This chapter provides an overview of the nonprofit organization in the United States, the main characteristics of nonprofit organizations, and the reality of the nonprofit sector today. It describes the differences between a nonprofit and a for-profit corporation. Nonprofit organizations have existed for many centuries, especially through religious groups or religious-based activities. The nongovernmental sector is growing throughout the world. Increasingly, these organizations are playing key roles in the economic and social contexts of their countries. Unlike private-sector organizations concerned primarily with making a profit, nonprofit organizations are focused on carrying out a specific public-service mission. Successful nonprofit organizations require substantial capability in key areas of management: developing strong boards of directors, recruiting and motivating talented staff and volunteers, creating plans to focus resources on relevant goals and innovative programs, winning the support of diverse stakeholders, raising funds, and wisely managing fiscal and human resources.

This chapter discusses the term “service delivery” and describes a service delivery system in the context of a nonprofit organization. Servitization is the process whereby an organization develops creative and innovative ways to create a product-service system that integrates value-based products and service offerings. The chapter discusses the roles of client-centeredness, decision making, scheduling, priority setting, effective and efficient flow of services or activities, quality assurance, and continuing quality improvement, and how these factors contribute in their own context to influence positively or negatively the financial sustainability of a nonprofit organization. A customer-centric service design is a service delivery system that focuses on providing the best quality service possible to customers or clients or the service target, based on a service concept, a service decision path, service sustainability, and service quality. The chapter explains the relationship between service delivery and financial sustainability.

This chapter defines the concept of social marketing and provides some of the common areas for the use of social marketing by nonprofit organizations. The term “social marketing” has been used for several decades to refer to a systematic process of using marketing strategy to influence current behaviors of a target population into a desired behavior in order to positively change a social or community issue. The chapter describes the contents of a social marketing plan. A social marketing plan is a document that justifies the needs for a social marketing campaign, as well as the process of implementation by outlining a SWOT (strength, weakness, opportunity, threat) analysis, a description of the target population, the goals and objectives, an impact statement, the marketing mix strategies, an implementation plan, an evaluation plan, and a budget. The chapter establishes the relationship between social marketing and financial sustainability.

The electrical discharge of neurons associated with seizure activity stimulates a marked rise in cerebral metabolic activity. Estimates from animal experiments indicate that energy utilization during seizures increases by more than 200", while tissue adenosine triphosphate (ATP) levels remain at more than 95" of control, even during prolonged status epilepticus. The brain generally withstands the metabolic challenge of seizures quite well because enhanced cerebral blood flow delivers additional oxygen and glucose. Mild to moderate degrees of hypoxemia that commonly accompany seizures are usually harmless. However, severe seizures and status epilepticus can sometimes produce an imbalance between metabolic demands and cerebral perfusion, especially if severe hypotension or hypoglycemia is present. A marked increase in glutamate release, which occurs during a prolonged seizure, is likely to result in the activation of all types of glutamate receptors. Although kainic acid produces seizures in the immature brain, it produces little cytotoxicity.

This chapter discusses both successes and failures in affiliation and collaboration techniques among nonprofits, including details on what the parties involved found to be the most valuable or most problematic aspects of the affiliations. It explores an overview of what has been and is versus what could be in the business models for both the nonprofit and the for-profit sectors, with the aim of shaking things up in the nonprofit world’s business-as-usual model. Clearly, a new business model is needed for the new paradigm, one that enables nonprofit organizations to adapt to the industry’s greater demands and the emerging market for corporate control without sacrificing core values. Capitalizing on the opportunities presented by the new human service paradigm will require nonprofit providers to adopt a new business model that is both capable of pursuing traditional consolidation strategies and supported by innovative organizational and financial designs.

This chapter focuses on a series of case studies and best practices for partnerships that discuss in detail the provision of back-office support for nonprofit partners. Public Health Management Corporation (PHMC) is a nonprofit public health institute that creates and sustains healthier communities using best practices to improve community health through direct service, partnership, innovation, policy, research, technical assistance, and a prepared work force. Traditional back-office services are usually designed to address many of the challenges of today’s changing nonprofit environment. Services depend on the level of organizational need and affordability, but are usually identified through a comprehensive organizational assessment of the nonprofit client. The Urban Affairs Coalition (UAC) is a Philadelphia-based nonprofit that was founded in 1969 following a historic meeting between the city’s business and community leaders. Most nonprofits never rise to the scale of having a full internal administrative staff and purchased equipment.

For nonprofit agencies, there are generally two ways of growing: organically, which takes longer and is more detailed, or through strategic partnerships with other nonprofits. This chapter focuses on a wide range of strategic partnerships. Few nonprofits in the sector, other than hospitals and insurers, enter into strategic partnerships, and far fewer merge or affiliate with other nonprofits. The Public Health Management Corporation (PHMC), however, is one of the rare nonprofit health and human service organizations that has been engaged in mergers and affiliations in the past 20 years. Environmental factors such as increased organizational competition or decreased foundation or donor funding encourage nonprofits to contemplate mergers. Nonprofit mergers provide a variety of benefits including the opportunity for expanded social impact. Merged nonprofits can roll together annual audits, combine insurance programs, and consolidate staffs and boards. Mergers and affiliations are one way that organizations are attempting to temper competition.

Recent advancements in molecular genetics have expanded our understanding of the etiology of many neurological diseases and neurodevelopmental abnormalities. Having a comprehensive understanding of genetics is essential in treating patients with metabolic epilepsies. Genetic counseling has been defined as a process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. Some of the components of a genetic counseling interaction include interpretation of family and medical histories to assess the chance of disease occurrence or recurrence; education about inheritance, testing, management, prevention, resources, and research; and counseling to promote informed choices and adaptation to the risk or condition. The genetic counselor may also educate patients and their families about the underlying genetics of their epilepsy and the relevance of a genetic cause of epilepsy for family members, including recurrence risk, reproductive options and the possible teratogenic effect of antiepileptic drugs.

This chapter presents a brief review of the enzymes, transporters, and cofactor producers of the urea cycle. Seizures have long been associated with urea cycle disorders (UCDs), thought to be caused by high levels of ammonia. Furthermore, the brain damage obtained during metabolic crisis has been thought to damage critical structures, leading to epilepsy after the conclusion of the crisis. The first and most critical step of successful treatment of UCDs is recognition. Neurologic monitoring is an essential part of the emergency management of UCDs. The neurological abnormalities observed in patients with urea cycle defects are vast. Controlling ammonia levels by dialysis and complementary medication are needed. EEG monitoring should be initiated early, as this may be very useful for clinical management and indication of untreated metabolic crises. Furthermore, aggressive treatment of clinical and subclinical seizure activity may be helpful in optimizing outcomes for these patients.

Clinical neurophysiology (CNP) is a time-honored medical specialty that continues to make great strides, bolstered by rapid advances in neuroscience, biomedical engineering, and computer technology. It encompasses a wide range of methods and techniques for recording, presenting, and analyzing neurophysiologic signals in order to diagnose sensory, motor, autonomic, and central nervous system disorders. Testing performed in CNP or procedures used in current neurological practice include a variety of modality-specific and mixed-modality tests. Modality-specific CNP tests are performed to assess specific functional modalities using biomedical instruments that measure changes in neurophysiologic signals that occur spontaneously or with activation. Mixed-modality CNP tests utilize two or more test modalities to assess complex states (e.g., sleep, coma), to track multiple physiologic parameters, or to obtain more accurate results. CNP tests are classified based on functional anatomy or neural pathway tested. This chapter discusses artifact recognition and presents sources of artifacts in clinical neurophysiologic testing.