Context Matters Research Articles

A formative mixed methods evaluation of a new Ross program: why context matters

BackgroundThe Ross procedure is a technically complex operation to address the pathology of the aortic valve. Prior attempts at widespread implementation have been plagued with variations in effectiveness. We report our initial programmatic outcomes using dissemination and implementation (D&I) science frameworks, with an aim to define both programmatic efficacy and effectiveness. The study design was a single center, explanatory sequential mixed methods evaluation of a Ross surgery program from June 2020 to April 2023. Quantitative measures for baseline patient characteristics and postoperative outcomes were summarized. Qualitative measures were obtained using semi-structured interviews and characterized using implementation science frameworks.ResultsA total of 71 patients underwent the Ross procedure at a single academic center. Mean age was 40 years (± 13). There were no perioperative deaths or valve-related reinterventions (0%). During the follow-up period, 2 (2.8%) patients required re-operation and 2 (2.8%) required balloon dilation of the pulmonary homograft. Qualitative measures noted communication and prospective self-audit facilitated measures of effectiveness, as dichotomy within expected vs. observed outcomes led to program modifications. Collaboration across hospital systems promoted adoption and implementation, which led to the incorporation of the Ross procedure into accepted organizational practice.ConclusionsIn this formative evaluation, limited-efficacy outcomes demonstrated similar programmatic success to data from other established centers. With the prerequisite center volume and case selection, the Ross procedure is a safe and efficacious treatment for aortic valvular disease. Implementation science can be used both in real-time and retrospectively to guide organizational efforts to improve outcomes and to improve the translation of results across centers.

How the Social Gets Under the Skin: From the Social as Signal to Society as a Metabolic Milieu

Inflammation has risen to the forefront of biomedical research into many chronic diseases prevalent in industrialized countries, including mental, metabolic, and postviral conditions. For sociologists, the rise of inflammation in explanatory models of chronic disease is an opportunity to grasp a historical shift in thinking about how society gets under the skin as new modes of conceptualization of the relationship between societies and bodies emerge in this domain. Highlighting two historical conjunctures between epidemiology and molecular biology concerning hormones and fat, this paper thereby contrasts an older cybernetic model of the social as a signal transduced via the brain and hormonal signaling system to become a biological accretion of stress or adversity with an explanatory trajectory centered on chronic inflammation. Rather than transducing the social environment, the inflammatory body emerging from the studies of adiposity and diabetes is produced by metabolizing material and psychosocial conditions. Inequalities in the social world are thereby reflected as inflammatory states that exist upstream of, not downstream to, the kinds of social signals previously deemed important to health and health disparities. Signals still matter, but they are not their own key determinant in terms of action or impact—that is a contextual matter within the chronicity of the processual metabolic life of a cellular and bodily milieu.

Crop yields fail to rise in smallholder farming systems in sub-Saharan Africa

Drawing on a harmonized longitudinal dataset covering more than 55,000 smallholder farms in six African countries, we analyze changes in crop productivity from 2008 to 2019. Because smallholder farmers represent a significant fraction of the world's poorest people, agricultural productivity in this context matters for poverty reduction and for the broader achievement of the UN Sustainable Development Goals. Our analysis measures productivity trends for nationally representative samples of smallholder crop farmers, using detailed data on agricultural inputs and outputs which we integrate with detailed data on local weather and environmental conditions. In spite of government commitments and international efforts to strengthen African agriculture, we find no evidence that smallholder crop productivity improved over this 12-y period. Our preferred statistical specification of total factor productivity (TFP) suggests an overall decline in productivity of -3.5% per year. Various other models we test also find declining productivity in the overall sample, and none of them finds productivity growth. However, the different countries in our sample experienced varying trends, with some instances of growth in some regions. The results suggest that major challenges remain for agricultural development in sub-Saharan Africa. They complement previous analyses that relied primarily on aggregate national statistics to measure agricultural productivity, rather than detailed microdata.

Attracting and securing budgets for agricultural and applied economics departments

AbstractThe aim of this paper is to discuss the challenges in attracting and securing adequate budgets for departments of agricultural and applied economics, while recognizing that the institutional and political contexts matter. Agricultural and applied economics departments that operate with an entrepreneurial mindset, that maintain and grow their student numbers, and that have a vibrant demand for their extension and research activities will thrive. The good news is we often have considerable control over the factors that contribute to our longer‐term success.

Context matters: Rethinking resource governance theories for Mongolian pastoral systems

Globally, rangelands face interacting pressures from climate, land-use, socio-economic and political changes, all of which threaten herder livelihoods and grassland health. Given these dynamics, it is often unclear which policies would best support sustainable land use and livelihoods in the future. There are multiple theories for how tenure, rules, social relations and environmental variability intersect to influence pastoral resource governance, but these have largely been developed based on empirical data from specific social and environmental contexts. Few studies have attempted to evaluate empirically how the factors driving pastoral management decisions might vary across a social-ecological gradient. In this work we attempt to reconcile the current diversity of theories around pastoral resource governance with an empirical dataset on household herd and pasture management decisions in Mongolia, where there is ongoing debate over proposed rangeland policies, including formalization of land tenure. We assess the relationship between theorized predictors of herder behavior (i.e. formal rights, formal rules, social capital, and environmental variability), and household-level management decisions about pastoral mobility and storage. We compare our findings from a survey of 760 households across four ecozones to predictions from pastoral resource governance theories to assess which theories best match the complex realities on the ground. We observed a continuum of de facto pastoral governance regimes that roughly map onto a social-ecological gradient defined by (i) resource variability and predictability, and (ii) the relative prevalence of formal rule-based vs. implicit norm-based governance. We find that rules, social capital, and forage availability are the strongest predictors of whether a household will reserve forage, with consistent effects across ecological zones. In contrast, social ties and environmental conditions most strongly predict mobility practices. While most households reserved pastures regardless of tenure status, those households who do not reserve pastures are more likely to lack formal use rights. Our findings reinforce the importance of avoiding “one size fits all” rangeland governance policies. We demonstrate that herders make decisions in response to environmental productivity and variability over space and time, and that social ties and mobility are critical for maintaining access to forage. This may explain why many herders remain skeptical of formal pasture tenure, which could restrict this flexibility. Policies that ensure herders’ collective rights to pasture through large-scale zoning rather than tenure could potentially achieve both secure pasture rights and maximum flexibility.

Context matters, but interactions matter too

Context matters, but interactions matter too

Context matters: exploring teacher and learner contexts in ICT integration in slum public basic schools in Ghana

Context matters: exploring teacher and learner contexts in ICT integration in slum public basic schools in Ghana

Creation of state organizations: experiments with ideal-type reform models in a non-Western country

ABSTRACT By studying organizational creations, this article documents the reform trajectory of a non-Western country from 1947 to 2018, using a comparative analytical framework for the operationalization of reform trends on an original dataset – PSAD. Pakistan has paralleled Western world in following the ideal-type reforms without entirely shifting to the new models. Context matters, but the type of government – civilian or military – has not made vivid difference. No one reform type was pushed away; instead, country moved beyond hierarchies and markets creating blends, staging the co-existence of NPM with hierarchies and networks at its 40th.

Context matters: the importance of extra-mathematical knowledge in solving mathematical problems

Extra-mathematical knowledge is often overlooked when investigating mathematical skills. This study explores profiles of mathematical skills and associations with extra-mathematical knowledge and the understanding of complex sentences. The study involved 1,288 sixth-grade students (52.1% male) from 95 classes in 58 schools in Estonia. Students completed a math test as part of their regular lessons. The profiles of mathematical skills included students’ calculation skills, standard problems, and complex problems. Three distinct profiles of students emerged: students with high skill levels, students with average skill levels, and students with low skill levels. Students with high mathematical skills also had high extra-mathematical knowledge showing the crucial role of understanding the context of the math tasks in addition to having good mathematical skills.

Information and context matter: debiasing the disposition effect with lasting impact

The disposition effect is one of the most prominent and widely studied behavioral biases observed among investors. It describes the tendency to close out winning investments prematurely while holding on to losing ones for too long and is generally associated with reduced investment returns. Researchers have explored various debiasing strategies and interventions to mitigate the disposition effect and its detrimental impact on returns. We summarize a between-subject experiment with n = 132 UK participants testing the impact of an informational feedback-like intervention to mitigate the disposition effect, informing participants about the disposition effect. Moreover, we re-examine our intervention's impact in the follow-up measurements which are 2 weeks and again 3 months after the first measurement. We find our intervention to have a significant impact, reducing the disposition effect in the first measurement. In addition, we still find a significant impact of the intervention, reducing the disposition effect after 2 weeks, while no significant impact is observed at the 3-month point. While we find a higher disposition effect to be associated with lower returns for one measurement, the opposite is true for the other two measurements. Moreover, the intervention had a return reducing impact for one measurement and no significant impact for the other two. Overall, our study shows a promising intervention that may be readily deployed among retail investors with a somewhat lasting impact to mitigate the disposition effect. However, our study also shows that the relationship between the disposition effect and investment returns is nuanced.

Perceptions of the use of terms of endearment among older adults in an assisted living facility.

'Elderspeak' has been defined as a form of communication overaccommodation used with older adults that typically involves inappropriate simplified speech. One aspect of elderspeak is the use of terms of endearment such as 'honey', sweetie' and 'dear'. There is disagreement regarding the use of terms of endearment with older adults, with differing views on whether it is beneficial or harmful. To explore the perceptions of older adults residing in an assisted living facility on the use of terms of endearment by healthcare staff. This qualitative study used a descriptive phenomenological design. Semi-structured interviews were undertaken with 15 older adults regarding their perceptions of the use of terms of endearment. The data were analysed to identify themes. Two themes emerged from the interview data: 'it's a matter of opinion' and 'context matters'. Not all older adults viewed terms of endearment negatively; some liked them, others were neutral and some viewed them as childish or disrespectful. Perceptions regarding the use of terms of endearment appear to differ among older adults. Therefore, the use of such terms should be individualised based on the preferences of the older adult.

Maximum sustainable employment: Adding to the beacons of wild fisheries governance

AbstractThis paper proposes to establish Maximum Sustainable Employment (MSE) as a new guiding light, or beacon, for wild fisheries governance. This new social beacon complements the directives provided by the prevailing beacons: Maximum Sustainable Yield (MSY) and Maximum Economic Yield (MEY). The argument is that context matters: in countries where poverty levels are high and alternative employment is scarce, fisheries governors cannot limit themselves to a sectoral perspective. Instead, they must include the remunerative employment and ‘decent work’ that wild fisheries offer society in their strategic deliberations. This perspective is especially relevant for countries in the Global South, but it also has a bearing on the Global North. After discussing the history of scientific fisheries management and the relevance of employment in fisheries, the paper considers the arguments made against MSE. It concludes with a reflection on the balancing of the three beacons in line with prevailing circumstances.

Context matters: Tumor microenvironments impact cellular therapy success

In a recent publication, Locke etal. present data from pretreatment tumor biopsies taken on the ZUMA-7 trial. Their results identify tumor microenvironment (TME) contexts and level of CD19 expression as prognostic indicators for responses to axicabtagene ciloleucel (axi-cel).

Context matters: DNA virus infection reshapes DNA damage response pathways

The cellular DNA damage response pathway can have vastly different outcomes depending on the source of its activation. Justice and colleagues apply phosphoproteomics to uncover a divergence in DNA-PK and ATM kinase activities in the contexts of DNA damage and DNA virus infection.

Does context matter for memory? Testing the effectiveness of learning by imagining situated interactions with objects

ABSTRACT Mounting evidence supports the efficacy of mental imagery for verbal information retention. Motor imagery, imagining oneself interacting physically with the object to be learned, emerges as an optimal form compared to less physically engaging imagery. Yet, when engaging in mental imagery, it occurs within a specific context that may affect imagined actions and consequently impact the mnemonic benefits of mental imagery. In a first study, participants were given instructions for incidental learning: mental rehearsal, visual imagery, motor imagery or situated motor imagery. The latter, which involved imagining physical interaction with an item within a coherent situation, produced the highest proportion of correct recalls. This highlights memory’s role in supporting situated actions and offers the possibility for further developing the mnemonic potential of embodied mental imagery. Furthermore, item-level analysis showed that individuals who engaged in situated motor imagery remembered words primarily due to the sensorimotor characteristics of the words’ referent. A second study investigating the role of inter-item distinctiveness in this effect failed to determine the extent to which the situational and motor elements need to be distinctive in order to be considered useful retrieval cues and produce an optimal memory performance.

Context matters: Exploring the adaptive nature of self-regulation skills in predicting abstinence among veteranswith alcohol use disorder.

Alcohol use disorder (AUD) is highly prevalent among veterans in the United States. Self-regulation skills (e.g., coping and emotion regulation) are important biopsychosocial factors for preventing relapse. However, how variation in self-regulation skills supports abstinence based on contextual demands is understudied in veterans with AUD. In a prospective longitudinal design, treatment-seeking veterans (n = 120; 29 females) aged 23-91 with AUD completed the Alcohol Abstinence Self-Efficacy Scale to assess temptation to drink across several high-risk situations (i.e., negative affect, social/positive emotions, physical concerns, and craving/urges) as well as the Brief-COPE and Emotion Regulation Questionnaire to assess self-regulation skills. Abstinence status was assessed at 6 months. T-tests were used to identify self-regulation skills that differed between abstinent and non-abstinent individuals. Multivariate regression with model selection was performed using all possible interactions between each high-risk situation and the self-regulation skills that significantly differed between groups. Overall, 33.3% of participants (n = 40; nine females) were abstinent at 6 months. Abstinent individuals reported significantly higher use of suppression (p = 0.015), acceptance (p = 0.005), and planning (p = 0.045). Multivariate regression identified significant interactions between (1) planning and physical concerns (p = 0.010) and (2) acceptance, suppression, and craving/urges (p = 0.007). Greater planning predicted abstinence in participants with higher temptation to drink due to physical concerns (e.g., pain). For individuals with lower temptation to drink due to cravings/urges, simultaneous higher suppression and acceptance increased the likelihood of abstinence. Conversely, for participants with higher cravings, greater acceptance with lower suppression was linked to a higher probability of abstinence. Results suggest that the adaptiveness of self-regulation skills in predicting AUD recovery is dependent on contextual demands and highlight the need for culturally sensitive treatments. Collectively, these findings indicate that further research on coping and regulatory flexibility may be an important avenue for tailoring AUD treatment for veterans.

Market context matters: the impact of corporate diversification on REIT performance in Malaysia and Singapore

PurposeThis study aims to investigate the impact of corporate diversification and growth opportunities on the performance of real estate investment trusts (REIT) in Malaysia and Singapore before and during the pandemic.Design/methodology/approachThe sample consists of 33 public-listed REITs across Singapore and Malaysia. A dynamic panel system generalized method of moments (DPS-GMM) estimation is used to account for unobservable factors and a relatively short sample period (2009–2022).FindingsResults indicate that the impact of diversification is contingent on the market where the REIT is based and other institutional factors. The estimates also show that diversified REITs are better able to weather period of economic uncertainty.Practical implicationsWe provided a definitive answer as to why corporate diversification leads to conflicting outcomes – market and institutional factors, strategic intent and the overall economic environment. We also show that the impact of typical firm controls (i.e. free cash, size) can differ. Future firm-level work should thus study similar phenomenon more contextually and carefully consider these varying effects.Originality/valueThe literature is divided on the impact of diversification on firm performance. By using a two-country sample, we show conclusive evidence that this contradictory outcome is due to market and institutional factors. We also show evidence that strategic intent is an important factor that influences the outcomes of diversification, regardless of market. We also infer that excess cash aids the resilience of the firm, contrary to the negative perception of excess cash during normal times. Firm size, in contrast, does not contribute to firm performance during a crisis.

Abstract 3584: Context matters: Genomic profiling of PR isoform-specific actions in breast cancer stem cells reveals novel therapeutic insights for ER+ breast cancer

Abstract Exposure to progesterone is a recognized risk factor for breast cancer, and PGR polymorphisms are associated with various malignancies. The two progesterone receptor (PR) isoforms, full length PR-B and truncated PR-A, are expressed from the PGR gene in breast tissue and play crucial roles in normal physiology. An imbalance in the expression ratio of these isoforms, favoring increased levels of PR-A, is common in breast cancer and is associated with resistance to tamoxifen in Luminal A-type tumors. Notably, PRs have recently been implicated in promoting endocrine resistance and driving the expansion of cancer stem-like cell (CSC) populations implicated in early dissemination and maintenance of metastatic populations. Because prior gene expression studies were primarily conducted in 2D culture conditions, the isoform-specific molecular and epigenetic mechanisms underlying PR actions in advanced ER+ breast cancer remain elusive. Our goal was to define progesterone-driven gene expression in CSC cells by employing transcriptomic profiling of T47D cells cultivated in spheroid-culture conditions (3D) expressing exclusively PR-A or PR-B. Utilizing CUT&RUN, we have mapped the genomic binding sites unique to each PR isoform and identified shared sites. This genomic data has been integrated with phenotypic studies in cells expressing a single PR isoform. Our findings indicate that PR-A acts as a regulator of the cell cycle and senescence, while PR-B plays a pivotal role in cell metabolism and intracellular signaling. We find little overlap between PR-regulated gene sets derived from the same hormone-treated cells harvested from 2D relative to 3D conditions. Our genomic profiling of PRs in this 3D model system has unveiled novel strategies to combat CSC outgrowth and late recurrence in luminal breast cancer patients. This work has shifted our prior understanding of the role of PRs in gene regulation within the CSC population, and offers potential insights for therapeutic interventions in ER+ breast cancer. Citation Format: Noelle E. Gillis, Thu H. Truong, Jessica Finlay-Schultz, Carol A. Sartorius, Carol A. Lange. Context matters: Genomic profiling of PR isoform-specific actions in breast cancer stem cells reveals novel therapeutic insights for ER+ breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3584.

Learning preferences of emergency medicine residents: Does context matter?

Background Delivery of education varies between Emergency Medicine (EM) residencies. EM requires residents to be trained in three domains of foundational knowledge: pathophysiology, procedure skills, and clinical reasoning. The “Visual, Auditory, Read, and Kinesthetics” (VARK) learning model has been studied previously in the medical professions. These methods pertain to viewing material, listening to content, reading or writing content and to performing activities, respectively. EM residents may prefer different VARK methods, and furthermore their preferences may change depending on the foundational knowledge domain to be learned. Methods In a multi-site survey-based study, 90 EM residents of various post-graduate year (PGY) levels completed a 30-question questionnaire on SurveyMonkey™ about their learning preferences of the foundational knowledge based on the VARK learning model. Demographic information was obtained. Data was analyzed via a Kruskal-Wallis test and followed by post-hoc analyses for statistical significance. Results For clinical knowledge questions, EM residents favored Kinesthetics, followed closely by Vision (p = 0.0010). For pathophysiology, they overwhelmingly favored Vision over other learning methods (p <.0001). For procedure questions, they preferred Vision, followed closely by Kinesthetics (p <.0001). PGY1 residents had a higher preference for Kinesthetic (p = 0.0198) and PGY3-4 residents had a slightly higher preference for Read and Vision learning methods (Read p = 0.0234, Vision p = 0.0131). These results are statistically significant. There was no significant difference between residents of different genders in learning preferences. Conclusion Emergency medicine residents may prefer different learning methods depending on the content of material being learned. A relatively small sample size is a limitation of the study. Future studies could investigate if tailoring educational delivery to residents’ preferences may improve outcomes.

Citizens’ e-participation in the digital world: empirical insights from Europe

IMPACT This study investigates citizens’ e-participation, examining a large sample of European countries from 2017–2021. Empirical results suggest that the investigation of e-government initiatives cannot be limited to technocracy, requiring the consideration of different factors and the various features of citizens’ engagement. Policy-makers and local government leaders planning e-government strategies should know that e-maturity is highly dependent on the characteristics of the context in which a public sector entity operates: meaning that norms, rules and societal values depicting the institutional context matter. They should also go beyond the efficiency dimension of public service delivery and focus on effectiveness.