To investigate the change in the prevalence of reduced visual acuity (VA) in Taiwanese school children after a policy intervention promoting increased time outdoors. Prospective cohort study based on the Taiwan School Student Visual Acuity Screen (TSVAS) by the Ministry of Education in Taiwan. All school children from grades 1 through 6 were enrolled in the TSVAS from 2001 through 2015. The TSVAS requires each school in Taiwan to perform measurements of uncorrected VA (UCVA) on all students in grades 1 through 6 every half year using a Tumbling E chart. Reduced VA was defined as UCVA of 20/25 or less. Data from 1.2 to 1.9 million primary school children each year were collected from 2001 through 2015. A policy program named Tian-Tian 120 encouraged schools to take students outdoors for 120 minutes every day for myopia prevention. It was instituted in September 2010. To investigate the impact of the intervention, a segmented regression analysis of interrupted time series was performed. Prevalence of reduced VA. From 2001 to 2011, the prevalence of reduced VA of school children from grades 1 through 6 increased from 34.8% (95% confidence interval [CI], 34.7%-34.9%) to 50.0% (95% CI, 49.9%-50.1%). After the implementation of the Tian-Tian 120 outdoor program, the prevalence decreased continuously from 49.4% (95% CI, 49.3%-49.5%) in 2012 to 46.1% (95% CI, 46.0%-46.2%) in 2015, reversing the previous long-term trend. For the segmented regression analysis controlling for gender and grade, a significant constant upward trend before the intervention in the mean annual change of prevalence was found (+1.58%; standard error [SE], 0.08; P < 0.001). After the intervention, the trend changed significantly, with a constant decrease by -2.34% annually (SE, 0.23; P < 0.001). Policy intervention to promote increased time outdoors in schools was followed by a reversal of the long-term trend toward increased low VA in school children in Taiwan. Because randomized trials have demonstrated outdoor exposure slowing myopia onset, interventions to promote increased time outdoors may be useful in other areas affected by an epidemic of myopia.

There is evidence that cardiorespiratory fitness and physical activity significantly reduce cardiovascular risks in adults. A better understanding of the association between cardiorespiratory fitness, physical activity, and childhood obesity is vital in assessing the benefits of interventions to prevent obesity. This study was to examine the relationship between physical activity, body mass index, and cardiorespiratory fitness levels in Taiwanese children. A cross-sectional study was designed. Study participants consisted of 2419 school children (1230 males and 1189 females) aged 12 years old living in a southern Taiwan county with one the highest countrywide rates of childhood obesity. The weight status of the participants was defined as underweight, normal, overweight, or obese according to specific criteria. Cardiorespiratory fitness was then assessed by an 800-m run. Participants were queried on their physical activity habits via a questionnaire survey. The overall prevalence of overweight/obesity was 29.6%. Normal, underweight and overweight boys and girls had an increased odds ratio of being categorized with higher cardiorespiratory fitness than obese one for both gender. A significantly higher level of cardiorespiratory fitness was found in children who engaged in regular physical activity than in children who engaged only in irregular physical activity. Obese children are more likely to lack cardiorespiratory fitness. Physically active children have significantly better cardiorespiratory fitness levels than inactive children. This study supports the conclusion that BMI and physical activity are significantly correlated with cardiorespiratory fitness levels. Findings may provide educational professionals with information to assist their developing effective health promotion programs to healthy weight and improving cardiorespiratory fitness for children.

The aim of the study was to investigate the effect of elastic band exercise activities on lower extremity rehabilitation in elderly patients subjected to an elastic band exercise intervention 2 and 4 weeks after total knee arthroplasty. A quasiexperimental study was conducted. Participants were recruited from southern Taiwan who were over 65 years old and had a first unilateral total knee arthroplasty for osteoarthritis. The control and experimental groups comprised 25 patients each. The control group received conventional treatment after total knee arthroplasty; by contrast, the experimental group engaged in elastic band exercise activities demonstrated by instructors, in addition to receiving conventional treatment. Effects of the lower extremity rehabilitation of the two groups were evaluated 2 and 4 weeks after total knee arthroplasty. Most of the participants were above 70 years of age, 17 of whom were in the control group (68%) and 16 in the experimental group (64%). The active and passive knee flexion angles of the experimental group were greater than those of the control group (p < .001) 2 and 4 weeks after surgery. The muscle strength of the quadriceps of the experimental group was higher than that of the control group (p < .001) 2 and 4 weeks after surgery. The experimental group exhibited significantly higher physical function than that of the control group 2 and 4 weeks after surgery (p < .001). The elastic band exercise program shows promising effects on improving the lower limb rehabilitation of elderly patients with total knee arthroplasty. Healthcare professionals who work with elderly patients with total knee arthroplasty may consider recommending and implementing the elastic band exercise program as a home rehabilitation method for this population. However, we recommend further testing of the long-term effects of this program on a larger population. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Chronic kidney disease (CKD) is a chronic and often irreversible disease that requires active self-care to mitigate adverse outcomes. This study aimed to analyze the associations of demographic and disease data, frailty, health literacy (HL), and CKD self-care (CKDSC) in patients with CKD. We conducted a cross-sectional study at two hospitals in Taiwan. A total of 144 CKD patients with a mean age of 66.8 ± 9.1 years were included in the study. Among them, 79.2% were in CKD G3, and the mean time since diagnosis of CKD was 86 ± 48 months. Approximately 62.5% were identified as non-frail. The mean of HL and CKDSC were 11.76 ± 4.10 and 62.12 ± 9.31. In multivariate linear regression analysis, age ≥ 65 years (odds ratio (OR) = 5.67, 95% confidence interval (CI) 1.59–9.75), non-frailty (OR = 2.19, 95% CI 0.02–5.40), and high critical HL (OR = 1.43, 95% CI 0.13–2.90) showed significant positive correlation with CKDSC. Therefore, management of patients with CKD should focus on the young population, reinforcing health education strategies that improve critical HL and preventing frailty that may interfere with self-care. In addition, the patient’s social support resources should be expanded to achieve the goal of CKDSC.

The body mass index (BMI) of school children in Taiwan is markedly increasing. According to statistical data from the Taiwan Ministry of Education, the prevalence of obesity in school children from the southern part of the country is the highest in Taiwan. Thus, exploring the factors influencing BMI in elementary school children from southern Taiwan is crucial. This study investigated the influencing factors including physical activity levels, sedentary behaviors, dietary habits, and perceived body shape on the BMIs of elementary school children from southern Taiwan. A cross-sectional design was used, and the participants consisted of 3251 fifth-grade students (1628 boys, 50.1%; 1623 girls, 49.9%). The average BMI values for boys and girls were 19.69 and 18.70 (kg/cm) respectively. Statistically significant associations were observed between BMI and sex, 31–60 min of daily vigorous or moderate physical activities levels, length of time spent watching television, time spent on video games or the computer, and intake of vegetable or meat gravy with rice (p < 0.001). Perceived body shape also affected the BMI of school children. The results of this study enable educational institutions in Taiwan to understand the factors affecting the BMI of school children and use this information as the basis for future healthy body weight policies.