The Malaysian Northern Stars (supervision, training, and reflective system) project: a multi-facet ecosystem of producing local talents

AimsThe MRCPsych (Membership of the Royal College of Psychiatrists, United Kingdom) parallel training pathway has been introduced in Malaysia to produce competent psychiatrists to deliver evidence-based psychiatric care. Certain training centres faced specific challenges during the process of implementation, including the lacking of supervisors with experience in the MRCPsych examination, over-reliance on self-study and existing continuous medical education (CME), logistic difficulty in accessing specific training courses, the sustainability of local training, and loss of manpower due to frequent mobilisation of trainees. This article is aimed to illustrate the Northern STARS (Supervision, Training, and Reflective System) project, i.e. a project implemented as a solution for those challenges and an effort to develop a sustainable model of training for the local talents in Perlis, a northern state in Malaysia.MethodThe Northern STARS initiatives included: setting up a library with more MRCPsych-related materials; introducing trainees to virtual MRCPsych support groups; organizing both physical and virtual training locally, collaborating with local and international experts for consultation and teaching, and the introduction of protected study time. Virtual platforms were used innovatively to minimise cost. Ongoing data were collected for programme evaluation and quality improvement. Trainees were actively involved in the process to facilitate the development of leadership and administrative skills.ResultA total of seven courses covering both skill and theory training had been organised: Ultra-brief Psychological Intervention Workshop, Dialectic Behavioural Therapy workshop, Personality Disorder Workshop, Critical Appraisal Workshop, MRCPsych Lecture Series, Addiction Psychiatry Lecture, and Basic Revision Course on Electroconvulsive Therapy. An estimated amount of twenty thousand Malaysian Ringgit had been generated and channelled into the community mental health centre, accounting for the indirect cost of a subscription to ZoomTM and the intangible cost of labour effort. Overall feedback revealed a high level of satisfaction together with some specific suggestions on areas of improvement, including the timing of course and coverage of the curriculum. To date, six medical officers are pursuing this pathway with three of them passing one paper and another two pursuing the final part.ConclusionThe Northern STARS project is an ecosystem of training solutions while generating income and producing more local talents to expand this project further. More long-term evaluation from the perspective of human resource and health economics can be considered to understand the efficiency of the current initiative.

Reflective and Impulsive Predictors of Unhealthy Snack Impulse Buying

While impulse buying has been conceptualized as a product of impulses, this study proposes that both reflective and impulsive determinants can outline impulse buying. Following a dual-system model that distinguishes between a reflective and an impulsive system, we hypothesized that unhealthy snack impulse buying can be differentially influenced by either impulsive system or reflective system as a function of self-regulatory resources. Participants in the experiment were randomly assigned to one of the conditions of the two-group design (self-regulatory resources depletion vs. control condition); then they were given the opportunity to take part in a mock store spontaneous buying situation. While the impulsive system was represented by impulse buying tendency and unhealthy snack buying habit, dietary restraint represented the reflective system. The dependent variables were the number of unhealthy snacks purchased and the percentage of unhealthy snacks purchased. The results provided the first empirical foundation for reflective and impulsive aspects of impulse buying behavior. The findings showed that self-regulatory resources moderate the impact of both reflective and impulsive determinants on unhealthy snack impulse buying. While the reflective system (dietary restraint) only determined the behavior in the high self-regulatory resource condition, the impulsive system (impulse buying tendency and habit) associated with the behavior when self-regulatory resources were diminished. There was one exceptional case in which habit determined the percentage of unhealthy snacks purchased even in the high self-regulatory resource condition.

Music Shaped in Time: Musical Sense-Making Between Perceptual Immediacy and Symbolic Representation

What does music signify? And how do listeners make sense of music as a collection of sounding stimuli? A common way is to study the structure of the music, conceiving of music as a self-reflective system with elements that refer mainly to themselves. This is a position that deals with music in computational terms relying on symbols that can be manipulated at a virtual level of imagery, without any connection to the music as it sounds. Music, however, is also a temporal and sounding art. It can be described in acoustic terms, providing a totally objective rendition of the sonorous articulation through time. As such, there is a major distinction between “in time” and “outside of time” descriptions of the music, with the former relying on the first hand sounding stimuli and the latter on second-order symbolic replicas of the sounds.