The Cleveland Foundation, based in Cleveland, Ohio, is the world's first community foundation and one of the largest today, with assets of $2.5 billion and annual grants of more than $100 million. Established in 1914 by banker Frederick Harris Goff, the Cleveland Foundation partners with donors to improve the lives of residents in Cuyahoga, Lake and Geauga counties, now and for generations to come. The Cleveland Foundation is made up of more than 800 funds representing individuals, families, organizations and corporations. The current president and chief executive officer is Ronald "Ronn" Richard.The foundation was founded by Frederick Harris Goff, a well-known banker at the Cleveland Trust Company, who sought to eliminate the "dead hand" of organized philanthropy. He created a dynamic, corporately structured foundation that could utilize community gifts in a responsive and need-appropriate manner. In 2019, 1,871 place-based foundations exist internationally.In its first decade, the foundation accomplished innovative projects to improve the quality of life for Greater Cleveland residents[citation needed] including conducting research surveys to promote public education reforms and understand the relationship between poverty and crime. In 1919, the Foundation's call for an expansion in public recreational opportunities led to launching Cleveland Metroparks.In 1963, the Cleveland Foundation took over the stewardship of the Anisfield-Wolf Book Award, the only literary prize in the country dedicated to honoring written works that make important contributions to our understanding of racism and appreciation of the rich diversity of human culture.The foundation has taken a leadership role in fueling multiple revitalization projects including the resurgence of Downtown Cleveland in the 1950s, the rebirth of Playhouse Square in the 1970s and the Greater University Circle Initiative in the early 2000s.Frederick Harris Goff led from 1914 to 1919. Raymond C. Moley led the foundation from 1919 to 1923. Carlton K. Matson, 1924–1928. Leyton E. Carter led the Foundation for 25 years, from 1928 to 1953. From 1953 to 1967, J. Kimball Johnson. James A. Norton, 1968 - 1973, left the foundation upon State of Ohio Governor John J. Gilligan’s invitation to serve as chancellor of the Ohio Board of Regents. Barbara Haas Rawson served as interim director, 1973–1974. Homer C. Wadsworth, 1974–1983. Steven A. Minter, who had served as the commissioner of public welfare for the State of Massachusetts and first under secretary of the US Department of Education, was CEO from 1984 to 2003. Ronald B. Richard, with experience in the U.S. Foreign Service, the CIA, and the private sector, has led the Foundation since 2003..
BACKGROUND Low socioeconomic status (SES) has been theorized to be a risk factor for faltering weight (previously “failure to thrive”) in infants and children, but evidence is needed to understand the certainty of the association. Many treatment options exist with the aim of weight gain in infants and young children; however, the comparative effectiveness is not well understood. OBJECTIVE This technical report assessed SES as a risk factor for faltering weight in children younger than 5 years who live in high-income countries and determined the comparative efficacy of available treatment options for children with faltering weight (eg, increased calories, supplementation, feeding/speech therapies). Feeding and speech therapies were almost always combined in the literature and were combined in this review. METHODS The systematic review updates a previous review, from January 1, 2017 through June 27, 2022, for studies reporting on the relationship between SES and faltering growth on prevalence of faltering weight or thrive index (TI). To identify studies reporting on treatment options for faltering weight, reviewers searched PubMed, Embase, and Cochrane Library for comparative, English-language studies published from the database’s inception through August 19, 2022. Eligible studies were conducted in high-income countries with at least 80% of the sample population younger than 5 years with suspected or diagnosed faltering weight. Data were extracted from studies and narratively summarized. Risk of bias was assessed by 2 researchers using the Prediction model of Risk of Bias Assessment Tool (PROBAST) tool, the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I), and version 2 of the Cochrane risk-of-bias tool for randomized trials (ROB 2). Certainty of evidence was assessed using the Grading of Recommendations, Assessments, Development, and Evaluation (GRADE) approach. FINDINGS Of 9111 records, the search identified 2 new cohort studies to update the body of evidence from the previous SES review. Of the 5 studies reporting on prevalence of faltering weight, 2 showed a U-shaped association between SES and prevalence of faltering weight, 1 study showed an inverse relationship, and the other 2 studies showed no association. The 2 studies that reported on mean TI also showed U-shaped association between TI and SES. Certainty of evidence was very low for all studies. Of 8959 records, 1 study investigated increasing calorie intake; 3 studies investigated supplementation; and 3 studies investigated feeding and speech therapies for the treatment of children with faltering weight. None of the interventions studied were associated with a meaningful increase in weight gain compared with usual care. There is very low certainty that increased caloric intake and supplementation led to more growth than usual care and low certainty that feeding and speech therapy supplementation led to more growth than usual care. CONCLUSIONS AND RELEVANCE The results suggest that SES is not a reliable predictor of failure to thrive in children younger than 5 years who live in high-income countries. Studies that investigated the impact of different treatment modalities for faltering weight have inconsistent findings.
Introduction: The incidence of Large Vessel Occlusion-Acute Ischemic Stroke (LVO-AIS) continues to increase in young adults. Although young adults who undergo mechanical thrombectomy have favorable outcomes, it is unclear if stroke etiology affects rehabilitation outcomes & discharge destination for these patients. Hypothesis: Large artery atherosclerosis (LAA) results in worse outcomes as compared to other etiologies in terms of discharge destination. Methods: This retrospective study cohort comprised of patients 18-50 years of age, presenting to the Cleveland Clinic Stroke Enterprise, with LVO-AIS from January 2017 to December 2021. Patients with LVO on CTA or MRA at presentation were included. We then assessed patients with LAA and compared their discharge destination to patients with other etiologies. Results: Out of 1210 patients with AIS, 172 with LVO were included. 31 patients (18%) had stroke etiology as Large Artery Atherosclerosis (per TOAST criteria). Among patients with LAA, the median initial NIHSS was 6 and median discharge NIHSS 4. 16.2% of these patients received IV thrombolysis and 32.4% underwent mechanical thrombectomy (MT). 48.4% patients were discharged to acute rehabilitation, 32.3% went home, 12.9% SNF, and 6.5% deceased. In contrast, patients for whom TOAST criteria was not “Large Artery Atherosclerosis”, had a median initial NIHSS 9 and median discharge NIHSS 2. 31.2% received IV thrombolysis and 43.9% underwent MT. Their discharge destination was home for 56%, acute rehabilitation for 27.7%, LTAC for 5%, 2.8% SNF, and 8.5% deceased. Both these groups had similar initial mRS. Conclusions: Young adults with LVO-AIS had good outcomes irrespective of stroke etiology, however LAA patients were less likely to be discharged home compared to other etiologies, likely owing to less functional recovery as compared to other etiologies. Further studies are needed to determine why young adults with LVO with LAA have worse outcomes.
