BackgroundPost-stroke depression is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine, such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. Thus, this trial aims to (...) assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation. Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale, Self-Rating Depression Scale, and Activity of Daily Living Scale. And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment Scale, and the Pittsburgh Sleep Quality Index. All outcome measures will be evaluated at baseline, week 4, and week 8. Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975. (shrink)

Although sufficient attention has been paid to residents' attitudes to tourism in previous studies, few studies have used residents' attitudes to tourists and tourism simultaneously to explain their support for tourism. This study fills this gap by examining the effect of place image and host–tourist interactions on residents' attitudes to tourists and tourism, respectively, and their consequent reactions by considering the moderating effect of Chinese traditionality. The proposed model is tested using data from 357 residents living in Huangshan, a fifth-tier (...) city in China. Results demonstrate that attitudes to tourism and host-tourists interaction positively affect their pro-tourism behaviours. Moreover, attitudes to tourism mediate place the image's, host–tourists interaction's and attitudes to tourists' respective relationships with pro-tourism behaviours. Furthermore, the higher the Chinese traditionality of residents, the stronger the influence of their attitudes to tourism on pro-tourism behaviours. However, the relationship of place image and attitudes of residents towards tourists with pro-tourism behaviours are not supported. Findings offer critical implications for planners, practitioners and interested researchers. (shrink)