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BACKGROUND: Complementary and alternative (CAM) cancer treatment is often expensive and not covered by insurance. As a result, many people turn to crowdfunding to access this treatment. OBJECTIVE: The aim of this study is to identify the rationales of patients with cancer seeking CAM treatment abroad by looking specifically at crowdfunding campaigns to support CAM cancer treatment in Tijuana, Mexico. METHODS: We scraped the GoFundMe.com and GiveSendGo.com crowdfunding platforms for campaigns referencing CAM cancer clinics in Tijuana, initiated between January 1, 2022, and February 28, 2023. The authors created a coding framework to identify rationales for seeking CAM treatment in Tijuana. To supplement campaign metadata, we coded the beneficiary's cancer stage, type, age, specific treatment sought, whether the beneficiary died, gender, and race. RESULTS: Patients sought CAM cancer treatment in Tijuana because the (1) treatment offers the greatest efficacy (29.9%); (2) treatment offered domestically was not curative (23.2%); (3) the clinic treats the whole person, and addresses the spiritual dimension of the person (20.1%); (4) treatments are nontoxic, natural, or less invasive (18.2%); and (5) clinic offers the newest technology (8.5%). Campaigns raised US $5,275,268.37 and most campaign beneficiaries were women (69.7%) or White individuals (71.1%). CONCLUSIONS: These campaigns spread problematic misinformation about the likely efficacy of CAM treatments, funnel money and endorsements to CAM clinics in Tijuana, and leave many campaigners short of the money needed to pay for CAM treatments while costing beneficiaries and their loved one's time, privacy, and dignity. This study affirms that Tijuana, Mexico, is a very popular destination for CAM cancer treatment.

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Este artigo problematiza o caso de Brotas, município do estado de São Paulo, que mesmo com seu pioneirismo no ecoturismo e práticas corporais de aventura em ambientes naturais, especialmente relacionados ao rio Jacaré-Pepira, recentemente vem sofrendo com impactos ambientais e ameaça de suas paisagens. Inspirado no método etnográfico, que combina interação virtual, conversas presenciais, observação participante e análise documental, esse estudo analisa a mobilização dos trabalhadores do lazer de aventura, mais especificamente do rafting, pela conservação ambiental de sua cidade a partir do ano de 2020. Constata-se que, apesar de avanços em políticas públicas efetivas, persistem desafios que levaram a períodos de seca extrema alternados com inundações, deslizamentos de terra e assoreamento. Identificou-se a importância dos profissionais de lazer na produção de informações para o poder público, reivindicações aos suspeitos, conscientização da população e articulação coletiva para manter a integridade ambiental e o turismo e o esporte como vetores de desenvolvimento sustentável, embora encontre divergências de posicionamentos entre seus agentes.

This paper problematizes the case of Brotas, a city in the state of São Paulo/Brazil, which, despite its pioneering rolein ecotourism and adventurous body practicesin natural environments, especially related to the Jacaré-Pepira river, has recently been suffering from environmental impacts and threats to its landscapes.Inspired by the ethnographic methodcombining virtual interaction, face-to-face conversations, participant observation and documentary analysis, this studyinvestigates the mobilization of adventure leisure workers, more specifically rafting,for the environmental conservation from the year 2020 onwards. Despite advances in effective public policies, challengespersistthat have led to periods of extreme drought alternating with floods, landslides andsiltation. The importance of leisure professionals in the production of information for public authorities, claims against suspects, publicawareness and collective articulationto maintain environmental integrity and tourism and sport as vectors ofsustainable developmentwas identified, although divergences in positionswere found. among its agents.

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Considerado patrimônio natural, o litoral piauiense é referência nacional e internacional para o Kitesurf, esporte na natureza pouco estudado, embora conste em pesquisas sobre desenvolvimento turístico na região. Este artigo analisa implicações da prática do Kitesurf nesse litoral e identifica ações que podem contribuir para sua conservação. Realizou-se pesquisa qualitativa, exploratória, mediante pesquisa bibliográfica e documental. Em certas praias há conflitos entre kitesurfista, pescador e/ou banhista; além da prática oferecer riscos para animais silvestres. Todavia, há kitesurfista que recolhe lixo no mar e promove discussões sobre efeitos do esporte na região. Abordar a educação ambiental em clínicas de certificação de kitesurfistas e regulamentar o Kitesurf pode colaborar com a resolução de conflitos e perspectivar um turismo mais sustentável, almejando conservar esse patrimônio e suas potencialidades.

The coast of Piauí, considered a natural heritage, is a national and international reference for kitesurfing, sport in naturelittle studied, although it is part of research on the regional tourism development. This article analyzes the implications of the practice of kitesurfing on this coast and identifies actions that can contribute to its conservation. Qualitative, exploratory research was carried out through bibliographical and documentary research. On certain beaches there are conflicts between kitesurfers, fishermen and/ or bathers; in addition, its practice offers risks to wild animals. However, there are kitesurfers who collects garbage at sea and promotes discussions about the effects of the sport in the region. Addressing environmental education of kitesurfers in certification clinics and regulating kitesurfing can collaborate with conflict resolution and envisage a more sustainable tourism, aiming to conserve this heritage and its potential.

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O objetivo deste estudo é compreender as correlações e interações entre a paisagem, caminhadas de lazer e o contexto sistêmico de desenvolvimento turístico na cidade de Linha Nova, Rio Grande do Sul. O estudo de natureza aplicada tem abordagem qualitativa. Quanto aos procedimentos, caracteriza-se como um estudo de caso do município de Linha Nova. Foram entrevistados seis organizadores de caminhadas e disponibilizado um questionário online para pessoas que praticam caminhadas de lazer, totalizando 40 participantes. As respostas indicaram dois temas: a) A natureza como principal atrativo; b) Desenvolvimento econômico e turístico através das caminhadas. Os resultados demonstraram que existe uma relação positiva entre eventos de caminhada e o desenvolvimento da cadeia produtiva do turismo, além de uma percepção de "paisagem" associada à natureza, espaços naturais e cenários panorâmicos.

The objective of this study is to understand the correlations and interactions between the landscape, leisure walks and the systemic context of tourist development in the city of Linha Nova, Rio Grande do Sul. The study of an applied nature has aqualitative approach. As for the procedures, it is characterized as a case study of the municipality of Linha Nova. Six walk organizers were interviewed,and an online questionnaire was made available to people who take leisure walks, totaling 40 participants. The responses indicated two themes: a) Nature as the main attraction; b) Economic and tourist development through hiking. The results demonstrated that there is a positive relationship between walking events and the development of the tourism production chain, in addition to a perception of "landscape" associated with nature, natural spaces and panoramic scenarios.

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This study aimed to identify the motivations of sports tourists to attend Soccer World Cups and to determine the motivational dimensions that predict their satisfaction. The research took place in Doha, the capital of Qatar, during the FIFA World Cup in 2022, where 503 valid questionnaires were collected. Exploratory factor analysis and linear regression with the Enter method were used for data analysis. The results show four motivational dimensions: Sports Passion, Escape & Relaxation, Patriotism & Attachment, and Recreation. Additionally, a positive and significant relationship was found between the Escape & Relaxation factor and overall satisfaction. In contrast, a negative correlation was identified between the Patriotism & Attachment dimension and satisfaction. These findings will contribute to the academic literature related to the Soccer World Cups as part of sports tourism and will also assist sporting event organizers in developing marketing and management plans to benefit this tourist demand.

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Designing Augmented Reality (AR) throughout service experiences remains under studied in several industries, despite the fact of growing consumer interest and use through different platforms and applications globally. Consequently, there is growing interest in understanding the what, the why and the how for designing AR applications in practice to boost ecotourism experiences, with the purpose of enhancing customer value creation and organizations differentiation. Consequently, the authors conducted an eleven-month practical theoretical study in 10 ecotourism SMEs purposefully recruited in Latin America, adopting service design as a main research framework. Using interviews, contextual analyses, buyer personas, observation, storytelling creation sessions, prototyping sessions and accompaniment sessions as research methods, researchers studied, (1) what were the key facilitators and hinderers for designing AR in practice at the SMEs ecotourism context following a service design lens and, (2) how the inherent principles of service design influence ecotourism SME's for the strategically adoption of AR in their service experiences. The study suggests key elements that can facilitate or hinder designing AR at ecotourism SME's Experiences in practice. Furthermore, the authors suggest a practical protocol for designing AR for ecotourism SMEs from the lens of service design (SD), User Experience (UX), and Augmented Reality (AR). Finally, the study also contributes to shade light on the marketing role and potential adoption of Augmented Reality (AR) in practice in SME's through a service design lens.

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The aim of this study was to assess space-time clustering of suicide in Argentina between 2017 and 2020. A spatio-temporal scan statistic using a space-time permutation model was employed to retrospectively detect clusters of total suicides by sex and by age group. From 2017 to 2020, six statistically significant spatio-temporal clusters were identified in Argentina with either more or less suicides than expected. Two clusters extended from May 2019 to July and September 2020, while the remaining four clusters were detected only during 2020. The start of the COVID-19 pandemic seems to have changed the spatio-temporal patterns of suicide in Argentina. Despite the national decrease in the number of suicides during 2020 compared to previous years, the spatio-temporal analysis revealed both areas with decreases and increases in suicide. This heterogeneous scenario highlights the need for the study of local effects behind the emergence of these spatio-temporal suicide clusters.

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Payment for ecosystem services (PES) is a mechanism where a consumer is able and ready to pay for the protection of the precise ecosystem service and there must be a provider such as local societies receiving an economic resource, who in return, must have the ability to maintain that ecosystem service. Economic valuation provides basis for payment for ecosystem services. Therefore, objective of this study was to evaluate tourism and carbon stock services of the Islamabad Capital Territory (ICT), Pakistan. Two forest zones (Chirpine and Scrub) of Islamabad capital territory (ICT) were selected for estimation of carbon stock and their carbon credits and carbon worth, a questionnaire-based survey was conducted for tourism as a payment for ecosystem services. The method for carbon stock assessment was systematic sampling for Chirpine forest whereas random sampling was done for scrub forest. The size of sampling plot was 17.84 m radius, and a total of 93 plots (49 Scrub zone and 44 Chirpine zone) was taken in the study area. The carbon stock of both zones (Chirpine and Scrub zone) is 22556.75 ton/ha (Chirpine 20105.79, Scrub 2450.96) and total carbon dioxide sequestered by both zone is 82557.72 ton/ha (Chirpine 73587.2, Scrub 8970.52), total carbon credits of both zone is 302160.87 (Chirpine 269328.97, Scrub 32831.9) and the carbon worth of both Chirpine and scrub zone is 4532418.92 $ (Chirpine 4039937.09$, Scrub 492481.83$). Similarly, from tourism point of view, in Shakar Parian, 94% tourists were agreed for PES whereas 6% were disagreed for the PES (the 6% tourist were disagreed to contribute for PES, 40% were agreed for Rs.5 contribution and 54% for Rs.10.). moreover, in Lake view Park, 97% tourists were agreed and 3% are disagreed (In Lake View Park 5% tourists were disagreed for the PES contribution whereas 32% were agreed for Rs.5 and 63% were for Rs.10). In Damen e Koh, around 87% tourist were agreed and 13% were disagreed, (24% were agreed for the contribution of Rs.5 and 63% tourists were agreed for the contribution of Rs.10). In Marghazar Zoo, 93% tourists were agreed (22% were agreed for contribution of Rs.5 and 71% tourist were agreed for contribution of Rs.10) and 7% are disagreed for PES whereas 7% tourists were not agreed for contribution. PES may implement to compensate forest and parks manager to ensure better management of the forests and parks. Due to prime location and scenic beauty of the ICT, it has huge potential for implementation of PES mechanism for sustainable forest management and conservation. Therefore, it is recommended that Capital Development Authority (CDA) Islamabad should devise a plan for implementation of PES in forests and parks of ICT for its sustainable management of recreational and forest resources.

O pagamento por serviços ecossistêmicos (PES) é um mecanismo no qual um consumidor é capaz e está pronto para pagar pela proteção do serviço ecossistêmico preciso e deve haver um provedor, como sociedades locais, que recebe um recurso econômico, que, em troca, deve ter capacidade para manter esse serviço ecossistêmico. A avaliação econômica fornece a base para o pagamento de serviços ecossistêmicos. Portanto, o objetivo deste estudo foi avaliar os serviços de turismo e estoque de carbono do território da capital de Islamabad (ICT), Paquistão. Duas zonas florestais (Chirpine e Scrub) do território da capital de Islamabad (ICT) foram selecionadas para estimativa do estoque de carbono e seus créditos de carbono e valor de carbono. Uma pesquisa baseada em questionário foi realizada para turismo como pagamento por serviços ecossistêmicos. O método para avaliação do estoque de carbono foi a amostragem sistemática para a floresta de Chirpine, enquanto a amostragem aleatória foi feita para a floresta de cerrado. O tamanho da parcela de amostragem foi de 17,84 m de raio, e um total de 93 parcelas (49 zona Scrub e 44 zona Chirpine) foi considerado na área de estudo. O estoque de carbono de ambas as zonas (zona Chirpine e Scrub) é de 22.556,75 ton/ha (Chirpine 20.105,79, Scrub 2.450,96), e o dióxido de carbono total sequestrado por ambas as zonas é de 82.557,72 ton/ha (Chirpine 73.587,2, Scrub 8.970,52); créditos totais de carbono de ambas as zonas são 302.160,87 (Chirpine 269.328,97, Scrub 32.831,9), e o valor de carbono tanto do Chirpine quanto da zona de scrub é 4.532.418,92 $ (Chirpine 4.039.937,09 $, Scrub 492481,83 $). Da mesma forma, do ponto de vista do turismo, em Shakar Parian 94% dos turistas concordaram com o PES, enquanto 6% discordaram do PES (6% dos turistas não concordaram em contribuir para o PES, 40% concordaram com a contribuição de R$ 5 e 54% para R$ 10). além disso, no Lake View Park, 97% dos turistas concordaram e 3% discordaram (no Lake View Park, 5% dos turistas discordaram da contribuição do PES, enquanto 32% concordaram em R$ 5 e 63% foram em R$ 10). Em Damen e Koh, cerca de 87% dos turistas concordaram e 13% discordaram (24% concordaram com a contribuição de R$ 5 e 63% dos turistas concordaram com a contribuição de R$ 10). No Jardim Zoológico de Marghazar, 93% dos turistas concordaram (22% aceitaram a contribuição de R$ 5 e 71% dos turistas aceitaram contribuir com R$ 10) e 7% discordaram para PES. enquanto 7% turistas não foram acordados para contribuição. O PSA pode ser implementado para compensar o gestor florestal e de parques para garantir uma melhor gestão de florestas e parques. Devido à localização privilegiada e beleza cênica do ICT, possui enorme potencial para implementação de mecanismo de PSA para manejo e conservação florestal sustentável. Portanto, recomenda-se que a autoridade de desenvolvimento da capital (CDA) de Islamabad elabore um plano para implementação de PES em florestas e parques de ICT para sua gestão sustentável de recursos recreativos e florestais.

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Wildlife tourism is increasing worldwide and monitoring the impact of tourism on wild populations is of the utmost importance for species conservation. The Magellanic penguin Spheniscus magellanicus colony at Martillo Island, Argentina, was studied in the 2016-2020 breeding seasons. In all seasons, adults and chicks belonged to: (i) an area close to or within the tourist trail or (ii) an area far from the tourist trail and out of sight of the tourists. Blood samples were taken for carbon and nitrogen stable isotope composition, in order to estimate trophic niches, and for smears that were made in situ and were then stained in the laboratory where leucocyte counts and differentiation were made under optical microscope. Heterophil to lymphocyte ratios were used as proxies of stress. Repeated sampling showed individual stress levels reduced while wintering. In 2017, stress levels and trophic values were lower than 2018 for the same individuals. Trophic levels did not differ between tourism and no tourism areas within each season, and differed between 2017 and the remaining seasons, indicating a possible diet shift that year. Stress levels were higher for the tourism area than the no tourism area for adults and chicks in all years except for 2020, when stress levels in the tourism area were lower and similar to the no tourism area that year and previous years. Vessel transit within the Beagle Channel and tourist visitation to the penguin colony was greatly reduced in 2020 due to the Covid-19 pandemic. A combination of internal characteristics and external factors may be affecting the stress physiology of individuals. Therefore, future research should include sampling of multiple aspects of penguin physiology, behaviour and environmental context in order to evaluate each effect on Magellanic penguin stress and, ultimately, inform the conservation of this iconic species in time.

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RESUMEN Las Áreas Naturales Protegidas (ANP) son demandadas por visitantes que buscan vivir experiencias con calidad ambiental y contacto con las comunidades anfitrionas. Es por ello que, su aprovechamiento turístico debe ser de bajo impacto y que proyecte un desarrollo armónico de los recursos naturales. El objetivo del trabajo fue determinar la capacidad de carga turística del sendero en el Parque Nacional El Veladero, que permita reducir el impacto de las actividades recreativas y prevenir el deterioro ambiental. La metodología se desarrolló a partir de una revisión documental y el análisis de las condiciones sociales y ambientales del parque, que permitieron calcular la capacidad de carga turística (CCT). La capacidad de carga física (CCF) se estimó en 1 988 visitantes, la real (CCR) en 34 visitas y la efectiva (CCE) en 11 visitas por día, la cual deberá ser respetada para no demeritar la calidad del medio ambiente. La implementación de acciones que posibiliten desarrollar un aprovechamiento turístico sustentable, acorde a las condiciones naturales del sitio, así como a las culturales y sociales de la comunidad anfitriona, permitirán preservar a largo plazo la ANP estudiada. La determinación de la CCT es de utilidad para el aprovechamiento turístico, sin afectar el medio ambiente ni la generación de recursos económicos de los habitantes de la zona analizada.

ABSTRACT Natural Protected Areas (NPAs) are demanded by visitors who seek to live experiences with environmental quality and contact with host communities. For this reason, its tourist use must be of low impact and project a harmonious development of natural resources. The objective of this work was to determine the tourism carrying capacity of a trail in el Veladero National Park, which enables a reduction of the impact of recreational activities and stop environmental deterioration. The methodology was based on documentary research, and the analysis of the social and environmental conditions of the park, which enabled the calculation of the tourism carrying capacity (TCC). Results showed that the physical carrying capacity (PCC) was 1 988 visitors, the real (CCR) was 34 visits, and the effective (ECC) 11 visits per day, which must be respected so as to not negatively impact the environmental quality. Conclusions indicate that it is advisable to implement actions that enable the development of sustainable tourism, which is in line with the natural conditions of the site. In a similar vein, respecting the social and cultural traditions of the host community, will enable the longterm preservation of the studied NPA. The calculation of the TCC has been proved useful for tourist use, without negatively impacting the environment or the generation of economic benefits for the host community in the studied area.