From charity to social enterprise: the marketization of social care

Purpose In Scotland, the self-directed support (SDS) legislation is a catch-all payment system which brings challenges to local authorities, service delivery organisations and the service users it is intended to empower. Set against a backdrop of cuts to local authorities and third-sector funding, this policy presents third-sector organisations with both the opportunities and challenges of commercialising their activities to become more sustainable. The purpose of this paper is to provide evidence of the challenges faced by one charity as it engages in a process of hybridity to accommodate changes in its funding due to the introduction of SDS. Design/methodology/approach The paper utilises a case study approach. The paper captures the experiences and views of managers, staff and parents advocating for their children through interviews with a purposive sample from each group. The challenges of gathering data and giving a voice to caregivers advocating for children with complex needs are discussed, particularly the difficulties in accessing a hard to reach group. Findings The findings identifies issues which have arisen because of the proposed changed in strategic direction of the organisation due to the introduction of SDS and are all related to hybridity. The findings are arranged in four sub-sections based on the themes that emerged from the qualitative data generated from the interviews: the practical delivery of care; tensions between care and quality, the care workforce, and the parent perspective. Research limitations/implications SDS policy has had unexpected impacts and reactions whilst rolling out across regions in Scotland, but policymakers and those involved in the care sector, including consumers, face significant challenges in gathering evidence not only from the vulnerable populations this policy affects but also from organisations already under pressure from austerity-led cuts. This paper presents the challenges to organisations involved in caring for children with complex needs, who are a particularly neglected group of stakeholders. Practical implications Organically arising barriers to organisational transition from charity to social enterprise are presented, as staff and caregivers react to the prospect of SDS uptake affecting their organisation. Proactive attempts to embrace a hybrid approach by the organisation are analysed. Social implications Understanding how social care organisations and clients are reacting to the implementation of individual payments as opposed to the previous system of block contracts is crucial as the sector faces very real prospects of organisations closing when individuals are able to pick and choose care. A policy based on choice and control for the consumer risks removing choice through a loss of services in the marketplace, leaving vulnerable populations at risk. Originality/value This study is unique. No research has been done exploring the transition of charities servicing children with complex needs in anticipation of self-directed payments creating an open market. The paper further contributes to the existing knowledge regarding hybrid organisations within the third sector. </jats:sec

Mucosal Immunity and Candida albicans Infection

Interactions between mucosal surfaces and microbial microbiota are key to host defense, health, and disease. These surfaces are exposed to high numbers of microbes and must be capable of distinguishing between those that are beneficial or avirulent and those that will invade and cause disease. Our understanding of the mechanisms involved in these discriminatory processes has recently begun to expand as new studies bring to light the importance of epithelial cells and novel immune cell subsets such as Th17 T cells in these processes. Elucidating how these mechanisms function will improve our understanding of many diverse diseases and improve our ability to treat patients suffering from these conditions. In our voyage to discover these mechanisms, mucosal interactions with opportunistic commensal organisms such as the fungus Candida albicans provide insights that are invaluable. Here, we review current knowledge of the interactions between C. albicans and epithelial surfaces and how this may shape our understanding of microbial-mucosal interactions

Interannual variation in seasonal drivers of soil respiration in a semi-arid Rocky Mountain meadow

pre-printSemi-arid ecosystems with annual moisture inputs dominated by snowmelt cover much of the western United States, and a better understanding of their seasonal drivers of soil respiration is needed to predict consequences of climatic change on soil CO2 efflux. We assessed the relative importance of temperature, moisture, and plant phenology on soil respiration during seasonal shifts between cold, wet winters and hot, dry summers in a Rocky Mountain meadow over 3.5 separate growing seasons. We found a consistent, unique pattern of seasonal hysteresis in the annual relationship between soil respiration and temperature, likely representative for this ecosystem type, and driven by (1) continued increase in soil T after summer senescence of vegetation, and (2) reduced soil respiration during cold, wet periods at the beginning versus end of the growing season. The timing of meadow senescence varied between years with amount of cold season precipitation, but on average occurred days before soil temperature peaked in late-summer. Autumn soil respiration was greatest when substantial autumn precipitation events occurred early. Surface CO2 efflux was temporarily decoupled from respiratory production during winter 2006/2007, due to effects of winter surface snow and ice on mediating the diffusion of CO2 from deep soil horizons to the atmosphere. Upon melt of a capping surface ice layer, release of soil-stored CO2 was determined to be 65 g C, or *10 % of the total growing season soil respiration for that year. The shift between soil respiration sources arising from moisture-limited spring plant growth and autumn decomposition indicates that annual mineralization of soil carbon will be less dependent on projected changes in temperature than on future variations in amount and timing of precipitation for this site and similar semiarid ecosystems

Identification of citrullinated α-enolase as a candidate autoantigen in rheumatoid arthritis

Antibodies against citrullinated proteins are highly specific for rheumatoid arthritis (RA), but little is understood about their citrullinated target antigens. We have detected a candidate citrullinated protein by immunoblotting lysates of monocytic and granulocytic HL-60 cells treated with peptidylarginine deiminase. In an initial screen of serum samples from four patients with RA and one control, a protein of molecular mass 47 kDa from monocytic HL-60s reacted with sera from the patients, but not with the serum from the control. Only the citrullinated form of the protein was recognised. The antigen was identified by tandem mass spectrometry as α-enolase, and the positions of nine citrulline residues in the sequence were determined. Serum samples from 52 patients with RA and 40 healthy controls were tested for presence of antibodies against citrullinated and non-citrullinated α-enolase by immunoblotting of the purified antigens. Twenty-four sera from patients with RA (46%) reacted with citrullinated α-enolase, of which seven (13%) also recognised the non-citrullinated protein. Six samples from the controls (15%) reacted with both forms. α-Enolase was detected in the RA joint, where it co-localised with citrullinated proteins. The presence of antibody together with expression of antigen within the joint implicates citrullinated α-enolase as a candidate autoantigen that could drive the chronic inflammatory response in RA

In perspective: Supporting knowledge exchange in rural busines:A case story from Dumfries and Galloway, Scotland

This study arose from a knowledge exchange project whereby business support and knowledge exchange opportunities were provided to rural small businesses as an academic outreach programme. We review how academic support to small businesses in rural Southwest Scotland was delivered. Academic support for micro-business in Southwest Scotland is an under-researched topic. The owners volunteered to share their experiences of this support with the wider business community and university staff acted as consultants and researchers, mentoring the businesses and developing insights into rural business support. The article describes the processes and outcomes of the project, and the factors which affected the ability of the businesses to take advantage of academic business support. We utilised a case-study approach, in-depth interviews and follow-ups over a one-year period, later adding a longitudinal perspective. Our findings indicate that rural factors, business life cycle stage, sectoral skills availability along with the specific market and organisational context combine to create challenges for small business owners and impact on their ability to access and benefit from business support services. The results are significant for business engagement strategies of universities and for business support policy for small and micro-businesses in geographically isolated regions. The participant-consultant roles of the researchers facilitated the development of rich, ‘insider’ insights into this neglected topic. </jats:p

Candida albicans Yeast and Hyphae are Discriminated by MAPK Signaling in Vaginal Epithelial Cells

We previously reported that a bi-phasic innate immune MAPK response, constituting activation of the mitogen-activated protein kinase (MAPK) phosphatase MKP1 and c-Fos transcription factor, discriminates between the yeast and hyphal forms of Candida albicans in oral epithelial cells (ECs). Since the vast majority of mucosal Candida infections are vaginal, we sought to determine whether a similar bi-phasic MAPK-based immune response was activated by C. albicans in vaginal ECs. Here, we demonstrate that vaginal ECs orchestrate an innate response to C. albicans via NF-κB and MAPK signaling pathways. However, unlike in oral ECs, the first MAPK response, defined by c-Jun transcription factor activation, is delayed until 2 h in vaginal ECs but is still independent of hypha formation. The ‘second’ or ‘late’ MAPK response, constituting MKP1 and c-Fos transcription factor activation, is identical to oral ECs and is dependent upon both hypha formation and fungal burdens. NF-κB activation is immediate but independent of morphology. Furthermore, the proinflammatory response in vaginal ECs is different to oral ECs, with an absence of G-CSF and CCL20 and low level IL-6 production. Therefore, differences exist in how C. albicans activates signaling mechanisms in oral and vaginal ECs; however, the activation of MAPK-based pathways that discriminate between yeast and hyphal forms is retained between these mucosal sites. We conclude that this MAPK-based signaling pathway is a common mechanism enabling different human epithelial tissues to orchestrate innate immune responses specifically against C. albicans hyphae