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Purpose Hotel employees’ occupational stigma is often overlooked. Exploration of hotel employees’ occupational stigma representations, perception pathways and destigmatization provides an empirical basis for positive organizational behavior and psychology in the hotel industry. Therefore, this study aims to better understand the mechanism underlying inherent of occupational stigma. Design/methodology/approach This study adopts a five-factor narrative analysis involving stigma narrative interviews with a purposed sampling of hotel employees (n = 18). Based on occupational stigma and resource conservation theories, this study designed a five-factor narrative analysis structure chart as the basis for data analysis. Findings Findings indicate the existence of four quadrants of perceived occupational stigma attribute distribution, two paths of perceived occupational stigma formation and a more systematic occupational destigmatization mechanism path. Research limitations/implications The occupational destigmatization path and countermeasures proposed in this study can resolve talent drain and eliminate stereotyping in the hotel industry, which promote the industry’s rapid recovery and sustainable healthy development, providing the practical management guidelines for public communication via social media, and offer practical significance for existing hotel human resource management in modules such as organizational culture and training. Originality/value This study broadens investigations of occupational stigma in a single, static context and explains the relationship between hotel employees’ stigma perceptions and destigmatization paths. Further, the mechanism of emotional energy distribution on spatial stigma was identified. These results have practical implications for organizational culture, training and employee care in hotel human resource management.

Background Streptococcus salivarius is an opportunistic pathogen, and there have been no reported cases of Streptococcus salivarius pneumonia to date. Pneumomediastinum is usually secondary to tracheal or esophageal injury and is very rare as a complication of pneumonia. We report a case of Streptococcus salivarius pneumonia complicated by pneumomediastinum, aiming to enhance clinicians’ awareness of rare pathogens and uncommon complications in pneumonia. Case presentation The patient, a 36-year-old male, presented with a persistent cough and sputum production for one week, accompanied by a sore throat that had developed just one day prior. Chest computed tomography (CT) disclosed pneumomediastinum alongside obstructive atelectasis in the left lower lobe. Streptococcus salivarius infection was conclusively identified through bronchoalveolar lavage metagenomic next-generation sequencing (mNGS), as well as smear and culture analyses. The patient was administered intravenous amoxicillin-clavulanate potassium for a duration of seven days as part of the anti-infection regimen. Given the stability of the patient’s respiratory and circulatory systems, a tube drainage procedure was deemed unnecessary. Post-treatment, the patient’s clinical symptoms notably improved. A subsequent chest CT scan revealed the re-expansion of the left lower lung and near-complete resolution of pneumomediastinum. Conclusion There are numerous pathogens that can cause pneumonia. While focusing on common pathogens, it is important not to overlook rare ones. When considering infections from rare pathogens, it is recommended to promptly perform a bronchoscopy and submit bronchoalveolar lavage fluid for mNGS to improve pathogen detection rates. During the diagnosis and treatment of pneumonia, it is crucial to be vigilant for rare complications. When a patient presents with symptoms such as dyspnea or subcutaneous emphysema, it is advisable to immediately perform a chest CT scan to rule out pneumomediastinum.

The value of tourism has been included in studies of active aging, and the existing public health implications of the physical and mental health effects of tourism among seniors are recognized as important issues. This study uses a mixed methods research approach to explore the effects of tourism value on the health and mortality risk of older adults, referred to in this paper as seniors. Survival analysis and cohort analysis are combined with the narrative analysis of in-depth interviews with eight convenience-sampled seniors to construct a narrative framework of seniors’ active aging tourism and its intrinsic drivers. The study found that the intrinsic framework of active aging tourism values for seniors has a three-stage continuum, an interaction, and orientation characteristics. There are six intrinsic key value drivers of tourism value and public health for seniors. In addition, this study identifies the personal characteristics and strengths of seniors as important influences on tourism value practices for active aging and public health. This study provides a positive psychological and behavioral research direction for existing research on the value of tourism in active aging. It provides an empirical basis for exploring the intrinsic mechanisms of tourism and public health.

Understanding the relationship between tourists' consumption behavior and their willingness to substitute consumption in unusual environments can promote tourists' sustainable consumption behavior. This study explores the internal relationship between tourists' willingness to engage in sustainable consumption behavior and the substitution of tourism consumption willingness in an unusual environment and the related factors. Through qualitative and quantitative mixed research, this study first invited 32 interviewees related to the tourism industry to conduct in-depth and focus group interviews and extracted a research model based on the push-pull theoretical model (PPM) through three rounds of coding of grounded theory. Then, through questionnaire design, pre-release, and formal release, 268 valid questionnaires were collected using a convenience sampling method, and the hypothesis and its mediating effect were verified using a structural equation model. Further quantitative analysis and verification showed that being in an unusual environment had a positive effect on tourists' perception of crisis awareness, safety risk, and willingness to engage in sustainable consumption behavior. However, the results did not support the unusual environment positively affecting the substitution of tourism consumption willingness, the psychological transformation cost, and the fixed consumption habit negatively affecting the substitution of tourism consumption willingness. In this study, two mediating variables were used to verify the indirect effect of being in an unusual environment and the substitution of tourism consumption willingness. The results showed that the mediating effect was significant. This study explored an action mechanism model aimed at guiding tourists' willingness for sustainable consumption, based on the environment and consumption behavior, and provided relevant countermeasures for the government and business decision-makers, enterprises, and investors in the tourism sector.

The voices of the marginalized and vulnerable groups, i.e., the sexual minorities, the underprivileged, and the victims of abusive/unfair treatment, are often neglected and understudied in policy research due to their social sensitiveness. Researchers may face difficulties accessing the data. Thus, they are unable to uncover the hidden truth. This qualitative study protocol suggests using images or text-based vignettes in social science research, which enable researchers to collect participants’ confidential thoughts and help participants feel safe enough to share their untold stories. We showcase how to effectively design a real-life vignette, recruit potential participants, and gather and report diverse respondents’ views by protecting their identity, in essence, internal and external confidentiality. The vignette method contributes to public policy study by addressing the common issues of marginalized and vulnerable groups, such as insufficient data for further analysis.

Introduction: This study proposed a model based on Izard's theory of differential emotions to examine the effects of heritage nostalgia on perceived authenticity towards tourist satisfaction and the moderation of self-congruity in Chinese niche tourism. Methods: We examined descriptive statistics to obtain an overview of the sample by using computer program SPSS 22. Then, for evaluation, partial least squares structural equation modelling (PLS-SEM) was employed as the appropriate statistical tool, and the statistical approach was implemented using the Smart PLS 3.0 computer program. Results: The results of partial least squares structural equation modelling showed that heritage nostalgia positively affects existential and object-based authenticity. Existential and object-based authenticity positively influences tourist satisfaction. Self- congruity positively moderates the relationship between existential or object-based authenticity and heritage nostalgia. Conclusion: The linkage mechanism of tourists' psychology and behavior in heritage tourism has been explored, the internal mechanisms such as heritage nostalgia, tourists' authenticity and tourists' satisfaction have been discovered, and the internal mechanism of tourists' consistency of psychology and behavior has also been explained. Keywords: heritage nostalgia, perceived authenticity, tourist satisfaction, self-congruity, niche tourism

This study explores the well-being dimensional components of event tourists and their identification processes in validating the well-being occurrence mechanism of event tourism and the correlation between the well-being of event tourists and the frequency and length of event tourism. This study adopted a sequential mixed-methods design that followed a pragmatic paradigm through a photo interview with event tourists and festival travel organizers (N=16). The qualitative research method provided evidence to explore the framework of content and dimensional identification of event tourists' well-being according to Seligman's PERMA model. The quantitative research phase (N=475) focused on identifying and validating the PERMA model in the event tourist well-being dimension through descriptive statistical analysis and validated factor analysis, followed by a one-way analysis of covariance to explore the effects of the frequency and endurance of FSE tourism. The results show quantitative differences in the well-being dimensions and framework presentation of the PERMA model (Positive emotion, Engagement, Relationship, Meaning, and Achievement). R (relationship) and A (achievement) are identified and validated as dimensions of well-being outcomes for event tourists, while single-day or short trips of 2-3 days were most significant for event tourists' perceived well-being. This study provides an empirical argument, thus providing an empirical argument for uncovering the deeper influencing and exhibiting factors of the PERMA theoretical framework and a research paradigm for PERMA theory in more tourism behaviors and psychology. Second, this study provides an in-depth explanation of the five dimensions of well-being in the PERMA model. The findings show the salience of the relationship and achievement in FSE tourism well-being, providing theoretical insight into existing studies integrating positive psychology models for in-depth tourism well-being research.

Environmental epidemiological studies often use both station-monitored and personal air pollutant exposures, which frequently yield different results. We aimed to identify key considerations when choosing between these measures. In a panel study of 37 college students assessed six times across three seasons for cardiorespiratory outcomes, personal PM 2.5 and O 3 exposures were monitored for 5 days with wearable sensors before each health assessment, alongside concurrent measurements from nearby monitoring stations. The association between station-monitored and personal concentrations was stronger for PM 2.5 (regression coefficient: 0.51 ± 0.16) than for O 3 (regression coefficient: 0.19 ± 0.15). Both station-monitored and personal PM 2.5 were associated with decreased forced expiratory volume in the first second (FEV 1 ), forced vital capacity (FVC), and increased fractional exhaled nitric oxide (FeNO). In contrast, only station-monitored O 3 was associated with decreased FEV 1 , FVC, increased FeNO, and worsening augmentation index (AI) and blood pressure. Personal O 3 showed mostly null associations or even “seemingly beneficial” associations with AI, FEV 1 , and FVC. These findings suggest station-monitored PM 2.5 can serve as a reasonable proxy for personal exposure in studies with minimal indoor PM 2.5 sources. However, this may be unsuitable for O 3 , given its high spatial variability and potential differences in exposure to ozone-derived reaction products.

Systemic pharmacokinetic (PK) studies can reflect the overall exposure of orally inhaled drug Products (OIDPs) in the blood after inhalation into the lung and can be used to evaluate the bioequivalence of test and reference products. The aim of this article is: (1) to study the PK characteristics and bioequivalence of ipratropium bromide (IB) inhalation aerosol, reference and test products in healthy Chinese subjects; (2) to establish a physiologically based pharmacokinetic (PBPK) model and verify the accuracy of the model in predicting bioequivalence; (3) attempt to use the model to predict the regional distribution of particles in the lung after inhalation, and discuss the effect of gastrointestinal drug absorption of IB on systemic exposure. The study involved two clinical studies. Clinical study-1 (registration number: CTR20201284) was used with non-clinical data to construct and validate a PBPK model in the B O simulator, a web-based virtual drug development platform. This model assessed different test and reference products' bioequivalence. Results were compared to a second clinical study (Clinical study-2: registration number CTR20202291). The particles' regional distribution in the lung and the gastrointestinal absorption effect on systemic exposure were discussed based on the simulation results. The established PBPK model successfully simulated the PK characteristics of IB inhalation aerosol, with close to 1. Gastrointestinal absorption had a negligible effect on systemic exposure. Particles accumulated in the alveolar area were cleared within an hour, followed by particles in the bronchioles and bronchi. This model provided a reliable method for exploring the correlation between and PK studies of IB inhalation aerosols. According to the simulation results, the test and reference products were bioequivalent.