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  1. Improving metabolic monitoring in patients maintained on antipsychotics in Penang, Malaysia
    Hor ES, Subramaniam S, Koay JM, Bharathy A, Vasudevan U, Panickulam JJ, et al.
    Australas Psychiatry, 2016 Feb;24(1):67-71.
    PMID: 26400455 DOI: 10.1177/1039856215604484
    OBJECTIVES: To evaluate the monitoring of metabolic parameters among outpatients maintained on antipsychotic medications in a general hospital setting in Malaysia and to assess the impact of a local monitoring protocol.
    METHODS: By performing a baseline audit of files from a random sample of 300 patients prescribed antipsychotic medications for at least 1 year; we determined the frequency of metabolic monitoring. The findings informed the design of a new local protocol, on which clinical staff was briefed. We re-evaluated metabolic monitoring immediately after implementation, in a small sample of new referrals and current patients. We explored staff perceptions of the initiative with a follow-up focus group, 6 months post-implementation.
    RESULTS: The baseline audit revealed a sub-optimal frequency of metabolic parameter recording. Re-audit, following implementation of the new protocol, revealed improved monitoring but persisting deficits. Dialogue with the clinical staff led to further protocol modification, clearer definition of staff roles and use of a standard recording template. Focus group findings revealed positive perceptions of the initiative, but persisting implementation barriers, including cultural issues surrounding waist circumference measurement.
    CONCLUSIONS: Responding to challenges in achieving improved routine metabolic monitoring of patients maintained on antipsychotics required on-going dialogue with the clinical staff, in order to address both service pressures and cultural concerns.
    KEYWORDS: Malaysia; antipsychotic agents; cultural issues; mental disorders; metabolic monitoring; metabolic syndrome; patient monitoring; staff behaviour; waist circumference
    Study site: Psychiatric clinic, Hospital Pulau Pinang, Pulau Pinang, Malaysia
  2. Educational environments in Asian medical schools: A cross-national comparison between Malaysia, Singapore, and China
    Arokiamary B, Russell V, Lim HA, Koay JM, Xia J, Zhao XH, et al.
    Asia Pac Psychiatry, 2021 Jun;13(2):e12454.
    PMID: 33646626 DOI: 10.1111/appy.12454
    INTRODUCTION: Perceptions of the educational environment (EE) represent an important source of information on medical students' learning experience. Understanding and addressing these perceptions can help inform initiatives designed to improve the learning experience and educational outcomes, while comparison of student perceptions across medical schools can provide an added perspective. The aim of the study was to compare the EEs of three Asian medical schools: Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Yong Loo Lin School of Medicine, Singapore and Xiangya School of Medicine, China.

    METHODS: Medical students in the clinical years (N = 1063) participated in a cross-sectional study using the Dundee Ready Educational Environment Measure (DREEM). Data were analyzed using SPSS version 22.

    RESULTS: There were significant differences between the three medical schools in the total DREEM scores (F [2, 1059] = 38.29, p 

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