Contextual differences considered in the Tunisian ADOLOPMENT of the European guidelines on breast cancer screening

Background Breast cancer is a common disease in Tunisia and is associated with high mortality rates. The “Instance Nationale de l’Evaluation et de l’Accréditation en Santé” (INEAS) and the Tunisian Society of Oncology decided to develop practice guidelines on the subject. While the development of de novo guidelines on breast cancer screening is a demanding process, guideline adaptation appears more appropriate and context sensitive. The objective of this paper is to describe the adaptation process of the European Guidelines on Breast Cancer Screening and Diagnosis to the Tunisian setting in terms of the methodological process, contextual differences between the source and adoloped guideline, and changes in the recommendations. Methods We used the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE)-ADOLOPMENT methodology to prioritize the topic, select the source guideline, and prioritize the questions and the outcomes. Once the source guideline was selected—the European Breast Cancer Guidelines—the European Commission´s Joint Research Centre shared with the project team in Tunisia all relevant documents and files. In parallel, the project team searched for local studies on the disease prevalence, associated outcomes’ baseline risks, patients’ values and preferences, cost, cost-effectiveness, acceptability, and feasibility. Then, the adoloping panel reviewed the GRADE evidence tables and the Evidence to Decision tables and discussed whether their own judgments were consistent with those from the source guideline or not. They based their judgments on the evidence on health effects, the contextual evidence, and their own experiences. Results The most relevant contextual differences between the source and adoloped guidelines were related to the perspective, scope, prioritized questions, rating of outcome importance, baseline risks, and indirectness of the evidence. The ADOLOPMENT process resulted in keeping 5 out of 6 recommendations unmodified. One recommendation addressing “screening versus no screening with ultrasound in women with high breast density on mammography screening” was modified from ‘conditional against’ to ‘conditional for either’ due to more favorable ratings by the adoloping panel in terms of equity and feasibility. Conclusion This process illustrates both the feasibility of GRADE-ADOLOPMENT approach and the importance of consideration of contextual evidence. It also highlights the value of collaboration with the organization that developed the source guideline.

Speaker’s verbal behavior and collective audience responses in Korean political oratory

An analysis was conducted of the discourse of South Korean political speakers in relation to collective audience responses, based on three situational contexts. Results showed marked contextual differences in the formatting of messages used to invite audience responses. In campaign speeches, explicit (dialogic) rhetorical devices (RDs) occurred most frequently, thereby supporting Bull and Miskinis’ (2015) hypothesis that such RDs are characteristic of political speech-making in collectivist far eastern societies. However, this hypothesis was substantively qualified by findings that (1) in the acceptance and inauguration speeches, implicit RDs were utilized more frequently than explicit (dialogic) RDs, and (2) in those two contexts, it was non-formatted messages that occurred more frequently than either explicit or implicit RDs separately.

The interplay of personal and contextual diversity during the first year at Higher Education: Combining a quantitative and a qualitative approach

Research on student transition into Higher Education (HE) has taken different theoretical perspectives. First, studies investigated personal variables such as students´ self-efficacy, emotions and motivation regarding the transition from school to HE. A second strand of research focused on contextual variables, for instance college effectiveness research. With this paper, we combine both the personal and the contextual approach. We aim to investigate the interaction between personal and contextual diversity during the transition into HE, taking into account students’ diversity in particular with regard to gender and individual characteristics, such as self-efficacy. We explored the heterogeneity in students’ personal characteristics by conducting a latent profile analysis (LPA) based on students’ intrinsic motivation, self-efficacy and anxiety before entering Higher Education. LPA resulted in three distinct profiles, with significant differences in how students perceived the first year. This finding suggests that students’ personal characteristics when entering Higher Education influence how they experience the study environment. To investigate the interplay between individual and contextual differences in more detail, we conducted a qualitative longitudinal study with 14 first-year students in parallel with the panel survey. We found that individual students react very differently to specific characteristics and events of the first-year environment. Our study adds to the growing body of research that aims to grasp the complexity of interactions between individual and contextual differences. Specifically, we illustrate how combining quantitative and qualitative methods can provide new insights into person-context interactions.

Migration and intergenerational stability in female employment: The impact of differences between sending and receiving countries

Objective: This article studies the intergenerational stability of employment in families of immigrants cross-nationally by investigating to what extent contextual differences between sending and receiving countries affect the transmission of labour force participation from mothers to daughters. Background: It is often argued that a low level of labour force participation among female immigrants reflects gender norms inherited from the sending country, or, alternatively, that it is indicative of obstacles to social mobility in the receiving country. We seek to add to the existing research on this topic by providing evidence of differences between sending and receiving countries that systematically affect the labour market behaviour of female immigrants. Method: We use individual-level data from the European Social Survey (ESS) for 35 receiving countries for a 14-year period (2004-2018) in combination with contextual data for 172 sending countries from 1960 to 2018. First, we provide an overview of employment rates and intergenerational employment stability for different combinations of sending and receiving contexts with respect to the labour force participation rates of female immigrants. Second, we corroborate our descriptive findings with multilevel models. Results: Our paper shows that there are changes in the levels of intergenerational employment stability among immigrants depending on the differences in the female labour force participation rates between the sending and the receiving countries. We find that when women migrate from countries with low female labour force participation rates to countries with high female labour force participation rates, their probability of participating in the labour force increases. However, we also find that the levels of intergenerational employment stability in this group are high. Conclusion: Intergenerational employment stability seems to be responsive to contextual differences between sending and receiving countries. We observe the highest levels of intergenerational stability in employment between mothers and daughters in families who migrated from countries with low female labour force participation rates to countries with high female labour force participation rates.

Racial appraisal and constraints of identity among multiracial and multiethnic persons in Sweden and Japan

Increasing immigration and intermarriage in Sweden and Japan have led to a growing multiracial and multiethnic population. Approximately 7% of the Swedish population and 2% of the Japanese population are multiracial and multiethnic today. Based on a total of 39 interviews with mixed persons in Sweden and Japan, I examine the self-claimed and ascribed identification among mixed Japanese and mixed Swedes. I argue that, despite the contextual differences, there are commonalities of experiences and identification. These commonalities of experiences shed light on the conditions the mixed individuals feel that they must fulfill in order to have their different claims to identities validated. The study gives a unique insight into how racial appraisal constrains individual choices of identity in a context where there is no official classification of racial and ethnic groups.