Browsing by Subject "Risk management"
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Item Microbial Spectrum and Antibacterial Susceptibility of Endophthalmitis Cultures in a Tertiary Referral Center in the Midwestern United States: An Analysis From 295 Patients(Sage, 2020-09-22) Gemayel, Michael; Neiweem, Ashley; Aebi, Brent; Bracha, Peter; Ciulla, Thomas; Ophthalmology, School of MedicinePurpose: This work evaluates the microbial spectrum and antibiotic susceptibility pattern of endophthalmitis cases in a large tertiary referral center in the Midwestern United States. Methods: This retrospective case series included patients with clinically diagnosed endophthalmitis between April 14, 2006 and April 14, 2016, in whom ocular samples were submitted to the Microbiology Department at Indiana University. The patients were assessed by 11 vitreoretinal surgeons from 6 different sites in Indianapolis, including Indiana University and private practices, who receive patients from urban, suburban, and rural agricultural areas. Submitted specimens were cultured with the following media: blood agar, chocolate agar, MacConkey agar, and thioglycolate broth. Results: A total of 327 specimens from 295 patients were analyzed, with 96 (32.5%) samples from 90 (30.5%) patients meeting the criteria of confirmed growth. Of these 96 positive specimens, 83 (86.5%) organisms were identified as bacterial, and 13 (13.5%) were identified as fungal. Coagulase-negative Staphylococcus was the most common isolate (37.5%). Fifty gram-positive isolates and 10 gram-negative isolates underwent susceptibility testing. All 40 of the gram-positive isolates tested for vancomycin sensitivity were susceptible, whereas all 7 of the gram-negative isolates tested for ceftazidime sensitivity were susceptible. Conclusions: Empiric treatment with vancomycin and ceftazidime remains appropriate in most cases of endophthalmitis in the Midwestern United States, with 100% susceptibility of bacterial organisms tested with these antibiotics in this series. The high fungal culture rates in this study highlight the utility of obtaining vitreous cultures and potential need for antifungal agents in suspicious cases.Item Norovirus on Cruise Ships: Should Americans Be Worried?(SAGE, 2020) Liu-Lastres, Bingjie; Ogbeide, Godwin-CharlesNorovirus, known as “cruise ship virus,” has become one of the most significant public health challenges for the cruise industry over the past decade. It is imperative for cruise lines and other sectors within the hospitality industry to learn how to manage health-related issues such as norovirus outbreaks. This case study provides an overview of how the cruise industry has responded to norovirus outbreaks over the years. The goal of this case study is to encourage critical thinking about risk and crisis management within the cruise industry and inspire future cruise ships’ leaders in developing risk and crisis management skills.Item Obstacles and disaster risk reduction: Survey of Memphis organizations(http://dx.doi.org/10.1061/(ASCE)NH.1527-6996.0000016, 2010-08) Sadiq, Abdul-Akeem; Weible, Christopher M.The disaster management literature is replete with surveys at the community and household levels. However, few exist at the organizational level. This study attempts to fill this void by examining the effect of organizational obstacles on disaster risk reduction. The data come from a survey of 227 organizations in Memphis, Tennessee. This study investigates three obstacles to disaster risk reduction: lack of organizational support, lack of information, and lack of financial resources. The findings show that organizations are more likely to engage in low-effort activities indirectly related to risk reduction and are less likely to engage in high-effort activities directly related to risk reduction. The most important obstacle is lack of information about the frequency of disasters, magnitude of disasters, or organizational benefits of reducing disaster risks. Lack of financial resources and lack of organizational support are sometimes positively associated with risk-reducing activities, suggesting that, when organizations engage in risk-reducing activities, some obstacles become more apparent. The study concludes with implications, limitations, and future research strategies.Item Two essays on nonprofit finance(2016-05-06) Qu, Heng; Steinberg, Richard S.; Konrath, Sara; Ottoni-Wilhelm, Mark; Wu, Jisong; Greenlee, JanetThis dissertation consists of two essays on nonprofit finance. Nonprofit finance concerns obtaining and managing financial resources to support the social purposes of nonprofit organizations. A unique feature of nonprofit finance is that nonprofits derive revenue from a variety of sources. Nonprofit finance thus involves answering two fundamental questions: What is the optimal combination of revenue sources that supports a nonprofit to achieve its mission? Where and how to obtain the revenue sources? The two dissertation essays address these two questions respectively. The first essay, titled “Modern Portfolio Theory and the Optimization of Nonprofit Revenue Mix,” is among the first to properly apply modern portfolio theory (MPT) from corporate finance to nonprofit finance. By analyzing nonprofit tax return data, I estimate the expected return and risk characteristics for five nonprofit revenue sources as well as the correlations among these returns. I use the estimates to identify the efficient frontiers for nonprofits in different industries, based on which nonprofit managers can select an optimal portfolio that can minimize the risk given a preferred level of service provision or maximize the return given a level of risk. The findings also pose a challenge to the predominant approach used in previous nonprofit finance studies (Herfindahl-Hirschman Index) and suggest that MPT is theoretically and practically more helpful in guiding nonprofit revenue management. The second essay, titled “Charitable Giving in Nonprofit Service Associations: Identities, Incentives, and Gender Differences,” concerns nonprofit resource attainment, specifically, how do decisionmaking contexts and framing affect donations. Membership in a service club is characterized by two essential elements: members’ shared interest in the club’s charitable mission; and private benefits that often come as a result of social interactions with other members, such as networking, fellowship, and fun. A laboratory experiment was designed to examine 1) whether membership in a service club makes a person more generous and 2) the effect of service club membership—stressing either the service or socializing aspects—on individual support for collective goods. The study finds that female individuals are the least generous when they are reminded of the socializing aspect of service-club membership.Item The Unfinished Business of US Drug Safety Regulation(Food & Drug Law Journal, 2006) Evans, Barbara J.; Flockhart, David A.Various proposals have been advanced in response to recent problems with the safety of Food and Drug Administration (FDA)-approved drugs. Many call for incremental change, such as new safety oversight bodies or minor expansions of FDA's existing powers. "Fixing" FDA may not fix the problem, without related reform of the broader legal framework in which FDA operates. Key reform challenges include promoting clinical compliance with important safety warnings while preserving needed flexibility for physicians to adapt drug use to the individual patient; developing a clearer distinction between pre- and postapproval safety regulation; and devising mechanisms for funding investments in safety improvements. Until these fundamental problems are addressed, the United States will face ongoing problems with drug safety and patients will be denied the full measure of safety and therapeutic benefit that today's technologies could support. This article proposes a new direction to address these problems in the context of an insurance-based framework for promoting drug safety.