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Decades of research on red tape have still to provide final answers as to whether red tape reduces performance. This may be due to not distinguishing the different dimensions that public service performance consists of. Shifting the focus to rules and their characteristics, this study analyses how the degree of compliance burden and lack of functionality of rules relates to overall and dimensional public performance. Building upon the argument that red tape reduces resources and motivation and by doing so influences performance, hypotheses are put forward regarding the relationship to performance. Using red tape reports from employees in 49 work units and performance rated by the supervisor, this study shows that performance is at its lowest when the rules have a high compliance burden and lack functionality. Moreover, the dimensional analyses show that compliance burden may be most detrimental for output, whereas lack of functionality reduces responsiveness and democratic outcomes.

Reported are the results of a study of an enterovirus proficiency panel for use in isolation and serotyping and/or the polymerase chain reaction (PCR) carried out by 12 laboratories in nine European countries. Eleven laboratories reported results of virus isolation and serotyping. In addition, four laboratories reported results of a PCR for enterovirus detection. Correct virus isolation results were obtained for 105 of 110 samples (95.5%, four false-negatives, one false-positive), and correct PCR results for 39 of 40 (97.5%, one false-negative). The highest isolation rate (87.5%) was observed in primary and tertiary monkey kidney cells; on monkey kidney cell lines, human diploid fibroblasts or human heteroploid cells the isolation rate varied between 64% and 71.4%. Serotyping results were less satisfactory. Only 63 of 106 (59.4%) isolated viruses were typed correctly. Major problems were seen with samples containing mixtures of enteroviruses and with enterovirus 71 or echovirus 4, with 9%, 50%, and 55% correct results, respectively. These results underline the need for improvement of enterovirus typing, especially in view of the poliomyelitis eradication initiative.

AbstractAs evidence mounts about the positive effects of autonomous motivation such as public service motivation, there is a growing case for public organizations to design reforms to better support public employees' inherent desire to help others. But how feasible is this in reality? Most experimental evidence on autonomous motivation stems from interventions at the individual level, possibly exaggerating what government reforms can achieve in reality. We present a longitudinal study that analyses a three‐year trial in Danish hospitals in which incentives and autonomy were changed to encourage autonomous motivation. This set‐up offers a rare opportunity to observe the potential malleability of intrinsic, public service, user and external motivation. The results show little observable change in motivation due to the reform. We explore the practical difficulties of translating evidence about motivation into reforms given implementation challenges, contextual factors and a recognition that motivation might be less malleable than implied by research.

Demands that exceed time and resources place pressure on public professionals, resulting in coping behavior. This study aims to provide insight in the prevalence and consequences of taking a more active strategy, professional coping. Next to traditional forms of coping studied in public administration, studying active coping can result in more insight in when and with what consequences frontline employees speak up and resist pressures. We explore to what degree teachers use speaking out using professional norms as a way to tackle the pressures they face. Moreover, we analyze the relationship between professional coping, work engagement, and intent to leave as important indicators of how immersed frontline employees are in their work. Using survey data ( n = 1,270) from primary school teachers, we conclude that professional coping is in general regularly but not very often applied, but that professional coping is related to higher work engagement and lower intent to leave. We conclude that studying active coping strategies can not only be important for street-level literature in gaining insight in all types of behavior and their consequences but also for public service providers aiming for an engaged workforce.

AbstractRed tape studies typically focus on burdensome rules that have negative effects on organizations, as perceived by managers. The one‐item general red tape scale is representative of this approach. However, scholars have called for improved measures that address the scale's shortcomings. This article introduces a new measurement scale that features (1) red tape as a two‐dimensional construct that includes compliance burden and lack of functionality and (2) a job‐centered approach that measures red tape as experienced by employees in their jobs rather than more generally in the organization. A set of survey questions derived from interviews with government employees was validated using data from 1,203 government employees. The findings indicate that the two‐dimensional job‐centered red tape scale is reliable and valid. The authors conclude that this measure can improve research and be used by managers for a "quick scan" to detect the location and severity of red tape.

To assess the performance of laboratories in detecting and quantifying hepatitis C virus (HCV) RNA levels in HCV-infected patients, we distributed two proficiency panels for qualitative and quantitative HCV RNA testing. The panels were designed by the European Union Quality Control Concerted Action, prepared by Boston Biomedica Inc., and distributed in May 1999 (panel 1) and February 2000 (panel 2). Each panel consisted of two negative samples and six positive samples, with HCV RNA target levels from 200 to 500,000 copies/ml. Panel 1 had four samples with at least 50,000 copies/ml, and panel 2 had two samples with at least 50,000 copies/ml. Fifty-seven laboratories submitted 45 qualitative and 35 quantitative data sets on panel 1, and 81 laboratories submitted 75 qualitative and 48 quantitative data sets on panel 2. In both panels, about two-thirds of the qualitative data sets and >90% of the quantitative data sets were obtained with commercial assays. With each panel, two data sets gave one false-positive result, corresponding to false-positivity rates of 1.3% and 0.8% for panel 1 and panel 2, respectively. Samples containing at least 50,000 copies/ml were found positive in 97% and 99% of the cases with panel 1 and panel 2, respectively. In contrast, the positive samples containing ≤5,000 copies/ml were reported positive in only 71% and 77% of the cases with panel 1 and panel 2, respectively. Adequate or better scores on qualitative results (all results correct or only the low-positive samples missed) were obtained in 84% (panel 1) and 80% (panel 2) of the data sets. In the analysis of quantitative results, 60% (panel 1) and 73% (panel 2) of the data sets obtained an adequate or better score (≥80% of the positive results within the range of the geometric mean ± 0.5 log10). Our results indicate that considerable improvements in molecular detection and quantitation of HCV have been achieved, particularly through the use of commercial assays. However, the lowest detection levels of many assays are still too ...

External quality control of hepatitis B virus (HBV) DNA detection remains an important issue. This study reports and compares the results obtained from two different proficiency panels for both the qualitative and quantitative assessment of HBV DNA. The panels were designed by the European Union Quality Control Concerted Action, prepared by Boston Biomedica, Inc., and distributed in May 1999 (panel 1) and February 2000 (panel 2). Each contained two negative samples and six positive samples with 103 to 107 copies/ml (panel 1) or 103 to 2 × 106 copies of HBV DNA per ml (panel 2). For panel 1, 42 laboratories submitted 20 qualitative (all in-house PCRs) and 37 quantitative (87% commercial assays) data sets. For panel 2, 51 laboratories submitted 25 qualitative (all in-house PCRs) and 47 quantitative (94% commercial assays) data sets. Five data sets (8.8%) in panel 1 and two data sets (2.8%) in panel 2 contained totals of six and two false-positives, respectively, corresponding to false-positive result rates of 5.3% for panel 1 and 1.4% for panel 2. The false-negative result rates of 10.5% for panel 1 and 17.4% for panel 2 were dependent on the detection levels of the assays employed as well as panel composition. In the qualitative analysis of all data sets, 47.4% (panel 1) and 51.4% (panel 2) had all samples correct. An adequate or better score (all correct or only the weak-positive sample missed) was obtained with 77.2% of the panel 1 samples and 68.1% of the panel 2 samples. In the quantitative analysis, 57.1% (panel 1) and 42.6% (panel 2) of the data sets achieved an adequate or better score (positive results within the acceptable range of the geometric mean ± 0.5 log10 of all positive results). These results demonstrate that while the qualitative performance of HBV detection has considerably improved compared to that of a previously published HBV proficiency study, the detection levels of many commercial quantitative assays are still too high to allow adequate quantitation of all relevant clinical samples.

AbstractCaring for a family member with Huntington's disease (HD) can be seriously burdensome. Cognitive and neuropsychiatric symptoms that are part of HD can impact the quality of life of caregivers. Therefore, we investigated the relationship between caregiver burden, cognitive impairment and patient characteristics. A retrospective cross-sectional study was performed on 33 adult HD-outpatient-caregiver dyads. We assessed caregiver burden and cognitive functioning of the included patient on the same day with the MCSI and MoCA respectively. For statistical analysis, we performed a network analysis and used descriptive statistics to describe our study sample. Caregivers scored on average 13.5 out of 26 points on the MCSI. The scores on the MoCA of the HD patients varied from 9 to 30 and was on average 22. Our network analysis demonstrated an indirect relationship between cognitive functioning and caregiver burden, in which CAG repeat length and the time since HD has been diagnosed are the primary mediators. We found a negative association between CAG repeat length and cognitive functioning. Furthermore, a relationship was found between higher caregiver burden and psychotropic drug use. We observed an indirect relationship between cognitive functioning and caregiver burden using network analysis. This analysis produces comprehensible results with the variables of interest. This study sheds new light on the components that make up caregiver burden in HD.