Yuh Jang - Academia.edu (original) (raw)

Papers by Yuh Jang

研究目的：按摩屬於高度重複及高度施力型工作且採用特定及不適當工作姿勢，此種工作特性讓按摩從業人員屬於罹患肌肉骨骼疾病之高危險群。本研究的目的乃是在探討視覺障礙按摩從業人員肌肉骨骼疾病的盛行率及找... more 研究目的：按摩屬於高度重複及高度施力型工作且採用特定及不適當工作姿勢，此種工作特性讓按摩從業人員屬於罹患肌肉骨骼疾病之高危險群。本研究的目的乃是在探討視覺障礙按摩從業人員肌肉骨骼疾病的盛行率及找出造成按摩從業人員肌肉骨骼疾病的原因。研究方法：以橫斷式的研究設計，採用實地訪查的方式在2004年期間，針對台北市18歲以上之視覺障礙者，且在按摩院所擔任全職按摩工作者進行問卷調查，調查內容包括：人口學、人體測計與力量資料、肌肉骨骼疼痛及工作姿勢。描述性統計用來描述按摩從業人員的人口學、人體測計及手部力量資料，以及肌肉骨骼疾病的盛行率及嚴重度；用Spearman ρ 相關用來測試變數間的共線性關係；最後，用backward logistic regression的方式來探討影響身體各部位疼痛的危害因子，計算機率（odds ratios, ORs）及95%信賴區間（95% confidence intervals, 95%CIs）。研究結果：161名按摩從業人員參與本研究，其中42人（26.1%）手部關節有異常腫大及變形現象；71.4%（115人）的受訪者身體至少一個部位有與工作相關之肌肉骨骼疼痛，手指及大拇指疼痛盛行率（50.3%）最高，其次為肩部（31.7%），手腕（28.6%），頸部（25.5%），上臂/肘（23.6%），前臂（20.5%）。神經學檢查結果出現正向反應（positive response）顯示疑似有腕道症候群的有29.8%，de Quervain氏症候群為33.5%，18.6%的受訪者在腕道症候群及de Quervain氏症候群神經學檢查同時呈現正向反應。肩頸疼痛、背部及下肢疼痛對於生活的影響屬輕度失能。手指腹力≤7公斤或不使用手指腹部及整個手掌來從事按摩的受訪者，手指及大拇指關節可明顯看出有變形及腫大的比例較高（OR=3.4-9.6；95%CI=1.3-44.3）。影響按摩從業人員身體各部位疼痛的因素包括：工作年資、年齡、手指腹力、直接及持續與顧客接觸的時間、工作檯高度，以及工作姿勢。每天與顧客直接接觸的時間≥4小時罹患手指疼痛的機率是＜4小時者的3.2倍（95%CI=1.3-8.1）。按摩從業人員的手指腹力≤7公斤罹患前臂或上臂/肘部疼痛的機率是手指腹力＞7公斤者的2.9-3.2倍（95%CI=1.5-13.8）。從事按摩＞20年者罹患手指...

復健的目標是讓病患能夠在社會扮演主動的、獨立的、具生產性的角色，並對生活品質有高度的滿足感。本研究遵循世界衛生組織生活品質小組發展「世界衛生組織生活品質問卷」的步驟，發展出屬於脊髓損傷者的生... more 復健的目標是讓病患能夠在社會扮演主動的、獨立的、具生產性的角色，並對生活品質有高度的滿足感。本研究遵循世界衛生組織生活品質小組發展「世界衛生組織生活品質問卷」的步驟，發展出屬於脊髓損傷者的生活品質問卷，且此問卷經過初步的信效度分析顯示出具備相當的信效度。相信此「脊髓損傷生活品質問卷」將可應用在日後對於脊髓損傷者治療或服務的一種指標及依據

Journal of Visual Impairment & Blindness, 2013

Introduction We investigated the employment status and identified factors that may affect the emp... more Introduction We investigated the employment status and identified factors that may affect the employment outcomes of people with visual impairments in Taiwan. Methods A retrospective, ex post facto design study was conducted. The sample included 313 visually impaired clients who commenced and “closed” (completed) disability employment services between 2008 and 2010 in a metropolitan area in Taiwan. Results Two hundred and seventy-one out of 313 (87%) clients were gainfully employed after receiving services. Among those employed, 224 clients were employed as massage practitioners. Factors that increased the likelihood of successful employment outcomes after receiving services included more postemployment services, fewer pre-employment services, and having a vocational qualification. Discussion This study provides some empirical support documenting the association between the provision of employment services and employment outcomes among people with visual impairments in Taiwan. Impli...

British Journal of Occupational Therapy, 1995

A study of the relationship between Chinese culture and occupational therapy is presented in this... more A study of the relationship between Chinese culture and occupational therapy is presented in this paper. Based on a literature review and direct observations and analysis by the author, it was found that Chinese culture and occupational therapy share common thinking on the concept of the use of activity, the concept of balance and harmony, the environmental influences in treatment and evaluation, intrinsic motivation and meaningful existence. The major difference between Chinese culture and occupational therapy is the perception of the role of the sick person. In the Chinese society, the role of the patient is dependent and passive, but occupational therapy believes that the patient should be independent and actively participate in the therapy. The implications of these aspects for clinical practice are also described. This article is reprinted from the Journal of the Occupational Therapy Association of the Republic of China, 1993, Volume 11, pp 95–104, by kind permission of the aut...

i-Perception, 2011

Contrast perception depends on not only the early visual responses, but also top-down modulations... more Contrast perception depends on not only the early visual responses, but also top-down modulations. We measured how does P300, a well-documented event-related potential (ERP) index for top-down influence, change with both spatial frequency and contrast. ERP were acquired from 10 participants, aged 18-50 years, when they were performing a visual oddball task. The target was a Gabor patch whose spatial frequency was either 4 or 8 cy/degree and contrasts 90% or 30%. The probability of target presence in a trial was 30%. All target stimuli produced a reliable P300 component. At the low spatial frequency, the amplitude of P300 was larger and the latency was shorter for the low contrast patterns than for the higher contrast ones for all electrodes. Such difference was not observed in high spatial frequency patterns. The latency was slightly longer for high spatial frequency patterns than the low spatial frequency ones. Our results showed an interaction between spatial frequency and contrast in P300. The characteristics of P300 at low spatial frequency correlated with task difficulty, but not at high spatial frequency. This suggests that the top-down influence on contrast perception may be spatial frequency depended.

Spine, 2007

Study Design. A prospective interview study. Objective. To determine whether items of the Frencha... more Study Design. A prospective interview study. Objective. To determine whether items of the Frenchay Activities Index (FAI) measure Instrumental Activities of Daily Living (IADL), as a unidimensional construct, in patients with spinal cord injury (SCI). To examine whether the response categories of the FAI are useful in discerning the various ability levels of IADL. Summary of Background Data. No known IADL scale has been designed for SCI patients. The FAI, to our knowledge, has never been validated in patients with SCI. Methods. A total of 233 persons with SCI participated in this study. The FAI was administered to the patients by interview at locations convenient for the participants. A Rasch analysis was used to examine the unidimensionality and appropriateness of the response categories of the FAI. Results. All but 2 items ("going outside" and "reading books") of the FAI fitted the model's expectations. The results of Rasch analysis indicated that the response categories for the remaining 13 items of the FAI should be collapsed to create more suitable response categories (4 items, into dichotomies, and the remaining 9 items, into trichotomies). Thus, a revised 13-item FAI was formed by deleting the 2 misfitting items and collapsing the response categories of the items. Conclusions. This study demonstrated that the revised 13-item FAI assesses a single, unidimensional IADL for SCI patients living in the community. The revised FAI shows potential for assessment of IADL in SCI patients.

International Journal of Rehabilitation Research, 2009

International Journal of Industrial Ergonomics, 2004

We examined the psychometric properties (internal consistency, concurrent criterion validity, and... more We examined the psychometric properties (internal consistency, concurrent criterion validity, and known-group validity) of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) in people with intellectual disabilities. A total of 111 people with intellectual disabilities and 19 people with no disabilities were included. We used Cronbach’s alpha, Spearman’s rho, the Kruskal–Wallis test, and one-way analysis of variance for analysis, where appropriate. Results showed good internal consistency on Orientation, Visual Perception, Spatial Perception, Visuomotor Organization, and Thinking Operations subscales (Cronbach’s αs = .82, .74, .76, .86, and .80, respectively), but not on the Motor Praxis subscale (α = .48). We found significant correlations between participants’ performance on the Pictorial IQ test and disability level and scores on the LOTCA. The known-group validity of the LOTCA in people with intellectual disabilities was satisfactory. We concluded that the LOTCA is...

Scientific Reports, 2021

Although the association between visual acuity (VA) and vision-related quality of life (VRQoL) ha... more Although the association between visual acuity (VA) and vision-related quality of life (VRQoL) has been well reported in patients with type 2 diabetes mellitus (T2DM), little is known about how unilateral and bilateral VA affects daily performance in such patients. For this cross-sectional study, patients were recruited from the Diabetes Shared Care Network of the Division of Endocrinology and Metabolism, Zhong-Xiao Branch, Taipei City Hospital in Taiwan. Ninety patients with T2DM (51 men and 39 women) with a mean age of 60.3 ± 10.5 (standard deviation) years, 47% of whom had diabetic retinopathy, were included. The purposes were to compare the impacts of VA in the better eye, both eyes, and three forms of functional acuity scores (FAS) on VRQoL in patients with T2DM. VRQoL and corrected VA were assessed with the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Early Treatment Diabetic Retinopathy Study (ETDRS) chart, respectively. Three FAS algorithms p...

PLOS ONE, 2019

The assessment of daily living activities could provide information about daily functions and par... more The assessment of daily living activities could provide information about daily functions and participation restrictions to develop intervention strategies. The purposes of this study were to assess the scores of the Barthel Index (BI) and Lawton Instrumental Activities of Daily Living (IADL) scale in older adults with cognitive impairment and to explore the different effects that levels of cognitive functions have on changes in IADL functions. We recruited 31 participants with dementia, 36 with mild cognitive impairment (MCI), and 35 normal controls (NCs) from the neurology outpatient department of a regional hospital. The results of the demographic and clinical characteristics through the Lawton IADL scale, BI, Quick Mild Cognitive Impairment (Qmci) screen, Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE), were collected on the same day and compared with the Kruskal-Wallis test, Wilcoxon rank-sum test, Fisher's exact test, and a multiple linear regression analysis, as appropriate. In the BI, bathing was the most discriminating activity to differentiate patients with MCI and dementia; in the Lawton IADL scale, medication responsibility and shopping were the most discriminating activities to differentiate NCs and patients with MCI, and patients with MCI and dementia, respectively. In addition, the predictors of changes in Lawton IADL scale scores were the problem-solving score of the Clinical Dementia Rating scale, a Qmci score of > 20.4 and an age of � 81.2 years, a MoCA score of < 9.4 and an age of > 81.2 years, and the MMSE score and an age of > 81.2 years. This study adds to the evidence that the description of basic and instrumental daily activities is integrated in older adults with cognitive impairment. Notably, the Qmci is the most significant predictor of changes in IADL function for "young" older adults, as are the MoCA and MMSE for "old" older adults.

Scientific Reports, 2019

For a reliable visual test, it is important to evaluate the legibility of the symbols, which depe... more For a reliable visual test, it is important to evaluate the legibility of the symbols, which depends on several factors. Previous studies have compared the legibility of Latin optotypes. This study developed a visual function test based on identification visual capacity for a Chinese reading population. The legibility of word symbols was assessed with three methods: (1) Identification of the contrast thresholds of the character sets, (2) patterns of confusion matrices obtained from analysis of the frequency of incorrect stimulus/response pairs, and (3) pixel ratios of bitmap images of Chinese characters. Then characters of similar legibility in each character set were selected. The contrast thresholds of the final five character sets and the Tumbling E and Landolt C optotypes were evaluated. No significant differences in contrast threshold were found among the five selected character sets (p > 0.05), but the contrast thresholds were significantly higher than those of the E and C optotypes. Our results indicate that combining multiple methods to include the influences of the properties of visual stimuli would be useful in investigating the legibility of visual word symbols. A typical visual function test usually uses simple, standardized visual optotypes to examine the visual capacity of patients 1,2. However, for reliable data collection and accurate diagnosis, the development of a visual test actually involves very complex procedures, from optotype selection and test construction to psychometric validation, before the test can be applied in a clinical setting 3,4. The Landolt C, Tumbling E, and Sloan letters, the most popular optotypes, have been used extensively and globally in several kinds of clinical vision tests. However, an important question is whether they are the most suitable optotypes for testing the functional vision capacities of people whose primary language does not use Latin letters 5. The Sloan letter test, which requires the patients to name the letters, is obviously not suitable for patients with limited knowledge of the Latin alphabet. It is possible to use the Landolt C or Tumbling E charts for people who cannot read Latin optotypes by instructing the patients to respond to the orientation of the gap in an E or C, and quite a number of studies support the relationship between the visual acuity and functional vision performance 6,7. However, debate continues on the nature of the mechanisms underlying the visual acuity measured with the Landolt C or Tumbling E 8,9. It is possible that such orientation identification tasks measures only resolution acuity rather than recognition acuity 10,11. The latter, as measured with the Sloan letters, includes more compensatory top-down cognitive components and may be more related than the former to functional vision performance 10,12. Whether or not Latin optotypes are used, one of the major concerns about the use of visual symbols to measure visual function is their legibility 4,13. The legibility of visual symbols depends on the physical properties of the symbols, such as size, contrast, font type, and spacing 13,14. Thus, one classical approach to assess the legibility of visual symbols, as used in the development of the Sloan letter chart 1,13,15,16 , is to compare the percentage of correct responses for each optotype in an optotype set and to conduct an error analysis of the incorrect responses at the limit of visual acuity or contrast threshold. The other popular way to estimate the legibility is to use psychophysical methods to compare the size thresholds or contrast thresholds of the individual symbols 5,17,18. Other techniques, such as Fourier frequency spectrum analysis 19 , stroke frequency 5,17 and the image descriptors method 20 , have also been proposed for assessing legibility. Previous studies often used the size threshold of a high contrast target for assessing legibility 1,5,13,17. However, contrast is also an important criterion for legibility, which can vary under high or low contrast conditions for the same alphabetic characters or visual symbols 16,18,21-23. The Sloan letters were originally chosen to have similar legibility for visual acuity assessment 1 , but these letters are also used for contrast sensitivity (e.g., the Pelli-Robson

PLOS ONE, 2018

There is a need for a screening tool with capacities of accurate detection of early mild cognitiv... more There is a need for a screening tool with capacities of accurate detection of early mild cognitive impairment (MCI) and dementia and is suitable for use in a range of languages and cultural contexts. This research aims to evaluate the psychometric and diagnostic properties of the Taiwan version of Qmci (Qmci-TW) screen and to explore the discriminating ability of the Qmci-TW in differentiating among normal controls (NCs), MCI and dementia. Thirty-one participants with dementia and 36 with MCI and 35 NCs were recruited from a neurology department of regional hospital in Taiwan. Their results on the Qmci-TW, Taiwanese version of the Montreal Cognitive Assessment (MoCA), and Traditional Chinese version of the Mini-Mental State Examination (MMSE) were compared. For analysis, we used Cronbach's α, intraclass correlation coefficient, Spearman's ρ, Kruskal-Wallis test, receiver operating characteristic curve analysis, and multivariate analysis, as appropriate. The Qmci-TW exhibited satisfactory test-retest reliability, internal consistency, and interrater reliability as well as a strong positive correlation with results from the MoCA and MMSE. The optimal cutoff score on the Qmci-TW for differentiating MCI from NC was � 51.5/100 and dementia from MCI was � 31/100. The MoCA exhibited the highest accuracy in differentiating MCI from NC, followed by the Qmci-TW and then MMSE; whereas, the Qmci-TW and MMSE exhibited the same accuracy in differentiating dementia from MCI, followed by the MoCA. The Qmci-TW may be a useful clinical screening tool for a spectrum of cognitive impairments.

International Journal of Industrial Ergonomics, 2018

The current study applied productivity improvement tools, e.g., hierarchical task analysis, stand... more The current study applied productivity improvement tools, e.g., hierarchical task analysis, standard operating procedure (SOP), checklist, and plant layout analysis in two sheltered workshops for the disabled to facilitate the sustainable operation of the workshops. The study was conducted in two sheltered workshops where intellectually disabled workers were trained and employed to perform cleaning tasks as janitors while psychiatrically disabled workers were trained to assemble a stationery box. On-site job analysis was conducted to find feasible workplace accommodations for both workshops. The preliminary on-site job analysis indicated the need of a standard operating procedure for the cleaning tasks in the first sheltered workshop. Therefore, SOPs were developed based on hierarchical task analysis and will be presented in a checklist format for the training and payment of the disabled. In the second sheltered workshop, flow diagram analysis of the initial assembly layout revealed excessive moving and backtrackings of material handling. Thus, a revised layout is proposed to remove all of the inefficiencies. Relevance to industry: The current study demonstrates feasible applications of several productivity improvement tools in two sheltered workshops for disabled workers in order to enhance sustainability.

PLOS ONE, 2016

In addition to diabetic retinopathy, diabetes also causes early retinal neurodegeneration and oth... more In addition to diabetic retinopathy, diabetes also causes early retinal neurodegeneration and other eye problems, which cause various types of visual deficits. This study used a computer-based visual test (Macular Multi-Function Assessment (MMFA)) to assess contrast-dependent macular visual function in patients with type 2 diabetes to collect more visual information than possible with only the visual acuity test. Because the MMFA is a newly developed test, this study first compared the agreement and discriminative ability of the MMFA and the Early Treatment Diabetic Retinopathy Study (ETDRS) contrast acuity charts. Then symbol discrimination performances of diabetic patients and controls were evaluated at 4 contrast levels using the MMFA. Seventy-seven patients and 45 controls participated. The agreement between MMFA and ETDRS scores was examined by fitting three-level linear mixed-effect models to estimate the intraclass correlation coefficients (ICCs). The estimated areas under the receiver operating characteristic (ROC) curve were used to compare the discriminative ability of diseased versus non-diseased participants between the two tests. The MMFA scores of patients and controls were compared with multiple linear regression analysis after adjusting the effects of age, sex, hypertension and cataract. Results showed that the scores of the MMFA and ETDRS tests displayed high levels of agreement and acceptable and similar discriminative ability. The MMFA performance was correlated with the severity of diabetic retinopathy. Most of the MMFA scores differed significantly between the diabetic patients and controls. In the low contrast condition, the MMFA scores were significantly lower for 006Eon-DR patients than for controls. The potential utility of the MMFA as an easy screening tool for contrast-dependent visual function and for detecting early functional visual change in patients with type 2 diabetes is discussed.

The purpose of this study was to determine factors related to return to work following the comple... more The purpose of this study was to determine factors related to return to work following the completion of a Work-Oriented Occupational Therapy Program (WOOTP). This program is conducted at the Department of Occupational Therapy, National Taiwan University Hospital, Taipei, Taiwan, Republic of China. One hundred and twelve subjects were discharged from WOOTP between November 1, 1995 and May 31, 1997.