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This study aims to examine the multidimensional nature of institutional distance as a driver of acquisition decisions in emerging markets. Then, this study aims to offer a nuanced perspective on the role of its various formal and informal dimensions by taking into account the potential contingency role played by a firm’s context experience.

Building on institutional economics and organizational institutionalism, this study explores the heterogeneity of institutional distance and its effects on the decision to enter emerging versus advanced markets through cross-border acquisitions. Thus, institutional distance is disentangled into its formal and informal dimensions, the former being captured by regulatory efficiency, country governance and financial development. Furthermore, our framework examines the moderating effect of an acquiring firm’s experience in institutionally similar environments, defined as context experience. The hypotheses are analyzed on a sample of 496 cross-border acquisitions by Italian companies in 41 countries from 2008 to 2018.

Findings indicate that at an increasing distance in terms of regulatory efficiency and financial development, acquiring firms are less likely to enter emerging markets, while informal institutional distance is positively associated with such acquisitions. Context experience mitigates the negative effect of formal distance and enhances the positive effect of informal distance.

This study contributes to institutional distance literature in multiple ways. First, by bridging institutional economics and organizational institutionalism and second, by examining the heterogeneity of formal and informal dimensions of distance, this study offers a finer-grained perspective on how institutional distance affects acquisition decisions. Finally, it offers a contingency perspective on the role of context experience.

The purpose of this study was to assess the knowledge of head and neck cancers (HNCs), their risk factors, signs and symptoms among the general public of Karachi, Pakistan.

Initially, 503 individuals were approached for data collection, out of which 404 fit the inclusion criteria (response rate = 80.03%). Nonprobability convenience sampling was utilized to select participants who fell under the age group of 15–60 years, barring the fields of Bachelor of Medicine and Bachelors of Surgery (MBBS) and Bachelors of Dentistry (BDS). Knowledge was evaluated by a 9-item questionnaire, the scores of which yielded the following interpretations: No (0), low (1–3), moderate (4–6) and high (7–9) knowledge.

Of the 404 participants who completed the questionnaire, 357 (88.4%) participants claimed to be aware of HNC. The HNC knowledge scores had a statistical relevance with socioeconomic status (p = <0.01) and level of education (p = 0.02). Most participants recognized a “lump or swelling in the throat” (87.1%) as the most common symptom, followed by “bleeding in mouth or throat” (84.7%). Surprisingly, 75.25% of participants thought HNCs were inclusive of brain cancer.

Overall, knowledge of HNCs among the general public of Karachi surpasses the knowledge in other regions around the world. Our study demonstrated that people indulge in unhealthy habits despite having sufficient knowledge and this warrants prompt interventions and counseling of the people.