A Pilot Fuzzy System with Virtual Reality for Mild Cognitive Impairment (MCI) Assessment.

Mild cognitive impairment (MCI) is when brain function declines. MCI is the gray area transitioning from normal aging to the AD stage. Currently, the majority of early MCI diagnoses are processed through comprehensive neuropsychological tests. These tests may take the form of interviews, paper-and-pencil tests, or computer-based tests. There may be resistance from the subject if he/she has to undergo many screening tests simultaneously for multiple evaluation information, resulting in execution difficulty. The objectives of this study are to use 3D virtual reality to create an entertaining test scenario integrating the Mini-Cog, SPMSQ, MMSE, SLUMS, CDR, and CASI for middle-aged to older adults, furthermore, to employ fuzzy logic control (FLC) technology to develop a "MCI assessment system" for obtaining some pilot information for MCI assessment. There were 24 middle-aged to older adults aged from 50 to 65 years who participated in the evaluation experiment. The results showed that the MCI assessment system developed in this study is highly correlated with the traditional screening tests, including the Mini-Cog, SPMSQ, MMSE, SLUMS, and CASI. The assessment system can provide an integrated reference score for clinic workers in making judgments. In addition, the distribution of the System Usability Scale (SUS) evaluation scores for the MCI assessment system revealed that 87.5% were grade C (good to use) or above and 29.2% were grade B (extremely good to use) or above. The assessment system received positive feedback from the subjects.

Efficacy of Aromatherapy at Relieving the Work-Related Stress of Nursing Staff from Various Hospital Departments during COVID-19.

This study aimed to evaluate the efficacy of aromatherapy in relieving the stress of nursing staff working in different departments during COVID-19. A total of 26 nursing staff from Taiwan were recruited for this study. Bergamot essential oil was diffused for over a four-week period in four different hospital departments. We assessed heart rate variability indicators, Nurse Stress Checklist, and Copenhagen Burnout Inventory before and after the intervention. The results of the analysis showed that during a high workload period, aromatherapy had no significant effect on regulating physical stress. Subjective measurements showed a significant impact on work concern and personal fatigue. Moreover, there were large differences among the four departments; the aromatherapy treatment had a weak effect on those with a heavy workload, whereas those with a lighter workload showed a stronger effect. Finally, this study provides practical results about aromatherapy stress reduction applied during the pandemic on first-line medical staff.

Apply the SERVQUAL Instrument to Measure Service Quality for the Adaptation of ICT Technologies: A Case Study of Nursing Homes in Taiwan.

The adoption of information and communication technology by elderly care organizations is an inevitable trend. Most empirical studies on e-Health service quality have focused predominantly on the general population rather than on the elderly. Thus, the generalizations are rather problematic. In addition, in the planning stage, pre-implementation analysis is considered critical but seldom performed. In this research, an instrument to evaluate the e-Health service quality in nursing homes was developed based on the SERVQUAL model. Furthermore, a pre-implementation analysis combining the SERVQUAL questionnaire and importance performance analysis was performed. Dissatisfactory factors were identified as follows. Regarding the physical environment quality, the residents expressed that the nursing homes did not provide well-maintained rooms and that the temperature in the rooms was unsuitable. Regarding the outcome quality, the elderly residents replied that the medical treatments and doctor visits were not well scheduled. Regarding the interaction quality, the residents indicated that the staff did not solve their problems sincerely or clearly understand their needs. Health care informatics (HCI) such as an electronic shift system (ESS) and electronic health records (EHR) are proposed to eliminate these problems. Given current resource limitations, our instrument and methodology proposed in this research could be extremely meaningful in practical application.

The effect of cane length and step height on muscle strength and body balance of elderly people in a stairway environment.

BACKGROUND: It has been reported that 75% of stairway accidents occur while descending stairs. Using a cane can help to prevent older people and those with limited mobility from falling. However, studies have shown that two-thirds of older cane users use a cane that is longer than the recommended length, which may cause unnecessary muscular loads. This study aims to assess balance and muscular load in older people descending different height steps with different cane lengths. METHODS: Nine participants (5 males and 4 females) aged over 65 years participated in this study. Cane length and stair height were independent variables. Electromyography signals were recorded from the biceps brachii of the arm that usually held the cane and from both gastrocnemius muscles. In addition, the center of pressure (CoP) was assessed as an indicator of balance in older people descending a step. RESULTS: Descending from higher steps resulted in the use of greater arm and leg strength at the time of first foot contact. However, cane length did not affect any of the root mean square values. In addition, the CoP Stabilometric Parameters showed that mean distance, antero-posterior mean distance, total excursions, antero-posterior total excursions, mean velocity, and antero-posterior mean velocity were significantly affected by step height, but not by cane length. CONCLUSIONS: If cane length is within the currently suggested range, then it has little effect on the force load on the arm and legs when descending a step. Step height has a greater effect than cane length on the strategies used by older people to maintain stability.

Physiological strains of wearing aluminized and non-aluminized firefighters' protective clothing during exercise in radiant heat.

This study examined the influences of aluminized (Type A) and non-aluminized firefighters' protective clothing (Type B, C, D and CON) on physiological and subjective responses in radiant heat. Total clothing weight was 6.24, 6.38, 6.06, 5.76 and 3.82 kg for Type A, B, C, D and CON, respectively. Eight firefighters performed exercise at an air temperature of 30°C with 50%RH. Three bouts of 10 min-bicycle exercise in radiant heat (a globe temperature of 70°C) was spaced by a 10 min rest with no radiant heat. Results showed that rectal temperature, mean skin temperature, heart rate, and body weight loss were significantly greater in Type A than in other types (p<0.05). For Type A, thermal gradient of the body reached 0.0 ± 0.7°C, heart rate showed a maximum level of 183 ± 11 bpm and 1.9% of body weight was lost due to sweat secretion. Firefighters felt the hottest and most discomfort in Type A. It appeared that firefighters' thermoregulatory mechanism was severely challenged by wearing aluminized protective clothing during exercise in strong radiant heat. Therefore, it is suggested that the safe upper limits while wearing aluminized firefighters' clothing should be distinguished from those for typical firefighters' protective clothing.

Cutaneous Warm and Cool Sensation Thresholds and the Inter-threshold Zone in Malaysian and Japanese Males.

The purpose of this study was to investigate ethnic differences in cutaneous thermal sensation thresholds and the inter-threshold sensory zone between tropical (Malaysians) and temperate natives (Japanese). The results showed that (1) Malaysian males perceived warmth on the forehead at a higher skin temperature (Tsk) than Japanese males (p<0.05), whereas cool sensations on the hand and foot were perceived at a lower Tsk in Malaysians (p<0.05); (2) Overall, the sensitivity to detect warmth was greater in Japanese than in Malaysian males; (3) The most thermally sensitive body region of Japanese was the forehead for both warming and cooling, while the regional thermal sensitivity of Malaysians had a smaller differential than that of Japanese; (4) The ethnic difference in the inter-threshold sensory zone was particularly noticeable on the forehead (1.9±1.2C for Japanese, 3.2±1.6°C for Malaysians, p<0.05). In conclusion, tropical natives had a tendency to perceive warmth at a higher Tsk and slower at an identical speed of warming, and had a wider range of the inter-threshold sensory zone than temperate natives.

Physiological and subjective responses to cooling devices on firefighting protective clothing.

The aim of the present study was to examine the effectiveness of ice-packs (ICE) and phase change material (PCM) cooling devices in reducing physiological load based on subjects' physiological and subjective responses while the subjects exercised on a bicycle ergometer while wearing firefighting protective clothing in a relatively high temperature environment (30 degrees C, 50%RH). Subjects were eight graduate students, aged 25.9 years (SD 3.2). Each subject participated in four 50-min exposures: control (CON), ICE, PCM of 5 degrees C [PCM(5)] and 20 degrees C [PCM(20)]. Each subject rested in a pre-test room for 10 min before entering the test-room where they rested for another 10 min, followed by 30 min-exercise and a 10 min-recovery period. The exercise intensity was set at 55%VO(2max). Cooling effects were evaluated by measuring rectal temperature (Tre), mean skin temperature (Tsk), body weight loss and subjective responses. An increase in Tre for PCM(5) and PCM(20) which was less than that for CON and ICE was observed. The increases in Tsk were depressed using cooling devices, but the cooling effects of PCMs were greater than ICE. The subjects with CON felt hotter and wetter than those in the other conditions. The larger surface cooling area, higher melting temperature and softer material of PCMs which reduces absorption capacity caused a decrease in Tre and Tsk for PCM(5) and PCM(20) which was more than that for CON and ICE. Furthermore, PCM(20) does not require refrigeration. These results suggest that PCM(20) is more effective than other cooling devices in reducing the physiological load while wearing firefighting protective clothing.

Physiological and subjective responses to low relative humidity in young and elderly men.

In order to compare the physiological and the subjective responses to low relative humidity of elderly and young men, we measured saccharin clearance time (SCT), frequency of blinking, hydration state of the skin, transepidermal water loss (TEWL), sebum level recovery and skin temperatures as physiological responses. We asked subjects to evaluate thermal, dryness and comfort sensations as subjective responses using a rating scale. Eight non-smoking healthy male students (21.7+/-0.8 yr) and eight non-smoking healthy elderly men (71.1+/-4.1 yr) were selected. The pre-room conditions were maintained at an air temperature (Ta) of 25 degrees C and a relative humidity (RH) of 50%. The test-room conditions were adjusted to provide 25 degrees C Ta and RH levels of 10%, 30% and 50%. RH had no effect on the activity of the sebaceous gland or change of mean skin temperature. SCT of the elderly group under 10% RH was significantly longer than that of the young group. In particular, considering the SCT change, the nasal mucous membrane seems to be affected more in the elderly than in the young in low RH. Under 30% RH, the eyes and skin become dry, and under 10% RH the nasal mucous membrane becomes dry as well as the eyes and skin. These findings suggested that to avoid dryness of the eyes and skin, it is necessary to maintain greater than 30% RH, and to avoid dryness of the nasal mucous membrane, it is necessary to maintain greater than 10% RH. On the thermal sensation of the legs, at the lower humidity level, the elderly group felt cooler than the young group. On the dry sensation of the eyes and throat, the young group felt drier than the elderly group at the lower humidity levels. From the above results, the elderly group had difficulty in feeling dryness in the nasal mucous membrane despite being easily affected by low humidity. On the other hand, the young group felt the change of humidity sensitively despite not being severely affected by low humidity. Ocular mucosa and physiology of skin by dryness showed no difference by age. In the effect of longer exposure (180 min.) to low RH, only TEWL showed a slight decrease after 120 minutes in 30% RH, and all the measured results showed no noticeable differences compared with the result at 120 minutes.

Physiological and subjective responses to low relative humidity.

In order to investigate the influence of low relative humidity, we measured saccharin clearance time (SCT), frequency of blinking, heart rate (HR), blood pressure, hydration state of skin, transepidermal water loss (TEWL), recovery sebum level and skin temperature as physiological responses. We asked subjects to judge thermal, dryness and comfort sensations as subjective responses using a rating scale. Sixteen non-smoking healthy male students were selected. The pre-room conditions were maintained at an air temperature (Ta) of 25 degrees C and a relative humidity (RH) of 50%. The test room conditions were adjusted to provide a Ta of 25 degrees C and RH levels of 10%, 30% and 50%.RH had no effect on the activity of the sebaceous gland and on cardiovascular reactions like blood pressure and HR. However, it was obvious that low RH affects SCT, the dryness of the ocular mucosa and the stratum corneum of the skin and causes a decrease in mean skin temperature. Under 30% RH, the eyes and skin become dry, and under 10% RH the nasal mucous membrane becomes dry as well as the eyes and skin, and the mean skin temperature decreases. These findings suggested that to avoid dryness of the eyes and skin, it is necessary to maintain an RH greater than 30%, and to avoid dryness of the nasal mucous membrane, it is necessary to maintain an RH greater than 10%. Subjects felt cold immediately after a change in RH while they had only a slight perception of dryness at the change of humidity.