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iv In today's rapidly changing global world, the sustainability of an organization depends not only upon its financial performance, but also upon its environmental and social performance. It is suggested that policy makers, and corporate and engineering managers integrate economic, environmental and social objectives i.e., the triple bottom line (TBL) into their overall strategic plan and consider these objectives in their decision making. Investment planning and capital budgeting decisions play a critical role in aligning an organization with its economic, environmental and social strategic objectives. This research introduces a new decision making tool that integrates both financial and non-financial performance measures into the process of investment planning and capital budgeting via the TBL. It makes use of stakeholder theory for group decision making, analytic network process (ANP) as a decision support tool and stochastic linear programming to create an optimal investment portfolio. This new tool evaluates and prioritizes a set of projects and creates a long-term balanced investment portfolio based upon the perspectives and priorities of the stakeholder groups and decision makers. It can assist decision makers with developing and making proactive decisions which support the strategy of their organization with respect to economic, environmental and social issues, ensuring the sustainability of their organization in the future. To create a sustainability culture both in academia and business environment, and to encourage communities for sustainable development, a real life application of the developed tool is provided through coordination with Sustainable Pittsburgh and Cranberry Township business leaders. Table 3: Internal rate of returns (IRRs) of project alternatives during recession and boom times 48 Table 5: SRR values of the project alternatives (calculated by using the overall weights shown in Table 4 Conventional management tools and performance measures driven by economic rationality and profit maximization are relatively inadequate and poor in today's global conditions since they not only isolate or ignore the environmental and social impacts of organizational activities, but also consider only the local concerns and lack a global thinking perspective. In today's business environment, it is relatively easy to identify companies which are considered to be "big polluters." For instance, during the last three years, serious This dissertation is organized in the following way. First, the problem and related major research questions are presented. Second, background information is given about management and organizational sustainability, stakeholder theory, the TBL sustainability index system, analytic hierarchy process (AHP) and ANP, and stochastic linear programming. The proposed management tool and its assumptions are then discussed, followed by an illustration using the U.S. electric utility industry. A real life application of the tool is provided by working with Sustainable Pitts...

There has been increased interest in the aesthetic dimension of environmental and social issues. This research explores the aesthetic dimension of sustainable development and sheds light on how organizational sustainability might be related with aesthetics and art. First, based on literature, a conceptual model is proposed, envisioning organizational sustainability as a continuous process of creating and consuming technical, social and aesthetic values, by and for different stakeholders. The model provides a novel approach to managing organizational sustainability as it complements previously developed technical approaches with aesthetics and art‐based practices. Second, utilizing the model, several in‐depth interview questions are developed, and directed to the executives of 11 universities located in Istanbul, Turkey to understand the role of aesthetics and art in organizational sustainability from a practical standpoint which is largely ignored in literature. Face‐to‐face meetings with the executives indicate that aesthetics and art appear to be underutilized as strategic elements such that no participant measures organizational aesthetic value. However, the executives regard stakeholder involvement as an integral part of a potential measurement process. They cite lack of awareness and harmony among stakeholders, budget constraints and limited vision of management as the major barriers to creating aesthetic value. Although the executives have diverse views about the future role of aesthetics and art, and their relationship with organizational sustainability, they tell that aesthetics and art‐based practices contribute primarily to social sustainability while making partial and indirect contributions to economic and environmental sustainability, respectively.

Patients with aortic stenosis (AS) may have classic angina pectoris. The safety of exercise testing in adults with AS is controversial and, in fact, exercise testing in such patients is considered to be contraindicated especially in severe aortic stenosis (SAS). Furthermore, exercise testing has low specificity in uncovering coronary artery disease (CAD) in patients with AS, because the baseline ECG is frequently abnormal. We wished to assess the safety and diagnostic accuracy of dipyridamole stress myocardial perfusion tomography (DMPT) in the detection of CAD in patients with SAS. Methods: The study included 30 patients with SAS (mean aortic valve area 0.57 ± 0.09 cm²). All patients underwent dipyridamole myocardial perfusion scintigraphy (SPECT), coronary arteriography and catheterization, as well as Doppler echocardiography. Myocardial perfusion tomography was applied with ^99mTc hexakis-2-methoxyisobutyl isonitrile (MIBI) by a single day rest-dipyridamole infusion protocol. Hemodynamic, electrocardiographic and clinical responses were compared with those of 50 control patients without AS. Results: Hemodynamic responses during dipyridamole stress tests demonstrated no significant differences between the controls and the AS patients in the following parameters: systolic blood pressure, heart rate, rate-pressure product or incidence of headache, chest pain, dyspnea, flushing and dizziness. A reversible perfusion defect was observed in 10 patients with DMPT. The existence of coronary lesions was determined by coronary arteriography in 8 of 10 patients (sensitivity 100%, specificity 91%). Conclusion: The results showed that DMPT is well tolerated, even by patients with SAS and is of high diagnostic value in assessing CAD.