ApsS-TM-His6 from the fusion protein. Final recovery of ApsS-TM-His6 was achieved by nickel affinity chromatography under denaturing conditions. High amount and good purity of ApsS-TM-His6 protein were demonstrated. However, the protein was too hydrophobic to be solubilized in acetonitrile and in sodium dodecyl sulfate (SDS) detergents, preventing structural studies by NMR spectroscopy.Bachelor of Science in Biological Science

Self-assembled biomimetic membranes and de-novo peptides for nanomedicine and biosensing

Liposome and polymersome are hollow bilayer vesicles nanostructures formed by self-assembly of phospholipids and synthetic amphiphilic block copolymers, respectively. Liposomes have been widely studied and developed for wide range of applications. On the other hand, polymersomes have several features which make them better suited than liposomes for certain technological applications, amongst which are their superior stability and excellent chemical versatility. Nevertheless, the self-assembly as well as the interaction of phospholipids and block copolymers, during or after assembly process, have not been well understood. Mixing phospholipids and block copolymers forming hybrid vesicle has been proposed to tune the membrane properties to combine the robustness and chemical tunability of polymersomes with the softness, fluidity and biocompatibility of liposomes. The self-assembly, phase behaviour, membrane properties, and parameters controlling these hybrid vesicles are not yet fully understood. In chapter 3, nanoscale hybrid phospholipid/block copolymer vesicles of various compositions were prepared by film-hydration-extrusion and the mixing behaviours, stability, and membrane properties of these nanostructures have been explored. It was found that the size, encapsulation efficiency and content-release behaviour of nanoscale polybutadiene-b-poly(ethylene oxide) (PB-PEO)/1-palmitoyl-2-oleoyl-sn-glycero-3-hosphatidylcholine (POPC) hybrid phospholipid/block copolymer vesicles can be tuned by the mixing ratio of the amphiphiles. It was generally believed that in binary mixtures of phospholipids and block copolymers, each forms spherical vesicles when present alone, and form spherical hybrid vesicles in aqueous solution. Detailed characterizations by Cryo-TEM reveal that, surprisingly, mixing POPC and PB-PEO results in spontaneous formation of tubular vesicles. This tendency for tubular vesicle formation is most pronounced when the amphiphile composition reaches equimolar proportion of the lipid and the polymer. The spontaneous stabilization of tubular vesicles, which requires a significant spontaneous bilayer curvature or energy, was proposed to arise from the unusually asymmetric lipid/polymer membrane composition. Membrane active polypeptides are of large interest for development of novel therapeutics including peptide-mediated drug delivery and release systems, transfection agents and antibiotics. Finding routes to tune specificity and activity of membrane active polypeptides is hence of large importance to improve their efficacy and minimize harmful side effects. Chapter 5 describes a de novo designed antimicrobial-like helix-loop-helix polypeptide (JR2KC) that partition into zwitterionic lipid membranes when specifically and covalently anchored to the membrane. Anchoring and subsequent membrane partitioning triggers a structural transition of the polypeptide from random coil to α-helical conformation and induces pore formation. The extent of pore formation can be dynamically tuned by varying the number of anchoring moieties or by introducing a complementary polypeptide (JR2E) that is designed to heterodimerize with JR2KC and fold into four-helix bundles. Dimerization competes with membrane partitioning of the polypeptides and reduces the pore forming capacity of JR2KC. This system thus enables a precise and very specific route for tuning the permeability of lipid membranes and demonstrates a novel strategy for development of recognition based membrane active polypeptides. In Chapter 6, a tetramethylrhodamine-labeled peptides binder was assembled on graphene oxide in solution to develop as a fluorescence turn-on sensor for Lipopolysaccharide (LPS)/endotoxin detection. The fluorescence of the dye-labeled peptide is quenched upon interaction with GO. Specific binding to LPS triggers release of the peptide-LPS complex from GO, resulting in fluorescence recovery. This fluorescent turn-on sensor offers a limit of detection of 130 pM, which is the lowest ever achieved among all synthetic LPS sensors to-date. Importantly, this sensor is applicable for detection of LPS in commonly used clinical injectable fluids, and it enables selective detection of LPS from different bacterial strains as well as LPS on the membrane of living E. coli. Finally, the applications of self-assembled membranes, liposomes, polymersomes, and polypeptides for biosensing will be also demonstrated in the latter part of the thesis.Doctor of Philosophy (MSE

A Framework for Organizational Effectiveness in the Non-Profit Organization

None profit organizations are entrusted with societys most important functions educating minds, uplifting souls and protecting health and safety. Most research on management performance systems has focused on for profit organizations with less emphasis or research conducted in the none profit sector. Lately, however, the publics faith in these institutions has been seriously undermined by revelations of wrongdoing and mismanagement. Recent scandals in organizations such as United Way of America, the United Nations, Empire Blue Cross and the National Association for the Advancement of Colored People bring to light that the performance of none profits is shrouded behind a veil of secrecy lifted only when disasters occur. (Herzlinger, 1999) According to Herzlinger, four common problems manifest themselves in none profit organizations, which are being aggressively tackled in profit organizations. First is the problem of ineffective organizations, ones that do not accomplish their social missions. A second problem is inefficiency such as spending too much on fund raising and administration and devoting less than a majority of funds to a service. A third difficulty is that of private inurement, where individuals who control tax exempt organizations attain excessive benefits for themselves. A fourth problem is excessive risk and lack of accountability. These problems are readily associated with none profit organizations as they lack the self interest that comes with ownership ensuring managers do not receive excessive compensation, that the business accomplishes it goals efficiently, and that risks are appropriately evaluated. Second they often lack the competition that would force efficiency and finally they lack the ultimate barometer of business success, the profit measure. (1999

on Quality of Service (IWQOS’97)

This paper presents a summary of the fifth International Workshop on Quality of Service (IWQOS) which was held at Columbia University in May 1997. The goal of this three-day meeting was to foster interaction between researchers active in the area of Quality of Service (QOS) research, to reflect on past experiences and lessons learnt, and to discuss future QOS challenges. To reflect this goal, this year’s workshop included a hot program made up of (i) a keynote address on “Programming Telecommunications Networks”; (ii) panels addressing “QOS for Distributed Objec

Programmability and Service Creation for Multimedia Networks

The Binding Architecture is an open architecture for building multimedia networks that must guarantee Quality of Service (QOS). In this paper, we explore the notion of a service in the Binding Architecture and propose a conceptual model for building scalable multimedia distribution services based on it. We begin first by examining the relation between resources, their abstractions and the services that can be built from them and use this to derive a general model for binding. Based on this model, we identify a general set of capabilities required for building any multimedia distribution service. We also describe how these capabilities can be incorporated into our view of the service creation process. Finally, we augment our discussion with the description of an example service which we have developed using this paradigm. 1. Introduction Binding is the process of associating (interconnecting) different components of a system. The Binding Architecture [7] for multimedia networks is an o..