Legislative incapacity and underreporting of COVID-19 mortality.

The prevalent interpretation of COVID-19 mortality underreporting typically focuses on authoritarian regimes' propensity for data manipulation. This study, however, posits that the demand side is integral to enhancing the veracity of COVID-19 mortality figures. Through quantitative analysis, it is demonstrated that legislative oversight of the executive significantly correlates with the divergence between excess mortality and officially reported COVID-19 mortality. Moreover, such oversight is shown to bolster the influence of bureaucratic capacity on the precision of mortality data. Consequently, these findings suggest that the notion of "autocratic advantage" in COVID-19 management is not solely a byproduct of regime-led data falsification but also a reflection of deficiencies in legislative and bureaucratic capacities.

"You're only a receptionist, what do you want to know for?": Street-level bureaucracy on the front line of primary care in the United Kingdom.

Introduction: In care settings across the globe non-clinical staff are involved in filtering patients to the most appropriate source of care. This includes primary care where general practice receptionists are key in facilitating access to individual surgeries and the wider National Health Service. Despite the complexity and significance of their role little is known of how the decision-making behaviors of receptionists impact policy implementation and service delivery. By combining the agent-based implementation theory of street-level bureaucracy with a tri-level analytical framework this work acknowledges the impact of the decisions made by receptionists as street-level bureaucrats and demonstrates the benefits of using the novel framework to provide practical insight of the factors influencing those decisions. Methods: A secondary analysis of qualitative data gathered from a series of semi-structured interviews conducted with 19 receptionists in the United Kingdom in 2019 was used to populate a tri-level framework: the micro-level relates to influences on decision making acting at an individual level, the meso-level influences at group and organizational levels, and the macro-level influences at a societal or policy level. Results: At the micro-level we determined how receptionists are influenced by the level of rapport developed with patients and would use common sense to interpret urgency. At the meso-level, influences included their position at the forefront of premises, the culture of the workplace, and the processes and protocols used by their practice. At the macro-level, participants described the impact of limited health service capacity, the lack of mandatory training, and the growth in the use of digital technologies. Conclusions: Street-level bureaucracy, complemented with a tri-level contextual analysis, is a useful theoretical framework to understand how health workers, such as receptionists, attempt to provide universality without sufficient resource, and could potentially be applied to other kinds of public service workers in this way. This theoretical framework also benefits from being an accessible foundation on which to base practice and policy changes.

The post-award effort of managing and reporting on funded research: a scoping review.

INTRODUCTION: Reporting is a mechanism for funding organisations to monitor and manage the progress, outputs, outcomes, and impacts of the research they fund. Inconsistent approaches to reporting and post-award management, and a growing demand for research information, can lead to perception of unnecessary administrative effort that impacts on decision-making and research activity. Identifying this effort, and what stakeholders see as unmet need for improvement, is crucial if funders and Higher Education Institutions (HEIs) are to streamline their practices and provide better support with reporting activities. In this review, we summarise the processes in post-award management, compare current practices, and explore the purpose of collecting information on funded research. We also identify areas where unnecessary effort is perceived and improvement is needed, using previously reported solutions to inform recommendations for funders and HEIs. METHODS: We conducted a scoping review of the relevant research and grey literature. Electronic searches of databases, and manual searches of journals and funder websites, resulted in inclusion of 52 records and 11 websites. Information on HEI and funder post-award management processes was extracted, catalogued, and summarised to inform discussion. RESULTS: Post-award management is a complex process that serves many purposes but requires considerable effort, particularly in the set up and reporting of research. Perceptions of unnecessary effort stem from inefficiencies in compliance, data management and reporting approaches, and there is evidence of needed improvement in mechanisms of administrative support, research impact assessment, monitoring, and evaluation. Solutions should focus on integrating digital systems to reduce duplication, streamlining reporting methods, and improving administrative resources in HEIs. CONCLUSIONS: Funders and HEIs should work together to support a more efficient post-award management process. The value of research information, and how it is collected and used, can be improved by aligning practices and addressing the specific issues highlighted in this review.

The face of debt: Facial width-to-height ratios and regional debt in China.

Facial width-to-height ratio (fWHr) has been widely proven to exert a lasting influence on shaping behavior. In this paper, we provide empirical evidence on the relationship between the fWHr level of bureaucrats and local government debt performance and attempt to discuss the demographic differences in explaining the fWHr-behavior link. We manually collected the fWHr data of local bureaucrats and used prefecture-level panel data of China from 2006 to 2015. The results show that the fWHr levels of bureaucrats are highly correlated with local government debt-bureaucrats with higher fWHr tend to issue more debt and expand the local debt substantially. Results of heterogeneity analysis suggest that the level of fWHr is gender-related-male bureaucrats tend to issue more debt. In addition, bureaucrats who have higher fWHr and who also hold higher education degrees are more inclined to issue debt. In this paper, we concentrate on the Chinese bureaucrat group and provide new micro-evidence on fWHr-related behavior from the perspective of local debt.

How to combine rules and commitment in fostering research integrity?

Research integrity (RI) is crucial for trustworthy research. Rules are important in setting RI standards and improving research practice, but they can lead to increased bureaucracy; without commensurate commitment amongst researchers toward RI, they are unlikely to improve research practices. In this paper, we explore how to combine rules and commitment in fostering RI. Research institutions can govern RI using markets (using incentives), bureaucracies (using rules), and network processes (through commitment and agreements). Based on Habermas' Theory of Communicative Action, we argue that network processes, as part of the lifeworld, can legitimize systems - that is, market or bureaucratic governance modes. This can regulate and support RI practices in an efficient way. Systems can also become dominant and repress consensus processes. Fostering RI requires a balance between network, market and bureaucratic governance modes. We analyze the institutional response to a serious RI case to illustrate how network processes can be combined with bureaucratic rules. Specifically, we analyze how the Science Committee established at Tilburg University in 2012 has navigated different governance modes, resulting in a normatively grounded and efficient approach to fostering RI. Based on this case, we formulate recommendations to research institutions on how to combine rules and commitment.

Recordkeeping, logistics, and translation: a study of homeless services systems as infrastructure.

Homeless services systems provide unhoused individuals access to emergency shelter, subsidized housing, and other life-sustaining resources. In this paper, we present a qualitative study that draws on the experiences of fifteen social service workers to examine how recordkeeping practices sustain homeless services systems and unite a tangled web of institutions and actors, including public housing systems, nonprofit agencies, and local governments. We address the following research questions: How is the infrastructure of homeless services sustained by recordkeeping? How are social service workers affected by increasing recordkeeping demands? In what ways do social service workers work against or 'find the play' in this system? To address these questions, we collected interviews and conducted artifact walkthroughs with our study participants. We analyzed the data using an infrastructural lens and found that current recordkeeping practices within homeless services systems comprise an "infrastructure of last resort" that functions logistically, prioritizing efficiency and speed. We also found that social service workers "speak back" to logistification by making the homeless services infrastructure more legible to their unhoused clients through mediation and acts of translation that help to produce better resource outcomes. Our findings show how structuring recordkeeping in ways that privilege efficiency and speed disrupts social service work and interferes with social service workers' ability to provide care for vulnerable individuals facing life-altering and life-threatening hardships.

Sponsorship as a double-edged sword: Political contingency and mobility dynamics in the Chinese bureaucracy.

This article develops a theoretical model on the role of sponsorship in organizations as a double-edged sword. We highlight the political nature of sponsorship that is entrenched in formal authority relations, as it signals employee allegiance and affects career advancement through strategic appointments. We further distinguish the effect of sponsorship from that of sponsorship loss, highlighting the precariousness of sponsorship contingency in the face of leadership successions. The negative effect of sponsorship loss is mitigated by diverse networks, however, which dilute the loyalty affiliation to a particular sponsor and provide "robust action." The theoretical model is empirically tested in a study of mobility patterns in a large, multi-layered Chinese bureaucracy of over 32,000 officials during a 19-year period, from 1990 to 2008.

The safety risk of information overload and bureaucracy in oncology clinical trial conduct.

Performance of clinical trials has led to major therapeutic developments and substantial improvements in the field of medical oncology. To ensure patient's safety, regulatory aspects for proper clinical trial conduct have been increased over the past two decades but seem to cause information overload and ineffective bureaucracy, possibly even impacting patient safety. To put this in perspective, after the implementation of Directive 2001/20/EC in the European Union, a 90 per cent increase in trial launching time, a 25 per cent decrease in patient participation and a 98 per cent rise in administrative trial costs were reported. The time to initiate a clinical trial has increased from a few months to several years in the past three decades. Moreover, there is a serious risk that information overload with relatively unimportant data endangers the decision-making processes and distracts from essential patient safety information. It is now a critical moment in time to improve efficient clinical trial conduct for our future patients diagnosed with cancer. We are convinced that a reduction of the administrative regulations, information overload, and simplification of the procedures for trial conductance may improve patient safety. In this Current Perspective, we give insight in the current regulatory aspects of clinical research, evaluate the practical consequences of these regulations, and propose specific improvements for optimal clinical trial conduct.

Os burocratas de nível de rua: possibilidades para os estudos em implementação de políticas públicas de esporte e lazer / Street-level bureaucracy: possibilities of studies in implementation of public policies for sports and leisure / os burócratas a pie de calle: posibilidades de estudio en la implementación de las políticas públicas de deporte y ocio

Considerando os estudos de implementação de políticas públicas, a teorização sobre os burocratas de nível de rua, de Michael Lipsky, é fundamental para entender os dilemas dos serviços públicos. Porém, essa temática ainda é pouco difundida nos estudos sobre as políticas públicas de esporte e lazer. Nesse ensaio objetivamos apresentar uma possibilidade de leitura da implementação de políticas públicas de esporte e lazer por meio do arcabouço teórico dos burocratas de nível de rua. Desse modo, compreendemos que os estudos em políticas públicas de esporte e lazer aliados à teorização dos burocratas de nível de rua poderão ser um caminho para o melhor entendimento dos fatores que impactam na tomada de decisões dos agentes esportivos que estão em contato com os cidadãos (Au)

Considering public policy implementation studies, Michael Lipsky's theorizing about street-level bureaucracy is critical to understanding public service dilemmas. However, this theme is still not widespread in studies on public sports and leisure policies. In this essay the main objective is introduce a possibility of public sports and leisure policies reading of implementation based on street level bureaucracy studies. Thereby studies on public sports and leisure policies, combined with the theorizing of street-level bureaucracy, may be a way to better understand the major factors that impact the decision-making by sports agents who are in contact with citizens (AU).

Considerando los estudios sobre la implementación de políticas públicas, la teorización sobre los burócratas a pie de calle, de Michael Lipsky, es fundamental para comprender los dilemas de los servicios públicos. Sin embargo, este tema aún está poco difundido en los estudios sobre políticas públicas de deporte y ocio. En este ensayo, pretendemos presentar una posibilidad de lectura de la implementación de las políticas públicas de deporte y ocio a través del marco teórico de los burócratas a pie de calle. Así, entendemos que los estudios sobre políticas públicas de deporte y ocio aliados a la teorización de los burócratas de calle pueden ser una forma de comprender mejor los factores que inciden en la toma de decisiones de los agentes deportivos que están en contacto con los ciudadanos (AU).

Unlimited Discretion: How Unchecked Bureaucratic Discretion Can Threaten Abortion Availability.

Previous research has assessed the impact of state regulations on abortion clinics and patients, but how bureaucrats implement them is less understood and is increasingly important as states arbitrate abortion regulation. The authors conducted a case study of how bureaucrats use discretion to implement state regulations on abortion, focusing on two abortion facilities in southwest Ohio from 2010 to 2022. Ohio abortion facilities are required to obtain a written transfer agreement, despite it offering no demonstrable health or safety benefits. The authors find that state requirements for obtaining variances-a process that allows abortion facilities to operate without a written transfer agreement-have become exceedingly difficult to comply with. The authors show how state statutes and administrative law have enabled bureaucrats to wield unlimited discretion and enforce arbitrary requirements. This unlimited bureaucratic discretion and accompanying administrative burden exacerbated clinic instability and threatened abortion availability in southwest Ohio for almost a decade. As implementation and interpretation of abortion policy is increasingly left to state bureaucrats and civil servants following the Supreme Court's Dobbs decision, how bureaucrats use discretion will influence clinic stability and abortion availability. The authors posit that unlimited bureaucratic discretion may exert greater influence on abortion availability across the nation as states scramble to clarify and implement policies after Dobbs.

The effect of government support on Bureaucracy, COVID-19 resilience and export intensity: Evidence from North Africa.

The literature on the imperativeness of government support for firm survival since the onset of COVID-19 is vast, but scholars have scarcely considered the impact of such assistance on managers' time, nor the extent to which support measures induce resilience and export activity. Accordingly, this study assesses the impact of government support on (1) bureaucracy and (2) resilience using data from 535 Moroccan SMEs. It further evaluates the influence of resilience on direct versus indirect exports, and espouses the institutional voids, resource-based and strategy-creation view to explain the associations through a contingency lens. The results demonstrate that (1) government support increases bureaucracy which, (2) surprisingly triggers and enhances resilience. Furthermore, (3) resilience has a positive impact on direct exports but (4) adversely affects indirect exports. Theoretically, the findings acquiesce extant calls for measurement specificity in export performance. Practically, stakeholders' attention is drawn to the value of managers' time well spent.

Happenstance and regulatory culture: the evolution of innovative community mental health services in Oxfordshire in the late twentieth century.

This paper uses co-produced historical material to explore the evolution of two innovative mental healthcare institutions that emerged in Oxfordshire in the 1960s. We highlight how the trajectories of both institutions were driven by chance events occurring within social environments, rather than emerging out of evidence or policy initiatives. Both institutions found a role for spontaneity and an openness to chance in the way they worked. We argue that this kind of institutional history would be unlikely today; the paper develops and uses the concept of regulatory culture to explain why. We suggest that the role of regulatory culture has been neglected in the history of psychiatry.

The sense of meaninglessness in bureaucratized science.

Looking at scientists (in the life sciences), we focus on the sense of meaninglessness associated with bureaucratization. We define the sense of meaninglessness as a perception of meaning deficit or meaning conflict in particular situations that can be associated with frustration, irritation, and/or boredom. We show that it can be caused by identity disturbance - particularly the incongruence between the ideal self as a researcher and the imposed self as a bureaucrat. We claim that the sense of meaninglessness is more likely to emerge in those activities that are further from an individual's core identity, and more identity work is needed to make them meaningful. We also claim that processes of rationalization imposed by external agendas, particularly transitions from substantive to formal rationality (predictability, control and calculability, efficiency) contribute to the proliferation of meaninglessness in academia. The sense of meaninglessness is, therefore, ignited by the external forces colonizing academic life and constitutes an instance of the 'irrationality of rationality'. It is an outcome or side effect of the collision between two incompatible logics of practice: bureaucratic and scientific. To show the incongruence of those competing logics, we analyze the data derived from a mixed-method study conducted between 2013 and 2014 among beneficiaries of an international research grant project. As a supplementary source of reference, we use our research on academic boredom and laboratory scientists' work and careers.

Free, but at what cost? How US crisis pregnancy centres provide services.

In the USA, the most popular form of anti-abortion activism, crisis pregnancy centres (CPCs), provide a variety of services to prevent abortions. Moving beyond debate about misinformation and the ethics of CPCs, this study considers the services they provide and given their popularity among state legislatures, their connection to the state. Using interviews with ten CPC staff in Ohio (a state providing support to CPCs) and supplemental data from both state and CPC organisations, we find three relevant themes. First, CPC services reflect ideas about personal responsibility and Christianity held by the CPC staff. Second, we show that CPCs have assumed a variety of state duties (e.g. pregnancy testing and parenting classes), appealing to lawmakers in conservative states eager to transfer responsibility for disadvantaged residents to other entities. Finally, we consider the future direction of CPCs, highlighting tension between organisational goals (focusing on abortion prevention) and the on-the-ground experience of CPC staff (where non-pregnant clients need material aid). Drawing theoretical connections between CPC staff and social service workers sheds light on whose responsibility it is to address poverty in a post-welfare era.

The pox of politics: Troesken's tradeoff reexamined.

In The Pox of Liberty, Werner Troesken details the tradeoff between liberal institutions and communicable disease. According to Troesken, individual freedom presents a danger to the public health in the face of infectious disease, while constitutional constraints restrict the government's ability to implement effective policy. Contra Troesken, I argue that decision-makers, amidst a crisis of contagion, neglect intertemporal tradeoffs, thereby discounting long run costs while favoring short run policies. These policies, once implemented, are difficult to reverse due to the path dependent nature of political institutions. Irreversible and self-reinforcing growth in political institutions established to enhance health can have an unintended negative impact on health during future crises, where political agents must operate in a more cumbersome and error-prone institutional environment. Using events from the history of public health in the U.S. as support for my theory, I conclude that Troesken's alleged tradeoff ought to be met with greater skepticism.

Atuação da APS em tempos de crise: uma análise da discricionariedade dos profissionais de saúde na pandemia da COVID-19 / The role of PHC in times of crisis: an analysis of discretion of health workers during the COVID-19 pandemic

Resumo Crises são eventos excepcionais que alteram os arranjos estruturais sob os quais a burocracia de nível de rua (BNR) atua normalmente, gerando insuficiência de recursos, suspensão de regras e de rotinas, e alteração das práticas de trabalho. Essas características ressaltam a importância do espaço de discricionariedade, uma vez que decisões rápidas precisam ser tomadas em um contexto atravessado pela imprevisibilidade. Neste artigo, analisamos o impacto da pandemia de COVID-19 no Brasil na discricionariedade dos profissionais de saúde da atenção primária à saúde (APS). Portanto, o objetivo do artigo é entender quais fatores impactaram a discricionariedade dos BNRs da APS, examinando aspectos organizacionais, emocionais e científicos. Para isso, analisamos os dados de um questionário, com respostas abertas e fechadas, com 1218 profissionais que atuavam na APS em março de 2021. Os resultados mostram que, diferente do esperado, a discricionariedade dos BNRs não se transforma em uma panaceia pela crise. Uma grande parcela dos profissionais seguiu operando dentro das regras, o que demonstrou a tendência dos BNRs de buscar respaldo para sua atuação, seja por melhores condições organizacionais, pela redução de incerteza ou por amparo na ciência.

Abstract Crises are exceptional events that alter the structural arrangements under which street-level bureaucrats (SLBs) normally operate, generating resource shortages, the suspension of rules and routines, and changes in work practices. These characteristics highlight the importance of room for discretion, since quick decisions need to be made in a context pervaded by unpredictability. This study analyzed the impact of the COVID-19 pandemic in Brazil on the discretion of primary health care workers, seeking to understand which factors influence the exercise of discretion, focusing on organizational, emotional and scientific aspects. We used data from an online survey comprising open- and closed-ended questions conducted in March 2021 with 1218 primary care workers. The results show that, unexpectedly, discretion of SLBs does not become a panacea for the crisis. A large portion of professionals continued to operate within the rules, demonstrating a tendency to seek support at work, either through better organizational conditions, the reduction of uncertainty or from science.

Beliefs about minority representation in policing and support for diversification.

Diversification of police forces is widely promoted as a reform for reducing racial disparities in police-civilian interactions and increasing police legitimacy. Despite these potential benefits, nearly every municipal police department in the United States remains predominately White and male. Here, we investigate whether the scale and persistence of minority underrepresentation in policing might partly be explained by a lack of support for diversification among voters and current police officers. Across two studies (N = 2, 661) sampling the US adult population and residents from a city with one of the least representative police forces in the country, individuals significantly overestimate officer diversity at both the local and national levels. We find that correcting these biased beliefs with accurate information reduces trust in police and increases support for hiring new officers from underrepresented groups. In the municipal sample, these corrections also cause an increase in residents' willingness to vote for reforms to diversify their majority White police department. Additional paired decision-making experiments (N = 1, 663) conducted on these residents and current police officers demonstrate that both prefer hiring new officers from currently underrepresented groups, independent of civil service exam performance and other hiring criteria. Overall, these results suggest that attitudes among voters and police officers are unlikely to pose a major barrier to diversity reforms.

Mecanismos de governança, instituições societárias e burocracia estatal: reflexões sobre instituições societárias e porosidade governamental / Governance mechanisms, societal institutions, and State bureaucracy: concerns over societal institutions and governmental porosity

RESUMO Este ensaio discute os mecanismos de governança participativa no setor público a partir de teorias sobre liberdades civis, democracias dialógicas, formações burocráticas estatais e reformas de governança pública. O objetivo foi analisar a repercussão desses temas em agendas e alternativas de políticas de governança pública e participativa no Brasil com ênfase nos conflitos entre governantes, políticos, funcionários, grupos de interesses e coalizões civis em disputa nos processos decisórios. O artigo assinala o caráter híbrido da democracia brasileira, em que o universalismo weberiano e a orientação às instituições de Estado de Bem-Estar que foram entrelaçados na matriz constitucional de 1988 operam em competição com duas outras lógicas - por um lado, a herança estamental da burocracia pública e, por outro, as iniciativas de governanças horizontais e participativas. As contradições dinâmicas entre esses quatro eixos definirão a competição pelo aparelho de Estado no contexto atual.

ABSTRACT This essay discusses participative governance mechanisms in the public sector grounded on theories of civil liberties, dialogical democracies, patterns of state bureaucracies, and public governance reforms. We aimed to analyze the effects of these issues on political agendas and public and participative governance alternatives in Brazil, emphasizing conflicts among rulers, politicians, civil servants, interest groups, and advocacy coalitions in dispute in decision-making processes. The article signals a hybrid nature of the Brazilian democracy in which Weberian universalism and rules of Welfare State institutions inscribed in the 1988 constitutional matrix operate through competition between two other logic streams - strata inheritance of state bureaucracy on the one hand and initiatives in favor of horizontal and participative governance on the other. The dynamic contradictions among these four issues will define the pattern of current competition for State apparatus.

Discretion and local health policy implementation: street-level bureaucrats and integrative and complementary therapies in Santos' local health units.

This research discusses contextual factors that influence the development of complementary and/or integrative therapies developed by local health units on street-level bureaucracy in Santos. Through a qualitative approach, the research verifies that street-level bureaucracy is free to suggest and implement the aforementioned therapies, even if they do not have formal support of the municipality; however, they need support from their immediate local supervisors so they can adjust and implement the practice's routine, or the practice might not occur. Additionally, this text also presents guidelines in order to further develop the research.