Serving Many Masters: Public Accountability in Private Policy Implementation

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.In recent decades, the introduction of market principles has transformed public service delivery into a hybrid. However, little is known about how these changes are reflected in the attitudes of private implementing agents: The hybridization literature neglects individuals, and street-level bureaucracy research has disregarded hybridization. This article extends Hupe and Hill's (2007) accountability regimes framework to introduce the market as an additional accountability regime alongside state, profession, and society. Using a configurational approach, the article explores how public and private food safety inspectors in Switzerland perceive the multiple norms for behavior stemming from their environment. Results suggest that the plural accountabilities of for-profit street-level bureaucrats can increase the dilemmas involved in their work. Under certain circumstances, for-profit street-level bureaucrats have particular difficulties reconciling rule pressure with market incentives and client demands. The extended accountability regimes framework fruitfully captures such dilemmas and helps identify suitable governance responses

Omics derived biomarkers and novel drug targets for improved intervention in advanced prostate cancer

Prostate cancer (PCa) is one of the most frequently diagnosed malignancies, and the fifth leading cause of cancer related mortality in men. For advanced PCa, radical prostatectomy, radiotherapy, and/or long-term androgen deprivation therapy are the recommended treatment options. However, subsequent progression to metastatic disease after initial therapy results in low 5-year survival rates (29%). Omics technologies enable the acquisition of high-resolution large datasets that can provide insights into molecular mechanisms underlying PCa pathology. For the purpose of this article, a systematic literature search was conducted through the Web of Science Database to critically evaluate recent omics-driven studies that were performed towards: (a) Biomarker development and (b) characterization of novel molecular-based therapeutic targets. The results indicate that multiple omics-based biomarkers with prognostic and predictive value have been validated in the context of PCa, with several of those being also available for commercial use. At the same time, omics-driven potential drug targets have been investigated in pre-clinical settings and even in clinical trials, holding the promise for improved clinical management of advanced PCa, as part of personalized medicine pipelines

Antarctic Surface Reflectivity Measurements from the ANITA-3 and HiCal-1 Experiments

The primary science goal of the NASA-sponsored ANITA project is measurement of ultra-high energy neutrinos and cosmic rays, observed via radio-frequency signals resulting from a neutrino- or cosmic ray- interaction with terrestrial matter (atmospheric or ice molecules, e.g.). Accurate inference of the energies of these cosmic rays requires understanding the transmission/reflection of radio wave signals across the ice-air boundary. Satellite-based measurements of Antarctic surface reflectivity, using a co-located transmitter and receiver, have been performed more-or-less continuously for the last few decades. Satellite-based reflectivity surveys, at frequencies ranging from 2--45 GHz and at near-normal incidence, yield generally consistent reflectivity maps across Antarctica. Using the Sun as an RF source, and the ANITA-3 balloon borne radio-frequency antenna array as the RF receiver, we have also measured the surface reflectivity over the interval 200-1000 MHz, at elevation angles of 12-30 degrees, finding agreement with the Fresnel equations within systematic errors. To probe low incidence angles, inaccessible to the Antarctic Solar technique and not probed by previous satellite surveys, a novel experimental approach ("HiCal-1") was devised. Unlike previous measurements, HiCal-ANITA constitute a bi-static transmitter-receiver pair separated by hundreds of kilometers. Data taken with HiCal, between 200--600 MHz shows a significant departure from the Fresnel equations, constant with frequency over that band, with the deficit increasing with obliquity of incidence, which we attribute to the combined effects of possible surface roughness, surface grain effects, radar clutter and/or shadowing of the reflection zone due to Earth curvature effects.Comment: updated to match publication versio

Discrepancy between German S3 Guideline Recommendations and Daily Urologic Practice in the Management of Nonmuscle Invasive Bladder Cancer: Results of a Binational Survey

Introduction: Guideline recommendations are meant to help minimize morbidity and to improve the care of nonmuscle invasive bladder cancer (NMIBC) patients but studies have suggested an underuse of guideline-recommended care. The aim of this study was to evaluate the level of adherence of German and Austrian urologists to German guideline recommendations. Methods: A survey of 27 items evaluating diagnostic and therapeutic recommendations (15 cases of strong consensus and 6 cases of consensus) for NMIBC was administered among 14 urologic training courses. Survey construction and realization followed the checklist for reporting results of internet e-surveys and was approved by an internal review board. Results: Between January 2018 and June 2019, a total of 307 urologists responded to the questionnaire, with a mean response rate of 71%. The data showed a weak role of urine cytology (54%) for initial diagnostics although it is strongly recommended by the guideline. The most frequently used supporting diagnostic tool during transurethral resection of the bladder was hexaminolevulinate (95%). Contrary to the guideline recommendation, 38% of the participants performed a second resection in the case of pTa low-grade NMIBC. Correct monitoring of Bacille Calmette-Guerin (BCG) response with cystoscopy and cytology was performed by only 34% of the urologists. Conclusions: We found a discrepancy between certain guideline recommendations and daily routine practice concerning the use of urine cytology for initial diagnostics, instillation therapy with a low monitoring rate of BCG response, and follow-up care with unnecessary second resection after pTa low-grade NMIBC in particular. Our survey showed a moderate overall adherence rate of 73%. These results demonstrate the need for sharpening awareness of German guideline recommendations by promoting more intense education of urologists to optimize NMIBC care thus decreasing morbidity and mortality rates

Improvement and Public Service Relationships: Cultural Theory and Institutional Work

This article examines the influence of cultural-institutional factors on user–provider relationships in public services. Using Grid-Group Cultural Theory (CT) as a way to structure the complexity of public service relationships, the article considers the extent to which public services are attuned to users' relational concerns. This analysis shows particular tensions between how users think the service ‘should be’ compared with how they think the service ‘actually is’. Additional study evidence is used to assess these findings; in particular, the effects of different patterns of compatibility on both the perceived quality of public service relationships and the value added by this. Finally, relationships between ‘good opportunities’ for user voice and the above results are discussed. In response, opportunities for improvement are identified (within the institutional work done by public service organizations), and the implications for the relative value of CT analysis are discussed