Search results for: pre defined score range
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11120

Search results for: pre defined score range

10460 Intergenerational Trauma: Patterns of Child Abuse and Neglect Across Two Generations in a Barbados Cohort

Authors: Rebecca S. Hock, Cyralene P. Bryce, Kevin Williams, Arielle G. Rabinowitz, Janina R. Galler

Abstract:

Background: Findings have been mixed regarding whether offspring of parents who were abused or neglected as children have a greater risk of experiencing abuse or neglect themselves. In addition, many studies on this topic are restricted to physical abuse and take place in a limited number of countries, representing a small segment of the world's population. Methods: We examined relationships between childhood maltreatment history assessed in a subset (N=68) of the original longitudinal birth cohort (G1) of the Barbados Nutrition Study and their now-adult offspring (G2) (N=111) using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We used Pearson correlations to assess relationships between parent and offspring CTQ-SF total and subscale scores (physical, emotional, and sexual abuse; physical and emotional neglect). Next, we ran multiple regression analyses, using the parental CTQ-SF total score and the parental Sexual Abuse score as primary predictors separately in our models of G2 CTQ-SF (total and subscale scores). Results: G1 total CTQ-SF scores were correlated with G2 offspring Emotional Neglect and total scores. G1 Sexual Abuse history was significantly correlated with G2 Emotional Abuse, Sexual Abuse, Emotional Neglect, and Total Score. In fully-adjusted regression models, parental (G1) total CTQ-SF scores remained significantly associated with G2 offspring reports of Emotional Neglect, and parental (G1) Sexual Abuse was associated with offspring (G2) reports of Emotional Abuse, Physical Abuse, Emotional Neglect, and overall CTQ-SF scores. Conclusions: Our findings support a link between parental exposure to childhood maltreatment and their offspring's self-reported exposure to childhood maltreatment. Of note, there was not an exact correspondence between the subcategory of maltreatment experienced from one generation to the next. Compared with other subcategories, G1 Sexual Abuse history was the most likely to predict G2 offspring maltreatment. Further studies are needed to delineate underlying mechanisms and to develop intervention strategies aimed at preventing intergenerational transmission.

Keywords: trauma, family, adolescents, intergenerational trauma, child abuse, child neglect, global mental health, North America

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10459 Enhancement to Green Building Rating Systems for Industrial Facilities by Including the Assessment of Impact on the Landscape

Authors: Lia Marchi, Ernesto Antonini

Abstract:

The impact of industrial sites on people’s living environment both involves detrimental effects on the ecosystem and perceptual-aesthetic interferences with the scenery. These, in turn, affect the economic and social value of the landscape, as well as the wellbeing of workers and local communities. Given the diffusion of the phenomenon and the relevance of its effects, it emerges the need for a joint approach to assess and thus mitigate the impact of factories on the landscape –being this latest assumed as the result of the action and interaction of natural and human factors. However, the impact assessment tools suitable for the purpose are quite heterogeneous and mostly monodisciplinary. On the one hand, green building rating systems (GBRSs) are increasingly used to evaluate the performance of manufacturing sites, mainly by quantitative indicators focused on environmental issues. On the other hand, methods to detect the visual and social impact of factories on the landscape are gradually emerging in the literature, but they generally adopt only qualitative gauges. The research addresses the integration of the environmental impact assessment and the perceptual-aesthetic interferences of factories on the landscape. The GBRSs model is assumed as a reference since it is adequate to simultaneously investigate different topics which affect sustainability, returning a global score. A critical analysis of GBRSs relevant to industrial facilities has led to select the U.S. GBC LEED protocol as the most suitable to the scope. A revision of LEED v4 Building Design+Construction has then been provided by including specific indicators to measure the interferences of manufacturing sites with the perceptual-aesthetic and social aspects of the territory. To this end, a new impact category was defined, namely ‘PA - Perceptual-aesthetic aspects’, comprising eight new credits which are specifically designed to assess how much the buildings are in harmony with their surroundings: these investigate, for example the morphological and chromatic harmonization of the facility with the scenery or the site receptiveness and attractiveness. The credits weighting table was consequently revised, according to the LEED points allocation system. As all LEED credits, each new PA credit is thoroughly described in a sheet setting its aim, requirements, and the available options to gauge the interference and get a score. Lastly, each credit is related to mitigation tactics, which are drawn from a catalogue of exemplary case studies, it also developed by the research. The result is a modified LEED scheme which includes compatibility with the landscape within the sustainability assessment of the industrial sites. The whole system consists of 10 evaluation categories, which contain in total 62 credits. Lastly, a test of the tool on an Italian factory was performed, allowing the comparison of three mitigation scenarios with increasing compatibility level. The study proposes a holistic and viable approach to the environmental impact assessment of factories by a tool which integrates the multiple involved aspects within a worldwide recognized rating protocol.

Keywords: environmental impact, GBRS, landscape, LEED, sustainable factory

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10458 A Multicenter Assessment on Psychological Well-Being Status among Medical Residents in the United Arab Emirates

Authors: Mahera Abdulrahman

Abstract:

Objective: Healthcare transformation from traditional to modern in the country recently prompted the need to address career choices, accreditation perception and satisfaction among medical residents. However, a concerted nationwide study to understand and address burnout in the medical residency program has not been conducted in the UAE and the region. Methods: A nationwide, multicenter, cross-sectional study was designed to evaluate professional burnout and depression among medical residents in order to address the gap. Results: Our results indicate that 75.5% (216/286) of UAE medical residents had moderate to high emotional exhaustion, 84% (249/298) had high depersonalization, and 74% (216/291) had a low sense of personal accomplishment. In aggregate, 70% (212/302) of medical residents were considered to be experiencing at least one symptom of burnout based on a high emotional exhaustion score or a high depersonalization score. Depression ranging from 6-22%, depending on the specialty was also striking given the fact the Arab culture lays high emphasis on family bonding. Interestingly 83% (40/48) of medical residents who had high scores for depression also reported burnout. Conclusion: Our data indicate that burnout and depression among medical residents is epidemic. There is an immediate need to address burnout through effective interventions at both the individual and institutional levels. It is imperative to reconfigure the approach to medical training for the well-being of the next generation of physicians in the Arab world.

Keywords: mental health, Gulf, Arab, residency training, burnout, depression

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10457 A Novel Approach of Power Transformer Diagnostic Using 3D FEM Parametrical Model

Authors: M. Brandt, A. Peniak, J. Makarovič, P. Rafajdus

Abstract:

This paper deals with a novel approach of power transformers diagnostics. This approach identifies the exact location and the range of a fault in the transformer and helps to reduce operation costs related to handling of the faulty transformer, its disassembly and repair. The advantage of the approach is a possibility to simulate healthy transformer and also all faults, which can occur in transformer during its operation without its disassembling, which is very expensive in practice. The approach is based on creating frequency dependent impedance of the transformer by sweep frequency response analysis measurements and by 3D FE parametrical modeling of the fault in the transformer. The parameters of the 3D FE model are the position and the range of the axial short circuit. Then, by comparing the frequency dependent impedances of the parametrical models with the measured ones, the location and the range of the fault is identified. The approach was tested on a real transformer and showed high coincidence between the real fault and the simulated one.

Keywords: transformer, parametrical model of transformer, fault, sweep frequency response analysis, finite element method

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10456 Vibration Analysis of a Solar Powered UAV

Authors: Kevin Anderson, Sukhwinder Singh Sandhu, Nouh Anies, Shilpa Ravichandra, Steven Dobbs, Donald Edberg

Abstract:

This paper presents the results of a Finite Element based vibration analysis of a solar powered Unmanned Aerial Vehicle (UAV). The purpose of this paper was to quantify the free vibration, forced vibration response due to differing point inputs in order to mimic the vibration induced by actuators (magnet in coil generators) used to aid in the flight of the UAV. A Fluid-Structure Interaction (FSI) study was performed in order to ascertain pertinent deigns stresses and deflections as well as aerodynamic parameters of the UAV airfoil. The 10 ft span airfoil is modeled using Mylar as the primary material. Results show that the free mode in bending is 4.8 Hz while the first forced bending mode is in the range of 16.2 to 16.7 Hz depending on the location of excitation. The free torsional bending mode is 28.3 Hz, and the first forced torsional mode is in the range of 26.4 to 27.8 Hz, depending on the location of excitation. The FSI results predict the coefficients of aerodynamic drag and lift of 0.0052 and 0.077, respectively, which matches hand-calculations used to validate the Finite Element based results. FSI based maximum von Mises stresses and deflections were found to be 0.282 MPa and 3.4 mm, respectively. Dynamic pressures on the airfoil range of 1.04 to 1.23 kPa corresponding to velocity magnitudes in the range of 22 to 66 m/s.

Keywords: ANSYS, finite element, FSI, UAV, vibrations

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10455 Creativity in Development of Multimedia Presentation

Authors: Mahathir Sarjan, Ramos Radzly, Noor Baiti Jamaluddin, Mohd Hafiz Zakaria, Hisham Suhadi

Abstract:

Creativity is marked by the ability or power, to produce through imaginative skill and create something anew. The University is one of the great places to improve the talent in imaginative skill. Thus, it is important that for the student have a creativity to adapt the multimedia element in the development of presentation products for learning and teaching the process. The purpose of this study was to identify a creativity of the student in presentation product development. Two hundred seventeen Technical and Vocational Education (TVE) students in Universiti Tun Hussein Onn had chosen as a respondent. This study is to survey the level of creativity which is focused on knowledge, skills, presentation style and character of creative personnel. The level of creativity was measured based on the scale at low, medium and high followed by mean score level. The data collected by questionnaire then analyzed using SPSS version 20.0. The result of the study indicated that the students showed a higher of creativity (mean score in Knowledge = 4.12 and Skills= 4.02). In conjunction with the findings s implications and recommendations were suggested forward like to ensconce the research and improve with a more creativity concept in presentation product of development for learning and teaching the process.

Keywords: creativity, technical, vocational education, presentation products and development for learning and teaching process

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10454 FMCW Doppler Radar Measurements with Microstrip Tx-Rx Antennas

Authors: Yusuf Ulaş Kabukçu, Si̇nan Çeli̇k, Onur Salan, Mai̇de Altuntaş, Mert Can Dalkiran, Gökseni̇n Bozdağ, Metehan Bulut, Fati̇h Yaman

Abstract:

This study presents a more compact implementation of the 2.4GHz MIT Coffee Can Doppler Radar for 2.6GHz operating frequency. The main difference of our prototype depends on the use of microstrip antennas which makes it possible to transport with a small robotic vehicle. We have designed our radar system with two different channels: Tx and Rx. The system mainly consists of Voltage Controlled Oscillator (VCO) source, low noise amplifiers, microstrip antennas, splitter, mixer, low pass filter, and necessary RF connectors with cables. The two microstrip antennas, one is element for transmitter and the other one is array for receiver channel, was designed, fabricated and verified by experiments. The system has two operation modes: speed detection and range detection. If the switch of the operation mode is ‘Off’, only CW signal transmitted for speed measurement. When the switch is ‘On’, CW is frequency-modulated and range detection is possible. In speed detection mode, high frequency (2.6 GHz) is generated by a VCO, and then amplified to reach a reasonable level of transmit power. Before transmitting the amplified signal through a microstrip patch antenna, a splitter used in order to compare the frequencies of transmitted and received signals. Half of amplified signal (LO) is forwarded to a mixer, which helps us to compare the frequencies of transmitted and received (RF) and has the IF output, or in other words information of Doppler frequency. Then, IF output is filtered and amplified to process the signal digitally. Filtered and amplified signal showing Doppler frequency is used as an input of audio input of a computer. After getting this data Doppler frequency is shown as a speed change on a figure via Matlab script. According to experimental field measurements the accuracy of speed measurement is approximately %90. In range detection mode, a chirp signal is used to form a FM chirp. This FM chirp helps to determine the range of the target since only Doppler frequency measured with CW is not enough for range detection. Such a FMCW Doppler radar may be used in border security of the countries since it is capable of both speed and range detection.

Keywords: doppler radar, FMCW, range detection, speed detection

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10453 A Study of Lean Principles Implementation in the Libyan Healthcare and Industry Sectors

Authors: Nasser M. Amaitik, Ngwan F. Elsagzli

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The Lean technique is very important in the service and industrial fields. It is defined as an effective tool to eliminate the wastes. In lean the wastes are defined as anything which does not add value to the end product. There are wastes that can be avoided, but some are unavoidable to many reasons. The present study aims to apply the principles of lean in two different sectors, healthcare, and industry. Two case studies have been selected to apply the experimental work. The first case was Al-Jalaa Hospital while the second case study was the Technical Company of Aluminum Sections in Benghazi, Libya. In both case studies the Value Stream Map (VSM) of the current state has been constructed. The proposed plans have been implemented by merging or eliminating procedures or processes. The results obtained from both case studies showed improvement in capacity, idle time and utilized time.

Keywords: healthcare service delivery, idle time, lean principles, utilized time, value stream mapping, wastes

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10452 Wideband Performance Analysis of C-FDTD Based Algorithms in the Discretization Impoverishment of a Curved Surface

Authors: Lucas L. L. Fortes, Sandro T. M. Gonçalves

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In this work, it is analyzed the wideband performance with the mesh discretization impoverishment of the Conformal Finite Difference Time-Domain (C-FDTD) approaches developed by Raj Mittra, Supriyo Dey and Wenhua Yu for the Finite Difference Time-Domain (FDTD) method. These approaches are a simple and efficient way to optimize the scattering simulation of curved surfaces for Dielectric and Perfect Electric Conducting (PEC) structures in the FDTD method, since curved surfaces require dense meshes to reduce the error introduced due to the surface staircasing. Defined, on this work, as D-FDTD-Diel and D-FDTD-PEC, these approaches are well-known in the literature, but the improvement upon their application is not quantified broadly regarding wide frequency bands and poorly discretized meshes. Both approaches bring improvement of the accuracy of the simulation without requiring dense meshes, also making it possible to explore poorly discretized meshes which bring a reduction in simulation time and the computational expense while retaining a desired accuracy. However, their applications present limitations regarding the mesh impoverishment and the frequency range desired. Therefore, the goal of this work is to explore the approaches regarding both the wideband and mesh impoverishment performance to bring a wider insight over these aspects in FDTD applications. The D-FDTD-Diel approach consists in modifying the electric field update in the cells intersected by the dielectric surface, taking into account the amount of dielectric material within the mesh cells edges. By taking into account the intersections, the D-FDTD-Diel provides accuracy improvement at the cost of computational preprocessing, which is a fair trade-off, since the update modification is quite simple. Likewise, the D-FDTD-PEC approach consists in modifying the magnetic field update, taking into account the PEC curved surface intersections within the mesh cells and, considering a PEC structure in vacuum, the air portion that fills the intersected cells when updating the magnetic fields values. Also likewise to D-FDTD-Diel, the D-FDTD-PEC provides a better accuracy at the cost of computational preprocessing, although with a drawback of having to meet stability criterion requirements. The algorithms are formulated and applied to a PEC and a dielectric spherical scattering surface with meshes presenting different levels of discretization, with Polytetrafluoroethylene (PTFE) as the dielectric, being a very common material in coaxial cables and connectors for radiofrequency (RF) and wideband application. The accuracy of the algorithms is quantified, showing the approaches wideband performance drop along with the mesh impoverishment. The benefits in computational efficiency, simulation time and accuracy are also shown and discussed, according to the frequency range desired, showing that poorly discretized mesh FDTD simulations can be exploited more efficiently, retaining the desired accuracy. The results obtained provided a broader insight over the limitations in the application of the C-FDTD approaches in poorly discretized and wide frequency band simulations for Dielectric and PEC curved surfaces, which are not clearly defined or detailed in the literature and are, therefore, a novelty. These approaches are also expected to be applied in the modeling of curved RF components for wideband and high-speed communication devices in future works.

Keywords: accuracy, computational efficiency, finite difference time-domain, mesh impoverishment

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10451 Popular eReaders

Authors: Tom D. Gedeon, Ujala Rampaul

Abstract:

The evaluation of electronic consumer goods are most often done from the perspective of analysing the latest models, comparing their advantages and disadvantages with respect to price. This style of evaluation is often performed by one or a few product experts on a wide range of features that may not be applicable to each user. We instead used a scenario-based approach to evaluate a number of e-readers. The setting is similar to a user who is interested in a new product or technology and has allocated a limited budget. We evaluate the quality and usability of e-readers available within that budget range. This is based on the assumption of a rational market which prices older second hand devices the same as functionally equivalent new devices. We describe our evaluation and comparison of four branded eReaders, as the initial stage of a larger project. The scenario has a range of tasks approximating a busy person who does not bother to read the manual. We found that navigation within books to be the most significant differentiator between the eReaders in our scenario based evaluation process.

Keywords: eReader, scenario based, price comparison, Kindle, Kobo, Nook, Sony, technology adoption

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10450 Methodology to Achieve Non-Cooperative Target Identification Using High Resolution Range Profiles

Authors: Olga Hernán-Vega, Patricia López-Rodríguez, David Escot-Bocanegra, Raúl Fernández-Recio, Ignacio Bravo

Abstract:

Non-Cooperative Target Identification has become a key research domain in the Defense industry since it provides the ability to recognize targets at long distance and under any weather condition. High Resolution Range Profiles, one-dimensional radar images where the reflectivity of a target is projected onto the radar line of sight, are widely used for identification of flying targets. According to that, to face this problem, an approach to Non-Cooperative Target Identification based on the exploitation of Singular Value Decomposition to a matrix of range profiles is presented. Target Identification based on one-dimensional radar images compares a collection of profiles of a given target, namely test set, with the profiles included in a pre-loaded database, namely training set. The classification is improved by using Singular Value Decomposition since it allows to model each aircraft as a subspace and to accomplish recognition in a transformed domain where the main features are easier to extract hence, reducing unwanted information such as noise. Singular Value Decomposition permits to define a signal subspace which contain the highest percentage of the energy, and a noise subspace which will be discarded. This way, only the valuable information of each target is used in the recognition process. The identification algorithm is based on finding the target that minimizes the angle between subspaces and takes place in a transformed domain. Two metrics, F1 and F2, based on Singular Value Decomposition are accomplished in the identification process. In the case of F2, the angle is weighted, since the top vectors set the importance in the contribution to the formation of a target signal, on the contrary F1 simply shows the evolution of the unweighted angle. In order to have a wide database or radar signatures and evaluate the performance, range profiles are obtained through numerical simulation of seven civil aircraft at defined trajectories taken from an actual measurement. Taking into account the nature of the datasets, the main drawback of using simulated profiles instead of actual measured profiles is that the former implies an ideal identification scenario, since measured profiles suffer from noise, clutter and other unwanted information and simulated profiles don't. In this case, the test and training samples have similar nature and usually a similar high signal-to-noise ratio, so as to assess the feasibility of the approach, the addition of noise has been considered before the creation of the test set. The identification results applying the unweighted and weighted metrics are analysed for demonstrating which algorithm provides the best robustness against noise in an actual possible scenario. So as to confirm the validity of the methodology, identification experiments of profiles coming from electromagnetic simulations are conducted, revealing promising results. Considering the dissimilarities between the test and training sets when noise is added, the recognition performance has been improved when weighting is applied. Future experiments with larger sets are expected to be conducted with the aim of finally using actual profiles as test sets in a real hostile situation.

Keywords: HRRP, NCTI, simulated/synthetic database, SVD

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10449 Marketing Research and Analysis Improvement Effect on Production

Authors: Mina Zaky Sarofim Zaky

Abstract:

Experiential marketing is a form of marketing that offers a unique integration of experiential and entertainment elements into a product or service. Experiential marketing is defined as an unforgettable experience that penetrates the customer's mind. Customer satisfaction is also defined as the emotional response to the experience provided with the purchased product or service. Experiential marketing activities can, therefore, affect the level of customer satisfaction and loyalty. In this context, the study aims to determine the relationship between experiential marketing, customer satisfaction and customer loyalty in cosmetic products in Konya. The least squares method (PLS) was used to analyze the research data. Existing research has shown that experiential marketing is a significant predictor of customer satisfaction and customer loyalty, and that experiential marketing has a positive impact on customer satisfaction and customer loyalty.

Keywords: internet, marketing, tourism, tourism management corporate responsibility, employee organizational performance, internal marketing, internal customer experiential marketing, customer satisfaction, customer loyalty, social sciences

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10448 Developing an Active Leisure Wear Range: A Dilemma for Khanna Enterprises

Authors: Jagriti Mishra, Vasundhara Chaudhary

Abstract:

Introduction: The case highlights various issues and challenges faced by Khanna Enterprises while conceptualizing and execution of launching Active Leisure wear in the domestic market, where different steps involved in the range planning and production have been elaborated. Although Khanna Enterprises was an established company which dealt in the production of knitted and woven garments, they took the risk of launching a new concept- Active Leisure wear for Millennials. Methodology: It is based on primary and secondary research where data collection has been done through survey, in-depth interviews and various reports, forecasts, and journals. Findings: The research through primary and secondary data and execution of active leisure wear substantiated the acceptance, not only by the millennials but also by the generation X. There was a demand of bigger sizes as well as more muted colours. Conclusion: The sales data paved the way for future product development in tune with the strengths of Khanna Enterprises.

Keywords: millennials, range planning, production, active leisure wear

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10447 Emerging Issues of Non-Communicable Diseases among Older Persons in India

Authors: Dhananjay W. Bansod, Santosh Phad

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Non-Communicable Diseases (NCD) are major contributing factors to the disease burden in the world as well as in India. With a growing proportion of older persons in India gives rise to several challenges. With the advancement of age, elderly is exposed to various kinds of health problems more specifically NCDs. Therefore, an effort has been made to examine the prevalence of NCDs among older persons and its treatment-seeking behaviour, also it is tried to explore the association between the NCDs and its effect on the overall wellbeing of older persons. Data used from “Building Knowledge Base of Population Ageing Survey” conducted in 2011 in seven states of India. Six chronic diseases used (non-communicable diseases) namely Arthritis, Hypertension, Cataract, Diabetes, Asthma and Heart diseases to understand the issues related to NCDs. Also seen the effect of NCDs on the wellbeing of the elderly, the subjective well-being consists of nine questions from which SUBI score generated for mental health status, which ranges from 9 to 27. This Index indicates that lower the score better is the mental health status. Further, this index modified and generated three categories of Better (9-15), Average (16-20) and Worse (21-27). The reliability analysis is carried out with the coefficient (Cronbach’s alpha) of the scale was 0.8884. The result shows that Orthopedic / musculoskeletal ailments involving arthritis, rheumatism and osteoarthritis are the most common type of ailment followed by hypertension. Two-thirds of the elderly reported suffering from at least one chronic ailment. Most chronic illness conditions received some form of treatment and mainly depend on public health facilities. Financial insecurity is the primary obstruction in seeking treatment for most of the chronic ailments which typically require a longer duration of medication and repeated medical consultations, both having significant economic implications. According to SUBI index, only 15 per cent of the elderly are in Better mental health status, and one-third of the elderly are with the worse score. Elderly with the ailments like Cataract, Asthma and Arthritis have worse mental health. It depicts that the burden of disease is more among the elderly and it is directly affecting the overall wellbeing of older persons.

Keywords: NCD, well-being, older person, India

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10446 Imidocloprid as a Systemic-Acquired Resistant (SAR) Inducer in Nicotiana tabacum Var. Samsun NN Infected with Tobacco Mild Green Mosaic Virus

Authors: Mohammad Reza Hossein Zadeh

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Plants have different layers of defense responses against biotic and abiotic stresses. One of the well-defined defense mechanism in plants is systemic acquired resistance (SAR) against a broad-range of pathogens. Salicylic acid (SA) plays a crucial role in regulation of the SAR pathway. It has been proved that Chemically SA-like compounds can mimic the SA signaling role. Imidocloprid is an insecticide being used to control whiteflies on crop plants. In order to study the possible role of Imidocloprid as an elicitor of SAR in plants, experiments were conducted in a completely randomized design frame with three treatments and duplicates on the detached leaves and whole Nicotiana tabacum var. Samsun NN. plants inoculated with Tobacco mild green mosaic virus (TMGMV). Compared with the effect of other SAR-inducers such as SA, Imidoclorid conferred a robust SAR induction in the infected plants. The results suggested that Imidocloprid even more powerful than SA can be considered as strong SAR inducer in the infected plants with viruses, which develop the local lesion symptoms.

Keywords: imidocloprid, Nicotiana tabacum var. Samsun NN, SAR, tobacco mild green, mosaic virus

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10445 Perception and Participation Quality Assurance in Higher Education: A Case Study of Phranakhon Rajabhat University, Thailand

Authors: O. Vanijajiva, K. Oumaree, N. Ngampak

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This research aims to study the level of perception and participation of Phranakhon Rajabhat University staff and to study the relationship between the levels of perception and participation with the score of University evaluation of quality assurance in education. The respondents were composed of 479 staffs. The tool used in this research is perceived and participation questionnaire of quality assurance in education of Phranakhon Rajabhat University. The results found that the most staffs are female with undergraduate education. Most 2 respondents are revealing educational staffs without academic position. The fact of times to gain knowledge of quality assurance in education is 1-3 times. The perception of knowledge about quality assurance in education is moderate (3.74 ± 0.65) with most respondent are more focus on university activity than quality assurance in education activity. The participation of quality assurance in education activities involved in moderate (3.17 ± 0.88), with most respondents more involved in student affair than quality assurance in education motion. For assessment of the relationship of perception and participation of quality assurance in education are average score (4.31 ± 0.16) showed that the level of perception and participation was associated with university evaluation in very low level (r = -0.103 and -0.121, respectively), while perception and participation are correlated with the moderate level (r = 0.691).

Keywords: quality assurance education, awareness, participation, higher education, Thailand

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10444 Influence of Mothers’ Knowledge, Attitude and Behavior on Diet and Physical Activity of Their Pre-School Children: A Cross-Sectional Study from a Semi-Urban Area of Nepal

Authors: Natalia Oli, Abhinav Vaidya, Katja Pahkala, Gabriele Eiben, Alexandra Krettek

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The nutritional transition towards a high fat and energy dense diet, decreasing physical activity level, and poor cardiovascular health knowledge contributes to a rising burden of cardiovascular diseases in Nepal. Dietary and physical activity behaviors are formed early in life and influenced by family, particularly by mothers in the social context of Nepal. The purpose of this study was to explore knowledge, attitude and behavior of mothers regarding diet and physical activity of their pre-school children. Cross-sectional study was conducted in the semi-urban area of Duwakot and Jhaukhel communities near the capital Kathmandu. Between August and November 2014, nine trained enumerators interviewed all mothers having children aged 2 to 7 years in their homes. Questionnaire contained information about mothers’ socio-demographic characteristics; their knowledge, attitude, and behavior regarding diet and physical activity as well as their children’s diet and physical activity. Knowledge, attitude and behavior responses were scored. SPSS version 22.0 was used for data analyses. Out of the 1,052 eligible mothers, 962 consented to participate in the study. The mean age was 28.9 ± 4.5 years. The majority of them (73%) were housewives. Mothers with higher education and income had higher knowledge, attitude, and behavior scores (All p < 0.001) whereas housewives and farmers had low knowledge score (p < 0.001). They, along with laborers, also exhibited lower attitude (p<0.001) and behavior scores (p < 0.001). Children’s diet score increased with mothers’ level of education (p <0.001) and income (p=0.041). Their physical activity score, however, declined with increasing level of their mothers’ education (p < 0.001) and income (p < 0.001). Children’s overall behavior score correlated poorly with mothers’ knowledge (r = 0.009, p=0.003), attitude (r =0.012, p=0.001), and behavior (r = 0.007, p= 0.008). Such poor correlation can be due to existence of the barriers among mothers. Mothers reported such barriers as expensive healthy food, difficulty to give up favorite food, taste preference of others family members and lack of knowledge on healthy food. Barriers for physical activity were lack of leisure time, lack of parks and playgrounds, being busy by caring for children and old people, feeling lazy and embarrassed in front of others. Additionally, among the facilitators for healthy lifestyle, mentioned by mothers, were better information, family eating healthy food and supporting physical activity, advice of medical personnel regarding healthy lifestyle and own ill health. The study demonstrated poor correlation of mothers’ knowledge and attitude with children’s behavior regarding diet and physical activity. Hence improving mothers’ knowledge or attitude may not be enough to improve dietary and physical activity habits of their children. Barriers and facilitators that affect mothers’ practices towards their children should also be addressed due to future intervention.

Keywords: attitude, behavior, diet, knowledge, mothers, physical activity

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10443 Development and Validation of a HPLC Method for 6-Gingerol and 6-Shogaol in Joint Pain Relief Gel Containing Ginger (Zingiber officinale)

Authors: Tanwarat Kajsongkram, Saowalux Rotamporn, Sirinat Limbunruang, Sirinan Thubthimthed.

Abstract:

High-Performance Liquid Chromatography (HPLC) method was developed and validated for simultaneous estimation of 6-Gingerol(6G) and 6-Shogaol(6S) in joint pain relief gel containing ginger extract. The chromatographic separation was achieved by using C18 column, 150 x 4.6mm i.d., 5μ Luna, mobile phase containing acetonitrile and water (gradient elution). The flow rate was 1.0 ml/min and the absorbance was monitored at 282 nm. The proposed method was validated in terms of the analytical parameters such as specificity, accuracy, precision, linearity, range, limit of detection (LOD), limit of quantification (LOQ), and determined based on the International Conference on Harmonization (ICH) guidelines. The linearity ranges of 6G and 6S were obtained over 20-60 and 6-18 µg/ml respectively. Good linearity was observed over the above-mentioned range with linear regression equation Y= 11016x- 23778 for 6G and Y = 19276x-19604 for 6S (x is concentration of analytes in μg/ml and Y is peak area). The value of correlation coefficient was found to be 0.9994 for both markers. The limit of detection (LOD) and limit of quantification (LOQ) for 6G were 0.8567 and 2.8555 µg/ml and for 6S were 0.3672 and 1.2238 µg/ml respectively. The recovery range for 6G and 6S were found to be 91.57 to 102.36 % and 84.73 to 92.85 % for all three spiked levels. The RSD values from repeated extractions for 6G and 6S were 3.43 and 3.09% respectively. The validation of developed method on precision, accuracy, specificity, linearity, and range were also performed with well-accepted results.

Keywords: ginger, 6-gingerol, HPLC, 6-shogaol

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10442 The Effect of Environmental, Social, and Governance (ESG) Disclosure on Firms’ Credit Rating and Capital Structure

Authors: Heba Abdelmotaal

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This paper explores the impact of the extent of a company's environmental, social, and governance (ESG) disclosure on credit rating and capital structure. The analysis is based on a sample of 202 firms from the 350 FTSE firms over the period of 2008-2013. ESG disclosure score is measured using Proprietary Bloomberg score based on the extent of a company's Environmental, Social, and Governance (ESG) disclosure. The credit rating is measured by The QuiScore, which is a measure of the likelihood that a company will become bankrupt in the twelve months following the date of calculation. The Capital Structure is measured by long term debt ratio. Two hypotheses are test using panel data regression. The results suggested that the higher degree of ESG disclosure leads to better credit rating. There is significant negative relationship between ESG disclosure and the long term debit percentage. The paper includes implications for the transparency which is resulting of the ESG disclosure could support the Monitoring Function. The monitoring role of disclosure is the increasing in the transparency of the credit rating agencies, also it could affect on managers’ actions. This study provides empirical evidence on the material of ESG disclosure on credit ratings changes and the firms’ capital decision making.

Keywords: capital structure, credit rating agencies, ESG disclosure, panel data regression

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10441 Electrocardiogram-Based Heartbeat Classification Using Convolutional Neural Networks

Authors: Jacqueline Rose T. Alipo-on, Francesca Isabelle F. Escobar, Myles Joshua T. Tan, Hezerul Abdul Karim, Nouar Al Dahoul

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Electrocardiogram (ECG) signal analysis and processing are crucial in the diagnosis of cardiovascular diseases, which are considered one of the leading causes of mortality worldwide. However, the traditional rule-based analysis of large volumes of ECG data is time-consuming, labor-intensive, and prone to human errors. With the advancement of the programming paradigm, algorithms such as machine learning have been increasingly used to perform an analysis of ECG signals. In this paper, various deep learning algorithms were adapted to classify five classes of heartbeat types. The dataset used in this work is the synthetic MIT-BIH Arrhythmia dataset produced from generative adversarial networks (GANs). Various deep learning models such as ResNet-50 convolutional neural network (CNN), 1-D CNN, and long short-term memory (LSTM) were evaluated and compared. ResNet-50 was found to outperform other models in terms of recall and F1 score using a five-fold average score of 98.88% and 98.87%, respectively. 1-D CNN, on the other hand, was found to have the highest average precision of 98.93%.

Keywords: heartbeat classification, convolutional neural network, electrocardiogram signals, generative adversarial networks, long short-term memory, ResNet-50

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10440 Comparative Study of Active Release Technique and Myofascial Release Technique in Patients with Upper Trapezius Spasm

Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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10439 Comparison Between Bispectral Index Guided Anesthesia and Standard Anesthesia Care in Middle Age Adult Patients Undergoing Modified Radical Mastectomy

Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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10438 A Comparison between the McGrath Video Laryngoscope and the Macintosh Laryngoscopy in Children with Expected Normal Airway

Authors: Jong Yeop Kim, Ji Eun Kim, Hyun Jeong Kwak, Sook Young Lee

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Background: This prospective, randomized, controlled study was performed to evaluate the usefulness of the McGrath VL compared to Macintosh laryngoscopy in children with expected normal airway during endotracheal intubation, by comparing the time to intubation and ease of intubation. Methods: Eighty-four patients, aged 1-10 years undergoing endotracheal intubation for elective surgery were randomly assigned to McGrath group (n = 42) or Macintosh group (n = 42). Anesthesia was induced with propofol 2.5-3.0 mg/kg and sevoflurane 5-8 vol%. Orotracheal intubation was performed 2 minutes after injection of rocuronium 0.6 mg/kg with McGrath VL or Macintosh laryngoscope. The primary outcome was time to intubation. The Cormack and Lehane glottic grade, intubation difficulty score (IDS), and success rate of intubation were assessed. Hemodynamic changes also were recorded. Results: Median time to intubation [interquartile range] was not different between the McGrath group and the Macintosh group (25.0 [22.8-28.3] s vs. 26.0 [24.0-29.0] s, p = 0.301). The incidence of grade I glottic view was significantly higher in theMcGrath group than in the Macintosh group (95% vs. 74%, p = 0.013). Median IDS was lower in the McGrath group than in the Macintosh group (0 [0-0] vs. 0 [0-1], p = 0.018). There were no significant differences in success rate on intubation or hemodynamics between the two groups. Conclusions: McGrath VL provides better laryngeal views and lower IDS, but similar intubation times and success rates compared to the Macintosh laryngoscope in children with the normal airway.

Keywords: intubation, Macintosh laryngoscopy, Mcgrath videolaryngoscopy, pediatrics

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10437 A Procedure for Post-Earthquake Damage Estimation Based on Detection of High-Frequency Transients

Authors: Aleksandar Zhelyazkov, Daniele Zonta, Helmut Wenzel, Peter Furtner

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In the current research structural health monitoring is considered for addressing the critical issue of post-earthquake damage detection. A non-standard approach for damage detection via acoustic emission is presented - acoustic emissions are monitored in the low frequency range (up to 120 Hz). Such emissions are termed high-frequency transients. Further a damage indicator defined as the Time-Ratio Damage Indicator is introduced. The indicator relies on time-instance measurements of damage initiation and deformation peaks. Based on the time-instance measurements a procedure for estimation of the maximum drift ratio is proposed. Monitoring data is used from a shaking-table test of a full-scale reinforced concrete bridge pier. Damage of the experimental column is successfully detected and the proposed damage indicator is calculated.

Keywords: acoustic emission, damage detection, shaking table test, structural health monitoring

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10436 Rethinking the Value of Pancreatic Cyst CEA Levels from Endoscopic Ultrasound Fine-Needle Aspiration (EUS-FNA): A Longitudinal Analysis

Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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10435 Rare Earth Doped Alkali Halide Crystals for Thermoluminescence Dosimetry Application

Authors: Pooja Seth, Shruti Aggarwal

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The Europium (Eu) doped (0.02-0.1 wt %) lithium fluoride (LiF) crystal in the form of multicrystalline sheet was gown by the edge defined film fed growth (EFG) technique. Crystals were grown in argon gas atmosphere using graphite crucible and stainless steel die. The systematic incorporation of Eu inside the host LiF lattice was confirmed by X-ray diffractometry. Thermoluminescence (TL) glow curve was recorded on annealed (AN) crystals after irradiation with a gamma dose of 15 Gy. The effect of different concentration of Eu in enhancing the thermoluminescence (TL) intensity of LiF was studied. The normalized peak height of the Eu-doped LiF crystal was nearly 12 times that of the LiF crystals. The optimized concentration of Eu in LiF was found to be 0.05wt% at which maximum TL intensity was observed with main TL peak positioned at 185 °C. At higher concentration TL intensity decreases due to the formation of precipitates in the form of clusters or aggregates. The nature of the energy traps in Eu doped LiF was analysed through glow curve deconvolution. The trap depth was found to be in the range of 0.2 – 0.5 eV. These results showed that doping with Eu enhances the TL intensity by creating more defect sites for capturing of electron and holes during irradiation which might be useful for dosimetry application.

Keywords: thermoluminescence, defects, gamma radiation, crystals

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10434 Proposals of Exposure Limits for Infrasound From Wind Turbines

Authors: M. Pawlaczyk-Łuszczyńska, T. Wszołek, A. Dudarewicz, P. Małecki, M. Kłaczyński, A. Bortkiewicz

Abstract:

Human tolerance to infrasound is defined by the hearing threshold. Infrasound that cannot be heard (or felt) is not annoying and is not thought to have any other adverse or health effects. Recent research has largely confirmed earlier findings. ISO 7196:1995 recommends the use of G-weighted characteristics for the assessment of infrasound. There is a strong correlation between G-weighted SPL and annoyance perception. The aim of this study was to propose exposure limits for infrasound from wind turbines. However, only a few countries have set limits for infrasound. These limits are usually no higher than 85-92 dBG, and none of them are specific to wind turbines. Over the years, a number of studies have been carried out to determine hearing thresholds below 20 Hz. It has been recognized that 10% of young people would be able to perceive 10 Hz at around 90 dB, and it has also been found that the difference in median hearing thresholds between young adults aged around 20 years and older adults aged over 60 years is around 10 dB, irrespective of frequency. This shows that older people (up to about 60 years of age) retain good hearing in the low frequency range, while their sensitivity to higher frequencies is often significantly reduced. In terms of exposure limits for infrasound, the average hearing threshold corresponds to a tone with a G-weighted SPL of about 96 dBG. In contrast, infrasound at Lp,G levels below 85-90 dBG is usually inaudible. The individual hearing threshold can, therefore be 10-15 dB lower than the average threshold, so the recommended limits for environmental infrasound could be 75 dBG or 80 dBG. It is worth noting that the G86 curve has been taken as the threshold of auditory perception of infrasound reached by 90-95% of the population, so the G75 and G80 curves can be taken as the criterion curve for wind turbine infrasound. Finally, two assessment methods and corresponding exposure limit values have been proposed for wind turbine infrasound, i.e. method I - based on G-weighted sound pressure level measurements and method II - based on frequency analysis in 1/3-octave bands in the frequency range 4-20 Hz. Separate limit values have been set for outdoor living areas in the open countryside (Area A) and for noise sensitive areas (Area B). In the case of Method I, infrasound limit values of 80 dBG (for areas A) and 75 dBG (for areas B) have been proposed, while in the case of Method II - criterion curves G80 and G75 have been chosen (for areas A and B, respectively).

Keywords: infrasound, exposure limit, hearing thresholds, wind turbines

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10433 Yang-Lee Edge Singularity of the Infinite-Range Ising Model

Authors: Seung-Yeon Kim

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The Ising model, consisting magnetic spins, is the simplest system showing phase transitions and critical phenomena at finite temperatures. The Ising model has played a central role in our understanding of phase transitions and critical phenomena. Also, the Ising model explains the gas-liquid phase transitions accurately. However, the Ising model in a nonzero magnetic field has been one of the most intriguing and outstanding unsolved problems. We study analytically the partition function zeros in the complex magnetic-field plane and the Yang-Lee edge singularity of the infinite-range Ising model in an external magnetic field. In addition, we compare the Yang-Lee edge singularity of the infinite-range Ising model with that of the square-lattice Ising model in an external magnetic field.

Keywords: Ising ferromagnet, magnetic field, partition function zeros, Yang-Lee edge singularity

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10432 Pain Analysis in Musicians Using Digital Pain Drawings

Authors: Cinzia Cruder, Deborah Falla, Francesca Mangili, Laura Azzimonti, Liliana Araujo, Aaron Williamon, Marco Barbero

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Background and aims: According to the existing literature, musicians are at risk to experience a range of musculoskeletal painful conditions. Recently, digital technology has been developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing analysis. Additionally, the association between pain drawing (PD) variables and clinical features in musicians with pain were explored. Materials and Methods: One hundred fifty-eight musicians (90 women and 68 men; age 22.4±3.6 years) were recruited from Swiss and UK conservatoires. Participants were asked to complete a survey including both background musical information and clinical features, the Quick Dash (QD) questionnaire and the digital PDs. Results: Of the 158 participants, 126 musicians (79.7%) reported having pain, with more prevalence in the areas of the neck and shoulders, the lower back and the right arm. The mean of pain extent was 3.1% ±6.5. The mean of QD was larger for musicians showing the presence of pain than for those without pain. Additionally, the results indicated a positive correlation between QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity. Conclusions: The high prevalence of pain among musicians has been confirmed using a digital PD. In addition, positive correlations between pain extent and upper limb disability has been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.

Keywords: pain location, pain extent, musicians, pain drawings

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10431 Evaluation of Cooperative Hand Movement Capacity in Stroke Patients Using the Cooperative Activity Stroke Assessment

Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann

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Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.

Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke

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