Evidence-based mapping of design heterogeneity prior to meta-analysis: a systematic review and evidence synthesis

BACKGROUND: Assessment of design heterogeneity conducted prior to meta-analysis is infrequently reported; it is often presented post hoc to explain statistical heterogeneity. However, design heterogeneity determines the mix of included studies and how they are analyzed in a meta-analysis, which in turn can importantly influence the results. The goal of this work is to introduce ways to improve the assessment and reporting of design heterogeneity prior to statistical summarization of epidemiologic studies. METHODS: In this paper, we use an assessment of sugar-sweetened beverages (SSB) and type 2 diabetes (T2D) as an example to show how a technique called ‘evidence mapping’ can be used to organize studies and evaluate design heterogeneity prior to meta-analysis.. Employing a systematic and reproducible approach, we evaluated the following elements across 11 selected cohort studies: variation in definitions of SSB, T2D, and co-variables, design features and population characteristics associated with specific definitions of SSB, and diversity in modeling strategies. RESULTS: Evidence mapping strategies effectively organized complex data and clearly depicted design heterogeneity. For example, across 11 studies of SSB and T2D, 7 measured diet only once (with 7 to 16 years of disease follow-up), 5 included primarily low SSB consumers, and 3 defined the study variable (SSB) as consumption of either sugar or artificially-sweetened beverages. This exercise also identified diversity in analysis strategies, such as adjustment for 11 to 17 co-variables and a large degree of fluctuation in SSB-T2D risk estimates depending on variables selected for multivariable models (2 to 95% change in the risk estimate from the age-adjusted model). CONCLUSIONS: Meta-analysis seeks to understand heterogeneity in addition to computing a summary risk estimate. This strategy effectively documents design heterogeneity, thus improving the practice of meta-analysis by aiding in: 1) protocol and analysis planning, 2) transparent reporting of differences in study designs, and 3) interpretation of pooled estimates. We recommend expanding the practice of meta-analysis reporting to include a table that summarizes design heterogeneity. This would provide readers with more evidence to interpret the summary risk estimates

Planning and Leveraging Event Portfolios: Towards a Holistic Theory

This conceptual paper seeks to advance the discourse on the leveraging and legacies of events by examining the planning, management, and leveraging of event portfolios. This examination shifts the common focus from analyzing single events towards multiple events and purposes that can enable cross-leveraging among different events in pursuit of attainment and magnification of specific ends. The following frameworks are proposed: (1) event portfolio planning and leveraging, and (2) analyzing events networks and inter-organizational linkages. These frameworks are intended to provide, at this infancy stage of event portfolios research, a solid ground for building theory on the management of different types and scales of events within the context of a portfolio aimed to obtain, optimize and sustain tourism, as well as broader community benefits

God\u27s Church Is Just: A Specific Discussion Of Some Cases of Church Discipline

https://digitalcommons.acu.edu/crs_books/1364/thumbnail.jp

Towards reviving post-Olympic Athens as a cultural destination

This paper examines the effects of global change on the status and qualities of the Greek national capital, Athens, focusing on how they affect the development of cultural tourism in the city. Although Athens constituted one of the most significant destinations for Greek tourism in the past, in recent years it started to weaken. Athens is characterised by a series of problems, among them are the degradation of its environment and quality of life and traffic congestion. However, in terms of tourism development, the Olympic Games helped in re-imaging the city and upgrading its infrastructure. This study based on semi-structured interviews with top officials reveals how global change has affected Athens’ socio-cultural/economic status, identity and image. Despite the tourism policy/planning responses to global changes, Athens’ tourism continues to decline leaving unexplored potential such as its rich cultural heritage, new multicultural identity and the New Acropolis Museum. The paper suggests that cultural elements of capital cities must be multidimensional including a variety of attractions and amenities. The use of cultural heritage assets needs to be in line with global developments in order for cities to effectively leverage heritage for cultural tourism

Russian Artistic Gymnastics as a Sports Tourism Product: Some Observations and a Research Agenda

Tourism and its importance to the Russian Federation are very much in the headlines at present. Considering the huge investment made in facilities for the Winter Olympics, the building of new sports facilities for such mega events as the Football World Cup, and the status of St Petersburg as a candidate city for the 2028 Olympics, it is clear that Russia has long term plans to attract visitors to their sporting events. The purpose of this paper is to develop a research agenda to explore the potential of artistic gymnastics, a sport in which the Russian Federation has excelled for many years, as an agent of tourism development. The paper will take a case study approach, considering the nature of fandom and identifying features of artistic gymnastics as cultural heritage and sports tourism product. The national and international environment within which it is set are examined, prior to the development of a research agenda. A detailed review of literature on the historic, current and emerging trends in Russian artistic gymnastics; the place of artistic gymnastics in tourism development and sports tourism in Russia will be carried out. The paper’s findings will include considerations of: • The nature of gymnastics fandom, both in Russia and internationally • The nature of sports tourism development in the Russian Federation • The nature of gymnastics as a sport and its competition cycle • Artistic gymnastics as cultural heritage, and its potential as an autonomous means of promoting Russian national identity • The relationship between Russia’s sometimes fading gymnastics competition results, and its potential to leverage the sport for tourism interest • The potential for tourism product development linked to artistic gymnastics in the Russian Federation. The paper contributes to the literature on the nature of sports tourism as it relates to artistic gymnastics in the Russian Federation in particular

For the benefit of all? Developing a critical perspective in mega-event leverage

The purpose of this article is to bring to light the need for developing a critical leveraging perspective on mega-events and propose a research agenda that extends the focus of the leverage concept towards this direction. Current research on leverage focuses on the attainment and magnification of mega-event outcomes. A critical lens of inquiry however is needed to move forward and take into account the influence of power structures and social-ordering processes on developing and implementing strategic leveraging programs. Such a perspective can help examine if and how the benefits of mega-events are fairly delivered to host communities, equally distributed among stakeholders and then sustained, while negative impacts are minimised. Ten research themes are brought forward to help build a robust ground for a critical mega-event leveraging perspective

Conservatively treated glassy cell carcinoma of the cervix

<p>Abstract</p> <p>Background</p> <p>Very little data about the conservative treatment of early stage glassy cell cervical cancer have been reported.</p> <p>Case presentation</p> <p>A 30-year old patient, nulligravida was admitted to the Gynecologic Oncology Unit of the Catholic University of Campobasso for irregular post-coital vaginal bleeding. The patients was staged as having FIGO stage IB1 (tumor diameter = 2 cm) squamous cervical cancer. After extensive counseling of the patient and her family, laparoscopic pelvic lymphadenectomy and cold knife conization were performed. The final diagnosis was FIGO Stage IB1 glassy cell carcinoma. Currently, after a follow-up of 38 months, she has no evidence of disease.</p> <p>Conclusion</p> <p>We reported a case of early stage glassy cell cancer patient, who was conservatively treated by conization and laparoscopic pelvic lymphadenectomy.</p

Leveraging the sport participation legacy of the London 2012 Olympics: Senior managers’ perceptions

The purpose of this study was to understand how a sports mega event (SME) was leveraged to try and increase participation, through the investigation of national governing bodies (NGBs) opinions and atti- tudes. Critical realism (CR) was used as a tool to aid understanding of leveraging and legacy conceptualisation, through an empirical investiga- tion. An extensive, mixed method online survey was conducted post London 2012 with senior staff members of NGBs, the main delivery agent chosen to support the participation initiatives associated with the London 2012 Olympics. This research provides valuable findings surrounding the use of CR as a tool to investigate legacy creation, whilst at the same time offering insights to enhance the policy implementation process within the sports development sector. The importance of com- munication, competitive nature of sports system, media, club engage- ment, organisational capacity and monitoring and evaluation were highlighted, which provided useful insights into the multidimensional constructs that can aid future leveraging strategies prior to hosting SMEs

Understanding cycle tourism experiences at the Tour Down Under

Sport tourism experiences are subjective and emotional, laden with symbolic meaning. This study explores the experiences of participants who adopted the multiple roles of both an active participant and event spectator, within the parameters of one chosen sporting event. A professional cycling race event, the Tour Down Under in South Australia was chosen for this investigation, and 20 face-to-face individual interviews were conducted with cycle tourists. The three main themes emerging from the data were the interaction of people and temporary spaces on a sport tourism ‘stage’; the co-creation of authentic personal experiences and meanings; and identity reinforcement and the development of a sense of belonging. Consequently, a model for understanding sport event tourism experiences is proposed. The findings suggest that providing tourists with authentic and memorable experiences lies at the heart of what constitutes sport tourism. Whilst the results demonstrate that cycling events provide the individual with a sense of belonging or membership to a wider social group, they also illustrate that there is a continued need for more focused and nuanced approaches towards understanding sport tourism experiences that reflect the ever-increasing diversity and complexity of the interaction between sport, events and tourism