No abstract

The use of polypharmacy has become significantly more common over the past two decades, increasing the risk of drug-drug interactions and adverse drug reactions. Pharmacogenomic (PGx) assays have the purported benefit of being able to predict an individual's response to a specific medication based on genetic markers, which may facilitate the development of optimized medication regimens for patients prescribed polypharmacy. This 12-week pilot study examined the impact of the PGx results on the clinical management of Veterans who were prescribed psychiatric polypharmacy. Psychiatric medication providers were given access to the PGx assay results, including notification of drug-drug-gene interactions computed from an algorithm decision tool, to assist with medication management decisions. Veteran outpatients (N = 53) prescribed polypharmacy (mean = 13.15 medications) were enrolled into the study. In 92.4% of cases, providers changed medications at baseline, with 83% of providers indicating that they changed their original medication plan based on the PGx results. Clinical improvement over the 12-week treatment phase was seen in depression (F(1.63, 45) = 5.45, P = .01, η 2 = .11) and mental health quality of life (F(2.00, 45) = 4.16, P < .05, η 2 = .16). Adverse drug effects were unchanged or improved over time. Rates of polypharmacy remained unchanged. The results suggest that medication changes based on the PGx assay may be beneficial in a complex patient population prescribed polypharmacy.

Purpose The purpose of this paper is to examine the potential of Penang in being a dark tourism destination in Malaysia with the influence of urban tourism development. Design/methodology/approach A systematic review was conducted to serve as a foundation by highlighting the number of dark tourism studies conducted in Southeast Asia (SEA). Findings The results projected a total of 23 dark tourism studies conducted within the SEA region. These papers revolve around the following key themes that were conducted in these countries: tourists’ behaviour (motivation, satisfaction and experience), nation building and narratives, dark tourism development (management, marketing and implications), theoretical underpinnings and the role of dark tourism. Amongst these, it was found that tourists’ behaviour is the most studied with eight papers while the least is on nation building and theoretical underpinnings of dark tourism with three papers each. Research limitations/implications The lack of dark tourism studies in SEA results in insufficient existing literature which justifies the need of exploring Penang as a potential dark tourism destination. Originality/value This paper builds on prior dark tourism studies that are significantly related to urban tourism but takes a step further by exploring the Asian settings. Specifically, into Malaysia which is more than just an SEA country, but a multicultural one which is rich and diverse with its culture and heritage that leads to many unique tourists’ destinations. This paper extends the geographical scope of the dark tourism literature as it focuses on Penang in Malaysia.

Purpose This concept paper aims to discuss the effects of network hospitality on women empowerment in the city of Kuala Lumpur. Design/methodology/approach This paper uses a qualitative approach to analyse women engaged in Airbnb activity as hosts or guests. Findings Findings show new types of entrepreneurs, hospitality services, and socio-cultural expectations under this change. Originality/value The recent growth of Network Hospitality platforms such as Airbnb around the world has generated multiple impacts on urban destinations worldwide. Network hospitality is transforming the way tourism is produced and consumed. Several studies have analysed the impact of network hospitality on destinations’ accommodation and housing markets, the gentrification effects and users’ experience. However, studies on the social impacts of Airbnb in developing economies remain scarce. Network hospitality is creating entrepreneurship and mobility opportunities for women. In the case of Malaysia, there is a noticeable empowerment trend of women through network hospitality.