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In the international education market, much attention has been paid to China, as it is the world's largest source country in sending students abroad. The other side of the story, that is, China, as the world's third most popular destination, is considerably less known and researched. This study seizes this research opportunity and focuses on exploring why international students choose to do their higher education in mainland China. International students from five Chinese coastal universities are the research respondents. Focus group discussions were first conducted and elicited 31 motivating items. They were later evaluated through a questionnaire-based survey. The push-pull model was critically reviewed and then used to organise the results. A questionnaire-based survey (n = 462) was later undertaken. Seven motivation factors were identified and a hierarchical relationship among the motivations was observed. The most influential push factor is the students' desire for learning, novelty and challenge seeking, while the strongest pull factor is their expectation for China's prosperous future. The motivations with medium priority were self-understanding, quality of education, and value for money. Also, stimulating factors and admission issues were important, but significantly less important than other factors. Demographic factors were found to be influential to motivations. Focusing on "reverse" international student mobility, this research enriches knowledge about international students' destination choice. It also offers practical implications to universities and institutes in China and other emerging countries, who are interested in offering better programmes and attracting more international students.

Restoring a World Natural Heritage Site (WNHS) after a disaster to attract tourists raises multifaceted issues that concern heritage authenticity, environmental ethics, and tourists' acceptance. In the case of Jiuzhaigou post-earthquake landscape, this study analyses authenticity perceptions, attitudes, and behavioral intentions of tourists and explores environmental ethics through three perspectives. Results reveal tourists' authenticity perception affects their attitudes and behaviors towards environmental restoration. Moreover, tourists tend to recognize and support Awe for Nature (Awe-N) more than Respect for Nature (Res-N) and significant differentiation exists among potential tourists according to their environmental ethics, demographic characteristics, and behaviors. Altogether, our work presents innovative arguments on post-disaster WNHS restoration by highlighting the complexities of heritage authenticity, environmental ethics, and tourist' dynamics. [ABSTRACT FROM AUTHOR]

Background: Azithromycin is a commonly prescribed antibiotic included in many first-line regimens for pneumonia. Azithromycin also carries an FDA warning for increased risk for abnormal cardiac electrical activity, including QTc prolongation. Objective: To examine the effect of intravenous azithromycin on the QT interval in a cohort of patients receiving antibiotic therapy for community acquired pneumonia. Methods: A single-center, retrospective chart review of patients admitted to the Intensive Care Unit (ICU). The primary endpoint was change in QTc 48-72 hours after antibiotic initiation. The primary outcome was analyzed using ANOVA matched comparison. Results: Between 6/1/2019 and 3/31/2020, 241 total ICU patients received doses of either antibiotic. After application of exclusion criteria, the total number of patients included in analysis was 93, including 75 azithromycin patient and 18 doxycycline patients. The baseline QTc in the azithromycin group was 449 (95% CI 438-461) and the 72-hour QTc was 442 (95% CI 427-453) with an average change in QTc of -4 ms (P =.14). No statistically significant difference was found in QTc interval change between azithromycin and doxycycline. Conclusion: In this study, azithromycin use was not associated with a statistically significant increase in QTc interval. Based on these results, for the majority of patients receiving azithromycin, QTc prolongation is not likely a major concern. However, caution may still be warranted in patients considered high risk. [ABSTRACT FROM AUTHOR]

As cultural carriers of intangible cultural heritage (ICH), practitioners are key stakeholders in its inheritance and tourism use. Master-apprentice transmission is a major mechanism of generational inheritance. This paper examines ICH masters and apprentices at the Arts & Crafts Museum of Hangzhou, China, and analyzes the cultural composition of handicraft ICH and its intergenerational evolutionary mechanisms. Semi-structured interviews with two generations of practitioners and participant observation were undertaken. Research results reveal that intergenerational evolution involves multifaceted stakeholder interactions centred on practitioners with the support of government, management of the museum and participation of visitors. With patterns of family and master-apprentice inheritance, two generations of practitioners facilitate the evolution of handicraft ICH though both co-creations and conflicts. Second, six cultural attributes for handicraft ICH as of material, pattern, shape, technique, image and system are identified to visualise the process of intergenerational evolution. Third, driven by internal and external factors, ICH evolves through tracks of inheritance, selection and variation as presented through the above six cultural attributes. Moreover, the interdependence of cultural elements highlights the heritage framework of handicraft ICH and reflects the fluidity of authenticity. Accordingly, theoretical contributions and future research directions are offered for the sustainable development of handicraft ICH. [ABSTRACT FROM AUTHOR]

Agritourism is considered an effective strategy for revitalizing traditional agriculture, enhancing rural economics, and achieving sustainable livelihoods. While the processes of how the conventional agrarian industry has taken up diversified management and affiliated with the creative supply of tourist services remain unclear, the theoretical interpretations of the diversification processes have yet to be articulated. This study explores agritourism innovation and proposes a conceptual framework of agritourism diversification built upon the connotations of integration of production sectors and the multi-functionality of rural and land resources. Different styles of agritourism innovation detail the progress of agritourism diversification and how various functions of farm resources are initiated and capitalized upon. Results show that diversification through agritourism has brought considerable economic returns to farms, and increased their resilience in the face of possible business challenges. [ABSTRACT FROM AUTHOR]

Both livelihood resilience and sustainability have received substantial attention from tourism researchers. Capital is crucial to livelihood resilience, and different livelihoods depend on different asset portfolios. However, the transformation of capital across livelihoods has not been examined carefully. Instead of treating capital as singular, we investigate capital as a multiplicity. We evaluate the transformation of capital through a qualitative approach to better understand livelihood resilience through changes in asset assemblages. We made multiple field visits to a Chinese coastal community that is developing a tourism industry, where we collected data through semi-structured interviews and observation that revealed that livelihood capitals have multiple properties and functions, enabling their transformation among asset assemblages. The buffering capacity of livelihood systems, and thereby the livelihood resilience of fishing households, substantially depends on the transformation of capitals. We conclude that the understanding of livelihood resilience can be deepened through assemblage thinking that considers both the multiplicity of capitals and their relations in different production contexts. [ABSTRACT FROM AUTHOR]

This study attempts to explore the establishment of a low-carbon tourism community by public cognition, intention, and behaviour change analysis in a case study of a heritage site, China. Low carbon tourism advocates a way of travel with low energy consumption, low pollution and low CO2 emissions during personal activities. Behaviour change is not only influenced by internal individual aspects including a person’s awareness, attitudes, and capacity to change, but is also driven by external social aspects including the culture and environments in which a person lives. In this paper, questionnaire surveys and field interviews were used to obtain basic information, and with reference to TPB, studied and analyzed the characteristics of cognition, intention and behaviour change practice by low carbon tourism community economy participants. With the help of SPSS analysis software, we found that a person’s educational level or occupation might affect cognition of low carbon tourism, and motives for participating in low carbon tourism could reflect the public’s perception of its emotional value, cognitive value and functional value. Most respondents knew about low carbon tourism; however, when putting it into practice, habitual behaviour was the main barrier for tourists while the residents were passive and followed the needs and choices of the tourists. Therefore, a comprehensive low carbon tourism community system was proposed not only for addressing the aspects of awareness, intention, and practice from individual behavior, but also for covering policy, infrastructure, institution systems and mechanisms at the community level.

Few tourism studies have focused on tourists who have been victims of a disaster. Their destination attachment has implications for re-establishment of market confidence and resilience. Structural equation modelling of data from 242 tourists who were victims of the Jiuzhaigou earthquake was used to explore their feelings of attachment. The results confirm that earthquake-affected tourists can generate positive emotional attachment toward the destination. Destination attachment is related to such factors as positive emotions, social support, and severity of disaster exposure. Positive emotions mediate the relationships between severity of disaster exposure, social support and destination attachment. It is revealed that experiences of a disaster event can be a turning point, prompting positive change in tourist-destination relationships across the destination life-cycle. Implications for emergency management and for post-disaster market recovery are presented. [ABSTRACT FROM AUTHOR]

Background: Status epilepticus (SE) is a neurologic emergency that can result in serious morbidity and mortality. Recent studies have suggested underdosing of both benzodiazepines (BZDs) and antiseizure medications (ASM) which may result in poorer outcomes. Objectives: This study aims to determine the dose of BZDs and levetiracetam given in our emergency department for episodes of SE and determine the outcomes associated with this dosing. Methods: We conducted a retrospective cohort study of all adult patients with SE admitted to our hospital from 2017 to 2020. We collected demographic data, type of SE, dose of BZD and levetiracetam, and outcomes which included mortality and a calculated Glasgow outcome scale (GOS). We compared outcomes of patients with SE who received adequate dosing (according to practice guidelines) to those who did not. Results: 111 adult patients were included of whom 91% were seen initially in our emergency department. 75% had convulsive SE on presentation. Approximately 55% and 68% of patients did not receive an appropriate dose of BZD or levetiracetam, respectively. Inadequate dosing of BZD was associated with worse clinical outcomes based on GOS (43.6% favorable outcome vs 62.5% with adequate dosing P =.046 (95% CI, 1.01–4.60)) and inadequate dosing of both drugs was also associated with a worse GOS outcome (HR, 2.91 (95% CI, 1.05–9.67, P =.02). No difference was found in length of stay or mortality alone. Conclusion: Our study found inadequate dosing of drugs to treat SE in adults was common in our institution and was associated with worse outcomes. [ABSTRACT FROM AUTHOR]