Coupling beams between shear walls are one of the key elements for energy dissipation in tall buildings. A representative mathematical model of coupling beam should represent flexure, shear and interface slip/extension mechanisms simultaneously. This goal can be achieved by using either detailed finite element models or by using macro models. This paper presents a review of various macro model alternatives for diagonally reinforced coupling beams in the literature. Three distinct methods have been reviewed in terms of their modeling techniques, the cyclic response overlap and the amount of cumulative plastic energy dissipated based on the results of previously performed tests. Through an analytical study, adequately accurate results can be captured by using macro models, although they are simpler in practice compared to sophisticated micro models. This study shows that, by modifying ultimate shear capacities where concrete material between diagonal bundles is adequately confined, it is possible to capture a more realistic result and a better approximation to the actual responses. It is also concluded that a simpler numerical model for diagonally reinforced coupling beams can be achieved by introducing linear part of slip/extension behavior into elastic part of the beam. It is observed, as a result of this study, that the ratio of effective stiffness to that of the gross cross-sectional one ranges from 0.04 to 0.14 in diagonally reinforced coupling beams depending on the aspect ratio and the beam strength parameters.
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Many countries and health systems are pursuing integrated care as a means of achieving better outcomes. However, no standard approaches exist for comparing integration approaches across models or settings, and for evaluating whether the key components of integrated care are present in different initiatives. This study sheds light on how integrated care is being implemented in Australia, using a new tool to characterise and compare integration strategies at micro, meso and macro levels. In total, 114 staff from a purposive sample of 38 integrated care projects completed a survey based on the Rainbow Model of Integrated Care. Ten key informants gave follow-up interviews. Participating projects reported using multiple strategies to implement integrated care, but descriptions of implementation were often inconsistent. Micro-level strategies, including clinical-professional service coordination and person-centred care, were most commonly reported. A common vision was often described as an essential foundation for joint work. However, performance feedback appeared under-utilised, as did strategies requiring macro-level action such as data linkages or payment reform. The results suggest that current integrated care efforts are unevenly weighted towards micro-level strategies. Increased attention to macro-level strategies may be warranted in order to accelerate progress and sustain integrated care in Australia.
