Financial Health of Nonprofit Organizations

Nonprofit financial health is the least developed among the three sectors – public, private nonprofit --and often focuses on vulnerability, capacity, and stability (E. I. Altman, Haldeman, & Narayanan, 1977; Ashley & Faulk, 2010; Carroll & Stater, 2009; Chang & Tuckman, 1991, 1994, 2010; Chikoto & Neely, 2014; Foster & Fine, 2007; Greenlee & Trussel, 2000; Gronbjerg, 1992; Kingma, 1993; Pfeffer & Salancik, 2003; Trussel, 2002; Yan, Denison, & Butler, 2009). The definitions of each dimension, method of measurement, and their degree of importance in evaluating financial health have not been sufficiently clarified within existing research. At the level of nonprofit organization, these are important because financial position is closely tied to mission and quality programs. At the level of sector, the sustainability of nonprofits plays a significant role alongside public and private organizations, in better connecting people to themselves, their communities and opportunities for quality of life and well-being. This makes a study of nonprofit financial health one of practical assessment, economic and management theory, but also grounded in a normative connection to valuable role of nonprofits in the American system of organizational life. This research asks three questions. First, how can nonprofit organizations monitor financial measures to guard against financial distress? Second, how do successful organizations strategize to build stable and sustainable financial health? And third, how do membership associations build sustainable financial health? Three main limitations of previous research are addressed through empirical analysis. First, nonprofit research focuses on a very limited pool of financial ratios. Second, nonprofit studies fail to examine the factors that explain the difference between large organizations’ financial health and smaller organizations’ health (or lack thereof). Third, nonprofit research largely focuses on ordinary nonprofits, neglecting the other types of nonprofit organizations, including membership associations. These three limitations are the basis of the proposed empirical articles. A second gap in previous research concerns the consistent finding that larger organizations report better financial health (Carroll, 2005; Carroll & Stater, 2009; Chikoto & Neely, 2014). We do not yet understand which characteristics of larger organizations contribute to their better financial health. A more precise definition of financial health might provide insight into the differentiating factors that contribute to this finding, particularly inclusion of multiple time frames and management strategies such as nonprofit lobbying. Also, exploration of unique characteristics of nonprofits, including volunteer workforce may provide insights. The third gap addressed by this research is the lack of finance studies focused on a critical subset of nonprofits: membership associations. Scholarship broadly recognizes the role of nonprofit organizations in supplying goods and services, as well as acting at times as agents of the government in delivering on social needs. Berry (1999), however, has notably brought attention to the contributions of nonprofits to political life and discourse, and specifically that membership organizations are engaging more than ever within this space. Membership associations are categorized as expressive organizations that promote values, affiliative organizations that promote social intercourse, and instrumental organizations that provide useful services to members (Mason, 1996). These organizations are also likely to have more representational infrastructure, in terms of internal decision making, as well as produce more excludeable benefits. For these reasons, the determinants of financial health may be enabled and constrained in ways that cannot be presumed for all nonprofits

The Decision to Withhold Resuscitation in Australia: Problems, Hospital Policy and Legal Uncertainty

Decisions to withhold cardio-pulmonary resuscitation (CPR) should provide explicit clinical and ethical justification, be stated in an unambiguous manner, and be formally documented in the medical chart. Even so, the legal status of decisions to withhold CPR remains uncertain, in part because there is all too often no written justification for a No-CPR order; no statement of the overall management plan subsequent to an order; no indication of who made the decision; no explanation as to what may lead to changes in the decision; and no reference to the wishes of the patient, family or surrogate. The fact that hospital policies regarding No-CPR orders are rare or are ignored may be symptomatic of failures in communication between physicians on the one hand and the patient and the health care team on the other. Communication failures often mask paternalism and concepts such as "futility" and "medical indications" are used to override patient autonomy in decisions regarding cardio-pulmonary resuscitation. In Newcastle, Australia, a recent review of current CPR practice and its ethical implications led to the formulation of policy guidelines concerning the problems of when to initiate CPR and when and how No-CPR orders should be issued

The Decision to Withhold Resuscitation in Australia: Problems, Hospital Policy and Legal Uncertainty

Decisions to withhold cardio-pulmonary resuscitation (CPR) should provide explicit clinical and ethical justification, be stated in an unambiguous manner, and be formally documented in the medical chart. Even so, the legal status of decisions to withhold CPR remains uncertain, in part because there is all too often no written justification for a No-CPR order; no statement of the overall management plan subsequent to an order; no indication of who made the decision; no explanation as to what may lead to changes in the decision; and no reference to the wishes of the patient, family or surrogate. The fact that hospital policies regarding No-CPR orders are rare or are ignored may be symptomatic of failures in communication between physicians on the one hand and the patient and the health care team on the other. Communication failures often mask paternalism and concepts such as "futility" and "medical indications" are used to override patient autonomy in decisions regarding cardio-pulmonary resuscitation. In Newcastle, Australia, a recent review of current CPR practice and its ethical implications led to the formulation of policy guidelines concerning the problems of when to initiate CPR and when and how No-CPR orders should be issued

A questionnaire investigation of the organizations for elementary religious education in the Protestant Evangelical denominations in the United States

STATEMENT OF THESIS: The purpose of this Thesis is to present a study of the organizations that have been developed in the denominations to meet th© needs for elementary religious education of the children of the churches. That they have not been adequate to meet these needs in a large measure has been brot to the attention of many of the leaders of church and nation. Some remedy must be found in the next few years to change, the program of the churches to teach the youth of the land religion. As a means to this end a questionaire was sent to the Boards of the denominations in order to learn the real strength and weakness of these organizations to deal with problem and thus to be able to build a new type that would be fitted to do the task efficiently. In our study we shall present the results as far as the data could be secured and discuss them

Visiting Trainees in Global Settings: Host and Partner Perspectives on Desirable Competencies

Background: Current competencies in global health education largely reflect perspectives from high-income countries (HICs). Consequently, there has been underrepresentation of the voices and perspectives of partners in low- and middle-income countries (LMICs) who supervise and mentor trainees engaged in short-term experiences in global health (STEGH). Objective: The objective of this study was to better understand the competencies and learning objectives that are considered a priority from the perspective of partners in LMICs. Methods: A review of current interprofessional global health competencies was performed to design a web-based survey instrument in English and Spanish. Survey data were collected from a global convenience sample. Data underwent descriptive statistical analysis and logistic regression. Findings: The survey was completed by 170 individuals; 132 in English and 38 in Spanish. More than 85% of respondents rated cultural awareness and respectful conduct while on a STEGH as important. None of the respondents said trainees arrive as independent practitioners to fill health care gaps. Of 109 respondents, 65 (60%) reported that trainees gaining fluency in the local language was not important. Conclusions: This study found different levels of agreement between partners across economic regions of the world when compared with existing global health competencies. By gaining insight into host partners' perceptions of desired competencies, global health education programs in LMICs can be more collaboratively and ethically designed to meet the priorities, needs, and expectations of those stakeholders. This study begins to shift the paradigm of global health education program design by encouraging North–South/East–West shared agenda setting, mutual respect, empowerment, and true collaboration

What do the public know about anatomy?:Anatomy education to the public and the implications

Public knowledge of the anatomical “self” is lacking and evidence points towards a growing need for anatomy education to the wider public. The public were offered the opportunity to learn human anatomy and complete an anatomical knowledge survey afterwards. Sixty-three participants volunteered to attempt to place 20 anatomical structures on a blank human body template. Responses were scored independently and then collated. A mixed effects logistic model was used to examine any associations with participants’ as a random effect and all other factors as fixed effects. Results showed a statistically significant quadratic trend with age. Participants in health-related employment scored significantly higher than those not in health-related employment. There was a significant interaction between gender and organ type with males scoring higher than females in identifying muscles, but not in identifying internal organs. The current study demonstrates the general public’s eagerness to learn anatomy despite their limited knowledge of the human body, and the need for widening participation. Furthermore, it raises an awareness of the anatomical literacy needs of the general public, especially in school children and young adults. Furthermore, it emphasizes the value of health literacy as a focus in undergraduate medical education. Anatomy literacy appears to be neglected, and this experience provides an example of a possible mode of public engagement in anatomy