Chronic fatigue syndrome (CFS) is a long-term and debilitating condition that regards as a neurological disease. Its symptoms include profound physical and mental fatigue (characteristically made worse by exertion), muscle and joint pain, disturbed sleep, and both concentration and memory problems. CFS is a kind of human stress-related disorders that are characterized by alterations in hypothalamic-pituitary-adrenal (HPA) axis activity. Investigation of abnormal activity of the HPA axis in various neurological and neuropsychiatric disorders can date back at least 60 years, and its relation to CFS had been reported in the early 1990s. This chapter further disseminated updated evidence for disruption of HPA function in CFS, with the explanation on the relationship between cytokines and HPA activities. Moreover, very limited literature had addressed the importance of rehabilitation to them. This chapter addresses this gap by sharing a pilot rehabilitation outcome on a single-blinded randomized control trial with a parallel group experimental design in the application of activity scheduling (AS) program of occupational therapy for a group of community-dwelling older adults with CFS. The primary objective is to study the outcome of physical functioning of individual participants. The second objective is to study the outcome of AS on impact of caring role through assessing individual caregivers' perceived burden in care. The third objective is to study the time that needed in taking care; individuals' perception of enjoyment and achievement in their participated activities will be evaluated. There was a significant effect of AS on the physical functioning of participants as measured by Functional Independence Measure (FIM), as the primary outcome measure, in experimental group, with Wilk's λ = 0.72, F (2,57) = 18.75, p < 0.001. Moreover, in secondary outcome measures, there is a significant decrease in the impact of caring role as reflected by their perceived burden as measured by the Chinese Zarit Burden Interview (CZBI) in caring for experimental group, with Wilk's λ = 0.72, F (2,97) = 18.75, p < 0.001. Another study set out to examine the effect of time on caring activities for those recruited couples in AS group. There was significant effect of AS on caring activities with Wilk's λ = 0.71, F (2,97) = 12.47, p < 0.001. With proper coaching and regular facilitation regarding AS, activity participation in older adults with CFS can be greatly enhanced. Behavioral intervention, such as AS, can supplement therapeutic treatment or may lead to decline in CFS symptoms.
Background Social distancing under the COVID‐19 pandemic has restricted access to community services for older adults with neurocognitive disorder (NCD) and their caregivers. Telehealth is a viable alternative to face‐to‐face service delivery. Telephone calls alone, however, may be insufficient. Here, we evaluated whether supplementary telehealth via video‐conferencing platforms could bring additional benefits to care‐recipient with NCD and their spousal caregivers at home. Method Sixty older adults NCD‐and‐caregiver dyads were recruited through an activity centre. The impact of additional services delivered to both care‐recipient and caregiver through video conference (n=30) was compared with telehealth targeted at caregivers by telephone only (n=30), over 4 weeks in a pretest‐posttest design. Interviews and questionnaires were conducted at baseline and study’s end. Result Supplementary telemedicine had averted the deterioration in the Montreal Cognitive Assessment evident in the telephone‐only group (ηp2=0.50). It also reversed the falling trend in quality of life observed in the telephone only group (QoL‐AD, ηp2=0.23). Varying degrees of improvements in physical and mental health (Short‐Form 36 v2), perceived burden (Zarit Burden Interview Scale) and self‐efficacy (Revised Caregiving Self‐Efficacy Scale) were observed among caregivers in the video‐conferencing group, which were absent in the telephone‐only group (ηp2=0.23–0.51). Conclusion Telehealth by video conference was associated with improved resilience and wellbeing to both people with NCD and their caregivers at home. The benefits were visible already after 4 weeks and unmatched by telephone alone. Video conference as the modus operandi of telehealth beyond the context of pandemic‐related social distancing should be considered.
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This paper focuses on the use of machine learning models to forecast economic recessions caused by incidents such as the COVID-19 pandemic. Relevant economic variables are selected to fit into the VAR, SVR, Random Forest, and LSTM models. The study examines the cases of the US and Italy, analyzing how the models predict the Euro crisis, 2008 Financial Crisis, and the economic recession induced by COVID-19. Evaluations and comparisons among these models and cases are made to determine appropriate models. Additionally, an analysis based on US 2020 mobility data is applied to demonstrate the difference in economic activities between normal and crisis times.
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