Strengthening Interventions Research Articles

Exploring pathways to adherence and retention for HIV-positive savings group members in Ethiopia

ABSTRACT Savings groups are an economic strengthening intervention used to enhance the well-being of vulnerable groups. However, it is unclear how savings groups influence treatment outcomes for people living with HIV. This article reports on a study that conducted 48 in-depth interviews with HIV-positive savings group members in Ethiopia and used their narratives to qualitatively assess pathways linking savings group participation to adherence, retention, and general well-being. No single pathway was described, but almost the entire sample described improved adherence or retention through a combination of increased food security, economic and social well-being. The complexity of pathways supports the necessity for multisectoral approaches that address structural barriers to care.

The condition of the contralateral knee may induce different degrees of knee extensor strength asymmetry and affect functionality in individuals with unilateral or bilateral osteoarthritis

BackgroundLoss of knee extensor strength in individuals with knee osteoarthritis (KOA) may induce inter-limb strength asymmetries and alter functionality. The aims were to analyse whether the condition of the uninvolved knee (advanced to severe KOA or no affection) may induce different degrees of knee extensor strength asymmetry in individuals with KOA and to study whether functionality may differ in cases of unilateral or bilateral KOA. MethodsSixty-eight subjects with advance-to-severe KOA were categorized into two groups (unilateral or bilateral KOA). The knee extensor strength ratio (KESR), and self-reported and performance-based functionality were analysed and compared. Sex and age were independent factors. One- and two-way analysis of variance assessed for significant between-group differences (95% confidence interval (CI)). ResultsParticipants with unilateral KOA presented with 20% knee extensor strength asymmetry. The mean difference with the bilateral KOA group in terms of Knee Extensors Strength Ratio was 0.2 (95% CI 0–0.3; P = 0.021), of the Oxford Knee Scale score was 4.2 (95% CI 3.4–5.1; P = 0.037), and of the Timed Up and Go was 1.3 s (95% CI 0.5–2.2; P > 0.05). There were significant sex and age interactions (P < 0.05). ConclusionsIndividuals with unilateral or bilateral KOA present with different degrees of knee extensor strength asymmetry. The non-affected knee seems to help to better develop functional tasks in cases of unilateral condition. The findings may help the design of tailored strengthening interventions in which each knee condition in individuals with KOA should be considered.

Connecting Cash Transfers with Care for Better Child and Family Well-Being: Evidence from a Qualitative Evaluation in South Africa

Limited evidence exists of the effectiveness of combining cash transfers and family strengthening interventions in developing country contexts. This study provides evidence from an evaluation of a bespoke family strengthening intervention for Child Support Grant beneficiaries in 10 urban communities in Johannesburg, South Africa. A qualitative pre-post design was used to assess the effectiveness of this combination intervention including a nine-month follow-up study. Participants were randomly assigned to intervention and non-intervention groups allowing for comparison between the groups over time. The intervention improved child-caregiver and family relations; strengthened networks of social support and caregiver engagement in schooling and enhanced parenting and financial capabilities. Findings were inconclusive in improving symptoms of depression and in nutritional knowledge and skills. Combination interventions of this kind have the potential to improve child and family well-being in certain domains.

Seismic retrofit solutions using base isolation for existing RC buildings: economic feasibilty and pay-back time

The existing reinforced concrete buildings typical of the Mediterranean area commonly have poor seismic performance and high vulnerability to the seismic events. As demonstrated by recent post-earthquake reconstruction processes, they commonly exhibited significant damage to structural components and to infills and partitions resulting in very high repair costs. This suggests that effective seismic strengthening interventions should aim at both improving the safety and reducing the expected annual losses. Nowadays, the seismic retrofitting of existing RC buildings by using base isolation is becoming popular because of the high effectiveness as seismic protection strategy. However, the high costs of installation are limiting the widespread in the common design practice. In this context, a unique design parameter capable of combining the increasing seismic safety, the cost of installation and the reduction of the expected losses can be useful to draw simple cost-benefits considerations. This research work proposes a PBEE-based methodology to quantify the Pay-Back Time (PBT) of seismic retrofit solutions for existing RC buildings. The non-linear response of base isolated building is assessed and a comparison with different strengthening solutions is proposed to show the applicability of the PBT as a unique design parameter to select the most effective retrofit solution. A database of 59 RC buildings retrofitted by using base isolation during the L’Aquila reconstruction process, where actual retrofit costs are available, is used for the validation. Finally, these data are used to calibrate a simple formulation of the PBT to be used in the design practice.

Simple method to evaluate FRCM strengthening effects on in-plane shear capacity of masonry walls

Fabric Reinforced Cementitious Mortar (FRCM) strengthening demonstrated to be an efficient way to improve the in-plane shear capacity of masonry walls, in particular for its high compatibility with masonry substrate. Recently, Italian CNR guidelines provided two approaches to design in-plane shear strengthening interventions for masonry with FRCM system, one is very simple and practitioner oriented, but it has clear limitations in its applicability, while the second has a more complex formulation, but it is valid for a wider range of applications. The main aim of this work is to reconciliate the two approaches and to clarify the potential of FRCM systems in masonry strengthening with design charts and manipulations of the more refined available formulations, with the goal to provide a simple method to account for the refined version in a practitioner oriented approach. The focus is on the impact of material properties on the capability of strengthening. A final worked example provides a comprehensive overview of the potential of the proposed method.

Interventions for reducing violence against children in low- and middle-income countries: An evidence and gap map.

More than half of the children in the world experience some form of interpersonal violence every year. As compared with high-income countries, policy responses in low- and middle-income countries (LMICs) are limited due to resource constraints and paucity of evidence for effective interventions to reduce violence against children in their own contexts, amongst other factors. The aim of this evidence and gap map (EGM) is to provide an overview of the existing evidence available and to identify gaps in the evidence base on the effectiveness of interventions to reduce violence against children in LMICs. This report covers evidence published in English; a follow-up study is under preparation focusing on evidence in five additional languages-Arabic, Chinese, French, Portuguese and Spanish. The intervention-outcome framework for this EGM is based on INSPIRE-Seven Strategies for Ending Violence against Children, published by WHO and other partners in 2016. The seven strategies includeimplementation and enforcement of laws; norms and values, safe environment; parent-child and caregiver support; income and economic strengthening; response and support services; education and life skills. The search included both academic and grey literature available online. We included impact evaluations and systematic reviews that assessed the effectiveness of interventions to reduce interpersonal violence against children (0-18 years) in LMICs (World Bank, 2018b). Interventions targeting subpopulation of parents, teachers and caregivers of 0-18 years' age group were also included. A critical appraisal of all included studies was carried out using standardised tools. The map includes 152 studies published in English of which 55 are systematic reviews and 97 are impact evaluations. Most studies in the map are from Sub-Saharan Africa. Education and life skills are the most widely populated intervention area of the map followed by income and economic strengthening interventions. Very few studies measure impact on economic and social outcomes, and few conduct cost-analysis. More studies focusing on low-income and fragile and conflict-affected settings (FCS) and studying and reporting on cost-analysis are required to address gaps in the evidence. Most interventions covered in the literature focused on addressing a wide range of forms of violence and harm, which limited understanding of how and for whom the interventions work in a given context, for specific forms of violence. More impact evaluation studies are required that assess specific forms of violence, gendered effects of interventions and on diverse social groups in a given context, utilising mixed methods.

IMPACT OF ADDUCTOR STRENGTHENING ON SPRINT TIME AND AGILITY IN FOOTBALL PLAYERS

Background: The ability to tackle and dribble the ball swiftly past the rival player forms an important ball based football skill. Agility plays a crucial role for the players to gain good control over the ball. A combination of good agility with good sprint time is undoubtedly a distinguishing characteristic of elite level players. Football as a sport requires a rapid change of directions and speed several times during a match. This particular action requires the player to apply force rapidly into the ground, thereby putting a lot of stress on the adductor muscles. This research paper focuses on the impact of hip adductor exercises and their influence on agility and sprint time in football players.Methods: This interventional study was carried out on 131 male elite level football players playing from clubs and football academies in and around Mumbai city. All the players were assessed for 30 M sprint test, T-Test, and Dribble time test to assess sprint and agility pre and post-intervention. An adductor strengthening intervention consisting of 8exercises were performed for over four weeks.Results: Paired T-test was used to analyze the data, which showed statically significant improvement with p-value 0.000 (&lt;0.05) in the 30M sprint test, T-Test, and Dribble time post four weeks of intervention.Conclusion: We concluded that the adductor training intervention helped improve the sprint time and agility in football players. As the intervention helped improving performance in football players, it should be introduced in the routine conditioning program of the players.

More assets, more decision-making power? Mediation model in a cluster-randomized controlled trial evaluating the effect of the graduation program on women's empowerment in Burkina Faso

Abstract To promote women’s empowerment, numerous programs provide economic services meant to increase women’s access to economic resources in the household. However, women’s access to economic resources does not always translate into improved bargaining power, and effects of economic strengthening interventions may vary across different decision-making domains. There is little robust evidence, particularly in sub-Saharan Africa, showing the effect of improved access to economic resources on specific domains of decision-making within a family and very little is known about variation in this effect between monogamous and polygynous families. Furthermore, very few assessments explicitly examine specific pathways from participation in economic strengthening interventions to improved decision-making power in the household for women. Our study aims to address these gaps by examining—in the context of a randomized controlled trial administered in rural Burkina Faso—the effect of an economic strengthening intervention on specific domains of women’s decision-making power and how it relates to monogamous/polygynous family structures and challenges to intra-household gender roles and responsibilities. Furthermore, we examine a specific pathway to better understand whether increased access to economic resources from this intervention translates into improved decision-making power for women. We use repeated-measures data collected from 360 adult female caregivers in the 3-arm cluster-randomized controlled trial conducted among households living in abject poverty in Burkina Faso. We ran multilevel mixed-effects logistic regression models to examine the effect of the intervention on different domains of women’s involvement into household-level decision-making and variation of this effect by family structure (i.e. polygamous vs. monogamous families). We fit a structural equation model to examine whether access to assets mediates the effect of the intervention on different domains of women’s involvement into household-level decision-making. We found that economic empowerment intervention increased women’s involvement in making decisions about their children’s well-being, but had no effect on women’s say in making decisions about general household economy. We found most effects to be stronger in the treatment arm that received economic strengthening combined with family coaching offered to the whole household and directly targeting normative beliefs related to child wellbeing and gender norms. We also found no evidence that increased access to assets mediates the effect of intervention on improving women’s decision-making power in different domains. Our findings suggest that to improve decision-making power for women in their household it is important to address structural gender inequalities and gender norms rooted in patriarchy, alongside the efforts to economically empower women.

Muscle strengthening intervention for boys with haemophilia: Developing and evaluating a best-practice exercise programme with boys, families and health-care professionals.

BackgroundMuscle strengthening exercises have the potential to improve outcomes for boys with haemophilia, but it is unclear what types of exercise might be of benefit. We elicited the views of health‐care professionals, boys and their families to create and assess a home‐based muscle strengthening programme.ObjectiveTo design and develop a muscle strengthening programme with health‐care professionals aimed at improving musculoskeletal health, and refine the intervention by engaging boys with haemophilia and their families (Study 1). Following delivery, qualitatively evaluate the feasibility and acceptability of the exercise programme with the boys and the study's physiotherapists (Study 2).DesignA person‐based approach was used for planning and designing the exercise programme, and evaluating it post‐delivery. The following methods were utilized: modified nominal group technique (NGT) with health‐care professionals; focus group with families; exit interviews with boys; and interviews with the study's physiotherapists.ResultsThemes identified to design and develop the intervention included exercises to lower limb and foot, dosage, age accommodating, location, supervision and monitoring and incentivization. Programme refinements were carried out following engagement with the boys and families who commented on: dosage, location, supervision and incentivization. Following delivery, the boys and physiotherapists commented on progression and adaptation, physiotherapist contact, goal‐setting, creating routines and identifying suitable timeframes, and a repeated theme of incentivization.ConclusionsAn exercise intervention was designed and refined through engagement with boys and their families. Boys and physiotherapists involved in the intervention's delivery were consulted who found the exercises to be generally acceptable with some minor refinements necessary.

Effect of muscle strengthening on peripheral facial palsy: A randomized controlled trial.

To evaluate the effect of muscle strengthening intervention in peripheral facial palsy (PFP). A randomized controlled trial was conducted at five hospitals. Fifty-one subjects with PFP who showed a response of less than 20% on electroneurography (ENoG) were enrolled. Subjects in a muscle-strengthening-intervention group (MS Group) underwent a selective muscle contraction intervention (SMCI). Subjects in another group not receiving muscle strengthening intervention (Non-MS Group). Both groups underwent three interventions: Prohibition of maximum effort movements, Stretching of the affected facial muscles, and Mirror biofeedback therapy. The outcomes were measured by the Sunnybrook Facial Grading System (FGS) at 6 months after onset (primary endpoint) and at 12 months after onset (secondary endpoint). The subjects in the MS Group and Non-MS Group were further divided into subgroups showing ENoG responses of 10% or less and ENoG responses of over 10%, as a sub-analysis. No significant differences between the MS Group and Non-MS Group at either the primary endpoint or secondary endpoint. Among the subjects in the treatment group with an ENoG response of over 10% at the primary endpoint, the FGS Composite Score and FGS Voluntary Movement score were both significantly higher in the MS Group than in Non-MS Group. Although the MS Group had a significantly lower FGS Resting Symmetry Score, there was no significant difference between the two groups in the FGS Synkinesis Score. SMCI improved paralysis in subjects exhibiting an ENoG response of over 10% within the 6 months from onset without any deterioration of synkinesis.

Infiltration of intramuscular adipose tissue impairs skeletal muscle contraction.

Muscle infiltration with adipose tissue (IMAT) is common and associated with loss of skeletal muscle strength and physical function across a diverse set of pathologies. Whether the association between IMAT and muscle weakness is causative or simply correlative remains an open question that needs to be addressed to effectively guide muscle strengthening interventions in people with increased IMAT. In the present studies, we demonstrate that IMAT deposition causes decreased muscle strength using mouse models. These findings indicate IMAT is a novel therapeutic target for muscle dysfunction. Intramuscular adipose tissue (IMAT) is associated with deficits in strength and physical function across a wide array of conditions, from injury to ageing to metabolic disease. Due to the diverse aetiologies of the primary disorders involving IMAT and the strength of the associations, it has long been proposed that IMAT directly contributes to this muscle dysfunction. However, infiltration of IMAT and reduced strength could both be driven by muscle disuse, injury and systemic disease, making IMAT simply an 'innocent bystander.' Here, we utilize novel mouse models to evaluate the direct effect of IMAT on muscle contraction. First, we utilize intramuscular glycerol injection in wild-type mice to evaluate IMAT in the absence of systemic disease. In this model we find that, in isolation from the neuromuscular and circulatory systems, there remains a muscle-intrinsic association between increased IMAT volume and decreased contractile tension (r2 >0.5, P<0.01) that cannot be explained by reduction in contractile material. Second, we utilize a lipodystrophic mouse model which cannot generate adipocytes to 'rescue' the deficits. We demonstrate that without IMAT infiltration, glycerol treatment does not reduce contractile force (P>0.8). Taken together, this indicates that IMAT is not an inert feature of muscle pathology but rather has a direct impact on muscle contraction. This finding suggests that novel strategies targeting IMAT may improve muscle strength and function in a number of populations.

Market and Welfare Effects of Food Security Policies on Smallholder Rice Farmers and Consumers in Sierra Leone

This research examines the market and welfare effects of three food security policy options in Sierra Leone in response to the high rate of rice importation and rising rice prices over the last decade. These policies aimed at curbing the rate of rice importation, promoting local rice production, and enhancing welfare of smallholder rice farmers in rural communities. The policies investigated included: 1) reinstating tariffs on rice imports, 2) promoting value-chain strengthening interventions that increase production of locally produced rice and 3) instituting a quota (or some quantity restriction) on rice imports. A log-linear comparative static displacement model was used to carry out the analysis. For the first policy, 20%, 30% and 40% shocks were introduced in the equilibrium system to represent decreases in the quantity of rice imported as a result of reinstating tariffs on imported rice. Results revealed that welfare of consumers and or smallholder farmers of locally produced rice was enhanced by 9.4% at a 10% tariff increase and 17.8% at a 20% tariff increase. Consumers of imported rice had their welfare enhanced by 3.5% at a 10% tariff increase while welfare was dis-enhanced by 5.4% at a 20% tariff increase. With a 10% increase in the supply of locally produced rice, there was a corresponding welfare enhancement on smallholder rice farmers and consumers by 14.43% and by 27% for a 20% increase in supply. Marginal increases were recorded for consumers of imported rice. The results show that the optimal policy in the current post-Ebola national recovery environment is one that increases local rice production through cultivation intensification and rice value chain efficiency.

What is trauma? Qualitatively assessing stakeholder perceptions in Santa Cruz de la Sierra, Bolivia

ABSTRACT Addressing the burden of injury in low-resource settings requires development of trauma systems. This study aimed to describe perceptions of trauma in Santa Cruz, Bolivia to better inform strategies for trauma system development. In 2015–2016, we conducted 16 individual and 11 group interviews with key stakeholders involved with or exposed to trauma. A pile sorting activity showed participants pictures of injury mechanisms to explore perceptions of trauma. Responses were analysed for themes using content and discourse analysis. Among 27 interviews, six were with physicians, seven with first responders, three with community members, and 11 with trauma patients. Pictures commonly categorised as trauma depicted a road traffic incident (92.6%), fall (88.9%), gunshot wound (88.9%), and burn (85.2%). Fewer respondents stated intoxication (51.9%) or drowning (40.7%) were trauma. Coding of responses revealed five themes: trauma definition, mechanism, physical injury, management, and psychological trauma. Medical personnel focused more on trauma as mechanism, physical injury, and management, whereas laypersons commonly described trauma as psychological. Varied understanding of what represents trauma could influence trauma registry data collection. Laypersons’ focus on psychological trauma may affect use of designated trauma care hospitals. These viewpoints must be considered when designing policies and interventions for trauma system strengthening.

Seismic Assessment, Repair and Strengthening of a Medieval Masonry Tower in Southern Italy

Many historical masonry towers belong to architectural heritage. Their preservation is still a critical issue in several countries. In fact, the experience of past earthquakes has shown that even earthquakes of moderate intensity can cause the collapse of these historical structures due to their slenderness together with irregularities, openings, leaning phenomena and adjacent lower buildings. The damage and changes suffered over the centuries, and the complex behaviour of the materials makes the performance of this type of structures more uncertain, and the seismic analysis and the remedial measures to achieve their protection a very complex task. This paper presents a complete study (from the on-site diagnostic investigations to the seismic assessment and non-invasive strengthening) of an ancient masonry tower in Torre Orsaia (Southern Italy). The paper, through the discussion of the case study, shows effective procedures to assess the seismic safety of masonry towers and plan interventions without too time- and cost-consuming processes. The results have established that the deep and wide cracks on the belfry are due to the loss of tension of the ancient tie-rods. The seismic safety of the tower has been carried out using three levels of analysis: LV1 (evaluation with simplified models), LV2 (analysis of local collapse mechanisms) and LV3 (global analysis). The analyses have shown that the critical mechanism is the simple overturning of the masonry piers of the belfry due to the ineffective tie-rods. The corresponding safety index in terms of peak ground acceleration is 0.305. To avoid this undesired mechanism and, at the same time, fully close the cracks, a strengthening intervention based on stainless steel reinforcing rings has been developed. This chaining system avoids the local mechanisms of the piers of the belfry and allows developing global mechanisms. After retrofit intervention, the seismic analysis has shown that the safety index increases to 0.716 for the LV2 analysis and 0.793 for the LV3 analysis.

Modeling of the Tensile Behavior FRCM Systems for Repair and Strengthening Interventions of Masonry Structures

Fiber Reinforced Cementitious Matrix (FRCM) systems have been recently introduced as an alternative solution for strengthening interventions of existing masonry and concrete constructions. The current literature provides interesting experimental and numerical studies which underline the potentialities of FRCMs together and their specific features. Direct tensile tests are generally used for characterizing the behavior of FRCM. Indeed, these tests underline the occurrence of important phenomena influencing the behavior of FRCM, such as the cracking of the matrix and the debonding of the reinforcement from the matrix. The present paper aims at numerically analyzing the response of FRCM systems during tensile tests carried out throughout different setup configurations. To this end, a simple model carried out from literature and opportunely modified is presented in the paper and validated with reference to experimental case studies. Moreover, the obtained results are critically analyzed in order to emphasize the role of the proposed model for the interpretation of the results carried out from standard tensile tests.

A randomized controlled trial assessing the effects of preoperative strengthening plus balance training on balance and functional outcome up to 1year following total knee replacement.

To investigate the effects of including balance training in a preoperative strengthening intervention on balance and functional outcomes in patients undergoing total knee replacement (TKR) and compare these effects to those induced by preoperative strengthening and no intervention. Eighty-two subjects scheduled for TKR were randomly allocated into the strengthening (ST, n = 28) group: a preoperative lower limb strengthening intervention; the strengthening + balance (ST + B, n = 28) group: same intervention augmented with balance training; and the control group (n = 26). The Berg Balance Scale (BBS) and the function in daily living subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-ADL) were the primary outcomes. The secondary measures included balance and mobility, self-reported status, and knee function. The outcomes were assessed at baseline, 1week before surgery, and 2, (primary endpoint), 6 and 52weeks after surgery. Compared with the controls, the participants in the ST and ST + B groups presented significant improvements from baseline to the end of the preoperative intervention in BBS (p = 0.005) and KOOS-ADL (p < 0.001). At 6weeks post-surgery, the knee extensor strength values were similar in the two treatment groups and significantly higher than that in the controls. Overall, the participant outcomes in all groups stabilized at 1year after surgery. A preoperative strengthening intervention, regardless of whether it is complemented with balance training, enhances strength but not balance or functional outcomes at 6weeks after surgery. Patients are expected to present similar performance at 1year postoperatively, but adequately statistically powered trials are needed to confirm the findings. II. NCT02995668.

O05 How does radiographic knee OA impact musculoskeletal aging in midlife? Findings from the Hertfordshire Cohort study

Abstract Background With an aging population, the burden of musculoskeletal aging in joints, bones and muscles carries with it significant morbidity. Osteoarthritis (OA) is the most common joint condition, and can be defined clinically or radiologically. Musculoskeletal aging in bone and muscle can be assessed through change in body composition, grip strength and physical performance. The aim of this study was to investigate whether a diagnosis of radiological knee OA impacted involution in muscle or bone in the midlife in a group of community-dwelling older adults in the UK. Methods Our study comprised 220 members of the Hertfordshire Cohort Study (118 males and 102 females), a group of community dwelling older adults in the United Kingdom. Knee radiographs were performed at baseline (1999-2003), with osteoarthritis defined as a Kellgren and Lawrence score ≥2. At baseline and follow-up (2017) questionnaires assessed physical activity and lifestyle factors; JAMAR dynamometry was performed to assess grip strength; 8 foot walk test was performed to assess gait speed and DXA was performed to assess bone mineral density at the hips and body composition. Linear regression was performed to analyse associations in males and females, before and after adjustment for follow-up time, lifestyle factors (including smoking, alcohol consumption, social class, calcium intake and physical activity), anthropometric measures (BMI) and HRT use and age at menopause in women. The development of hand osteoarthritis was adjusted for grip strength outcomes. Results The mean age of participants at baseline was 65.0 years. Median follow-up was 16.7 years (range 15.0-18.4 years). Knee osteoarthritis was present in 75 (34%) participants. Radiographic knee osteoarthritis status at baseline was significantly associated with grip strength (β=-3.2kg, -5.3 to -1.1, p &amp;lt; 0.01) at follow-up in females but not in males (β=-2.9, -5.8 to 0.1, p = 0.06). No significant associations between radiographic osteoarthritis status at baseline and other measures of sarcopenia (gait speed or lean mass) or bone mineral density were found in either sex. Conclusion Our findings demonstrate that the presence of knee osteoarthritis in midlife can have a substantial bearing on grip strength in women over 15 years later independent of the presence of hand osteoarthritis. Grip strength has been shown to correlate closely with lower limb strength and so the demonstrated association between grip strength and knee osteoarthritis is representative of a global weakness resulting from the disease. Reduction in grip strength has been associated with an increased risk of morbidity including falls and fractures. Thus, in order to countermand this association, it may be that concerted interventions (including physical therapy, strengthening and surgical intervention) should be recommended for those with knee osteoarthritis at this stage in the lifecourse. Of course, these findings require replication and validation in other cohorts. Disclosures N.R. Fuggle None. M. Clynes None. F. Laskou None. K. Jameson None. C. Cooper None. E. Dennison None.

Assessment of Bedestan (St. Nicholas Church) on the first decade of conservation works

St. Nicholas Church (Bedestan) is one of the most significant monuments located exactly in the centre of the walled city of Nicosia, in the Selimiye Quarter. The significance of the heritage building lies on its temporal transformation. Bedestan initially built by Byzantines in the 5th century, and was later enlarged during the Lusignan, Venetian, Ottoman and British period. Between 2004 and 2009 had gone through conservation works by United Nations Development Programme Partnership for Future (UNDP-PFF) which is funded by European Union. In 2009 the project has won Europa Nostra Award between 140 projects. The project consisted of both architectural and structural strengthening interventions. The aim of the study is to assess current condition of the structure on the first decade of conservation works. The method had three objectives. Firstly, the literature was reviewed in order to understand the historical process of the building. Then, site survey was completed for further understanding of the applied intervention to the structure. Finally, the current condition of the structure was observed after ten years of completed restoration works. Deterioration on used materials as well as durability of strengthening works was assessed and observations were listed herein.

Identification and strengthening of positive deviance: An efforts to reduce the incidence of malaria in Selayar islands

This study aimed to determine the effect of positive deviance on decreasing malaria incidence in the Selayar Islands Regency and the effect of reinforcement on positive deviance behavior. This study used a mix-method design to find positive deviance in preventing malaria and intervene by applying positive deviance to the community in Bontona Saluk village and Batangmata village, Bontomatene District, Selayar Islands Regency. Sampling for quantitative data was 120 respondents, and qualitative data were ten informants using purposive sampling. Data collection was done through interviews and Focus Group Discussions (FGD). Quantitative data were analyzed using logistic regression and McNemar tests. The results showed the most influential factor in malaria incidence was positive deviance. Positive deviance behavior to prevent malaria were used long-sleeved clothing when working and when out at night, use oil, and burn trash and coconut belts. Intervention monitoring results show that there is a significant effect of positive deviance strengthening interventions on increasing the use of long-sleeved clothes when working in the garden/forest and when going out at night to prevent malaria. The positive deviance approach could be used as an effort to prevent and control malaria.

Changes in Torque-Angle Profiles of the Hamstrings and Hamstrings-to-Quadriceps Ratio After Two Hamstring Strengthening Exercise Interventions in Female Hockey Players.

Delextrat, A, Bateman, J, Ross, C, Harman, J, Davis, L, Vanrenterghem, J, and Cohen, DD. Changes in torque-angle profiles of the hamstrings and hamstrings-to-quadriceps ratio after two hamstring strengthening exercise interventions in female hockey players. J Strength Cond Res 34(2): 396-405, 2020-The aim of this study was to compare the effects of 2 hamstring strengthening interventions (Nordic hamstrings [NHE] vs. eccentric leg curl [ELC]) on the hamstring torque-angle profiles and functional hamstrings-to-quadriceps ratio (Hecc:Qcon) in female hockey players. Female university-level players were randomly allocated to an NHE group (n = 9, 19.7 ± 1.4 years; 168.4 ± 4.4 cm; 66.2 ± 7.2 kg, 26.0 ± 4.4%), an ELC group (n = 8, 19.5 ± 1.0 years; 168.1 ± 3.4 cm; 66.7 ± 4.5 kg, 24.8 ± 3.5%), or a control (C) group (n = 8, 19.6 ± 1.4 years; 169.9 ± 7.5 cm; 70.7 ± 13.0 kg, 25.9 ± 5.2%). They performed baseline isokinetic concentric strength tests of the quadriceps (Qcon) and eccentric strength of the hamstrings (Hecc) at 120°·s, followed by a 6-week intervention with exercises (NHE or ELC) performed 3 times weekly, before post-tests. Analyses of variance with repeated measures were used to assess the effects of knee position angle (from 90° of knee flexion to 10° close to extension), group, and time on Qcon, Hecc, and Hecc:Qcon. There were no interactions between independent variables. Significant increases in Hecc and Hecc:Qcon were shown after NHE (+29.9 and +27.8%) and ELC (+30.5 and +38.3%) in the nondominant leg only. Furthermore, significant shifts in the hamstring eccentric angle of peak torque toward a longer muscle length were shown in both legs (14.3-28.6%). These findings suggest that NHE and ELC both resulted in significant improvements in peak and muscle-length-specific neuromuscular risk factors in the nondominant (ND) limb, thereby reducing interlimb peak strength asymmetries. Strength and conditioning specialists could therefore use both the NHE and ELC exercises in female hockey players.