Changing Practices of Tourism Stakeholders in Covid-19 Affected Destinations

This book employs epistemological, methodological and discursive approaches to explore the practices of tourism stakeholders in Covid-19 affected destinations and to understand and explain their everyday real-time doings and sayings. It discusses the changing practices of tourists and stakeholders at both micro and meso levels and provides a range of contexts and destination case studies offering insights into supply and demand. The issues examined in the volume will have continued implications for further study of the relationships between tourism, crises, pandemics and global travel. It will be a useful resource for researchers and students in tourism studies, geography, politics and policy, as well as sociology, history, crisis management and development studies. © 2023 Erdinç Çakmak, Rami K. Isaac, Richard Butler and the authors of individual chapters. All rights reserved.

Adapting provision of structured diabetes education from face-to-face to virtual during the COVID-19 pandemic

In Bedfordshire, individuals newly diagnosed with type 2 diabetes are referred to the diabetes education team for either a group or one-to-one structured education session. The DESMOND Newly Diagnosed Programme is delivered to groups to support people to self-manage their condition through lifestyle modification and behaviour change. Prior to the COVID-19 pandemic, all options for structured education were in-person only. However, when the pandemic hit in March 2020, all face-to-face patient education sessions were immediately cancelled. As the initial three-week lockdown became an extended period, the Bedfordshire diabetes education team had to think how to continue to provide diabetes education and support to its patients whilst working within government guidelines and restrictions. This article describes how the team successfully moved its educational options from an entirely face-to-face provision to a virtual service and details the service’s post-pandemic plans. © 2022 SB Communications Group. All rights reserved.

Managing Tourism - A Missing Element?

The paper argues that despite the widespread use of the term management in the context of tourism destinations, there is little actual management of tourism or tourists in most destinations. The paper uses the Tourism Area Life Cycle (TALC) model (Butler 1980) as a lens through which to view some current issues and problems facing tourism destinations. It explores some of the basic elements of the TALC model including carrying capacity and triggers or forces bringing about change in destinations and argues that the reluctance of many stakeholders to adopt sustainable principles is reflected in current problems such as overtourism. Recognition of the often ignored political element in the sustainable triumvirate of economic, environmental and social components is important because without political support for appropriate initiatives has meant that efforts to move towards more sustainable destinations have often proved fruitless. The paper concludes that despite calls for new ways of defining success for tourism destinations and for drastically changing the nature and scale of tourism in the post-pandemic future, it is likely that tourism will resume, at least for the short to medium term, in a form very similar to what existed before the advent of COVID-19.

Managing Tourism - A Missing Element?

The paper argues that despite the widespread use of the term management in the context of tourism destinations, there is little actual management of tourism or tourists in most destinations. The paper uses the Tourism Area Life Cycle (TALC) model (Butler 1980) as a lens through which to view some current issues and problems facing tourism destinations. It explores some of the basic elements of the TALC model including carrying capacity and triggers or forces bringing about change in destinations and argues that the reluctance of many stakeholders to adopt sustainable principles is reflected in current problems such as overtourism. Recognition of the often ignored political element in the sustainable triumvirate of economic, environmental and social components is important because without political support for appropriate initiatives has meant that efforts to move towards more sustainable destinations have often proved fruitless. The paper concludes that despite calls for new ways of defining success for tourism destinations and for drastically changing the nature and scale of tourism in the post-pandemic future, it is likely that tourism will resume, at least for the short to medium term, in a form very similar to what existed before the advent of COVID 19.

Inhibition of WEE1 is effective in TP53 and RAS mutant metastatic colorectal cancer (mCRC): A randomised phase II trial (FOCUS4-C) comparing adavosertib (AZD1775) with active monitoring

Background: Outcomes in RAS-mutant metastatic colorectal cancer (mCRC) remain poor and patients have limited therapeutic options. Adavosertib is the first small molecule inhibitor of WEE1 kinase. We hypothesised that aberrations in DNA replication seen in mCRC with both RAS and TP53 mutations would sensitise tumours to WEE1 inhibition. Methods: Patients with newly diagnosed mCRC were registered into FOCUS4 and tested for TP53 and RAS mutations. Those with both mutations who were stable or responding after 16 weeks of chemotherapy were randomised 2:1 between Adavosertib or active monitoring (AM). The primary outcome was progression-free-survival (PFS). Results: Between Jul 2017 and Mar 2020 718 patients were registered into FOCUS4;247 (34%) were RAS/TP53-mutant. 69 patients were randomised from 25 UK hospitals (44 to Adavosertib;25 to AM) and recruitment terminated early due to COVID-19 and following DMEC review of efficacy data. Adavosertib was associated with a PFS improvement over AM (median 3.61 vs 1.87 months;HR=0.35[95% CI 0.18-0.68], p=0.0022). In pre-specified subgroup analysis, Adavosertib activity was greater in left-sided tumours HR=0.24 [95% CI 0.11–0.51], versus right-sided HR=1.02 [95% CI 0.41–2.56] (interaction p=0.043). Adavosertib activity was limited to tumours with KRAS12/13 mutations, rather than mutations in extended KRAS or NRAS (interaction p=0.01). Overall survival (OS) was not improved with Adavosertib vs AM (median 14.0 vs 12.8 months;HR=0.92[95%CI 0.44-1.94], p=0.93);however in left-sided tumours, median OS was 14.1 vs 11.3 months (HR=0.37 [95%CI 0.15-0.87]) and 6.5 vs 15.5 months in right-sided (HR=2.15 [95%CI 0.72-6.43], interaction p=0.0047). Adavosertib was well tolerated;grade 3 toxicities were diarrhoea (9%), nausea (5%) and neutropenia (7%). Conclusions: In this phase II randomised trial, Adavosertib improved PFS compared with AM and demonstrates potential as a well-tolerated therapy for RAS/TP53-mutant mCRC. Activity was greater in patients with left-sided tumours, with potential impact on OS. Further testing is required in this sizable population of unmet need. Clinical trial identification: ISRCTN90061546. Legal entity responsible for the study: The authors. Funding: MRC/NIHR, CRUK, AstraZeneca. Disclosure: J. Seligmann: Financial Interests, Personal, Invited Speaker: Pierre Fabre;Financial Interests, Personal, Invited Speaker: Merck Serono;Financial Interests, Personal, Advisory Board: Pierre Fabre;Financial Interests, Personal, Expert Testimony: Roche Diagnostics;Financial Interests, Personal, Invited Speaker: Servier. T. Maughan: Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Pierre Fabre;Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Institutional, Funding: AstraZeneca;Financial Interests, Institutional, Funding: Psioxus;Financial Interests, Institutional, Funding: Merck KGAA. All other authors have declared no conflicts of interest.

Nurses' Wages and Hours of Work in the COVID-19 Era

The differential quantile impact of COVID-19 on the relative wages and hours of work of U.S. registered nurses in 2020 was measured. Overall, and by separate quantiles, nurses' weekly wages increased 2% when COVID-19 cases increased. Weekly hours of work fell by nearly 1%, so hourly wage rates rose by almost 3% on average. The ongoing impact of COVID-19 will likely continue to affect hours worked, overall wages, and the physical and psychological well-being of frontline workers.

Tourism – resilient but vulnerable as “the times they are a changing” in the “new normality”

Purpose: The purpose of this paper is to present a viewpoint about the short- and long-term future of tourism in the light of the effects of the response to Covid-19 and the implications of potential changes tourism might be facing. Design/methodology/approach: The paper is based on a review of current media and academic commentaries and articles on the impact of Covid-19 on tourism, and the likelihood of changes being forced on tourism by external agents of change desiring a different form that the industry should take. Findings: Current concerns and changes in patterns of tourism are being driven by two main forces: restrictions imposed on travel, both domestic and international, and fear by potential tourists and destination hosts of infection being caused by the resumption of tourist travel. The situation is extremely vulnerable, changing long-established patterns of behaviour and the effects of tourism on economies, communities and environments. The future for tourism is seen as generally positive in the long term, but agents of change opposed to the traditional patterns of tourism may create a negative environment that could cause severe disruption to the industry and its customers, unless tourism displays willingness and resolve to correct previously inappropriate ways of operating. Originality/value: This paper presents a viewpoint about the short- and long-term future of tourism. © 2020, Emerald Publishing Limited.