Choosing a suitable sample size in qualitative research is an area of conceptual debate and practical uncertainty. That sample size principles, guidelines and tools have been developed to enable ...researchers to set, and justify the acceptability of, their sample size is an indication that the issue constitutes an important marker of the quality of qualitative research. Nevertheless, research shows that sample size sufficiency reporting is often poor, if not absent, across a range of disciplinary fields.
A systematic analysis of single-interview-per-participant designs within three health-related journals from the disciplines of psychology, sociology and medicine, over a 15-year period, was conducted to examine whether and how sample sizes were justified and how sample size was characterised and discussed by authors. Data pertinent to sample size were extracted and analysed using qualitative and quantitative analytic techniques.
Our findings demonstrate that provision of sample size justifications in qualitative health research is limited; is not contingent on the number of interviews; and relates to the journal of publication. Defence of sample size was most frequently supported across all three journals with reference to the principle of saturation and to pragmatic considerations. Qualitative sample sizes were predominantly - and often without justification - characterised as insufficient (i.e., 'small') and discussed in the context of study limitations. Sample size insufficiency was seen to threaten the validity and generalizability of studies' results, with the latter being frequently conceived in nomothetic terms.
We recommend, firstly, that qualitative health researchers be more transparent about evaluations of their sample size sufficiency, situating these within broader and more encompassing assessments of data adequacy. Secondly, we invite researchers critically to consider how saturation parameters found in prior methodological studies and sample size community norms might best inform, and apply to, their own project and encourage that data adequacy is best appraised with reference to features that are intrinsic to the study at hand. Finally, those reviewing papers have a vital role in supporting and encouraging transparent study-specific reporting.
What is food tourism? Ellis, Ashleigh; Park, Eerang; Kim, Sangkyun ...
Tourism management (1982),
10/2018, Volume:
68
Journal Article
Peer reviewed
Food tourism or food and tourism has emerged as a major theme for recent tourism research. This paper critically reviews and evaluates this growing subject area of tourism research thus identifies ...the core concepts associated with food tourism as major research themes, perspectives, and disciplinary approaches. Using the process of cognitive mapping this paper discovers that the literature on food tourism is dominated by five themes: motivation, culture, authenticity, management and marketing, and destination orientation. The authors conceptualise food tourism research from a cultural anthropology perspective, given that much of the literature on food tourism defines cuisine as place and is used in many forms and interactions with tourists.
•Terms used in food tourism research are not consistent, but there is a preference for terms with a consumer focus.•A supply-demand paradigm has led the growth of food tourism research.•Motivation, culture, authenticity, management, marketing and destination orientation are most common research themes.•Food tourism is about cultural anthropology.•Food tourism management is the management of food cultural resources.
Background - Body-mass index (BMI) and diabetes have increased worldwide, whereas global average blood pressure and cholesterol have decreased or remained unchanged in the past three decades. We ...quantified how much of the effects of BMI on coronary heart disease and stroke are mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors. Methods - We pooled data from 97 prospective cohort studies that collectively enrolled 1·8 million participants between 1948 and 2005, and that included 57¿161 coronary heart disease and 31¿093 stroke events. For each cohort we excluded participants who were younger than 18 years, had a BMI of lower than 20 kg/m2, or who had a history of coronary heart disease or stroke. We estimated the hazard ratio (HR) of BMI on coronary heart disease and stroke with and without adjustment for all possible combinations of blood pressure, cholesterol, and glucose. We pooled HRs with a random-effects model and calculated the attenuation of excess risk after adjustment for mediators. Findings - The HR for each 5 kg/m2 higher BMI was 1·27 (95% CI 1·23–1·31) for coronary heart disease and 1·18 (1·14–1·22) for stroke after adjustment for confounders. Additional adjustment for the three metabolic risk factors reduced the HRs to 1·15 (1·12–1·18) for coronary heart disease and 1·04 (1·01–1·08) for stroke, suggesting that 46% (95% CI 42–50) of the excess risk of BMI for coronary heart disease and 76% (65–91) for stroke is mediated by these factors. Blood pressure was the most important mediator, accounting for 31% (28–35) of the excess risk for coronary heart disease and 65% (56–75) for stroke. The percentage excess risks mediated by these three mediators did not differ significantly between Asian and western cohorts (North America, western Europe, Australia, and New Zealand). Both overweight (BMI =25 to
To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, ...we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions.
In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40–80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance.
Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0·685 (95% CI 0·629–0·741) to 0·833 (0·783–0·882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40–64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt.
We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide.
World Health Organization, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence, UK Medical Research Council, and National Institute for Health Research.
Returning biochar to fields: A review Tan, Zhongxin; Lin, Carol S.K.; Ji, Xiaoyan ...
Applied soil ecology : a section of Agriculture, ecosystems & environment,
08/2017, Volume:
116
Journal Article
Peer reviewed
•There is a disconnect between biochar preparation and its returning.•Return biochar from directional function for soil to directional preparation.•Returning biochar can improve the soil physical and ...chemical properties.•Returning biochar can improve the activity of soil microbes.•Returning biochar can reduce the emission of greenhouse gas.
Biochar generated from thermochemical conversion of biomass reduces greenhouse gas emissions and is useful for improving ecological systems in agriculture. However, certain biochars function well in improving soil, and other biochars do not. Why? Because it is not clear how to prepare the best biochar for soil. There is a disconnect between biochar preparation and returning the biochar to the soil. To elucidate this relationship, this paper reviews (i) technologies for preparing biochar, (ii) how preparation conditions affect biochar properties, and (iii) the effects on soil physical and chemical properties. In addition to reducing greenhouse gas emissions, biochar improves the physicochemical and microbial properties of soil and absorbs poisonous and pernicious substances. Therefore, as biochar is produced by pyrolysis, optimizing processing conditions to improve its properties for agricultural use is a key issue explored in this article.
Anxiety disorders are widespread across the world. A systematic understanding of the disease burden, temporal trend and risk factors of anxiety disorders provides the essential foundation for ...targeted public policies on mental health at the national, regional, and global levels.
The estimation of anxiety disorders in the Global Burden of Disease Study 2019 using systematic review was conducted to describe incidence, prevalence and disability-adjusted life years (DALYs) in 204 countries and regions from 1990 to 2019. We calculated the estimated annual percentage change (EAPC) to quantify the temporal trends in anxiety disorders burden by sex, region and age over the past 30 years and analysed the impact of epidemiological and demographic changes on anxiety disorders.
Globally, 45.82 95% uncertainty interval (UI): 37.14, 55.62 million incident cases of anxiety disorders, 301.39 million (95% UI: 252.63, 356.00) prevalent cases and 28.68 (95% UI: 19.86, 39.32) million DALYs were estimated in 2019. Although the overall age-standardised burden rate of anxiety disorders remained stable over the past three decades, the latest absolute number of anxiety disorders increased by 50% from 1990. We observed huge disparities in both age-standardised burden rate and changing trend of anxiety disorders in sex, country and age. In 2019, 7.07% of the global DALYs due to anxiety disorders were attributable to bullying victimisation, mainly among the population aged 5-39 years, and the proportion increased in almost all countries and territories compared with 1990.
Anxiety disorder is still the most common mental illness in the world and has a striking impact on the global burden of disease. Controlling potential risk factors, such as bullying, establishing effective mental health knowledge dissemination and diversifying intervention strategies adapted to specific characteristics will reduce the burden of anxiety disorders.
Over the past two decades, numerous global studies, including those conducted in Kuwait, have focused on examining and understanding delays in construction projects. These investigations aimed to ...identify causes of delays and rank them based on their impact on project objectives. In pursuit of this research goal, the present study adopts a systematic approach to analyze construction delays, building on related previous research efforts. The primary objective of this analytical approach was to determine the most significant and influential causes of delays and investigate changes in these causes over the span of two decades, during which measures were taken to address delays. Through comprehensive analyses, the critical delay causes within the Kuwaiti construction industry were identified as: contractor site management incompetence, subcontractor-related challenges, design quality deficiencies, problems arising from the used contract, and supply chain disruptions affecting labor availability and construction materials. Additionally, the body of research on the subject was divided into two distinct groups: studies conducted before and after the year 2010. A comparative examination of the outcomes from these two groups revealed notable enhancement for internal site management delay sources, which involve direct management teams including contractors, supervisors, and owners, whereas the influence of external delay causes increased, primarily attributed to the impact of governmental regulations. To assess the dissimilarities between the results of these two groups, an ANOVA analysis was applied, affirming the presence of statistically significant differences. The study concludes by emphasizing key areas requiring further attention to effectively mitigate the causes of delays in construction projects. Moreover, the proposed analysis procedure holds potential applicability to other countries, serving as a valuable tool to augment the understanding of delay analysis within the construction domain on a broader scale.
Abstract Background The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. Objectives The GBD (Global Burden of Disease) 2015 study integrated data on disease ...incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden. Methods CVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Results In 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75. Conclusions CVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.
Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international ...health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries.
We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories—government, out-of-pocket, and prepaid private health spending—and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health.
Between 1995 and 2016, health spending grew at a rate of 4·00% (95% uncertainty interval 3·89–4·12) annually, although it grew slower in per capita terms (2·72% 2·61–2·84) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5·55% 5·18–5·95), mainly due to growth in government health spending, and in lower-middle-income countries (3·71% 3·10–4·34), mainly from DAH. Health spending globally reached $8·0 trillion (7·8–8·1) in 2016 (comprising 8·6% 8·4–8·7 of the global economy and $10·3 trillion 10·1–10·6 in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184–5319) in high-income countries, $491 (461–524) in upper-middle-income countries, $81 (74–89) in lower-middle-income countries, and $40 (38–43) in low-income countries. In 2016, 0·4% (0·3–0·4) of health spending globally was in low-income countries, despite these countries comprising 10·0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($9·5 billion, 24·3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6·27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($644·7 million in 2018). Globally, health spending is projected to increase to $15·0 trillion (14·0–16·0) by 2050 (reaching 9·4% 7·6–11·3 of the global economy and $21·3 trillion 19·8–23·1 in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1·84% (1·68–2·02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0·6% (0·6–0·7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15·7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130·2 (122·9–136·9) in 2016 and is projected to remain at similar levels in 2050 (125·9 113·7–138·1). The decomposition analysis identified governments’ increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending.
Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets.
Bill & Melinda Gates Foundation.
The Architecture, Engineering and Construction (AEC) sector faces severe sustainability and efficiency challenges. The application of artificial intelligence in green building (AI-in-GB) is an ...effective solution to enhance the sustainability and efficiency of the sector. While studies have been conducted in the AI-in-GB domain, an in-depth study on the state-of-the-art of AI-in-GB research is hitherto lacking. To provide a better understanding of this underexplored area, this study was initiated via a bibliometric-systematic analysis method. The study aims to reveal the synthesis between AI and GB, as well as to highlight research trends along with knowledge gaps that may be tackled in future AI-in-GB research. A quantitative bibliometric analysis was conducted to objectively identify the major research hotspots, trends, knowledge gaps and future research needs based on 383 research publications identified from Scopus. A further qualitative systematic analysis was also conducted on 76 screened research publications on AI-in-GB. Through this mixed-methods systematic review, knowledge gaps were identified, and future research directions of AI-in-GB were proposed as follows: digital twins and AI of things; blockchain; robotics and 4D printing; and legal, ethical, and moral responsibilities of AI-in-GB. This study adds to the GB knowledge domain by synthesizing the state-of-the-art of AI-in-GB and revealing the research needs in this field to enhance the sustainability and efficiency of the AEC sector.
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•AI-in-GB promotes knowledge-discovery, intelligent optimization, and augmenting or automating decision-making process.•Major strengths of AI-in-GB include increased efficiency, cost-and-time savings, reliability, and improved accuracy.•AI-in-GB has significant scope for further research.•Key future research directions include digital twins and AIoT; blockchain; robotics and 4D printing.
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