Search results for: strengthening
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 637

Search results for: strengthening

547 Graphene Reinforced Magnesium Metal Matrix Composites for Biomedical Applications

Authors: Khurram Munir, Cuie Wen, Yuncang Li

Abstract:

Magnesium (Mg) metal matrix composites (MMCs) reinforced with graphene nanoplatelets (GNPs) have been developed by powder metallurgy (PM). In this study, GNPs with different concentrations (0.1-0.3 wt.%) were dispersed into Mg powders by high-energy ball-milling processes. The microstructure and resultant mechanical properties of the fabricated nanocomposites were characterized using transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), Raman spectroscopy (RS), compression and nano-wear tests. The corrosion resistance of the fabricated composites was evaluated by electrochemical tests and hydrogen evolution measurements. Finally, the biological response of Mg-GNPs composites was assessed using osteoblast-like SaOS2 cells. The results indicate that GNPs are excellent candidates as reinforcements in Mg matrices for the manufacture of biodegradable Mg-based composite implants. GNP addition improved the mechanical properties of Mg via synergetic strengthening modes. Moreover, retaining the structural integrity of GNPs during PM processing improved the ductility, compressive strength, and corrosion resistance of the Mg-GNP composites as compared to monolithic Mg. Cytotoxicity assessments did not reveal any significant toxicity with the addition of GNPs to Mg matrices. This study demonstrates that Mg-xGNPs with x < 0.3 wt.%, may constitute novel biodegradable implant materials for load-bearing applications.

Keywords: magnesium-graphene composites, strengthening mechanisms, In vitro cytotoxicity, biocorrosion

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546 Sustainable Upgrade of Existing Heritage Infrastructure - Strengthening and Rehabilitation of The LH Ford Bridge

Authors: Vince Scolaro, Lakshman Prasad, Ted Polley, Sanjivan Deshpande

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The LH Ford Bridge, built in the 1960s, comprises 28 spans, is 800m long and crosses the Macquarie River at Dubbo, NSW. The main bridge spans comprise three spans with a 63m center span (25m drop-in section) supported by halving joints from the main cantilevers and back spans of 28m. The main bridge spans were built using complex construction staging (the first of this type in NSW). They comprise twin precast boxes, in-situ reinforced concrete infills, and cantilevered outriggers stressed both longitudinally and transversely. Since construction, this bridge has undergone significantly increased design vehicle loads and showed signs of excessive shrinkage and creep leading to significant sagging of the centre span with evidence of previous failure and remediation of the halving joints. A comprehensive load rating assessment was undertaken taking account of the original complex construction staging. Deficiencies identified included inadequate capacity of the halving joints, failure of the bearings at the halving joints, inadequate shear capacity of the girder webs and inadequate girder flexural capacity to carry B-Double design vehicles. A unique strengthening system comprising two new piers (under each of the halving joints), new bearings and installation of external prestressing to the soffit of both drop-in-span and back spans was adopted. A portion of the dead load had to be transferred from the superstructure to the new piers via innovative soft/stiff bearing combinations to reduce new locked-in stresses resulting from the new pier supports. Significant temporary works comprised a precast concrete shell beam forming the pile cap/pier structure, addition of a temporary suspended scaffold (without overstressing the existing superstructure) and the installation of jacking stays for new bearing top and bottom plates. This paper presents how this existing historic and socially important bridge was strengthened and updated to increase its design life without the need for replacement.

Keywords: strengthening, creep, construction, box girder

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545 Structural Assessment of Low-Rise Reinforced Concrete Frames under Tsunami Loads

Authors: Hussain Jiffry, Kypros Pilakoutas, Reyes Garcia Lopez

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This study examines the effect of tsunami loads on reinforced concrete (RC) frame buildings analytically. The impact of tsunami wave loads and waterborne objects are analyzed using a typical substandard full-scale two-story RC frame building tested as part of the EU-funded Ecoleader project. The building was subjected to shake table tests in bare condition and subsequently strengthened using Carbon Fiber Reinforced Polymers (CFRP) composites and retested. Numerical models of the building in both bare and CFRP-strengthened conditions are calibrated in DRAIN-3DX software to match the test results. To investigate the response of wave loads and impact forces, the numerical models are subjected to nonlinear dynamic analyses using force-time history input records. The analytical results are compared in terms of displacements at the floors and the 'impact point' of a boat. The results show that the roof displacement of the CFRP-strengthened building reduced by 63% when compared to the bare building. The results also indicate that strengthening only the mid-height of the impact column using CFRP is more efficient at reducing damage when compared to strengthening other parts of the column. Alternative solutions to mitigate damage due to tsunami loads are suggested.

Keywords: tsunami loads, hydrodynamic load, impact load, waterborne objects, RC buildings

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544 Embodying the Ecological Validity in Creating the Sustainable Public Policy: A Study in Strengthening the Green Economy in Indonesia

Authors: Gatot Dwi Hendro, Hayyan ul Haq

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This work aims to explore the strategy in embodying the ecological validity in creating the sustainability of public policy, particularly in strengthening the green economy in Indonesia. This green economy plays an important role in supporting the national development in Indonesia, as it is a part of the national policy that posits the primary priority in Indonesian governance. The green economy refers to the national development covering strategic natural resources, such as mining, gold, oil, coal, forest, water, marine, and the other supporting infrastructure for products and distribution, such as fabrics, roads, bridges, and so forth. Thus, all activities in those national development should consider the sustainability. This sustainability requires the strong commitment of the national and regional government, as well as the local governments to put the ecology as the main requirement for issuing any policy, such as licence in mining production, and developing and building new production and supporting infrastructures for optimising the national resources. For that reason this work will focus on the strategy how to embody the ecological values and norms in the public policy. In detail, this work will offer the method, i.e. legal techniques, in visualising and embodying the norms and public policy that valid ecologically. This ecological validity is required in order to maintain and sustain our collective life.

Keywords: ecological validity, sustainable development, coherence, Indonesian Pancasila values, environment, marine

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543 Torsional Behavior of Reinforced Concrete (RC) Beams Strengthened by Fiber Reinforced Cementitious Materials– a Review

Authors: Sifatullah Bahij, Safiullah Omary, Francoise Feugeas, Amanullah Faqiri

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Reinforced concrete (RC) is commonly used material in the construction sector, due to its low-cost and durability, and allowed the architectures and designers to construct structural members with different shapes and finishing. Usually, RC members are designed to sustain service loads efficiently without any destruction. However, because of the faults in the design phase, overloading, materials deficiencies, and environmental effects, most of the structural elements will require maintenance and repairing over their lifetime. Therefore, strengthening and repair of the deteriorated and/or existing RC structures are much important to extend their life cycle. Various techniques are existing to retrofit and strengthen RC structural elements such as steel plate bonding, external pre-stressing, section enlargement, fiber reinforced polymer (FRP) wrapping, etc. Although these configurations can successfully improve the load bearing capacity of the beams, they are still prone to corrosion damage which results in failure of the strengthened elements. Therefore, many researchers used fiber reinforced cementitious materials due to its low-cost, corrosion resistance, and result in improvement of the tensile and fatigue behaviors. Various types of cementitious materials have been used to strengthen or repair structural elements. This paper has summarized to accumulate data regarding on previously published research papers concerning the torsional behaviors of RC beams strengthened by various types of cementitious materials.

Keywords: reinforced concrete beams, strengthening techniques, cementitious materials, torsional strength, twisting angle

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542 Seismic Retrofitting of RC Buildings with Soft Storey and Floating Columns

Authors: Vinay Agrawal, Suyash Garg, Ravindra Nagar, Vinay Chandwani

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Open ground storey with floating columns is a typical feature in the modern multistory constructions in urban India. Such features are very much undesirable in buildings built in seismically active areas. The present study proposes a feasible solution to mitigate the effects caused due to non-uniformity of stiffness and discontinuity in load path and to simultaneously hold the functional use of the open storey particularly under the floating column, through a combination of various lateral strengthening systems. An investigation is performed on an example building with nine different analytical models to bring out the importance of recognising the presence of open ground storey and floating columns. Two separate analyses on various models of the building namely, the equivalent static analysis and the response spectrum analysis as per IS: 1893-2002 were performed. Various measures such as incorporation of Chevron bracings and shear walls, strengthening the columns in the open ground storey, and their different combinations were examined. The analysis shows that, in comparison to two short ones separated by interconnecting beams, the structural walls are most effective when placed at the periphery of the buildings and used as one long structural wall. Further, it can be shown that the force transfer from floating columns becomes less horizontal when the Chevron Bracings are placed just below them, thereby reducing the shear forces in the beams on which the floating column rests.

Keywords: equivalent static analysis, floating column, open ground storey, response spectrum analysis, shear wall, stiffness irregularity

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541 Flexural Strengthening of Steel Beams Using Fiber Reinforced Polymers

Authors: Sally Hosny, Mona G. Ibrahim, N. K. Hassan

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Fiber reinforced polymers (FRP) is one of the most environmentally method for strengthening and retrofitting steel structure buildings. The behaviour of flexural strengthened steel I-beams using FRP was investigated. The finite element (FE) models were developed using ANSYS® as verification cases to simulate the experimental behaviour of using FRP strips to flexure strengthen steel I-beam. Two experimental studies were selected for verification; first examined the effect of different thicknesses and modulus of elasticity while the second studied the effect of applying different carbon fiber reinforced polymers (CFRP) bond lengths. The proposed FE models were in good agreement with the experimental results in terms of failure modes, load bearing capacities and strain distribution on CFRP strips. The verified FE models can be utilized to conduct a parametric study where various widths (40, 50, 60, 70 and 80 mm), thickness (1.2, 2 and 4 mm) and lengths (1500, 1700 and 1800 mm) of CFRP were analyzed. The results presented clearly revealed that the load bearing capacity was significantly increased (+7%) when the width and thickness were increased. However, load bearing capacity was slightly affected using longer CFRP strips. Moreover, applying another glass fiber reinforced polymers (GFRP) of 1500 mm in length, 50 mm in width and thicknesses of 1.2, 2 and 4 mm were investigated. Load bearing capacity of strengthened I-beams using GFRP is less than CFRP by average 8%. Statistical analysis has been conducted using Minitab®.

Keywords: FRP, strengthened steel I-beams, flexural, FEM, ANSYS

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540 Erosion Wear of Cast Al-Si Alloys

Authors: Pooja Verma, Rajnesh Tyagi, Sunil Mohan

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Al-Si alloys are widely used in various components such as liner-less engine blocks, piston, compressor bodies and pumps for automobile sector and aerospace industries due to their excellent combination of properties like low thermal expansion coefficient, low density, excellent wear resistance, high corrosion resistance, excellent cast ability, and high hardness. The low density and high hardness of primary Si phase results in significant reduction in density and improvement in wear resistance of hypereutectic Al-Si alloys. Keeping in view of the industrial importance of the alloys, hypereutectic Al-Si alloys containing 14, 16, 18 and 20 wt. % of Si were prepared in a resistance furnace using adequate amount of deoxidizer and degasser and their erosion behavior was evaluated by conducting tests at impingement angles of 30°, 60°, and 90° with an erodent discharge rate of 7.5 Hz, pressure 1 bar using erosion test rig. Microstructures of the cast alloys were examined using Optical microscopy (OM) and scanning electron microscopy (SEM) and the presence of Si particles was confirmed by x-ray diffractometer (XRD). The mechanical properties and hardness were measured using uniaxial tension tests at a strain rate of 10-3/s and Vickers hardness tester. Microstructures of the alloys and X-ray examination revealed the presence of primary and eutectic Si particles in the shape of cuboids or polyhedral and finer needles. Yield strength (YS), ultimate tensile strength (UTS), and uniform elongation of the hypereutectic Al-Si alloys were observed to increase with increasing content of Si. The optimal strength and ductility was observed for Al-20 wt. % Si alloy which is significantly higher than the Al-14 wt. % Si alloy. The increased hardness and the strength of the alloys with increasing amount of Si has been attributed presence of Si in the solid solution which creates strain, and this strain interacts with dislocations resulting in solid-solution strengthening. The interactions between distributed primary Si particles and dislocations also provide Orowan strengthening leading to increased strength. The steady state erosion rate was found to decrease with increasing angle of impact as well as Si content for all the alloys except at 900 where it was observed to increase with the increase in the Si content. The minimum erosion rate is observed in Al-20 wt. % Si alloy at 300 and 600 impingement angles because of its higher hardness in comparison to other alloys. However, at 90° impingement angle the wear rate for Al-20 wt. % Si alloy is found to be the minimum due to deformation, subsequent cracking and chipping off material.

Keywords: Al-Si alloy, erosion wear, cast alloys, dislocation, strengthening

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539 Structural Analysis and Strengthening of the National Youth Foundation Building in Igoumenitsa, Greece

Authors: Chrysanthos Maraveas, Argiris Plesias, Garyfalia G. Triantafyllou, Konstantinos Petronikolos

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The current paper presents a structural assessment and proposals for retrofit of the National Youth Foundation Building, an existing reinforced concrete (RC) building in the city of Igoumenitsa, Greece. The building is scheduled to be renovated in order to create a Municipal Cultural Center. The bearing capacity and structural integrity have been investigated in relation to the provisions and requirements of the Greek Retrofitting Code (KAN.EPE.) and European Standards (Eurocodes). The capacity of the existing concrete structure that makes up the two central buildings in the complex (buildings II and IV) has been evaluated both in its present form and after including several proposed architectural interventions. The structural system consists of spatial frames of columns and beams that have been simulated using beam elements. Some RC elements of the buildings have been strengthened in the past by means of concrete jacketing and have had cracks sealed with epoxy injections. Static-nonlinear analysis (Pushover) has been used to assess the seismic performance of the two structures with regard to performance level B1 from KAN.EPE. Retrofitting scenarios are proposed for the two buildings, including type Λ steel bracings and placement of concrete shear walls in the transverse direction in order to achieve the design-specification deformation in each applicable situation, improve the seismic performance, and reduce the number of interventions required.

Keywords: earthquake resistance, pushover analysis, reinforced concrete, retrofit, strengthening

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538 Societal Acceptability Conditions of Genome Editing for Upland Rice in Madagascar

Authors: Anny Lucrece Nlend Nkott, Ludovic Temple

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The appearance in 2012 of the CRISPR-CaS9 genome editing technique marks a turning point in the field of genetics. This technique would make it possible to create new varieties quickly and cheaply. Although some consider CRISPR-CaS9 to be revolutionary, others consider it a potential societal threat. To document the controversy, we explain the socioeconomic conditions under which this technique could be accepted for the creation of a rainfed rice variety in Madagascar. The methodological framework is based on 38 individual and semistructured interviews, a multistakeholder forum with 27 participants, and a survey of 148 rice producers. Results reveal that the acceptability of genome editing requires (i) strengthening the seed system through the operationalization of regulatory structures and the upgrading of stakeholders' knowledge of genetically modified organisms, (ii) assessing the effects of the edited variety on biodiversity and soil nitrogen dynamics, and (iii) strengthening the technical and human capacities of the biosafety body. Structural mechanisms for regulating the seed system are necessary to ensure safe experimentation of genome editing techniques. Organizational innovation also appears to be necessary. The study documents how collective learning between communities of scientists and nonscientists is a component of systemic processes of varietal innovation. This study was carried out with the financial support of the GENERICE project (Generation and Deployment of Genome-Edited, Nitrogen-use-Efficient Rice Varieties), funded by the Agropolis Foundation.

Keywords: CRISPR-CaS9, varietal innovation, seed system, innovation system

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537 Examining Moderating Mechanisms of Alignment Practice and Community Response through the Self-Construal Perspective

Authors: Chyong-Ru Liu, Wen-Shiung Huang, Wan-Ching Tang, Shan-Pei Chen

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Two of the biggest challenges companies involved in sports and exercise information services face are how to strengthen participation in virtual sports/exercise communities and how to increase the ongoing participatoriness of those communities. In the past, relatively little research has explored mechanisms for strengthening alignment practice and community response from the perspective of self-construal, and as such this study seeks to explore the self-construal of virtual sports/exercise communities, the role it plays in the emotional commitment of forming communities, and the factor that can strengthen alignment practice. Moreover, which factor of the emotional commitment of forming virtual communities have the effect of strengthening interference in the process of transforming customer citizenship behaviors? This study collected 625 responses from the two leading websites in terms of fan numbers in the provision of information on road race and marathon events in Taiwan, with model testing conducted through linear structural equation modelling and the bootstrapping technique to test the proposed hypotheses. The results proved independent construal had a stronger positive direct effect on affective commitment to fellow customers than did interdependent construal, and the influences of affective commitment to fellow customers in enhancing customer citizenship behavior. Public self-consciousness moderates the relationships among independent self-construal and interdependent self-construal on effective commitment to fellow customers. Perceived playfulness moderates the relationships between effective commitment to fellow customers and customer citizenship behavior. The findings of this study provide significant insights for the researchers and related organizations. From the theoretical perspective, this is empirical research that investigated the self-construal theory and responses (i.e., affective commitment to fellow customers, customer citizenship behavior) in virtual sports/exercise communities. We further explore how to govern virtual sports/exercise community participants’ heterogeneity through public self-consciousness mechanism to align participants’ affective commitment. Moreover, perceived playfulness has the effect of strengthening effective commitment to fellow customers with customer citizenship behaviors. The results of this study can provide a foundation for the construction of future theories and can be provided to related organizations for reference in their planning of virtual communities.

Keywords: self-construal theory, public self-consciousness, affective commitment, customer citizenship behavior

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536 Comparative Comparison (Cost-Benefit Analysis) of the Costs Caused by the Earthquake and Costs of Retrofitting Buildings in Iran

Authors: Iman Shabanzadeh

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Earthquake is known as one of the most frequent natural hazards in Iran. Therefore, policy making to improve the strengthening of structures is one of the requirements of the approach to prevent and reduce the risk of the destructive effects of earthquakes. In order to choose the optimal policy in the face of earthquakes, this article tries to examine the cost of financial damages caused by earthquakes in the building sector and compare it with the costs of retrofitting. In this study, the results of adopting the scenario of "action after the earthquake" and the policy scenario of "strengthening structures before the earthquake" have been collected, calculated and finally analyzed by putting them together. Methodologically, data received from governorates and building retrofitting engineering companies have been used. The scope of the study is earthquakes occurred in the geographical area of Iran, and among them, eight earthquakes have been specifically studied: Miane, Ahar and Haris, Qator, Momor, Khorasan, Damghan and Shahroud, Gohran, Hormozgan and Ezgole. The main basis of the calculations is the data obtained from retrofitting companies regarding the cost per square meter of building retrofitting and the data of the governorate regarding the power of earthquake destruction, the realized costs for the reconstruction and construction of residential units. The estimated costs have been converted to the value of 2021 using the time value of money method to enable comparison and aggregation. The cost-benefit comparison of the two policies of action after the earthquake and retrofitting before the earthquake in the eight earthquakes investigated shows that the country has suffered five thousand billion Tomans of losses due to the lack of retrofitting of buildings against earthquakes. Based on the data of the Budget Law's of Iran, this figure was approximately twice the budget of the Ministry of Roads and Urban Development and five times the budget of the Islamic Revolution Housing Foundation in 2021. The results show that the policy of retrofitting structures before an earthquake is significantly more optimal than the competing scenario. The comparison of the two policy scenarios examined in this study shows that the policy of retrofitting buildings before an earthquake, on the one hand, prevents huge losses, and on the other hand, by increasing the number of earthquake-resistant houses, it reduces the amount of earthquake destruction. In addition to other positive effects of retrofitting, such as the reduction of mortality due to earthquake resistance of buildings and the reduction of other economic and social effects caused by earthquakes. These are things that can prove the cost-effectiveness of the policy scenario of "strengthening structures before earthquakes" in Iran.

Keywords: disaster economy, earthquake economy, cost-benefit analysis, resilience

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535 Improving the Safety Performance of Workers by Assessing the Impact of Safety Culture on Workers’ Safety Behaviour in Nigeria Oil and Gas Industry: A Pilot Study in the Niger Delta Region

Authors: Efua Ehiaguina, Haruna Moda

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Interest in the development of appropriate safety culture in the oil and gas industry has taken centre stage among stakeholders in the industry. Human behaviour has been identified as a major contributor to occupational accidents, where abnormal activities associated with safety management are taken as normal behaviour. Poor safety culture is one of the major factors that influence employee’s safety behaviour at work, which may consequently result in injuries and accidents and strengthening such a culture can improve workers safety performance. Nigeria oil and gas industry has contributed to the growth and development of the country in diverse ways. However, in terms of safety and health of workers, this industry is a dangerous place to work as workers are often exposed to occupational safety and health hazard. To ascertain the impact of employees’ safety and how it impacts health and safety compliance within the local industry, online safety culture survey targeting frontline workers within the industry was administered covering major subjects that include; perception of management commitment and style of leadership; safety communication method and its resultant impact on employees’ behaviour; employee safety commitment and training needs. The preliminary result revealed that 54% of the participants feel that there is a lack of motivation from the management to work safely. In addition, 55% of participants revealed that employers place more emphasis on work delivery over employee’s safety on the installation. It is expected that the study outcome will provide measures aimed at strengthening and sustaining safety culture in the Nigerian oil and gas industry.

Keywords: oil and gas safety, safety behaviour, safety culture, safety compliance

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534 Sub-Municipal Government as a Tool for Decentralization

Authors: Mirko Klaric

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In different countries, sub-municipal units have different organizational and political positions. In some countries, the role of sub-municipal units is important; in others, it is marginal. That depends on the organization of the local government system in different countries, and the political role of local self-government units, their size, public authorities, and the possibility for managing various local public tasks. This paper attempts to analyze the sub-municipal government as an organizational form of local governance participation of citizens in the local community with a comparative perspective. Secondly, it presents elements that generally format sub-municipal government as a tool for strengthening of democratization processes in local government units. Those elements are crucial for the understanding of the dynamic in relation to local government vs. sub-municipal government. Special focus is put on the sub-municipal government in South-Eastern European countries, which have a common history and institutional framework, with this main question: how can sub-municipal government contribute to strengthening democratic processes in these countries. In centralized countries, the sub-municipal government usually has a reduced role, which relates to managing public tasks connected with local community needs. The purpose of this comparative research methodology is used for analyzing the present organization and role of sub-municipal government in local government systems in Croatia and other significant countries in Europe, with a special focus on the states in South-Eastern Europe and Croatia. Comparative analyses attempt to show that local government systems with bigger local government units have more significant sub-municipal government. On the other hand, local government systems with small local government units don’t have a strong sub-municipal government. Finally, this paper aims to present ideas on how the sub-municipal government can improve decentralization and contribute to better development of the local community and the whole of society.

Keywords: public administration, local government, sub-municipal government, decentralization

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533 Strengthening Social and Psychological Resources - Project "Herausforderung" as a (Sports-) Pedagogical Concept in Adolescence

Authors: Kristof Grätz

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Background: Coping with crisis situations (e.g., the identity crisis in adolescence) is omnipresent in today's socialization and should be encouraged as a child. For this reason, students should be given the opportunity to create, endure and manage these crisis situations in a sporting context within the project “Herausforderung.” They should prove themselves by working on a self-assigned task, accompanied by ‚coaches’ in a place outside of their hometown. The aim of the project is to observe this process from a resource-oriented perspective. Health promotion, as called for by the WHO in the Ottawa Charter since 1986, includes strengthening psychosocial resources. These include cognitive, emotional, and social potentials that contribute to improving the quality of life, provide favourable conditions for coping with health burdens and enable people to influence their physical performance and well-being self-confidently and actively. A systematic strengthening of psychosocial resources leads to an improvement in mental health and contributes decisively to the regular implementation and long-term maintenance of this health behavior. Previous studies have already shown significant increases in self-concept following experiential educational measures [Fengler, 2007; Eberle & Fengler, 2018] and positive effects of experience-based school trips on the social competence of students [Reuker, 2009]. Method: The research project examines the influence of the project “Herausforderung” on psychosocial resources such as self-efficacy, self-concept, social support, and group cohesion. The students participating in the project will be tested in a pre-post design in the context of the challenge. This test includes specific questions to capture the different psychosocial resources. For the measurement, modifications of existing scales with good item selectivity and reliability are used to a large extent, so that acceptable item and scale values can be expected. If necessary, the scales were adapted or shortened to the specific context in order to ensure a balanced relationship between reliability and test economy. Specifically, these are already tested scales such as FRKJ 8-16, FSKN, GEQ, and F-SozU. The aim is to achieve a sample size of n ≥ 100. Conclusion: The project will be reviewed with regard to its effectiveness, and implications for a resource-enhancing application in sports settings will be given. Conclusions are drawn as to which extent to specific experiential educational content in physical education can have a health-promoting effect on the participants.

Keywords: children, education, health promotion, psychosocial resources

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532 The Outcome of Early Balance Exercises and Agility Training in Sports Rehabilitation for Patients Post Anterior Cruciate Ligament (ACL) Reconstruction

Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

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531 Federalism and Good Governance in Nigeria: A Study of the Federal Capital Territory, Abuja, Nigeria

Authors: David C. Nwogbo

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Examining the impact of federalism on good governance is crucial for enhancing governance in Nigeria. This study focuses on the Federal Capital Territory (FCT), Abuja, as a case study. Employing a descriptive survey design, data was collected to explore the relationship between federalism and good governance in Abuja, Nigeria. A stratified random sampling method was used to select 289 respondents from the population of Abuja. The sample size was determined using a formula based on precision and population size. A survey questionnaire was employed to gather information on respondents' demographics, perceptions, and experiences concerning federalism and good governance in the FCT. Descriptive statistics, such as percentages and means, were utilized to analyze the study's findings. The findings provided insights into the perceptions and experiences of residents of the FCT with regard to the relationship between federalism and good governance. The results of this study will be useful for policy and decision-making related to the implementation of these concepts in Nigeria and, more specifically, in the FCT, Abuja. The study found that the majority of respondents believe that the federal system of government has not been effective in promoting accountability, transparency, and reducing corruption in Nigeria. There is a need for reforms to improve the effectiveness of the federal system in promoting good governance. These reforms include strengthening institutions, reallocation of resources, reform of the electoral system, decentralization of power, strengthening the role of the judiciary, capacity building, promoting transparency, and engagement of civil society. The findings also highlight the need for significant reforms to address these challenges and promote good governance in the country. The results of this study can be used to inform policy decisions and guide future research on the subject.

Keywords: accountability, federalism, good, governance

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530 Elevated Temperature Shot Peening for M50 Steel

Authors: Xinxin Ma, Guangze Tang, Shuxin Yang, Jinguang He, Fan Zhang, Peiling Sun, Ming Liu, Minyu Sun, Liqin Wang

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As a traditional surface hardening technique, shot peening is widely used in industry. By using shot peening, a residual compressive stress is formed in the surface which is beneficial for improving the fatigue life of metal materials. At the same time, very fine grains and high density defects are generated in the surface layer which enhances the surface hardness, either. However, most of the processes are carried out at room temperature. For high strength steel, such as M50, the thickness of the strengthen layer is limited. In order to obtain a thick strengthen surface layer, elevated temperature shot peening was carried out in this work by using Φ1mm cast ion balls with a speed of 80m/s. Considering the tempering temperature of M50 steel is about 550 oC, the processing temperature was in the range from 300 to 500 oC. The effect of processing temperature and processing time of shot peening on distribution of residual stress and surface hardness was investigated. As we known, the working temperature of M50 steel can be as high as 315 oC. Because the defects formed by shot peening are unstable when the working temperature goes higher, it is worthy to understand what happens during the shot peening process, and what happens when the strengthen samples were kept at a certain temperature. In our work, the shot peening time was selected from 2 to 10 min. And after the strengthening process, the samples were annealed at various temperatures from 200 to 500 oC up to 60 h. The results show that the maximum residual compressive stress is near 900 MPa. Compared with room temperature shot peening, the strengthening depth of 500 oC shot peening sample is about 2 times deep. The surface hardness increased with the processing temperature, and the saturation peening time decreases. After annealing, the residual compressive stress decreases, however, for 500 oC peening sample, even annealing at 500 oC for 20 h, the residual compressive stress is still over 600 MPa. However, it is clean to see from SEM that the grain size of surface layers is still very small.

Keywords: shot peening, M50 steel, residual compressive stress, elevated temperature

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529 Isolated Contraction of Deep Lumbar Paraspinal Muscle with Magnetic Nerve Root Stimulation: A Pilot Study

Authors: Shi-Uk Lee, Chae Young Lim

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Objective: The aim of this study was to evaluate the changes of lumbar deep muscle thickness and cross-sectional area using ultrasonography with magnetic stimulation. Methods: To evaluate the changes of lumbar deep muscle by using magnetic stimulation, 12 healthy volunteers (39.6±10.0 yrs) without low back pain during 3 months participated in this study. All the participants were checked with X-ray and electrophysiologic study to confirm that they had no problems with their back. Magnetic stimulation was done on the L5 and S1 root with figure-eight coil as previous study. To confirm the proper motor root stimulation, the surface electrode was put on the tibialis anterior (L5) and abductor hallucis muscles (S1) and the hot spots of magnetic stimulation were found with 50% of maximal magnetic stimulation and determined the stimulation threshold lowering the magnetic intensity by 5%. Ultrasonography was used to assess the changes of L5 and S1 lumbar multifidus (superficial and deep) cross-sectional area and thickness with maximal magnetic stimulation. Cross-sectional area (CSA) and thickness was evaluated with image acquisition program, ImageJ software (National Institute of Healthy, USA). Wilcoxon signed-rank was used to compare outcomes between before and after stimulations. Results: The mean minimal threshold was 29.6±3.8% of maximal stimulation intensity. With minimal magnetic stimulation, thickness of L5 and S1 deep multifidus (DM) were increased from 1.25±0.20, 1.42±0.23 cm to 1.40±0.27, 1.56±0.34 cm, respectively (P=0.005, P=0.003). CSA of L5 and S1 DM were also increased from 2.26±0.18, 1.40±0.26 cm2 to 2.37±0.18, 1.56±0.34 cm2, respectively (P=0.002, P=0.002). However, thickness of L5 and S1 superficial multifidus (SM) were not changed from 1.92±0.21, 2.04±0.20 cm to 1.91±0.33, 1.96±0.33 cm (P=0.211, P=0.199) and CSA of L5 and S1 were also not changed from 4.29±0.53, 5.48±0.32 cm2 to 4.42±0.42, 5.64±0.38 cm2. With maximal magnetic stimulation, thickness of L5, S1 of DM and SM were increased (L5 DM, 1.29±0.26, 1.46±0.27 cm, P=0.028; L5 SM, 2.01±0.42, 2.24±0.39 cm, P=0.005; S1 DM, 1.29±0.19, 1.67±0.29 P=0.002; S1 SM, 1.90±0.36, 2.30±0.36, P=0.002). CSA of L5, S1 of DM and SM were also increased (all P values were 0.002). Conclusions: Deep lumbar muscles could be stimulated with lumbar motor root magnetic stimulation. With minimal stimulation, thickness and CSA of lumbosacral deep multifidus were increased in this study. Further studies are needed to confirm whether the similar results in chronic low back pain patients are represented. Lumbar magnetic stimulation might have strengthening effect of deep lumbar muscles with no discomfort.

Keywords: magnetic stimulation, lumbar multifidus, strengthening, ultrasonography

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528 Cyclic Response of Reinforced Concrete Beam-Column Joint Strengthening by FRP

Authors: N. Attari, S. Amziane, M. Chemrouk

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A large number of old buildings have been identified as having potentially critical detailing to resist earthquakes. The main reinforcement of lap-spliced columns just above the joint region, discontinuous bottom beam reinforcement, and little or no joint transverse reinforcement are the most critical details of interior beam column joints in such buildings. This structural type constitutes a large share of the building stock, both in developed and developing countries, and hence it represents a substantial exposure. Direct observation of damaged structures, following the Algiers 2003 earthquake, has shown that damage occurs usually at the beam-column joints, with failure in bending or shear, depending on geometry and reinforcement distribution and type. While substantial literature exists for the design of concrete frame joints to withstand this type of failure, after the earthquake many structures were classified as slightly damaged and, being uneconomic to replace them, at least in the short term, suitable means of repairs of the beam column joint area are being studied. Furthermore; there exists a large number of buildings that need retrofitting of the joints before the next earthquake. The paper reports the results of the experimental programme, constituted of three beam-column reinforced concrete joints at a scale of one to three (1/3) tested under the effect of a pre-stressing axial load acting over the column. The beams were subjected at their ends to an alternate cyclic loading under displacement control to simulate a seismic action. Strain and cracking fields were monitored with the help a digital recording camera. Following the analysis of the results, a comparison can be made between the performances in terms of ductility, strength and mode of failure of the different strengthening solution considered.

Keywords: fibre reinforced polymers, joints, reinforced concrete, beam columns

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527 Seismic Reinforcement of Existing Japanese Wooden Houses Using Folded Exterior Thin Steel Plates

Authors: Jiro Takagi

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Approximately 90 percent of the casualties in the near-fault-type Kobe earthquake in 1995 resulted from the collapse of wooden houses, although a limited number of collapses of this type of building were reported in the more recent off-shore-type Tohoku Earthquake in 2011 (excluding direct damage by the Tsunami). Kumamoto earthquake in 2016 also revealed the vulnerability of old wooden houses in Japan. There are approximately 24.5 million wooden houses in Japan and roughly 40 percent of them are considered to have the inadequate seismic-resisting capacity. Therefore, seismic strengthening of these wooden houses is an urgent task. However, it has not been quickly done for various reasons, including cost and inconvenience during the reinforcing work. Residents typically spend their money on improvements that more directly affect their daily housing environment (such as interior renovation, equipment renewal, and placement of thermal insulation) rather than on strengthening against extremely rare events such as large earthquakes. Considering this tendency of residents, a new approach to developing a seismic strengthening method for wooden houses is needed. The seismic reinforcement method developed in this research uses folded galvanized thin steel plates as both shear walls and the new exterior architectural finish. The existing finish is not removed. Because galvanized steel plates are aesthetic and durable, they are commonly used in modern Japanese buildings on roofs and walls. Residents could feel a physical change through the reinforcement, covering existing exterior walls with steel plates. Also, this exterior reinforcement can be installed with only outdoor work, thereby reducing inconvenience for residents since they would not be required to move out temporarily during construction. The Durability of the exterior is enhanced, and the reinforcing work can be done efficiently since perfect water protection is not required for the new finish. In this method, the entire exterior surface would function as shear walls and thus the pull-out force induced by seismic lateral load would be significantly reduced as compared with a typical reinforcement scheme of adding braces in selected frames. Consequently, reinforcing details of anchors to the foundations would be less difficult. In order to attach the exterior galvanized thin steel plates to the houses, new wooden beams are placed next to the existing beams. In this research, steel connections between the existing and new beams are developed, which contain a gap for the existing finish between the two beams. The thin steel plates are screwed to the new beams and the connecting vertical members. The seismic-resisting performance of the shear walls with thin steel plates is experimentally verified both for the frames and connections. It is confirmed that the performance is high enough for bracing general wooden houses.

Keywords: experiment, seismic reinforcement, thin steel plates, wooden houses

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526 Teaching Critical Thinking in Post-Conflict Countries: The University of Liberia

Authors: Kamille Beye

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Critical thinking is a topic that has been disputed in the field of education for decades, but many resulting debates have centered around strengthening critical thinking capabilities in the societies, workforces, and educational centers of the global north. In contrast, this paper provides an analysis of the teaching of critical thinking in Liberia, which has been ravaged by years of war and a recent Ebola outbreak. These crises have decimated the Liberian education sector, leading to a loss of teaching capacities that are essential to providing critical thinking education. Until recently, critical thinking had no seat at the table when the future needs of the country were discussed by the government and non-governmental agencies. Now, the University of Liberia has a bold goal to become one of the top twenty universities in West Africa in the next seven years, which has led to a focus on teaching critical thinking skills to improve learning. This paper argues that critical thinking is essential to strengthening not only the Liberian education system, but for promoting peace amongst community members, and yet it suggests that commitments to the teaching of critical thinking in Liberia have hitherto been overly superficial. Based on an initial scoping study, this paper will examine the potential impacts of teaching critical thinking skills to undergraduate students in the William V. S. Tubman School of Education at the University of Liberia on continued peacebuilding and reconstruction efforts of the country. The research contends that if critical thinking skills are taught, practiced and continually utilized, teachers and students will have the ability to engage with information and negotiate challenges to solutions in ways that are beneficial to the communities in which they live. The research will use a variety of methods, that include the California Critical Thinking Disposition Inventory. This research will demonstrate that critical thinking skills are not only needed for entering the workforce, but necessary for negotiating and expressing the needs and desires of local communities in a peaceful way.

Keywords: critical thinking, higher education, Liberia, peacebuilding, post-conflict

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525 The Phenomenon of Rockfall in the Traceca Corridor and the Choice of Engineering Measures to Combat It

Authors: I. Iremashvili, I. Pirtskhalaishvili, K. Kiknadze, F. Lortkipanidze

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The paper deals with the causes of rockfall and its possible consequences on slopes adjacent to motorways and railways. A list of measures is given that hinder rockfall; these measures are directed at protecting roads from rockfalls, and not preventing them. From the standpoint of local stability of slopes the main effective measure is perhaps strengthening their surface by the method of filling, which will check or end (or both) the process of deformation, local slipping off, sliding off and development of erosion.

Keywords: rockfall, concrete spraying, heliodevices, railways

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524 Clinical Prediction Rules for Using Open Kinetic Chain Exercise in Treatment of Knee Osteoarthritis

Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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523 Finite Element Modeling and Analysis of Reinforced Concrete Coupled Shear Walls Strengthened with Externally Bonded Carbon Fiber Reinforced Polymer Composites

Authors: Sara Honarparast, Omar Chaallal

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Reinforced concrete (RC) coupled shear walls (CSWs) are very effective structural systems in resisting lateral loads due to winds and earthquakes and are particularly used in medium- to high-rise RC buildings. However, most of existing old RC structures were designed for gravity loads or lateral loads well below the loads specified in the current modern seismic international codes. These structures may behave in non-ductile manner due to poorly designed joints, insufficient shear reinforcement and inadequate anchorage length of the reinforcing bars. This has been the main impetus to investigate an appropriate strengthening method to address or attenuate the deficiencies of these structures. The objective of this paper is to twofold: (i) evaluate the seismic performance of existing reinforced concrete coupled shear walls under reversed cyclic loading; and (ii) investigate the seismic performance of RC CSWs strengthened with externally bonded (EB) carbon fiber reinforced polymer (CFRP) sheets. To this end, two CSWs were considered as follows: (a) the first one is representative of old CSWs and therefore was designed according to the 1941 National Building Code of Canada (NBCC, 1941) with conventionally reinforced coupling beams; and (b) the second one, representative of new CSWs, was designed according to modern NBCC 2015 and CSA/A23.3 2014 requirements with diagonally reinforced coupling beam. Both CSWs were simulated using ANSYS software. Nonlinear behavior of concrete is modeled using multilinear isotropic hardening through a multilinear stress strain curve. The elastic-perfectly plastic stress-strain curve is used to simulate the steel material. Bond stress–slip is modeled between concrete and steel reinforcement in conventional coupling beam rather than considering perfect bond to better represent the slip of the steel bars observed in the coupling beams of these CSWs. The old-designed CSW was strengthened using CFRP sheets bonded to the concrete substrate and the interface was modeled using an adhesive layer. The behavior of CFRP material is considered linear elastic up to failure. After simulating the loading and boundary conditions, the specimens are analyzed under reversed cyclic loading. The comparison of results obtained for the two unstrengthened CSWs and the one retrofitted with EB CFRP sheets reveals that the strengthening method improves the seismic performance in terms of strength, ductility, and energy dissipation capacity.

Keywords: carbon fiber reinforced polymer, coupled shear wall, coupling beam, finite element analysis, modern code, old code, strengthening

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522 The Flexural Behavior of Reinforced Concrete Beams Externally Strengthened with CFRP Composites Exposed for Different Environment Conditions

Authors: Rajai Al-Rousan

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The repair and strengthening of concrete structures is a big challenge for the concrete industry for both engineers and contractors. Due to increasing economical constraints, the current trend is to repair/upgrade deteriorated and functionally obsolete structures rather than replacing them with new structures. CFRP has been used previously by air space industries regardless of the high costs. The decrease in the costs of the composite materials, as results of the technology improvement, has made CFRP an alternative to conventional materials for many applications. The primary objective of this research is to investigate the flexural behavior of reinforced concrete (RC) beams externally strengthened with CFRP composites exposed for three years for the following conditions: (a) room temperature, (b) cyclic ponding in 15% salt-water solution, (c) hot-water of 65oC, and (d) rapid freeze/thaw cycles. Results indicated that the after three years of various environmental conditions, the bond strength between the concrete beams and CFRP sheets was not affected. No signs of separation or debonding of CFRP sheets were observed before testing. Also, externally strengthening RC beams with CFRP sheets leads to a substantial increase in the ductility of concrete structures. This is a result of forcing the concrete to undergo inelastic deformation, resulting in compression failure of the structure after yielding of steel reinforcement. In addition, exposure to heat water tank for three years reduces the ultimate load by about 11%. This 11% reduction in the ultimate load equates to about 53%, 46% and 68% loss of the gain of the strength attributed to the CFRP of 2/3 Layer, 1 Layers and 2 Layers CFRP Sheets respectively. This mean that with decreasing of number of layers the environmental exposure had an efficient effect on concrete by protection concrete from environmental effect and adverse effect on the bond performance.

Keywords: flexural, behavior, CFRP, composites, environment, conditions

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521 Role of Obama's Administration Counter-Terrorism Strategies towards Pakistan

Authors: Ahmed Bux Jamali

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The purpose of this study is to examine and evaluate the overall counterterrorism cooperation during Obama Administration towards Pakistan. It aims and focuses on the performances and measures taken by United States of America during President Obama in office in order to eradicate terrorism from Pakistan. Being a grave national security threat, terrorism played a disastrous role in the domestic peace and stability of both countries. For the sake of curbing this menace in South Asia in general and Pakistan in particular, the role of Obama Administration is viable and results-oriented despite major ups and downs in Pakistan U.S Relations during that period of time. Obama administration formulated policies when he comes to office in 2009 by looking at the already efforts done by Bush Administration to counterterrorism from Pakistan. Obama’s foreign policy was revolving around defense and diplomacy when it comes to dealing with Pakistan. The concept of smart power was indeed a core principle of Obama’s administration to gain the strategic objectives in Pakistan. Obama’s strategies in terms of providing military aid packages and various assistance programs, working on institutional building and strengthening the economy helped Pakistan in strengthening the military capabilities to go for militant operation in the safe havens area in the tribal areas of Pakistan. It further helped building institutional mechanism in the governmental policies to counter terrorism and militancy. The training of combat forces, artillery, and equipment provided by US proved fatal for the militant terrorist organizations seeking hideouts in the tribal areas of Pakistan. Resultantly, many top leaders of al Qaeda and many affiliated militant groups were captured and given to US as well. Despite many ups and downs in the bilateral relations on various domestic and international issues, both countries didn’t compromise the elimination of terrorist phenomena from Pakistan which was indeed a great success of the Obama administration’s counterterrorism and counterinsurgency strategies in the long run.

Keywords: counterterrorism cooperation, national security strategy, Obama administration, Pakistan-US relations

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520 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana

Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

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Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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519 Reducing Stunting, Low Birth Weight and Underweight in Anuradhapura District in Sri Lanka, by Identifying and Addressing the Underlying Determinants of Under-Nutrition and Strengthening Families and Communities to Address Them

Authors: Saman Kumara, Duminda Guruge, Krishani Jayasinghe

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Introduction: Nutrition strongly influences good health and development in early life. This study, based on a health promotion approach, used a community-based intervention to improve child nutrition. The approach provides the community with control of interventions, thereby building its capacity and empowering individuals and communities. The aim of this research was to reduce stunting, low birth weight and underweight in communities from Anuradhapura District in Sri Lanka, by identifying and addressing the underlying determinants of under-nutrition and strengthening families and communities to address them. Methods: A health promotion intervention was designed and implemented-based on a logical framework developed in collaboration with members of targeted community. Community members’ implements action, so they fully own the process. Members of the community identify and address the most crucial determinants of health including child health and development and monitor the initial results of their action and modify action to optimize outcomes as well as future goals. Group Discussion, group activities, awareness programs, cluster meetings, community tools and sharing success stories were major activities to address determinants. Continuous data collection was planned at different levels. Priority was given to strengthening the ability of families and groups or communities to collect meaningful data and analyze these themselves. Results: Enthusiasm and interest of the mother, happiness of the child/ family, dietary habits, money management, tobacco and alcohol use of fathers, media influences, illnesses in the child or others, hygiene and sanitary practices, community sensitiveness and domestic violence were the major perceived determinants elicited from the study. There were around 1000 well-functioning mothers groups in this district. ‘Happiness calendar’, ‘brain calendar’, ‘money tool’ and ‘stimulation books’ were created by the community members, to address determinants and measure the process. Evaluation of the process has shown positive early results, such as improvement of feeding habits among mothers, innovative ways of providing early stimulation and responsive care, greater involvement of fathers in childcare and responsive feeding. There is a positive movement of communities around child well-being through interactive play areas. Family functioning and community functioning improved. Use of alcohol and tobacco declined. Community money management improved. Underweight was reduced by 40%. Stunting and low birth weight among under-fives also declined within one year. Conclusion: The health promotion intervention was effective in changing the determinants of under-nutrition in early childhood. Addressing the underlying determinants of under-nutrition in early childhood can be recommended for similar contexts.

Keywords: birth-weight, community, determinants, stunting, underweight

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518 Strengthening Islamic Banking Customer Behavioral Intention through Value and Commitment

Authors: Mornay Roberts-Lombard

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Consumers’ perceptions of value are crucial to ensuring their future commitment and behavioral intentions. As a result, service providers, such as Islamic banks, must provide their customers with products and services that are regarded as valuable, stimulating, collaborative, and competent. Therefore, the value provided to customers must meet or surpass their expectations, which can drive customers’ commitment (affective and calculative) and eventually favorably impact their future behavioral intentions. Consequently, Islamic banks in South Africa, as a growing African market, need to obtain a better understanding of the variables that impact Islamic banking customers’ value perceptions and how these impact their future behavioral intentions. Furthermore, it is necessary to investigate how customers’ perceived value perceptions impact their affective and calculative commitment and how the latter impact their future behavioral intentions. The purpose of this study is to bridge these gaps in knowledge, as the competitiveness of the Islamic banking industry in South Africa requires a deeper understanding of the aforementioned relationships. The study was exploratory and quantitative in nature, and data was collected from 250 Islamic banking customers using self-administered questionnaires. These banking customers resided in the Gauteng province of South Africa. Exploratory factor analysis, Pearson’s coefficient analysis, and multiple regression analysis were applied to measure the proposed hypotheses developed for the study. This research will aid Islamic banks in the country in potentially strengthening customers’ future commitment (affective and calculative) and positively impact their future behavioral intentions. The findings of the study established that service quality has a significant and positive impact on perceived value. Moreover, it was determined that perceived value has a favorable and considerable impact on affective and calculative commitment, while calculative commitment has a beneficial impact on behavioral intention. The research informs Islamic banks of the importance of service engagement in driving customer perceived value, which stimulates the future affective and calculative commitment of Islamic bank customers in an emerging market context. Finally, the study proposes guidelines for Islamic banks to develop an enhanced understanding of the factors that impact the perceived value-commitment-behavioral intention link in a competitive Islamic banking market in South Africa.

Keywords: perceived value, affective commitment, calculative commitment, behavioural intention

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