Government provision of social services through nonprofit organisations

Historically, nonprofit organisations in the United States have played a critical role in helping people in need by providing education, training, residential, counselling and in-kind and cash support. Today, contrary to popular belief, most nonprofit service organisations in the United States depend on government for over half of their revenues. The paper by Lipsky and Smith considers the implications of this relationship between government and nonprofit organisations for our understanding of the welfare state in advanced industrial countries. They argue that recently the American government has used nonprofit agencies to expand the boundaries of the welfare state in a host of service categories, from child abuse to domestic violence to homelessness . The result is a welfare state that is more expansive than would be the case if policymakers relied solely on the public sector. The paper also examines the effe cts of this evolving relationship on the organisational norms of nonprofit agencies. These agencies have an emphasis on particularistic responses to the individual, while the government requires an equity-based focus in which all clients are treated alike. The new funding arrangements mean increased government intrusion into the affairs of nonprofit agencies, thereby altering the character of social policy and the American welfare state. In his paper, 'A Note on Contracting as a Regime', Michael Lipsky explores the notion of a 'contracting regime' as a set of "principles, norms, rules, and decision-making procedures around which actor expectations converge in a given issue-area." Regimes, however, are not simply collections of equal and independent entities, but instead are critically influenced by one of the participating actors. Specifically, in the contracting regime , nonprofit service organisations have changed. Nonprofit human service agencies may now be more expansive than they were able to be in the past, but they are also more tied to government and more reflective of public priorities than of the community values they represented in the past. Lipsky then poses a series of questions about the relationship of government and nonprofit organisations in Australia. To what extent do government agencies articulate separate purposes , priorities and standards? Alternatively, to what extent to they endorse current activities of the voluntary agencies from which the y purchase service? To what extent do government agencies have the capacity to articulate the service needs in their sectors? To what extent can voluntary agencies take actions outside the relationship defined by the contract to obtain public funds and achieve their purposes? To what extent does government possess the capacity to enforce contracts? He suggests that in Australia policymakers have gone far to achieve the hegemony of government over voluntary agencies in service delivery through contracting , but many believe that in selected instances there is still considerable ground to be covered.Note on contracting as a regime and its possible relevance to Australia / Micahel Lipsky -- Government provision of social services through nonprofit organisations / Michael Lipsky and Steven Rathgeb Smit

Mandatory Employment Arbitration: Dispelling the Myths

[Excerpt] Using mandatory arbitration to resolve employment disputes has been a major source of controversy since the practice emerged about twenty‐five years ago. On one side of the debate have been proponents of the practice, who contend that mandatory pre‐dispute arbitration provides a faster and cheaper means of resolving employment disputes than relying on conventional litigation

Expression of neuroimmune semaphorins 4A and 4D and their receptors in the lung is enhanced by allergen and vascular endothelial growth factor

<p>Abstract</p> <p>Background</p> <p>Semaphorins were originally identified as molecules regulating <b>a </b>functional activity of axons in the nervous system. Sema4A and Sema4D were the first semaphorins found to be expressed on immune cells and were termed "immune semaphorins". It is known that Sema4A and Sema4D bind Tim-2 and CD72 expressed on leukocytes and PlexinD1 and B1 present on non-immune cells. These neuroimmune semaphorins and their receptors have been shown to play critical roles in many physiological and pathological processes including neuronal development, immune response regulation, cancer, autoimmune, cardiovascular, renal, and infectious diseases. However, the expression and regulation of Sema4A, Sema4D, and their receptors in normal and allergic lungs is undefined.</p> <p>Results</p> <p>Allergen treatment and lung-specific vascular endothelial growth factor (VEGF) expression induced asthma-like pathologies in the murine lungs. These experimental models of allergic airway inflammation were used for the expression analysis of immune semaphorins and their receptors employing immunohistochemistry and flow cytometry techniques. We found that besides accessory-like cells, Sema4A was also detected on bronchial epithelial and smooth muscle cells, whereas Sema4D expression was high on immune cells such as T and B lymphocytes. Surprisingly, under inflammation various cell types including macrophages, lymphocytes, and granulocytes in the lung expressed Tim-2, a previously defined marker for Th2 cells. CD72 was found on lung immune, inflammatory, and epithelial cells. Bronchial epithelial cells were positive for both plexins, whereas some endothelial cells selectively expressed Plexin D1. Plexin B1 expression was also detected on lung DC. Both allergen and VEGF upregulated the expression of neuroimmune semaphorins and their receptors in the lung tissue. However, the lung tissue Sema4A-Tim2 expression was rather weak, whereas Sema4D-CD72 ligand-receptor pair was vastly upregulated by allergen. Soluble Sema4D protein was present in the lung lysates and a whole Sema4A protein plus its dimer were readily detected in the bronchoalveolar (BAL) fluids under inflammation.</p> <p>Conclusions</p> <p>This study clearly shows that neuroimmune semaphorins Sema4A and Sema4D and their receptors might serve as potential markers for the allergic airway inflammatory diseases. Our current findings pave the way for further investigations of the role of immune semaphorins in inflammation and their use as potential therapeutic targets for the inflammatory lung conditions.</p

CODIFI (Concordance in Diabetic Foot Ulcer Infection) : a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England

OBJECTIVE: To determine the extent of agreement and patterns of disagreement between wound swab and tissue samples in patients with an infected diabetic foot ulcer (DFU). DESIGN: Multicentre, prospective, cross-sectional study. SETTING: Primary and secondary care foot ulcer/diabetic outpatient clinics and hospital wards across England. PARTICIPANTS: Inclusion criteria: consenting patients aged ≥18 years; diabetes mellitus; suspected infected DFU. EXCLUSION CRITERIA: clinically inappropriate to take either sample. INTERVENTIONS: Wound swab obtained using Levine's technique; tissue samples collected using a sterile dermal curette or scalpel. OUTCOME MEASURES: Coprimary: reported presence, and number, of pathogens per sample; prevalence of resistance to antimicrobials among likely pathogens. Secondary: recommended change in antibiotic therapy based on blinded clinical review; adverse events; sampling costs. RESULTS: 400 consenting patients (79% male) from 25 centres.Most prevalent reported pathogens were Staphylococcus aureus (43.8%), Streptococcus (16.7%) and other aerobic Gram-positive cocci (70.6%). At least one potential pathogen was reported from 70.1% of wound swab and 86.1% of tissue samples. Pathogen results differed between sampling methods in 58% of patients, with more pathogens and fewer contaminants reported from tissue specimens.The majority of pathogens were reported significantly more frequently in tissue than wound swab samples (P<0.01), with equal disagreement for S. aureus and Pseudomonas aeruginosa. Blinded clinicians more often recommended a change in antibiotic regimen based on tissue compared with wound swab results (increase of 8.9%, 95% CI 2.65% to 15.3%). Ulcer pain and bleeding occurred more often after tissue collection versus wound swabs (pain: 9.3%, 1.3%; bleeding: 6.8%, 1.5%, respectively). CONCLUSION: Reports of tissue samples more frequently identified pathogens, and less frequently identified non-pathogens compared with wound swab samples. Blinded clinicians more often recommended changes in antibiotic therapy based on tissue compared with wound swab specimens. Further research is needed to determine the effect of the additional information provided by tissue samples. TRIAL REGISTRATION NUMBER: ISRCTN52608451

‘Street-level’ agents operating beyond ‘remote control’: how overseas liaison officers and foreign state officials shape UK extraterritorial migration management

Extraterritorial migration management perspectives on how states try to enforce immigration controls beyond their juridical borders are strongly influenced by ‘remote control’ metaphors. This is conceptually limited and outdated. Most research fails to sufficiently acknowledge agency by a destination state's officials acting abroad, foreign states and their officials, when evaluating extraterritorial measures and ‘outcomes’. We study UK liaison officers abroad, specifically, how they see their efforts to implement extraterritorial immigration control through interactions with foreign state officials. Our approach links inter-state relations to the social world of on-the-ground ‘street-level’ interactions between officers abroad and their foreign counterparts. The empirical analysis draws from original interviews and official sources. We compare factors accounting for the UK's activities and perceived ‘outcomes’ across USA, France, Thailand, Egypt and Ghana. Findings show the UK's extraterritorial migration management results from a very long chain of decisions and actions, by foreign and UK state actors, operating at different institutional-levels, with uncontrollable local circumstances abroad. Realising extraterritorial goals depends strongly on liaison officers’ agency, ‘soft power’ over foreign officials and foreign officials’ willingness to cooperate. Meanwhile liaison officers’ ‘feedbacks’ importantly influence Home Office decision-making. Against the simplistic one-way causality of ‘remote control’, this is ‘street-level’ agency beyond ‘remote control’

Cytogenetic analysis of 130 renal oncocytomas identify three distinct and mutually exclusive diagnostic classes of chromosome aberrations

The cytogenetic alterations in renal oncocytoma (RO) are poorly understood. We analyzed 130 consecutive RO for karyotypic alterations. Clonal chromosome abnormalities were identified in 63 (49%) cases, which could be categorized into three classes of mutually exclusive cytogenetic categories. Class 1 (N = 20) RO had diploid karyotypes with characteristic 11q13 rearrangement in balanced translocations with 10 or more different chromosome partners in all cases. We identified recurrent translocation partners at 5q35, 6p21, 9p24, 11p13-14, and 11q23, and confirmed that CCND1 gene rearrangement at 11q13 utilizing fluorescence in situ hybridization (FISH). Class 2 RO (N = 25) exhibited hypodiploid karyotypes with loss of chromosome 1 and/or losses of Y in males and X in females in all cases. The class 3 tumors comprising of 18 cases showed diverse types of abnormalities with the involvement of two or more chromosomes exclusive of abnormalities seen in classes 1 and 2 tumors. Furthermore, karyotypically uninformative cases were subjected to FISH analysis to identify classes 1 and 2 abnormalities. In this group, we found similar frequencies of CCND1 rearrangement, loss of chromosome 1 or Y as with karyotypically abnormal cases. We validated our results against 91 tumors from the Mitelman database. Correlation of clinical data with all the three classes of ROs showed no clear evidence of overall patient survival. Our findings support the hypothesis that RO exhibit three principal cytogenetic categories, which may have different roles in initiation and/or progression. These cytogenetic markers provide a key tool in the diagnostic evaluation of RO

Sentencing as craftwork and the binary epistemologies of the discretionary decision process

This article contends that it is time to take a critical look at a series of binary categories which have dominated the scholarly and reform epistemologies of the sentencing decision process. These binaries are: rules versus discretion; reason versus emotion; offence versus offender; normative principles versus incoherence; aggravating versus mitigating factors; and aggregate/tariff consistency versus individualized sentencing. These binaries underpin both the 'legal-rational' tradition (by which I mean a view of discretion as inherently suspect, a preference for the use of philosophy of punishment justifications and an explanation of the decision process through factors or variables), and also the more recent rise of the 'new penology'. Both approaches tend to rely on 'top-down' assumptions of change, which pay limited attention to the agency of penal workers. The article seeks to develop a conception of sentencing craftwork as a social and interpretive process.1 In so doing, it applies and develops a number of Kritzer's observations (in this issue) about craftwork to sentencing. These craftwork observations are: problem solving (applied to the rules - discretion and reason - emotion dichotomies); skills and techniques (normative penal principles and the use of cognitive analytical assumptions); consistency (tariff versus individualized sentencing); clientele (applied to account giving and the reality of decision making versus expression). By conceiving of sentencing as craftwork, the binary epistemologies of the sentencing decision process, which have dominated (and limited) the scholarly and policy sentencing imaginations, are revealed as dynamic, contingent, and synergistic. However, this is not to say that such binaries are no more than empty rhetoric concealing the reality of the decision process. Rather, these binaries serve as crucial legitimating reference points in the vocabulary of sentencing account giving

The effects of centralising electoral management board design

The public administration of elections frequently fails. Variation in the performance of electoral management boards around the world has been demonstrated, illustrated by delays in the count, inaccurate or incomplete voter registers, or severe queues at polling stations. Centralising the management of the electoral process has often been proposed as a solution. There has been little theorisation and no empirical investigations into the effects that centralising an already decentralised system would have, however. This article addresses this lacuna by conceptualising centralisation through the literature on bureaucratic control and discretion. It then empirically investigates the effects through a case study of centralisation in two UK referendums. Semi-structured interviews were used with those who devised the policy instrument and those who were subject to it. The introduction of central directions had some of the desired effects such as producing more consistent services and eliminating errors. It also had side effects, however, such as reducing economic efficiency in some areas and overlooking local knowledge. Furthermore, the reforms caused a decline of staff morale, job satisfaction and souring of relations among stakeholder organisations. The process of making organisational change therefore warrants closer attention by policy makers and future scholarship on electoral integrity

Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: Two randomized controlled trials

Context Patients with chronic disabling gout refractory to conventional urate-lowering therapy need timely treatment to control disease manifestations related to tissue urate crystal deposition. Pegloticase, monomethoxypoly(ethylene glycol)–conjugated mammalian recombinant uricase, was developed to fulfill this need. Objective To assess the efficacy and tolerability of pegloticase in managing refractory chronic gout. Design, Setting, and Patients Two replicate, randomized, double-blind, placebo-controlled trials (C0405 and C0406) were conducted between June 2006 and October 2007 at 56 rheumatology practices in the United States, Canada, and Mexico in patients with severe gout, allopurinol intolerance or refractoriness, and serum uric acid concentration of 8.0 mg/dL or greater. A total of 225 patients participated: 109 in trial C0405 and 116 in trial C0406. Intervention Twelve biweekly intravenous infusions containing either pegloticase 8 mg at each infusion (biweekly treatment group), pegloticase alternating with placebo at successive infusions (monthly treatment group), or placebo (placebo group). Main Outcome Measure Primary end point was plasma uric acid levels of less than 6.0 mg/dL in months 3 and 6. Results In trial C0405 the primary end point was reached in 20 of 43 patients in the biweekly group (47%; 95% CI, 31%-62%), 8 of 41 patients in the monthly group (20%; 95% CI, 9%-35%), and in 0 patients treated with placebo (0/20; 95% CI, 0%-17%; P < .001 and <.04 for comparisons between biweekly and monthly groups vs placebo, respectively). Among patients treated with pegloticase in trial C0406, 16 of 42 in the biweekly group (38%; 95% CI, 24%-54%) and 21 of 43 in the monthly group (49%; 95% CI, 33%-65%) achieved the primary end point; no placebo-treated patients reached the primary end point (0/23; 95% CI, 0%-15%; P = .001 and < .001, respectively). When data in the 2 trials were pooled, the primary end point was achieved in 36 of 85 patients in the biweekly group (42%; 95% CI, 32%-54%), 29 of 84 patients in the monthly group (35%; 95% CI, 24%-46%), and 0 of 43 patients in the placebo group (0%; 95% CI, 0%-8%; P < .001 for each comparison). Seven deaths (4 in patients receiving pegloticase and 3 in the placebo group) occurred between randomization and closure of the study database (February 15, 2008). Conclusion Among patients with chronic gout, elevated serum uric acid level, and allopurinol intolerance or refractoriness, the use of pegloticase 8 mg either every 2 weeks or every 4 weeks for 6 months resulted in lower uric acid levels compared with placebo

Sappers of Fortress Europe: exploring the micropolitics of borders through the occupational culture of asylum caseworkers in Greece

This paper considers borders as ubiquitous and pervasive social relations and as sites of struggles, which are shaped through and transformed by social antagonisms and contestations. While much discussion of border struggles focuses on migrants’ resistance and various forms of activism, this paper provides insights on the micro-resistance of those who, instead of overtly opposing and contesting the biopolitical power of border regimes, are integral to their operation: asylum caseworkers who filter and select border-crossers. The paper presents data from interviews with self-identified leftist asylum caseworkers in Greece who, through their work, seek to create cracks in the so-called ‘Fortress Europe’. By exploring the somewhat unexplored occupational culture of leftist asylum caseworkers, we show how, while trying to resist bordering regimes, leftist asylum caseworkers both critique and reproduce the power relations they seek to subvert. Essentially, we provide valuable insights on the limits of resistance due to the workings of powerful technologies of government – informed by neoliberal managerialism – that are operational in day-to-day life of the asylum process. The paper thus provides a novel exploration of the complex and entangled relation between technologies of power and micro-resistances within border regimes in the significant context of Greece