Hospitality and tourism industry amid COVID-19 pandemic: Perspectives on challenges and learnings from India.

COVID-19 outbreak has presented unprecedented circumstances before the fragile tourism and hospitality industry. The highly infectious novel coronavirus continues to thwart the sector and raises serious questions about the present and future survival of the sector. The research addresses two important concerns, first, pertains to the major challenges that hospitality and tourism industry faces amid current conditions; and second relates to the vital learnings for the industry. The study draws on the interviews with 15 participants in senior positions in hospitality industry, and tourism and hospitality education services. Responses to the interviews were content analysed, which resulted in 27 sub-themes that were further condensed into 4 major themes. The dominant sub-themes that emerged out of the qualitative enquiry included need of multiskilling and professional development of the employees, increased sense of hygiene, sanitation and related SOPs, optimism toward revival of the industry, media roles, and need of better crisis preparedness. Subsequent overarching themes included "Human Resource Management", "Health and Hygiene", "Continuity" and "Concerns". The study critically discusses prominent themes in the light of the existing arguments from the literature and reflects on implications for the decision makers. The major implications of the study are in the form of determined themes adding to the evolving theory on COVID-19 pandemic and tourism & hospitality industry; and managerial recommendations to address host of issues while taking essential learnings stemming from the current circumstances. Limitations and scope of future research are also discussed.

The chemotherapy response score is a useful histological predictor of prognosis in high-grade serous carcinoma.

AIMS: High-grade serous carcinoma (HGSC) is the most common tubal/ovarian malignant tumour, and usually presents at an advanced stage. Interval debulking surgery (IDS) after neoadjuvant chemotherapy (NACT) is being increasingly used for the management of these patients. The chemotherapy response score (CRS) has been proposed for grading the response of tubo-ovarian HGSC to NACT on the basis of examination of IDS specimens. Our aims were to evaluate the CRS in post-NACT cases, assess the interobserver agreement, and correlate it with overall and progression-free survival. METHODS AND RESULTS: The CRS was applied by two independent pathologists on omental and adnexal tumour tissue sections from post-NACT patients with HGSC who had undergone IDS. The assigned primary site of tumour origin was documented. The interobserver agreement and prognostic significance of the CRS were evaluated. There were 103 cases, and in 61.1% of cases a fallopian tubal origin was confirmed. There were 26, 35 and 42 cases with CRSs of 1, 2, and 3, respectively. The interobserver variability for CRS was low (κ = 0.806). The CRS showed a significant correlation with progression-free survival (CRS 1 and 2 versus 3: median survival 16 months versus 18 months; P = 0.004); however, after controlling for debulking status, this association was not significant. The CRS applied to adnexal sections did not show any prognostic significance for either progression-free or overall survival. CONCLUSION: The CRS is an easy and reproducible method for predicting the prognosis in post-NACT HGSC patients.

Effect of Supportive Psychotherapy on Mental Health Status and Quality of Life of Female Cancer Patients Receiving Chemotherapy for Recurrent Disease.

CONTEXT: Cancer patients receiving chemotherapy for their recurrent disease often report the presence of anxiety and depression. AIMS: In the study, we intended to find out the mental health status and overall quality of life (QOL) of such patients and to identify the effect of supportive psychotherapy. SUBJECTS AND METHODS: Forty cancer patients undergoing second or subsequent line chemotherapy(CCT) were selected for psychotherapy session. Pre- and post-psychotherapy evaluation of anxiety and depression was determined by hospital anxiety depression scale. The QOL was measured before and after psychotherapy sessions by using WHO QOL-BREF scale. STATISTICAL ANALYSIS USED: Statistical analysis was done by paired t-test, using SPSS V.20. RESULTS: Among 40 patients, 17 patients had breast cancer, and the remaining had ovarian cancer. All breast cancer and 19 ovarian cancer patients were receiving 2nd line CCT. Four ovarian cancer patients were undergoing 3rd line CCT. Results indicated that mean scores (± standard deviation) of anxiety 13.95 (±4) and depression 15.5 (±4.4) both exceeded the cut-off score of 11 and mean score of QOL physical health 29.77 (±10.1), psychological health 31.3 (±10.1), social relationship 35.1 (±9.6), and environmental condition 25.9 (±9.9) was below cut-off score of 60. After psychotherapy, there was significant reduction in anxiety (P < 0.01), depression (P < 0.01) and improvement on QOL physical heath (P = 0.02), psychological health (P < 0.01), environmental condition (P < 0.01), and social relationship (P < 0.01). CONCLUSIONS: Supportive psychotherapy helps to reduce the level of anxiety, depression, and increase the QOL. Therefore, psychotherapeutic intervention should be encouraged along with chemotherapy to promote positive mental health and to obtain full benefit of their physical treatment.

Prospective randomized trial to compare accelerated (six fractions a week) radiotherapy against concurrent chemoradiotherapy (using conventional fractionation) in locally advanced head and neck cancers.

BACKGROUND: Concurrent chemoradiation (CCRT) is currently considered to be the standard of care in locally advanced head and neck cancer. The optimum radiotherapy schedule for best local control and acceptable toxicity is not yet clear. We aimed at shortening of treatment time by using accelerated radiation, thereby comparing the disease response, loco-regional tumor control and tolerability of accelerated radiation (six fractions per week) against CCRT in locally advanced head and neck cancer. MATERIALS AND METHODS: We conducted the prospective randomized study for a period of 2 years from June 2011 to May 2013 in 133 untreated patients of histologically confirmed squamous cell carcinoma of head and neck. Study group (66 patients) received accelerated radiotherapy with 6 fractions per week (66Gy/33#/5½ weeks). Control group (67 patients) received CCRT with 5 fractions per week radiation (66 Gy/33#/6½ weeks) along with intravenous cisplatin 30 mg/m(2) weekly. Tumor control, survival, acute and late toxicities were assessed. RESULTS: Median overall treatment time was 38 days and 45 days in the accelerated radiotherapy and concurrent chemoradiation arm, respectively. At a median follow up of 12 months, 41 patients (62.1%) in the accelerated radiotherapy arm and 47 patients (70.1%) in the CCRT arm were disease free (P = 0.402). Local disease control was comparable in both the arms. Acute toxicities were significantly higher in the CCRT arm as compared with accelerated radiotherapy arm. There was no difference in late toxicities between the two arms. CONCLUSION: We can achieve, same or near to the same local control, with lower toxicities with accelerated six fractions per week radiation compared with CCRT especially for Indian population.