The Skills to Pay the Bills: An Evaluation of an Effort to Help Nonprofits Manage Their Finances

This study examines a Wallace Foundation-sponsored initiative aimed at improving the financial management skills and practices of 25 Chicago afterschool providers through training and coaching. Two models for this professional development were provided and each produced long-lasting improvements. Moreover, organizations receiving the less-expensive group training and coaching improved almost as much as those receiving more intensive customized coaching

Enhanced recovery after surgery: the future of elective arthroplasty?

Summary: Enhanced recovery after surgery is a method of streamlining the patient journey pre-, intra- and post-operatively in order to account for foreseeable and unforeseeable barriers to recovery. Originally pioneered in general surgery, the technique has been adopted in other specialities, given its potential to minimise the duration of hospitalisation, hasten recovery and improve patient experience. Enhanced recovery programmes are of particular interest in orthopaedic surgery, where patients who often have multiple comorbidities could gain substantial benefits from more efficient management. This is particularly pertinent given the rising prevalence of age-related joint disease requiring arthroplasty: Enhanced Recovery is more economically and clinically efficient. Relevance: Enhanced recovery is a relatively novel - heterogeneously implemented – method of managing the surgical patient journey. Intrinsic to the success of such programmes is a thorough understanding of its components and close communication within the multidisciplinary team. Medical students’ understanding of what these protocols involve will significantly affect their management of foreseeable – and unforeseeable – barriers to success in elective surgical patients during clinical years and in their future practice. It is therefore essential that all medical students – whether they have an interest in a surgical career or not – have a grounding in the components of enhanced recovery, because such programmes will form part of their practice at some point in their careers. Take-home message: Enhanced recovery is a proactive intervention, which has been shown to be extremely effective across a number of surgical disciplines in reducing length of stay, whilst maximising postoperative outcomes. Trainees would benefit from a detailed knowledge of enhanced recovery programmes in order to provide a higher standard of care during their encounters with patients at every stage of the surgical pathway

Biosafety Cabinets in Laboratory Planning

The purpose of this research and white paper is to design architectural module layouts for practical laboratory use by integrating biosafety cabinets (BSCs) in replacement of traditional fume hood ducting systems and discuss the findings. The desired outcome of this work is to use knowledge gained from research to propose potential BSC layouts within a laboratory type building, and how BSCs can benefit laboratory design. Based on advantages and restrictions between each BSC class, BSCs are strategically placed in appropriate locations throughout the structure. The results show that implementing BSCs reduces the floor-to-floor height and allows for more flexible module layouts. The research findings offer effective credibility for implementing BSCs into United States laboratory designs.https://pdxscholar.library.pdx.edu/research_based_design/1080/thumbnail.jp

The influence of dose distribution on treatment outcome in the SCOPE 1 oesophageal cancer trial

Purpose The first aim of this study was to assess plan quality using a conformity index (CI) and analyse its influence on patient outcome. The second aim was to identify whether clinical and technological factors including planning treatment volume (PTV) volume and treatment delivery method could be related to the CI value. Methods and materials By extending the original concept of the mean distance to conformity (MDC) index, the OverMDC and UnderMDC of the 95 % isodose line (50Gy prescribed dose) to the PTV was calculated for 97 patients from the UK SCOPE 1 trial (ISCRT47718479). Data preparation was carried out in CERR, with Kaplan-Meier and multivariate analysis undertaken in EUCLID and further tests in Microsoft Excel and IBM’s SPSS. Results A statistically significant breakpoint in the overall survival data, independent of cetuximab, was found with OverMDC (4.4 mm, p < 0.05). This was not the case with UnderMDC. There was a statistically significant difference in PTV volume either side of the OverMDC breakpoint (Mann Whitney p < 0.001) and in OverMDC value dependent on the treatment delivery method (mean IMRT = 2.1 mm, mean 3D-CRT = 4.1 mm Mann Whitney p < 0.001). Re-planning the worst performing patients according to OverMDC from 3D-CRT to VMAT resulted in a mean reduction in OverMDC of 2.8 mm (1.6–4.0 mm). OverMDC was not significant in multivariate analysis that included age, sex, staging, tumour type, and position. Conclusion Although not significant when included in multivariate analysis, we have shown in univariate analysis that a patient’s OverMDC is correlated with overall survival. OverMDC is strongly related to IMRT and to a lesser extent with PTV volume. We recommend that VMAT planning should be used for oesophageal planning when available and that attention should be paid to the conformity of the 95 % to the PTV

Managing the Tensions at the Intersection of the Triple Bottom Line: A Paradox Theory Approach to Sustainability Management

Corporate sustainability management encompasses multiple dimensions: environmental, social, and economic. Companies are increasingly evaluated within the public sphere, and within their own organizations, according to the degree to which they are perceived to simultaneously promote this nexus of virtues. This article seeks to explore the tensions frequently faced by organizations that strive to manage these dimensions and the role of public policy in that pursuit. A multiple–case study approach is utilized in which the authors selected case organizations according to whether they were attempting to manage the three dimensions of sustainability. The authors utilize paradox theory and a typology provided by previous research to understand the nature of the tensions that emerge in the selected case study organizations. They extend this previous work by examining the role of public policy in providing the situational conditions to make these paradoxical tensions salient, and they examine organizational responses to these conditions. Directions for firms, policy makers, and future researchers are provided on the basis of this study’s findings

Managing the Tensions at the Intersection of the Triple Bottom Line: A Paradox Theory Approach to Sustainability Management

Corporate sustainability management encompasses multiple dimensions: environmental, social, and economic. Companies are increasingly evaluated within the public sphere, and within their own organizations, according to the degree to which they are perceived to simultaneously promote this nexus of virtues. This article seeks to explore the tensions frequently faced by organizations that strive to manage these dimensions and the role of public policy in that pursuit. A multiple–case study approach is utilized in which the authors selected case organizations according to whether they were attempting to manage the three dimensions of sustainability. The authors utilize paradox theory and a typology provided by previous research to understand the nature of the tensions that emerge in the selected case study organizations. They extend this previous work by examining the role of public policy in providing the situational conditions to make these paradoxical tensions salient, and they examine organizational responses to these conditions. Directions for firms, policy makers, and future researchers are provided on the basis of this study’s findings

The effect of dose escalation on gastric toxicity when treating lower oesophageal tumours: a radiobiological investigation

Purpose Using radiobiological modelling to estimate normal tissue toxicity, this study investigates the effects of dose escalation for concurrent chemoradiation therapy (CRT) in lower third oesophageal tumours on the stomach. Methods and materials 10 patients with lower third oesophageal cancer were selected from the SCOPE 1 database (ISCRT47718479) with a mean planning target volume (PTV) of 348 cm3. The original 3D conformal plans (50Gy3D) were compared to newly created RapidArc plans of 50GyRA and 60GyRA, the latter using a simultaneous integrated boost (SIB) technique using a boost volume, PTV2. Dose-volume metrics and estimates of normal tissue complication probability (NTCP) were compared. Results There was a significant increase in NTCP of the stomach wall when moving from the 50GyRA to the 60GyRA plans (11–17 %, Wilcoxon signed rank test, p = 0.01). There was a strong correlation between the NTCP values of the stomach wall and the volume of the stomach wall/PTV 1 and stomach wall/PTV2 overlap structures (R = 0.80 and R = 0.82 respectively) for the 60GyRA plans. Conclusion Radiobiological modelling suggests that increasing the prescribed dose to 60Gy may be associated with a significantly increased risk of toxicity to the stomach. It is recommended that stomach toxicity be closely monitored when treating patients with lower third oesophageal tumours with 60Gy

Pre-treatment tumour perfusion parameters and initial RECIST response do not predict long-term survival outcomes for patients with head and neck squamous cell carcinoma treated with induction chemotherapy

<p>Tumour plasma perfusion (F_p) in relation to overall survival (a), disease specific survival (b) and locoregional control (c). Nodal plasma perfusion in relation to survival (d) disease specific survival (e) and locoregional control (f).</p