Instrumental activities of daily living (IADL) training is critical in clinical practice of occupational therapy (OT) for stroke patients. In the conventional approaches, the therapists simulate various occupational tasks in their healthcare settings or reach their nearby real circumstances for the training. As an alternative technology, immersive virtual reality (IVR) has been used widely in stroke rehabilitation for years; however, limited research has compared occupational performances between virtual and real environments. Our team has established a novel IVR shopping training system for stroke rehabilitation. We recruited 10 stroke patients from our department to test the system. All patients attempted to implement shopping tasks in the virtual and real environments respectively. The Wilcoxon test showed no significant differences between virtual and real environments in memory capacity and time-consuming for implementing tasks, and memory capacities in virtual and real environments presented excellent correlations with the IADL assessment. This study suggests that IVR shopping tasks can be used as an alternative approach in rehabilitation when there is limited resource for implementing shopping training in a real environment, while the psychometric property, clinical effect and the effect transferred to the real environment induced by virtual training require further study.

This study aims to quantify carotenoids and tocopherols in human milk from healthy Chinese women, and to explore their associations with region, lactation stage, and maternal socio-economic and obstetric factors. Human milk was obtained from 509 healthy mothers and the compounds of carotenoids and tocopherols were analyzed by high-performance liquid chromatography after mild saponification and solvent extraction. Socio-economic and obstetric characteristics of the mothers and their dietary intakes through a single 24-hour dietary recall were evaluated. The median content of each component [μg/100mL, median (interquartile range)] in colostrum and mature milk was, respectively, β-carotene 8.0 (4.7-15.2) and 1.8 (1.4-2.7), β-cryptoxanthin 6.2 (2.4-12.9) and 1.8 (1.1-3.4), lutein 5.7 (2.9-10.2) and 3.4 (1.5-6.0), lycopene 6.3 (4.0-9.9) and 1.4 (1.1-2.0), zeaxanthin 1.0 (0.6-1.5) and 1.0 (0.6-1.4), α-tocopherol 645 (388-1176) and 211 (131-321), γ-tocopherol 68 (48-121) and 77 (45-120). The levels of all those vitamins presented regional differences, and decreased as lactation stage increased except for zeaxanthin and γ-tocopherol. Associations of carotenoid contents with maternal education, delivery mode, and present body mass index were found in multivariate analyses. These results suggest that some region, lactation stage, obstetric and socio-economic factors are associated with human milk concentrations of carotenoids and tocopherols in healthy Chinese mothers.