A mechanical and simplified model for RC elements subjected to combined shear and axial tension.

Very little is known about the shear behavior of elements, in particular those subjected to axial tension. The shear accompanied by tensile forces could cause premature failure of reinforced concrete, which is sudden with minimal warning. Therefore, understanding the shear behavior of reinforced concrete (RC) elements, including those subjected to axial tension, is an ultimate goal of the worldwide research community. In the current study, a new shear mechanical model for RC elements subjected to axial tension is developed, which makes physical sense and explains the behavior. The model is strain-based, inspired by the critical crack theory model (CSCT). In addition, the proposed model extended CSCT (ECSCT) quantifies the effect of axial tension forces on the shear strength in terms of reduction in the compression zone depth and increase in the longitudinal strain. Moreover, the nonlinear trend observed in the literature was implemented using nonlinear multi-variable regression. The ECSCT is validated and compared with available design methods with respect to an extensive database, including 180 elements tested under shear and tension from 18 different research investigations. The ECSCT provided an accurate and physically sound model yet safe to an acceptable extent. Last but not least, a simplified model for the purpose of design is proposed. The simplified model was chosen based on the mechanical model and calibrated using the extensive experimental database. The simplified model provided an accurate and simple model, yet safe to an acceptable extent.

Prevalence and predictors of depression and suicidal ideation among adolescents attending government secondary schools in Malaysia.

No abstract available.

Study protocol: An investigation of mother-infant signalling during breastfeeding using a randomised trial to test the effectiveness of breastfeeding relaxation therapy on maternal psychological state, breast milk production and infant behaviour and growth.

BACKGROUND: The physiological and psychological signalling between mother and infant during lactation is one of the prominent mother-infant factors that may influence breastfeeding outcomes. The infant can 'signal' his needs through vocalisation, and the mother can respond by allowing or restricting nipple access, which might alter the breast milk composition or volume. This may lead to parent-offspring conflict during the lactation period. Challenging infant behaviour has also been associated with maternal psychological distress, which might affect breastfeeding performance. Most attempts to improve breastfeeding rates focus on providing additional support, yet many aspects of the breastfeeding process are poorly understood. Thus, our objective is to investigate mother-infant signalling during breastfeeding by manipulating maternal psychological state using a relaxation therapy intervention. The study will test the hypothesis that mothers who listen to the therapy will be more relaxed/less stressed and this will favourably alter breast milk composition and/or affect milk volume and hence influence infant outcomes. METHODS: A randomised controlled trial will be conducted in first-time breastfeeding mothers and their new-born infants. Pregnant mothers will be recruited at antenatal clinics in Selangor, Malaysia, and four home visits will be carried out at 2, 6, 12 and 14 weeks postnatally. Participants will be randomised into a control and an intervention group in the early post-partum period. Mothers from the intervention group will be asked to listen daily to an audio recording with relaxation therapy during breastfeeding. Maternal psychological state, breastfeeding practices and infant behaviour will be assessed using validated questionnaires. Milk volume will be measured using stable isotopes. Breast milk samples will be collected to measure macronutrient content and hormone levels. Anthropometric measurements (weight, length and head circumference) will be performed during all home visits, including body composition at week 14. DISCUSSION: The main outcomes will be the effect of the intervention on maternal psychological state, milk production, cortisol levels, and infant behaviour and growth. Secondary outcomes will be associations between breast milk composition and infant appetite and growth. This study aims to provide a greater understanding of maternal-infant factors which influence breastfeeding outcomes and which may be useful targets for future interventions. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01971216.

Protocol for a between-group experimental study examining cultural differences in emotion processing between Malay and Caucasian adults with and without major depressive disorder.

INTRODUCTION: Depression is a mood disorder that affects a significant proportion of the population worldwide. In Malaysia and Australia, the number of people diagnosed with depression is on the rise. It has been found that impairments in emotion processing and emotion regulation play a role in the development and maintenance of depression. This study is based on Matsumoto and Hwang's biocultural model of emotion and Triandis' Subjective Culture model. It aims to investigate the influence of culture on emotion processing among Malaysians and Australians with and without major depressive disorder (MDD). METHODS AND ANALYSIS: This study will adopt a between-group design. Participants will include Malaysian Malays and Caucasian Australians with and without MDD (N=320). There will be four tasks involved in this study, namely: (1) the facial emotion recognition task, (2) the biological motion task, (3) the subjective experience task and (4) the emotion meaning task. It is hypothesised that there will be cultural differences in how participants with and without MDD respond to these emotion tasks and that, pan-culturally, MDD will influence accuracy rates in the facial emotion recognition task and the biological motion task. ETHICS AND DISSEMINATION: This study is approved by the Universiti Putra Malaysia Research Ethics Committee (JKEUPM) and the Monash University Human Research Ethics Committee (MUHREC). Permission to conduct the study has also been obtained from the National Medical Research Register (NMRR; NMRR-15-2314-26919). On completion of the study, data will be kept by Universiti Putra Malaysia for a specific period of time before they are destroyed. Data will be published in a collective manner in the form of journal articles with no reference to a specific individual.

The reliability and validity of the Malay version 17-item Diabetes Distress Scale.

INTRODUCTION: Diabetes-related distress (DRD) refers to patient's concerns about diabetes mellitus, its management, need of support, emotional burden and access to healthcare. The aim of this study was to translate and examine the psychometric properties of the Malay version of the 17-item Diabetes Distress Scale (MDDS-17) in adult patients with type 2 diabetes mellitus (T2D). METHODS: A standard procedure was used to translate the English 17-items Diabetes Distress Scale into Malay language. We used exploratory factor analysis (EFA) with principal axis factoring and promax rotation to investigate the factor structure. We explored reliability by internal consistency and 1-month test-retest reliability. Construct validity was examined using the World Health Organization quality of life-brief questionnaire, Morisky Medication Adherence Scale, Patient Health Questionnaire and disease-related clinical variables. RESULTS: A total of 262 patients were included in the analysis with a response rate of 96.7%. A total of 66 patients completed the test-retest after 1 month. EFA supported a three-factor model resulting from the combination of the regimen distress (RD) and interpersonal distress (IPD) subscales; and with a swapping of an item between emotional burden (EB; item 7) and RD (item 3) subscales. Cronbach's α for MDDS-17 was 0.94, the combined RD and IPD subscale was 0.925, the EB subscale was 0.855 and the physician-related distress was 0.823. The test- retest reliability's correlation coefficient was r = 0.29 (n = 66; p = 0.009). There was a significant association between the mean MDDS-17 item score categories (<3 vs ≥3) and HbA1c categories (<7.0% vs ≥7.0%), and medication adherence (medium and high vs ≥low). The instrument discriminated between those having diabetes-related complication, low quality of life, poor medication adherence and depression. CONCLUSION: The MDDS-17 has satisfactory psychometric properties. It can be used to map diabetes-related emotional distress for diagnostic or clinical use.

The reliability and validity of the Malay version 17-item Diabetes Distress Scale

Introduction: Diabetes-related distress (DRD) refers to patient’s concerns about diabetes mellitus, its management, need of support, emotional burden and access to healthcare. The aim of this study was to translate and examine the psychometric properties of the Malay version of the 17-item Diabetes Distress Scale (MDDS-17) in adult patients with type 2 diabetes mellitus (T2D). Methods: A standard procedure was used to translate the English 17-items Diabetes Distress Scale into Malay language. We used exploratory factor analysis (EFA) with principal axis factoring and promax rotation to investigate the factor structure. We explored reliability by internal consistency and 1-month test-retest reliability. Construct validity was examined using the World Health Organization quality of life-brief questionnaire, Morisky Medication Adherence Scale, Patient Health Questionnaire and disease-related clinical variables. Results: A total of 262 patients were included in the analysis with a response rate of 96.7%. A total of 66 patients completed the test–retest after 1 month. EFA supported a three-factor model resulting from the combination of the regimen distress (RD) and interpersonal distress (IPD) subscales; and with a swapping of an item between emotional burden (EB; item 7) and RD (item 3) subscales. Cronbach’s α for MDDS-17 was 0.94, the combined RD and IPD subscale was 0.925, the EB subscale was 0.855 and the physician-related distress was 0.823. The test– retest reliability’s correlation coefficient was r = 0.29 (n = 66; p = 0.009). There was a significant association between the mean MDDS-17 item score categories (<3 vs ≥3) and HbA1c categories (<7.0% vs ≥7.0%), and medication adherence (medium and high vs ≥low). The instrument discriminated between those having diabetes-related complication, low quality of life, poor medication adherence and depression. Conclusion: The MDDS-17 has satisfactory psychometric properties. It can be used to map diabetes-related emotional distress for diagnostic or clinical use.

Effect of near-total thyroidectomy on thyroid orbitopathy due to toxic goiter.

BACKGROUND: The relative merit of surgery in the treatment of Graves' ophthalmopathy as well as the extent of surgical resection are still matters of debate. This study aimed at reporting an assessment of the impact of near-total thyroidectomy on the course of ophthalmopathy including exophthalmos. METHODS: A total of 20 patients with thyrotoxic goiters who were suffering from mild to moderate exophthalmos were enrolled in this prospective study. Preoperative evaluation of ophthalmopathy was accomplished through the NOSPECS classification, magnetic resonance imaging (MRI) for measuring the extraocular muscle diameters, and measurement of the exophthalmos using Hertel's exophthalmometer. Ophthalmopathy including exophthalmos was reevaluated 6 months after operation using the same parameters. RESULTS: Clinical activity evaluation, exophthalmometry, and extraocular muscles measurement by MRI revealed that most of the patients experienced improvement of their ophthalmopathy (65%). This improvement was statistically significant. In addition, no major postoperative complications were observed. However, the study, unlike a number of reported retrospective ones, failed to specify any statistically significant prognostic factors affecting the course of ophthalmopathy; this may have been due to the limited number of patients. In addition, all of the patients were of relatively young age and thyrotoxic, and most were female and nonsmoking. CONCLUSIONS: In addition to the fact that near-total thyroidectomy adds the advantages of total thyroidectomy (no recurrence) to those of subtotal thyroidectomy (low incidence of temporary and permanent hypoparathyroidism), it has a significant positive impact on thyroid-associated orbitopathy.

Responses of some Nigerian vegetables of plant growth regulator treatments.

The effects of single and combined growth regulator treatments of indole-3-acetic acid (IAA), gibberellic acid (GA3) and coconut milk on plant height, yield, chlorophyll and vitamin contents of Abelmoschus esculetus L and Solanum gilo L were investigated. The single growth regulator treatments consisted of 50mg/L, 100 mg/L of IAA and GA3 and 10%, 15% of coconut milk. In case of combined growth regulator treatments, the treatments were 100mg/L IAA + 100mg/L GA3, 100mg/L IAA + 15% coconut milk and 100mg/L GA3 + 15% coconut milk. Control vegetable plants were sprayed with water. Single treatments of 100mg/L IAA,100mg/L GA3. 10% and 15% coconut milk resulted in significantly increased plant height, chlorophyll contents and yield of A. esculentus, H. sabdariffa and S. gilo while only combined treatments of 100mg/L IAA + 10% coconut milk and 100mg/L GA3 + 15% coconut milk had such an effect on A. esculentus and S. gilo but not on H. sabdariffa. Moreover, singletreatments of 100mg/L GA3 and 15% coconut milk caused significantly higher vitamins A, B6 and C contents of treated plants whereas the combined treatments produced such an effect on only vitamin C contents of treated plants. Growth regulator treatments of 100mg/L GA3 and 15% coconut milk were consistently the best out of the entire growth regulator treatments tried with the treated plants having the greatest plant height, yield, chlorophyll and vitamin C contents.