Contextual Drivers Research Articles

Drivers of Environmental Institutional Dynamics in Decentralized African Countries.

This paper builds on the assumption that an effective approach to support the sustainability of natural resource management initiatives is institutional "bricolage." We argue that participatory planning processes can foster institutional bricolage by encouraging stakeholders to make their own arrangements based on the hybridization of old and new institutions. This papers aims at identifying how participatory process facilitators can encourage institutional bricolage. Specifically the paper investigates the specific contextual and procedural drivers of institutional dynamics in two case studies: the Rwenzori region in Uganda and the Fogera woreda in Ethiopia. In both cases, participatory planning processes were implemented. This research has three innovative aspects. First, it establishes a clear distinction between six terms which are useful for identifying, describing, and analyzing institutional dynamics: formal and informal; institutions and organizations; and emergence and change. Secondly, it compares the contrasting institutional dynamics in the two case studies. Thirdly, process-tracing is used to identify contextual and procedural drivers to institutional dynamics. We assume that procedural drivers can be used as "levers" by facilitators to trigger institutional bricolage. We found that facilitators need to pay particular attention to the institutional context in which the participatory planning process takes place, and especially at existing institutional gaps or failures. We identified three clusters of procedural levers: the selection and engagement of participants; the legitimacy, knowledge, and ideas of facilitators; and the design of the process, including the scale at which it is developed, the participatory tools used and the management of the diversity of frames.

Editorial: Planning Support Systems

This special issue of the journal aims to provide a series of papers representing the state-of-the-art in terms of the development of planning support systems (PSS). Four contributions are included which illustrate not only different systems and applications but also the contextual drivers that underpin their development, such as technological changes including the emergence of cloud computing, and austerity measures that have pervaded public sector institutions as a consequence of national debt crises following the global recession. The applications exemplify the use of PSS in different thematic contexts in different parts of the world including Western Australia, Wyoming, the north of England and the Netherlands. The first paper by Chris Pettit and colleagues provides an excellent example of the way in which one well-known desktop planning support system, What If? (Klosterman 2001), is being transformed to take advantage of the benefits of cloud computing and offer users the opportunity online to generate future land-use predictions under alternative scenarios. The new Online What If? (OWI) system is being developed as part of the Australian Urban Research Infrastructure Network (AURIN) initiative and the paper outlines one of the tools available from this workbench that enables maps to be produced that show the relative suitability of grid squares for different types of land use. The methodology is illustrated with a case study of the anticipated growth rate in the North West Metro Perth sub-region, in collaboration with the Western Australia State Government. The results of two scenarios – one focussed on employment generation and the other on environmental conservation – are investigated and a comparison of the simulations reveals that that even under the more restrictive assumptions of the latter scenario, the sub-region can accommodate the predicted population growth whilst not compromising the environmental considerations. In the second paper, the focus moves from land-use planning per se to the relationship between infrastructure development, residential growth and the cost and efficiency of providing public services in Wyoming in the USA. Scott Lieske and his co-authors present a methodology that begins with a comparison of the population growth trends

Seafood insecurity, bush meat consumption, and public health emergency in West Africa: Did we miss the early warning signs of an Ebola epidemic?

In this article, we frame issues around food security and the Ebola epidemic in West Africa and discuss the potential contribution of interrelated factors like seafood access, bush meat consumption, and public health concerns with the recent outbreak. Since seafood is a major dietary constituent in the affected countries, we posit that seafood unavailability due to unsustainable fishing practices and global change may increase the demand for bush meat and the risk of exposure to zoonosis such as Ebola through hunting and wildlife interactions. We discuss the potential contribution of these contextual drivers to public health within the wider milieu of changing climate, habitat disruptions, human migration and its implication for adaptive capacity, resilience and environmental governance. We conclude with policy options and research directives in addressing regional food security challenges, maritime policy, and emerging global health concerns.

The influence of livelihood dependency, local ecological knowledge and market proximity on the ecological impacts of harvesting non-timber forest products

It is well established that non-timber forest products make significant contributions to rural incomes throughout most of the developing world. NTFP use frequently raises concerns about the sustainability of, or ecological impacts associated with, NTFP harvesting, as well as local contextual factors which may limit or reduce the impacts. Here we test the conceptual model first advanced by Uma Shaanker et al. (2004) relating to the factors that may limit or exacerbate the ecological impacts associated with NTFP harvesting. These were the extent of local dependence on NTFPs, the degree of marketing and the level of local ecological knowledge. Data were collected via household questionnaires and ecological surveys of woody plants from eight villages throughout South Africa. We found no significant relationships between measures of ecological impact with local ecological knowledge or market proximity and engagement. There was a strong positive relationship between ecological impacts and NTFP dependency as indexed through mean annual direct-use value for NTFPs. This indicates that the higher the dependency and demand for NTFPs, the greater is the possibility of high impacts to the local environment. However, other contextual drivers not included in the original Uma Shaanker et al. (2004) model may also play a role, particularly the strength of local resource governance institutions.

Contextual variation in interdependent policy making: The case of tax competition

AbstractMany studies show that policy makers react to the policy choices made in other jurisdictions, but we still know relatively little about the factors driving interdependent policy making, especially about how context shapes interdependence. Theoretical arguments suggest that contextual factors, such as stable institutions and geographic location, explain variation in interdependence. However, there is a lack of empirical research investigating contextual heterogeneity in interdependent policy making, mainly because it cannot be analysed with standard spatial econometric methods. This article introduces multilevel modeling that allows the study of contextual variation in interdependence and illustrates the method with the analysis of uneven tax competition in Switzerland. The findings of fine‐grained data show that cantonal governments compete more strongly with their competitors the closer a unit is located to a metropolis with comprehensive public good provision. The analysis demonstrates that we can better understand the mechanisms of interdependent policy making by studying its contextual drivers.

Elements of effective palliative care models: a rapid review.

BackgroundPopulation ageing, changes to the profiles of life-limiting illnesses and evolving societal attitudes prompt a critical evaluation of models of palliative care. We set out to identify evidence-based models of palliative care to inform policy reform in Australia.MethodA rapid review of electronic databases and the grey literature was undertaken over an eight week period in April-June 2012. We included policy documents and comparative studies from countries within the Organisation for Economic Co-operation and Development (OECD) published in English since 2001. Meta-analysis was planned where >1 study met criteria; otherwise, synthesis was narrative using methods described by Popay et al. (2006).ResultsOf 1,959 peer-reviewed articles, 23 reported systematic reviews, 9 additional RCTs and 34 non-randomised comparative studies. Variation in the content of models, contexts in which these were implemented and lack of detailed reporting meant that elements of models constituted a more meaningful unit of analysis than models themselves. Case management was the element most consistently reported in models for which comparative studies provided evidence for effectiveness. Essential attributes of population-based palliative care models identified by policy and addressed by more than one element were communication and coordination between providers (including primary care), skill enhancement, and capacity to respond rapidly to individuals’ changing needs and preferences over time.ConclusionModels of palliative care should integrate specialist expertise with primary and community care services and enable transitions across settings, including residential aged care. The increasing complexity of care needs, services, interventions and contextual drivers warrants future research aimed at elucidating the interactions between different components and the roles played by patient, provider and health system factors. The findings of this review are limited by its rapid methodology and focus on model elements relevant to Australia’s health system.

Social Housing Organisations in England and The Netherlands: Between the State, Market and Community

Social Housing Organisations in England and The Netherlands: Between the State, Market and Community

Social Housing Organisations in England and The Netherlands: Between the State, Market and Community

Social Housing Organisations in England and The Netherlands: Between the State, Market and Community

Social Housing Organisations in England and The Netherlands: Between the State, Market and Community

Social Housing Organisations in England and The Netherlands: Between the State, Market and Community

The implications of redundancy on complex operations: An investigation of hospital operations

Researches on redundancy in complex operations have led to inconsistent findings and understanding of the implications of redundancy in the wider operations management domain. This paper seeks to clarify on these inconsistencies by taking a risk management perspective in examining the implications of redundancy in complex hospital operations. Extensive evidence were collected from two large hospitals in Singapore to examine the implications of redundancy in variant complex operations using a systems analytical approach - causal loop diagrams to illustrate the dominant tensions. We offer a novel approach by integrating two theoretical lenses – Normal Accident Theory (NAT) and High Reliability Theory (HRT) in developing a set of propositions to explain the tensions resulting from a general lack of redundancy. Our findings also suggest that NAT and HRT may be used in complement to inform on the appropriate risk management approach based on the distinctive contextual drivers to alleviate the operational strains due to the recurrent tensions. This paper extends literature on NAT-HRT and provides some initial resolution on the ensuing debate surrounding redundancy based on the two theoretical perspectives. This work constitutes an initial step to reconcile the extensive but fragmented literature on the implications of redundancy in complex hospital operations.

Systems Approaches to Animal Disease Surveillance and Resource Allocation: Methodological Frameworks for Behavioral Analysis

While demands for animal disease surveillance systems are growing, there has been little applied research that has examined the interactions between resource allocation, cost-effectiveness, and behavioral considerations of actors throughout the livestock supply chain in a surveillance system context. These interactions are important as feedbacks between surveillance decisions and disease evolution may be modulated by their contextual drivers, influencing the cost-effectiveness of a given surveillance system. This paper identifies a number of key behavioral aspects involved in animal health surveillance systems and reviews some novel methodologies for their analysis. A generic framework for analysis is discussed, with exemplar results provided to demonstrate the utility of such an approach in guiding better disease control and surveillance decisions.

Rallying intolerance in the valleys: Explaining support for the extreme right in Wales

Until its decline at the 2012 elections, the British National Party (BNP) was the most electorally successful extreme right party in the United Kingdom. Yet, although the party’s electoral growth in England has attracted attention, individual and contextual drivers of BNP support in other areas – namely, Wales – have been ignored. The lack of research is puzzling, given that the party has actively campaigned beyond England and attracted some support for its ethnic nationalism amidst a resurgence of support for Welsh nationalism. Drawing on a range of data, we examine the socio-economic, political and demographic drivers of BNP support in Wales. At the aggregate level, we find the party performs strongest in economically insecure and urban areas that have large social housing sectors, high deprivation rates, low education levels, large numbers of residents in precarious occupations, and which have experienced the largest increases in unemployment rates since the onset of the financial crisis. Politically, our findings suggest that the BNP has also rallied votes in areas where turnout is low, and where support for Labour has traditionally been strong. Individual-level analysis of ‘core’ and ‘soft’ supporters reveals that although they share a similar profile – less-well educated and middle-aged men who tend to be skilled workers – soft sympathy appears more widespread among women and younger citizens. Foremost, and despite a broader context of comparatively low migration and ethnic diversity rates in Wales, both groups of supporters are driven to the extreme right by concerns over immigration, which appear to be tied strongly to broader feelings of political abandonment. In contrast to results in England, our findings suggest that immigration-related concerns do not stem from the actual presence or proximity of immigrant and/or minority groups. Rather, it appears that structural economic disadvantage, political disenchantment and the perceived negative impact of immigration provide a more convincing explanation for the limited electoral appeal of the extreme right in Wales.

Universal health coverage in Turkey: enhancement of equity

Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with continuous learning, and simultaneous improvements in the health system, on both the demand side (increased health insurance coverage, expanded benefits, and reduced cost-sharing) and the supply side (expansion of infrastructure, health human resources, and health services).

Optimising workplace interventions for health and well‐being

PurposeThe purpose of this paper is to discuss contemporary approaches to workplace health and well‐being, articulating key differences in the intervention architecture between public and workplace health contexts and implications for intervention design.Design/methodology/approachContemporary practice is discussed in light of calls for a paradigm shift in occupational health from a treatment orientation to an holistic approach focused on mitigation of the causes of ill health and the promotion of well‐being. In practice, relatively few organizations have or seem able to engage with a broader perspective that encompasses challenges to health and well‐being associated with contextual organizational drivers, e.g. job design/role, workload, systems of reward, leadership style and the underpinning climate. Drawing upon insights from public health and the workplace safety tradition, the scope for broadening the perspective on intervention (in terms of vectors of harm addressed, theory of change and intervention logic) is discussed.FindingsThere are important differences in scope and options for intervention between public health and workplace health contexts. While there is scope to emulate public health practice, this should not constrain thinking over intervention opinions. Increased awareness of these key differences within work organizations, and an evidence‐based epidemiological approach to learning has the potential to strengthen and broaden the approach to workplace health and well‐being management.Originality/valueThe authors argue that approaches to workplace well‐being interventions that selectively cross‐fertilise and adapt elements of public health interventions offer promise for realising a broader change agenda and for building inherently healthy workplaces.

Spatial clusters of autism births and diagnoses point to contextual drivers of increased prevalence

Autism prevalence has risen dramatically over the past two decades in California. Although often suggested to have been crucial to the rise of autism, environmental and social contextual drivers of diagnosis have not been extensively examined. Identifying the spatial patterning of autism cases at birth and at diagnosis can help clarify which contextual drivers are affecting autism's rising prevalence. Children with autism not co-morbid with mental retardation served by the California Department of Developmental Services during the period 1992–2005 were matched to California's Birth Master Files. We search for spatial clusters of autism at time of birth and at time of diagnosis using a spatial scan approach that controls for key individual-level risk factors. We then test whether indicators of neighborhood-level diagnostic resources are associated with the diagnostic clusters and assess the extent of clustering by autism symptom severity through a multivariate scan. Finally, we test whether children who move into neighborhoods with higher levels of resources are more likely to receive an autism diagnosis relative to those who do not move with regard to resources. Significant birth and diagnostic clusters of autism are observed independent of key individual-level risk factors. While the clusters overlap, there is a strong positive association between the diagnostic clusters and neighborhood-level diagnostic resources. In addition, children with autism who are higher functioning are more likely to be diagnosed within a cluster than children with autism who are lower functioning. Most importantly, children who move into a neighborhood with more diagnostic resources than their previous residence are more likely to subsequently receive an autism diagnosis than children whose neighborhood resources do not change. We identify birth and diagnostic clusters of autism in California that are independent of individual-level autism risk factors. Our findings implicate a causal relationship between neighborhood-level diagnostic resources and spatial patterns of autism incidence but do not rule out the possibility that environmental toxicants have also contributed to autism risk.

Processes in widening access to undergraduate Allied Health Sciences education in South Africa

The purpose of this manuscript is to describe the processes followed in initiating and managing widening access to allied health sciences education at the University of Cape Town, South Africa. In response to national higher education policy imperatives in South Africa and in anticipation of the first cohort of Outcome Based Education (OBE) school leavers entering tertiary education, the School of Health and Rehabilitation Sciences at the university launched an extensive intra- and cross-programme transformation project in 2004. The project afforded four undergraduate professional programmes, namely audiology, occupational therapy, physiotherapy and speech therapy, an opportunity to address common educational and contextual drivers. These included, among others, the need for increased access and throughput of historically under-represented students in higher education. An advisory task team, named the curriculum review management team (CRMT), was engaged in envisaging, navigating and containing a complex sociopolitical process involving many stakeholders with disparate ideas, practice approaches, and focal concerns. The use of the Gale and Grant model of change management, augmented by the Community of Practice conceptual framework, to assist with these processes is described.

Six Sigma adoption: Operating performance impacts and contextual drivers of success

We assess the operational impacts of Six Sigma program adoptions through an event study methodology, comparing financial data for 200 Six Sigma adopting firms against data for matched firms, which serve as control groups for the analyses. We employ various matching procedures using different combinations of pre-adoption return on assets (ROA), industry, and size as matching criteria. By comparing performance outcomes across a hierarchy of operating metrics, we establish a pattern of Six Sigma adoption effects that provides strong evidence of a positive impact on ROA. Interestingly, these ROA improvements arise mostly from significant reductions in indirect costs; significant improvements in direct costs and asset productivity are not evident. We also find small improvements in sales growth due to Six Sigma adoption. Cross-sectional analyses of the performance results reveal that distinctions in Six Sigma impacts across manufacturing and service firms are negligible. Interestingly, we find that the performance impact of Six Sigma adoption is negatively correlated to the firm's quality system maturity (indicated by prior ISO 9000 certification). Further analyses of manufacturing and service firms reveals that Six Sigma benefits are significantly correlated with intensity in manufacturing, and with financial performance before adoption in services. We discuss the implications of these findings for practice and for future research.

Tailored sustainability assessment for urban masterplanning

Tailored sustainability assessment represents one approach to addressing sustainability issues on large-scale urban projects with varying geographical, social and political constraints and diverse incentives among stakeholders. This paper examines the value and limitations of this approach. Three case studies of tailored systems developed by the authors for three unique masterplanning projects are discussed in terms of: contextual sustainability drivers; nature and evolution of systems developed; outcomes of implementation; and overall value delivered. Analysis Leads to conclusions on the key features of effective tailored assessment, the value of tailored sustainability assessment from various perspectives (including client, designer, end-users and the environment), and the limitations of tailored assessment as a tool for comparative analysis between projects. Although systems considered here are specific to individual projects and developed commercially, the challenges and lessons learned are relevant to a range of sustainability assessment approaches developed under different conditions.

Operational and contextual drivers of hospital costs

The purpose of this paper is to examine empirically how operational performance and contextual factors contribute to differences in overall patient care costs across different hospitals. Administrative data are employed from a sample of hospitals in New York State to construct measures of contextual factors, operational performance, and cost per patient. Operational performance and cost variables are adjusted to account for case mix differences across hospitals. Hierarchical regression is used to analyze the effects of contextual and operational variables on cost performance. Increased length of stay, increased patient volume, and educational mission were associated with higher cost per patient. Mortality performance was associated with lower cost per patient. However, it was not found that location, size, or ownership status had a significant relationship with cost performance. This paper identifies several significant relationships between contextual and operational variables and hospital costs. From a managerial perspective, these findings highlight the fact that some drivers of cost in hospitals are under the control of managers. One of the primary cost drivers in the study is length of stay, which implies that there is significant room for improvement in healthcare performance through a focus on operational excellence. For researchers, the present study highlights the relative importance of operational versus contextual factors, with respect to cost performance in hospitals. The results of this study also provide direction for additional research into the role operational performance might play in determining the overall organizational performance in a hospital.

Human behavioral contributions to climate change: Psychological and contextual drivers.

We are facing rapid changes in the global climate, and these changes are attributable to human behavior. Humans produce this global impact through our use of natural resources, multiplied by the vast increase in population seen in the past 50 to 100 years. Our goal in this article is to examine the underlying psychosocial causes of human impact, primarily through patterns of reproduction and consumption. We identify and distinguish individual, societal, and behavioral predictors of environmental impact. Relevant research in these areas (as well as areas that would be aided by greater attention by psychologists) are reviewed. We conclude by highlighting ethical issues that emerge when considering how to address human behavioral contributions to climate change.