Under the microscope: Formaldehyde exposure in National Health Service pathology departments in the United Kingdom

A substantial body of occupational exposure data shows that formaldehyde inhalation is associated with myriad short- and long-term deleterious health effects on the respiratory, female reproductive and nervous systems. It is also a human carcinogen. Cell pathology departments are among the riskiest occupational environments for formaldehyde inhalation exposure and therefore require a high standard of governance and infrastructure to protect staff adequately. We show that formaldehyde airborne concentrations in most NHS cell pathology departments are monitored infrequently and regularly exceed EU work exposure limits. Our data raises concern for the health of thousands of NHS employees working in these environments. Urgent national regulatory intervention is now warranted to improve the occupational hygiene of NHS cell pathology departments. This will require a combination of upgraded infrastructure, more regular personal exposure monitoring, better employee education on basic laboratory practice and occupational health risks, improved access to appropriate personal protective equipment, management accountability for occupational health, and external oversight by the Health and Safety

Executive.

Plesa, Magdalena; Yates, Richard L. In-Press (2026). Under the microscope: Formaldehyde exposure in National Health Service pathology departments in the United Kingdom. Occupational and Environmental Medicine. http://dx.doi.org/10.1136/oemed-2025-110545. Due to be press-released by BMJ Group in May. Currently embargoed. Pre-print available at: https://www.medrxiv.org/content/10.1101/2025.08.22.25333970v2

Innovating perinatal mental health delivery in Pakistan: a public–private partnership model in primary care

In low- and middle-income countries (LMICs), mental health systems face persistent challenges in access, coverage, and quality, especially for vulnerable groups such as perinatal women. This case study from Pakistan describes an innovative, system-level model for scaling up a psychosocial intervention for perinatal depression - the World Health Organization Thinking Healthy Programme (THP). Originally designed for delivery by Community Health Workers, THP was adapted for delivery by trained lived-experience peers using a social franchise model led by a local non-governmental organization (NGO). The model integrated several innovations: public–private partnerships that leveraged the comparative strengths of government institutions, tertiary mental health services, and community organizations; a stepped-care service delivery framework embedded in primary health care; and digital platforms for intervention-delivery, training, supervision, and quality assurance. Community-based identification through informants and structured screening using PHQ-9 facilitated early detection. Health information generated by the NGO-led franchise was aligned with primary care data standards and partially integrated into the District Health Information System, enhancing accountability and visibility. This case-study illustrates how strategic innovation across multiple health system building blocks can enable the delivery of scalable, community-anchored mental health care in LMICs, offering a replicable model aligned with global goals for Universal Health Coverage and mental health equity.

Nazir, H., Malik, A., Nizami, A., Tariq, M., Nisar, A., Waqas, A., Arshad,K., Sikander, S., Atif, N., Plesa, M., Rahman, A. (2026). Innovatingperinatal mental health delivery in Pakistan: a public–private partnership model in primary care. International Review of Psychiatry, 1–9. https://doi.org/10.1080/09540261.2026.2621824

Social Impact Investing

Social impact investing has emerged as a powerful tool in the global effort to address pressing social and environmental issues. With roots in both the philanthropic sector and the financial markets, this approach has gained traction as investors increasingly seek to align their portfolios with their values. By targeting investments that yield measurable social impacts alongside financial returns, social impact investing offers a unique model for driving social change through market mechanisms.

Social impact investing is characterized by several key features that differentiate it from both traditional investing and philanthropy:

1. Intentionality: Investors aim to generate a positive, measurable social, or environmental impact alongside a financial return.

2. Impact Measurement: A defining feature of impact investing is the commitment to measuring and reporting on the social and environmental performance of investments. This differs from other forms of investing, where financial returns are the primary focus.

3. Diverse Asset Classes: Impact investments can be made in various asset classes, including venture capital, private equity, and fixed income. They can target various sectors, including renewable energy, healthcare, education, and affordable housing.

4. Financial Return: Impact investing seeks to generate financial returns, which can range from below-market to market-rate, depending on the investor’s objectives and the nature of the investment.

This entry examines the concept of social impact investing and situates it within the broader context of civil society, highlighting its potential to mobilize resources for the greater good.

Plesa, M. (2025). Social Impact Investing. In: List, R.A., Anheier,H.K., Toepler, S. (eds) International Encyclopedia of Civil Society.Springer, Cham. https://doi.org/10.1007/978-3-319-99675-2_9696-1

Dehybridization of Social Enterprises: A Process Model

In this paper, I introduce the concept of dehybridization, which I define as a process through which an organization transforms in a way that integrates fewer institutional logics than previously. To examine the phenomenon of dehybridization in the context of social enterprises I draw on the hybridity and hybrid organizations literature. This literature is integral in gaining a theoretical understanding of the challenges of hybrids and their transformations. Building upon this theory, I posit a process model of how dehybridization occurs in hybrid organizations and its influence over time. Illustrating dehybridization through a process model allows theorists and practitioners to recognize the transformational process from a hybrid to a less hybrid form and provides practical strategies for social entrepreneurs.

Magdalena Plesa, 2021: Dehybridization of Social Enterprises: A Process Model. Proceedings, 2021, https://doi.org/10.5465/AMBPP.2021.59

The Role of Governance in the Dehybridization of Social Enterprises

This paper examines the challenges of organizational governance in the transformation of hybrid organizations. Hybrid organizations, studied in the context of 33,350 Community Interest Companies from 2006-2020 in the United Kingdom, highlight tensions and contradictions arising from pursuing multiple goals. In the world of hybrid organizations, an important problem is how and why hybrid organizations shed one or more logics, which we conceptualize as the process of dehybridization. Dehybridization has implications which can transpire by the hybrid changing form to a dominant logic form, a new hybrid, or dissolution of the organization. Governance in the form of board heterogeneity is examined along eight dimensions—age, gender, title, education, occupation, directorships, tenure, and nationality—to find whether boards that are more heterogeneous are more adaptive in dehybridizing. This paper finds that boards with more overall heterogeneity are 4.5 times more likely to adaptively transform by shedding logics and dehybridizing than any other type of community interest company.

Magdalena Plesa, 2021: The Role of Governance in the Dehybridization of Social Enterprises. Proceedings, 2021, https://doi.org/10.5465/AMBPP.2021.15615abstract

Plesa, Magdalena; Lawrence, Tom. Dehybridization in social enterprises: A conceptual clarification and process model. Revise and Resubmit at International Small Business Journal.

Social enterprise research has generated rich insights into how hybrid organizations sustain, balance, and selectively integrate competing social and commercial logics. Less attention, however, has been paid to the inverse transformation: how and why social enterprises become less hybrid. This paper explores that possibility by theorizing dehybridization as an organizational-level process through which a hybrid social enterprise reduces the salience and structural embedding of one institutional logic in order to restore strategic coherence and organizational viability. We conceptualize and develop a process model of dehybridization in social enterprises, with particular relevance to small, resource-constrained, and founder-shaped hybrid ventures. First, we

distinguish dehybridization from related but analytically distinct responses to hybrid tensions, including mission drift, selective coupling, and rehybridization.

In doing so, we argue that dehybridization provides a more precise process construct for understanding deliberate reductions in hybridity that are often subsumed under the broader and normatively charged label of mission drift. Second, we theorize how dehybridization pathways—particularly toward either social or commercial dominance—are shaped by the accumulation of tensions, escalation points, governance conditions, and leadership-enabled reconfiguration. By moving beyond the dominant focus on the maintenance of hybridity, this paper extends research on social enterprise and hybrid organizing and offers a process-based account of strategic adaptation under persistent institutional complexity.

Plesa, Magdalena; Horner, Samuel; Cornelissen, Joep. Conceptualizing hybridity transitions in social enterprises: A dialectical model of dehybridization. Under Review at Journal of Business Venturing.

Research on social enterprise hybridity explains how organizations sustain competing social and commercial logics, but says less about how hybridity changes in degree when contradictions surface and when they may become intractable. We develop a dialectical model of dehybridization to explain how social enterprises move in degrees and types from more to less hybrid forms over time. Drawing on dialectical theories of organizational change, we conceptualize hybridity transitions as recursive movements across provisional equilibria rather than as isolated episodes of mission drift or failure. Our theoretical model specifies six linked mechanisms: hybridization, triggering conditions, untenable tensions, experimentation, pivoting, and dehybridization, through which contradictions embedded in structure, identity, and resource allocation accumulate, intensify, and become acted upon and institutionalized in revised forms. With our theorizing, we shift attention from the maintenance of hybridity to the processes through which hybridity is reconfigured, reduced, or partially decomposed. The paper contributes to social entrepreneurship and hybrid organizing research by integrating dialectical theory into hybridity
scholarship, clarifying when and how contradictions become transformative, and providing a basis for theorizing and empirically examining movement from more to less hybrid configurations.

Plesa, Magdalena; Hubbard, Tim; Curran, Kevin. From fragility to durability: Structured attention biases and social enterprise performance. Under Review at Journal of Business Venturing.

While research on hybrid organizing has extensively examined how social enterprises manage tensions between social and commercial goals, less is known about what explains variation in their durability. To address this lack of knowledge, we introduce the concept of structural attention biases, defined as a persistent tendency to prioritize specific goals over others. We theorize that social enterprises transformed from commercial organizations inherit a commercial attention bias that supports profitability but increases failure risk through mission drift, whereas those transformed from charities inherit a social attention bias that undermines financial performance and survival. In contrast, new hybrid ventures, unconstrained by pre-existing attentional

structures, can build balanced attention infrastructure from inception, enhancing both performance and resilience. Using a longitudinal dataset of 5,202 firm-year observations of UK Community Interest Companies (2005–2023), we find that new venture hybrids are significantly more profitable than transformed charities and substantially less likely to fail than either transformed type. Content analysis of annual reports corroborates our mechanism, showing that new ventures exhibit greater attentional balance between social and commercial language. These findings make three contributions: we deepen understanding of social enterprise durability by conceptualizing organizational hybridity through the lens of structured attention; we extend the ABV to hybrid contexts where balanced attention yields performance benefits rather than costs; and we provide evidence that social enterprises can be built

as durable organizational forms.

How Exogenous Shocks affect the dehybridization of social enterprises: the 2008 Financial Crisis, Brexit, and the Covid-19 Pandemic in the UK. Work in Progress

The world has been immensely disrupted by shocks such as the financial crisis, Brexit, and the Covid-19 pandemic. Organizations of all sizes and industries have been impacted but research still lacks profound insights into the transformative implications of these shocks. This paper addresses this gap by drawing on a rich body of evidence collected from a longitudinal study of 42,131 Community Interest Companies in the United Kingdom from 2005 to 2021. I develop a framework for understanding how social enterprises adapt to exogenous shocks by either dehybridizing, pivoting, hybridizing, sustaining hybridity, or dissolving. This paper finds evidence that the exogenous shocks are more likely to instigate different outcomes of dehybridization. By providing a quantitative understanding of how the 2008 Financial crisis, the Brexit vote, and the Covid-19 lockdown affects social enterprises, the insights from this study contribute to hybrid organizing research, business practice, and policy-making. More broadly this paper provides hybrid and organizational transformation scholars with a theoretical comprehension of how exogenous shocks can challenge out understanding of organizations' transformative behaviour.