<p>A code that specifies how this ActRelationship contributes to the context of the current Act, and whether it may be propagated to descendent Acts whose association allows such propagation (see ActRelationship.contextConductionInd).</p>
<p><i>Rationale:</i> In the interest of reducing duplication, humans tend to rely on context when interpreting information.  For example, when reading a report taken from a folder containing a patient's medical record, the reader will infer that the report deals with the patient, even if there is no direct reference to the patient on the form.  However, other pieces of information such as the author of the folder (the hospital that maintains it) may sometimes apply to the contents of the folder (e.g. a report generated by a doctor at the hospital) and other times not (e.g. a copy of a report from another institution).  Humans are quite good at making the necessary inferences about what context should be propagated from an item to something within that item.  However, incorrect inferences can occur (perhaps the report in the patient's record deals with a relative).  Furthermore, computers have substantially more difficulty making such inferences, even though they can be essential for decision-support systems.</p>
<p><i>Discussion:</i> This attribute allows the clear specification of whether an association adds to the context associated with a particular item (e.g. adding an additional author) or whether it replaces (overrides) part of the context associated with a particular item (e.g. identifying a sole author, independent of the containing item).  It also indicates whether the association applies to only this act (non-propagating), or whether it may apply to derived acts as well (propagating).</p>
<p>This attribute is closely liked with ActRelationship.contextConductionInd which determines whether associations that have been marked as propagating will actually be conducted to a child Act.  For example, an author participation might be marked as propagating, but still not conducted to a hyperlink to an external document.</p>
<p>If no value or default is specified for this attribute (i.e. it is null), no inference can be made about context.  Systems must make their own assumptions on the basis of what data is being represented.  (For this reason, committees are encouraged to specify a default or fixed value for this attribute as part of their designs to ensure consistency of interpretation.)</p>
<p><i>Examples:</i> An observation event has a patient participation marked "additive, propagating" (AP) and has component observation events linked through act relationships that are marked propagating. This means that the patient participation behaves as a patient participation of those component observation events in addition to the parent observation event.</p>
<p>A composite order is created containing a pharmacy order as well as requests for several lab tests.  The composite order has participations for patient and author, and an act relationship to a diagnosis, all marked as "additive, propagating".  The "component" association between the composite order and the pharmacy order is marked as conductive (contextConductionInd is TRUE).  The pharmacy order has an author participation marked as "additive, non-propagating" (AN), and a reason relationship to a diagnosis, marked as "overriding, propagating" (OP). The order further has a relationship to a dispense event, marked as conductive, and an association to a drug protocol marked as non-conductive (contextConductionInd is FALSE).  The meaning would be as follows:</p>
<p>The pharmacy order is interpreted as having the patient of from the composite order, and having two authors (the one from the composite order, and the one on the pharmacy order itself.  The diagnosis for the pharmacy order would <b>only</b> be the diagnosis specified on the pharmacy order, not the one specified on the composite order.  The dispense event would carry the patient from the composite order and the diagnosis from the pharmacy order, but no author.  The drug protocol would not be associated with a patient, diagnosis or author.</p>


